Proprioceptive sensory changes related to menopause

Menopause is an important transition period of woman. Female sex hormones have a robust neuroprotective role and the menopausal transition is associated with neurophysiological changes. Hormonal changes associated with menopause predispose women to mobility difficulties and fall-related fractures. It has been found that falls in women first increase during menopause. Proprioception is a sense that provides information to the central nervous system about the level of motor activities, and it is essential in maintaining postural balance. The aim of our study was to investigate the changes in proprioceptive sensation due to menopause in women. A total of 37 female volunteers (14 premenopausal, 12 postmenopausal and 11 menopausal transition stage) aged 45-52 years who were followed up by the Menopause Outpatient Clinic of the Department of Gynaecology and Obstetrics were included in the study. Menopausal status of the women was determined according to STRAW +10 staging criteria. Proprioceptive sensation was evaluated by active angle reproduction (AR) and joint position matching (JPM) tests, which are the methods of position sense measurement in knee and ankle joints. A universal goniometer was used for the measurements. The eyes of the participants were covered with an eye patch to prevent the contribution of visual stimuli. Descriptive statistics (mean ± standard deviation), ANOVA for parametric data and Kruskal-Wallis tests for non-parametric data were used for statistical analysis. Pearson test was used in correlation analyses. Significance level was adjusted to 0.05.Ankle AR deviation values in premenopause, perimenopause and postmenopause groups were 1.2±0.9, 2.5±1.7, 3.5±2.0, respectively (p=0.005). Ankle JPM deviation values in premenopause, perimenopause and postmenopause groups were 1.2±0.6, 3.0±2.1, 2.7±1.2 respectively (p=0.004). It was thought that menopause may primarily affect the ankle joint in terms of proprioception in women. In the evaluation of ankle proprioception, it was observed that the AR test was more negatively affected in the postmenopausal phase, while the JPM test was more negatively affected in the perimenopausal phase. The premenopausal group showed the least deviation from the target angle in all evaluations. As a result, it was observed that especially ankle proprioceptive performance was impaired during transition to menopause, while the knee joint was less affected by this process. This result is important because it is related to the deterioration of postural balance and the risk of falls in menopausal women. It also stresses the importance of incorporating balance and proprioception exercises into exercise programmes of menopausal women.