Short Report
Exercise for Symptoms of Menopause
By David Kiefer, MD
Sternfeld B, et al. Efficacy of exercise for menopausal symptoms: A randomized controlled trial. Menopause 2014;21:330-338.
- Twelve weeks of aerobic exercise in previously sedentary women did not improve menopausal symptoms, but did modestly improve perceived sleep quality.
The research presented in this article is part of a greater effort at five academic centers called MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health; msflash.org) in which menopausal women were randomized to yoga, exercise, or usual activity, and then further randomized to omega-3 fatty acid supplementation or placebo. Although the study is completed, only the exercise arm has been published. In the current article, the analysis included 248 menopausal women who were randomized to an exercise regimen or usual activity for 12 weeks, and were assessed for the frequency and "bother" of vasomotor symptoms, sleep symptoms, and mood. The exercise protocol included three 40-60 minute, individualized, supervised aerobic trainings weekly, either on a treadmill, elliptical trainer, or stationary bicycle as per the study participant’s choice. An intention-to-treat analysis was performed on the 106 exercise participants and the 142 women assigned to usual activity. Baseline characteristics between the two groups were similar, except for the fact that the exercise arm was older.
Both the exercise group and the usual activity group had a statistically similar decrease in hot flashes per day (2.4 and 2.6, respectively), although a sub-analysis by race found that white women had less hot flashes with exercise, whereas African American women had no benefit. The authors attribute this disparity to "racial differences in cardiovascular, metabolic, and neuroendocrine responses to exercise." There was a decrease in vasomotor symptoms "bother" in the exercise group, but it was not significantly different from the control group. Exercisers had better sleep, but only in perceived sleep quality, not insomnia symptoms, and had less depressive symptoms (P = 0.028; though significance was set at P < 0.0125, so this was not deemed significant).
Health care providers may be faced with trying to help women with vasomotor symptoms negotiate the many possible treatment options. Although an intensive exercise regimen appears to only provide modest sleep benefits to women with menopausal symptoms as based on this methodologically sound study, the authors themselves point out that there are many other reasons to consider exercise for patients in this demographic. It should continue to be considered as part of an integrative treatment approach.
