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This study determines whether maximal oxygen consumption (VO2max) is higher in perimenopausal women compared with similarly aged postmenopausal women and whether the lower VO2max in postmenopausal women is associated with a higher total and visceral fat mass, less favorable lipid and glucose metabolism, and lower bone mineral density (BMD).Participants were 18 perimenopausal women (mean ± SD; irregular menstrual cycle in the past 6 months) aged 49 ± 4 years and 18 postmenopausal women (no menstrual cycle in the past year) aged 52 ± 2 years who were matched for body mass index and race. Women were sedentary, and none were on hormone replacement therapy. Body composition (dual-energy x-ray absorptiometry and CT), VO2max, fasting concentrations of sex steroid hormones, lipoproteins, insulin, and glucose were determined.VO2max was 17% lower (22 ± 3 v 27 ± 7 mL·kg−1·min−1;P ≤ 0.01) and resting metabolic rate was 5% lower (P = 0.06) in postmenopausal women compared with perimenopausal women. Percent body fat was 11% higher, and visceral fat area was 42% higher in postmenopausal women, whereas total body and lumbar spine (L2-L4) BMD were 5% and 11% lower, respectively (P < 0.05). Low-density lipoprotein cholesterol, low-density lipoprotein cholesterol·high-density lipoprotein cholesterol ratio, and fasting glucose concentrations were 21%, 20%, and 8% higher, respectively, in postmenopausal versus perimenopausal women (P < 0.05). Except for total body and lumbar spine BMD, the effect of menopause status on these variables is independent of age. In all women, percent body fat, visceral adipose tissue, and low-density lipoprotein cholesterol·high-density lipoprotein cholesterol ratios related indirectly to VO2max (P < 0.05).Our data suggest that postmenopausal women have a lower VO2max than perimenopausal women of a similar age and adiposity, which may be associated with an increased risk of total and central obesity and cardiovascular disease.