Exercise for vasomotor menopausal symptoms
Abstract
Background
Evidence suggests that many perimenopausal and early postmenopausal women will experience menopause symptoms, hot flushes being the most common. Symptoms caused by fluctuating levels of oestrogen may be alleviated by HRT but there has been a marked global decline in its use due to concerns about the risks and benefits of HRT; consequently many women are now seeking alternatives. As large numbers of women are choosing not to take HRT, it is increasingly important to identify evidence based lifestyle modification interventions that have potential to reduce vasomotor menopausal symptoms.
Objectives
To examine the effectiveness of any type of exercise intervention in the management of vasomotor menopausal symptoms (hot flushes and night sweats) in perimenopausal and postmenopausal women.
Search methods
Searches of the following electronic bibliographic databases were performed to identify randomised controlled trials (RCTs): Cochrane Menstrual Disorders and Subfertility Group Specialised trials register; Cochrane Library (CENTRAL) (Wiley Internet interface), MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Science Citation Index and Social Science Citation Index (Web of Science), CINAHL (Ovid) and SPORT Discus. Searches included dates up until 16‐24 March 2010.
Selection criteria
RCTs in which any type of exercise intervention were compared no treatment/control or other treatments in the management of menopausal vasomotor symptoms in symptomatic perimenopausal/postmenopausal women.
Data collection and analysis
Six studies were deemed eligible for inclusion. Three authors independently extracted data from eligible studies. Three meta‐analyses according to comparator the group were performed.
Main results
In the comparison of exercise versus no treatment/control (three studies), the non‐significant effect size Standardised Mean Difference (SMD) for vasomotor symptoms was ‐0.14 (95% CI: ‐0.54 to 0.26); SMD was ‐0.04, ‐0.25, ‐0.38. For the analysis of exercise versus HRT (three studies), the non‐significant SMD was 0.49 (95% CI: ‐0.27 to 1.26); SMD across studies was 0.13, 0.19 and 1.52, with all studies favouring HRT. In the comparison of exercise versus yoga (two studies), the non‐significant SMD was ‐0.09 (95%CI:‐0.64 to 0.45); SMD was ‐0.37 and 0.19. All comparisons were based on small samples. One small study reported data that could not be included in the meta‐analysis; in this study hot flush scores were significantly lower in the exercise plus soy milk group (83%) than soy milk only group (72%).
Authors' conclusions
The existing studies provided insufficient evidence to determine the effectiveness of exercise as a treatment for vasomotor menopausal symptoms, or whether exercise is more effective than HRT or yoga.
PICOs
Plain language summary
Exercise for vasomotor menopausal symptoms
Evidence suggests that a high proportion of menopausal women will experience hot flushes and night sweats. Hormone replacement therapy (HRT) is considered to be the most effective treatment for symptoms. However, studies have reported that hormone therapies are potentially associated with some negative health effects and many women are now choosing not to use these and are looking for alternatives. Therefore, it is increasingly important to identify lifestyle modifications, which may help to reduce the frequency and severity of hot flushes and night sweats. We found no evidence from randomised controlled trials on whether exercise is an effective treatment for reducing hot flushes and night sweats in menopausal women.However, we did find a weak trend for exercise to be more effective than no intervention but we need more good quality studies before we can know for sure.
