Examining the role of physical activity interventions in modulating androgens and cardiovascular health in postmenopausal females: A narrative review

Growing literature has examined the role of physical activity (PA) in modifying the effects of estrogen withdrawal on cardiovascular health in postmenopausal females, yet the impact of PA on androgens is less clear. Changes in androgen concentrations following regular PA may improve cardiovascular health. This narrative review summarized the literature assessing the impact of PA interventions on androgens in postmenopausal females. The association between changes in androgen concentrations and cardiovascular health following PA programs was also examined. Randomized controlled trials were included if they: (i) implemented a PA program of any type and duration in postmenopausal females; and (ii) measured changes in androgen concentrations. Following PA interventions, no changes in androstenedione, conflicting changes in dehydroepiandrosterone/ dehydroepiandrosterone-sulfate, and increases in sex hormone-binding globulin (SHBG) concentrations were found. Total testosterone decreased following aerobic PA but increased after resistance training. Most aerobic PA interventions led to reductions in free testosterone. A combination of caloric restriction and/or fat loss enhanced the influence of PA on most androgens. Evidence exploring the relationship between changes in androgens and cardiovascular health indicators was scarce and inconsistent. PA has shown promise in modifying the concentrations of some androgens (free and total testosterone, SHBG), and remains a well-known beneficial adjuvant option for postmenopausal females to manage their cardiovascular health. Fat loss influences the effect of PA on androgens, however, the synergistic role of PA and androgens on cardiovascular health merits further examination. Many research gaps in the relationship between PA, androgens and cardiovascular disease in postmenopausal females remain.