Reviewer's report
Title:Association between physical activity and menopausal symptoms in
perimenopausal women
Version:6Date:13 June 2014
Reviewer: Maya Lambiase
Reviewer's report:
This study investigated the association between physical activity and
menopausal symptoms in perimenopausal Korean women. The main finding was
that women who participated in moderate levels of physical activity reported
fewer psychosocial and physical menopausal symptoms. Physical activity,
however, was not associated with vasomotor or sexual symptoms. This study
investigates an issue of great public health importance given the increasing
number of women who will be transitioning through menopause in the upcoming
years and the limited understanding of health during this transition period.
Furthermore, few effective non-pharmacological treatments exist for menopausal
symptoms. Thus, research that investigates the use of behavioral or lifestyle
treatments (e.g., physical activity) for menopausal symptoms is of great value for
improving health and quality of life in women during the menopausal transition
and beyond. This paper is well-written and the methods are appropriate and
generally well-described. I just have a few concerns the authors should address
to further strengthen their manuscript.
Major revisions:
1.The introduction and purpose of the study suggest that the authors will be
investigating the associations between physical activity and menopausal
symptoms. However, there seems to be a lot of cardiovascular variables that
were measured that are not included in any of the analyses (even just as
covariates). From what I could tell the only purpose for these cardiovascular
variables was to demonstrate differences in these measures between the 3
exercise groups. Given the associations between physical activity and these
cardiovascular risk factors have been well-established, the authors may consider
putting less emphasis on the cardiovascular results. Otherwise, if the authors
wish to include this information they should clarify the role of these
cardiovascular measures in the present study.
2.In Table 1, the authors indicate that information on marital status, family
income, and education was missing for some participants. How were missing
values accounted for in the multiple regression analyses?
3.In Table 3, it would be helpful if the authors could include the standard errors in
addition to the beta coefficients.
Discretionary revisions:
4.The largest study to date that has assessed the impact of moderate intensity
exercise on vasomotor symptoms also found no effect of exercise on vasomotor
symptoms (Sternfeld, B., et al. Efficacy of exercise for menopausal symptoms: a
randomized controlled trial. Menopause, 2013). The authors should considering
citing this study as it would provide nice support for the current findings.
5.Did the author consider the associations between the continuous physical
activity score and menopausal symptoms? Since there were relatively few
women in the high physical activity group, it might be interesting to see if there
was a general linear relationship between the continuous physical activity score
and menopausal symptoms.
Minor concerns
6.The authors should correct the following typos and proofread the manuscript
for other errors.
-Study Participants, Line 18: Insert space ‘perimenopauseand’
-Measurements, Line 19: Insert space ‘and>’
-Table 1: lots of spacing issues in the footnotes
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests