Postmenopausal Duration Shows No Significant Effect on Housewives’ Posture or Function

In an original comparative study investigating forty-two postmenopausal housewives aged between fifty and sixty-five years, physical therapy researchers determined that time elapsed since entering menopause does not significantly affect postural alignment, functional capacity, depressive symptoms, or health-related quality of life. The clinical investigation, published in the Bulletin of Faculty of Physical Therapy, categorized participants into two equal groups of twenty-one women based on postmenopausal duration: an early postmenopausal cohort with two to seven years postmenopause, and a late postmenopausal cohort with eight or more years. Across comprehensive evaluations, investigators observed no statistically significant differences between early and late postmenopausal groups in New York Posture Rating scores, Beck Depression Inventory measures, Nottingham Health Profile scores, bilateral handgrip strength, Timed Up and Go times, or Five Times Sit to Stand durations. The sole statistically significant difference was the most time-consuming domestic chore: early postmenopausal women spent more time cleaning, whereas late postmenopausal women spent more time cooking.

The research background highlights the biological transformations accompanying the menopausal transition. The World Health Organization defines menopause as the absence of menstruation for one full year resulting from reduced ovarian activity, occurring twelve months after a woman’s final menstrual cycle. The transition encompasses three stages: premenopause covering the reproductive phase, perimenopause preceding menopause, and postmenopause following menopause. Projections suggest that the global population of postmenopausal women will rise from four hundred million in 1996 to 1.2 billion by 2030. Given an average menopausal age of fifty-one years, women spend more than one-third of their lives in the postmenopausal phase. During this period, hormonal shifts markedly alter musculoskeletal, urogenital, metabolic, and vascular systems. Declining estrogen levels trigger reductions in bone mineral density, a general decrease in muscular strength, and a loss of endurance-type muscle fibers, predisposing women to postural abnormalities and diminished physical resilience.

Biomechanical and hormonal changes during menopause produce structural abnormalities, including excessive thoracic kyphosis or Dowager’s hump, hyperlordosis, forward head posture, knee flexion, genu valgus or varus, and abnormal foot pronation or supination. These alignments correlate with restricted motion, decreased endurance, and worsening activity-related discomfort. On average, muscle mass declines by 0.6 percent annually following menopause, while dynapenia and grip strength reduction elevate the likelihood of accidental falls. In addition, postmenopausal women experience accelerated knee cartilage degeneration and lumbar disc degeneration, particularly during the first fifteen years after menopause. Concurrently, traditional gender responsibilities assign physically demanding domestic chores—such as cooking, cleaning, and caregiving—to housewives. The repetitive execution of housekeeping creates asymmetric mechanical stress across the body, impairing musculoskeletal balance. When uncorrected postural faults combine with the continuous physical strain of housework, women encounter diminished functional capacities and compromised quality of life, underscoring the clinical importance of evaluating alignment in this population.

Despite the documented biomechanical consequences of estrogen loss, the scientific literature contains limited data regarding how the duration of menopause influences posture and functional capability. Most prior investigations concentrated on comparing premenopausal women directly against postmenopausal individuals, evaluating clinical interventions in women with specific pathologies, or analyzing subjective psychological variables such as sleep quality, mood disturbance, and general life satisfaction. Notably, researchers identified no previous studies examining postural alignment across different durations of postmenopause, nor any investigations focusing specifically on non-employed housewives. Furthermore, definitions and grouping thresholds for menopausal duration vary widely throughout published work, creating inconsistency across findings. These literature gaps prompted the authors to question whether postmenopausal duration independently alters functional performance and spinal posture in housewives. By studying women within the same fifty to sixty-five age bracket, the research team aimed to isolate the effects of hormonal duration from the confounding influences of biological aging.

A sample size of forty-two participants was established using GPower 3.1 software, maintaining statistical power of at least 80 percent and an alpha level of 0.05. The protocol received institutional ethical approval from the Yeditepe University Ethics Committee under issue number 202105028. Eligible participants were required to be female, non-employed housewives, aged fifty to sixty-five, who had attained menopause at least two years earlier and consented to voluntary participation. Exclusion criteria disqualified individuals who held employment, had endocrine disorders, suffered from conditions impairing communication, had undergone surgery in the preceding six months, had experienced menopause for under two years, or were taking antidepressant medication. The cohort was evenly stratified into two groups: Group 1 consisted of twenty-one early postmenopausal women with durations of two to seven years, while Group 2 comprised twenty-one late postmenopausal women with durations of eight years or more.

Data collection utilized standardized observational instruments and validated questionnaires. Postural alignment was assessed via the New York Posture Rating, which examines thirteen anatomical body alignment segments using three illustrative figures per segment. Ratings assign 5 points for proper posture, 3 for minor deviation, and 1 for significant deviation. Total scores denote very good posture at 45 or above, good posture between 40 and 44, moderate posture between 30 and 39, poor posture between 20 and 29, and bad posture at 19 or below. Depressive symptoms were evaluated using the 21-item Beck Depression Inventory, ranking emotional status over the preceding week, where scores of 0 to 10 indicate no depression, 11 to 17 mild, 18 to 23 moderate, and 24 or higher severe depression. Quality of life was measured using the Nottingham Health Profile, comprising a 38-question first part spanning pain, physical mobility, emotional reactions, energy, social isolation, and sleep, scored out of 600 points where 100 indicates poor health, and a second part containing seven separate items.

Functional physical performance was evaluated in a quiet clinical environment under the administration of a physiotherapist who demonstrated each procedure beforehand. Each physical test was repeated three times with one-minute rest intervals between sets, and the mean value was documented. Handgrip strength was quantified bilaterally with a JAMAR hand dynamometer in accordance with American Society of Hand Therapists guidelines, requiring maximal voluntary isometric effort. Lower limb functional capacity and muscular performance were appraised via the Five Times Sit to Stand Test, in which participants seated in an armless chair with crossed arms stood up fully and sat down five times consecutively as rapidly as possible without utilizing the backrest. Ambulatory balance, mobility, and walking velocity were tested using the Timed Up and Go protocol, timing the duration needed to rise from an armless chair, walk three meters to a floor mark, turn, return, and sit down again.

Statistical analysis performed in SPSS established significance at p < 0.05. Normality was evaluated using the Shapiro-Wilk test, directing normally distributed variables to independent sample t-tests and non-normal parameters to Mann-Whitney U tests, while categorical variables were assessed with Chi-square tests. Results demonstrated no statistically significant difference in age between early and late postmenopausal cohorts (p > 0.05), ensuring that biological aging did not skew findings. Furthermore, baseline evaluations confirmed no significant differences in body mass index, hand dominance, parity, educational level, or total weekly hours dedicated to household chores. The only statistically significant variation between groups was the specific chore demanding the most time: early postmenopausal housewives spent more time cleaning, whereas late postmenopausal housewives spent more time cooking (p < 0.05). The authors suggested this shift might indicate that women with longer menopausal duration adopt compensatory protective behaviors to limit heavier physical chores.

Across primary outcome measures, the study identified no significant differences between early and late postmenopausal housewives. Total scores on the New York Posture Rating and Beck Depression Inventory revealed no statistically significant between-group differences (p > 0.05). Similarly, Nottingham Health Profile domains, bilateral handgrip strength, Timed Up and Go scores, and Five Times Sit to Stand durations exhibited no statistically meaningful divergence. Contextualizing these outcomes with prior research, the authors noted that age-related postural changes typically progress after age fifty, with Akgül observing positive correlations between age and trunk inclination. Because age was equivalent across both cohorts, chronological aging had no confounding effect on alignment. In depression evaluations, the lack of divergence matched Yılmaz’s findings, reflecting literature showing depressive increases during perimenopause rather than postmenopause. Although prior MENQOL and SF-36 studies reported negative physical impacts with extended postmenopausal duration, the Nottingham Health Profile revealed no duration-related decline among housewives.

The investigators concluded that elapsed postmenopausal duration did not adversely alter posture, handgrip strength, mobility, or functional capacity in housewives. This stability suggests that clinical exercise programming can be tailored effectively for domestic workers without presuming progressive functional degradation solely based on menopausal years. However, several study limitations warrant consideration. Conducted during the COVID-19 pandemic outbreak, volunteer recruitment faced substantial difficulties, limiting face-to-face interaction and restricting total enrollment to forty-two participants. Furthermore, all participants shared a specific social environment, narrowing the demographic diversity of the cohort. Although rising life expectancy means women spend more than one-third of their lifetimes in the postmenopausal phase, these findings indicate that postmenopausal duration does not intrinsically impair posture or functional performance in housewives. Nevertheless, future investigations with larger cohorts and broader demographic representation remain necessary to elucidate long-term musculoskeletal adaptations during the postmenopausal period.

Subject of Research: Posture and functional activity across early and late postmenopausal duration in housewives

Article Title: Comparison of posture and functional activity in early and late postmenopausal housewives

Article References: Beğenen Şavlı, B., & Yazıcı-Mutlu, Ç. (2025). Comparison of posture and functional activity in early and late postmenopausal housewives. Bulletin of Faculty of Physical Therapy, 30(1), Article 74. https://doi.org/10.1186/s43161-025-00331-w

Image Credits: AI Generated

DOI: 10.1186/s43161-025-00331-w

Keywords: postmenopause, posture, functional activity, housewives, New York Posture Rating, handgrip strength, Timed Up and Go, Nottingham Health Profile, Comparison, functional, activity, early