Efficacy of Exercise for Menopausal Symptoms

Angela L. Thomson
Menopause is the time in every womans life when her menstrual cycle stops due to egg
depletion. The time before and during (peri), as well as, after menopause (post) is
fraught with many physiological and psychological changes due to a decrease in levels
of the hormones, estrogen and progesterone. A randomized trial was done to study the
effects of exercise on some of these changes, including, sleep disturbances (insomnia),
depression and more particularly, vasomotor symptoms.

Three hundred fifty-five sedentary women ages 40-62 years experiencing vasomotor
symptoms during late-peri and post-menopause were selected to participate in a 12-
week randomized trial to study the effect of exercise on the frequency and bother of
vasomotor symptoms (hot flashes), sleep symptoms (insomnia) and mood (depression).
Each participant was selected after an initial telephone interview, 2-week vasomotor
symptom diary, baseline questionnaire, blood draw, vital signs, graded treadmill test and
second questionnaire. Participants were then asked to complete another one-week
vasomotor symptoms diary and wear a pedometer before a second interview for
eligibility and randomization.

The 355 participants were randomly selected into three groups: 106 to exercise, 142 to
usual activity and 107 to yoga. Each of these three groups were then further
randomized into a 1:1 ratio to receive 1.8g/day of omega-3 fish oil or identical placebo.
Factoring the groups this way ensured that each participant believed they were
receiving an intervention and, therefore, had an expectancy of benefit. The exercise
intervention was held at three different MsFLASH fitness facilities (Indianapolis,
Oakland and Seattle) and consisted of three moderate-intensity 40-60minute
individualized cardiovascular conditioning training sessions per week. The usual
activity control group were asked not to change their current physical activity behavior.
The control group results and the exercise intervention results were then compared.
The Omega-3 and yoga intervention results were compared separately and wont be
evaluated in this review.

After the 12-week study, the exercise intervention group reported a mean frequency in
vasomotor symptom change of -2.4/day and a mean change of -0.5 points on a 4 point
scale of vasomotor symptom bother. The control group reports were not significantly
different from the exercise group; mean frequency of vasomotor symptom change of
-2.6/day and a mean change of -0.5 points for vasomotor symptom bother. As to reports
of improvement in insomnia symptoms, subjective sleep quality and depressive
symptoms, the exercise group reported a greater improvement, but not statistically
significant from the control group.
These results concluded that 12-weeks of moderate-intensity cardiovascular exercise in
previously sedentary pre- and post-menopausal women, in accordance with the ACSM
recommendations, does not significantly alter the frequency or bother of vasomotor
symptoms. However, regular exercise does have a small effect on the improvement of
sleep quality, insomnia and depression in study participants.

Reference

Sternfeld B, Guthrie KA, Ensrud KE, LaCroix AZ, Larson JC, Dunn AL, Anderson GL,

Seguin RA, Carpenter JS, Newton KM, Reed SD, Freeman EW, Cohen LS, Joffe

H, Roberts M, Caan BJ. Efficacy of Exercise for Menopausal Symptoms: A

Randomized Controlled Trial. Menopause, 2014 Apr;21(4):330-8.