Exercise Is Beneficial but Not for Hot Flashes

Vasomotor symptoms related to perimenopause and menopause in sedentary women are not alleviated by exercise, according to the results of a randomized controlled trial from the MsFLASH Research Network.¹ MsFLASH is the acronym for the NIH-established Menopause Strategies: Finding Lasting Answers for Symptoms and Health, a network of research studies that evaluates the most promising treatments for the most common symptoms of menopause.²
   
The results of previous studies evaluating the effect of exercise on vasomotor symptoms have been inconsistent. However, the findings of this new study corroborate those of a relatively recent Cochrane review that found no evidence to support the use of exercise as an effective treatment for hot flashes and night sweats.³
   
Of 248 sedentary women, all of whom were either perimenopausal or postmenopausal, 106 participated in aerobic exercise training 3 times per week for 12 weeks and 142 continued their usual activities. The aerobic exercise training occurred at a fitness center. All participants tracked their vasomotor symptoms-hot flashes and night sweats-and sleep quality in a daily diary and completed questionnaires about insomnia, depression, and anxiety. The frequency of vasomotor menopausal symptoms and the extent to which they were bothersome were evaluated at baseline, week 6, and week 12.
   
The results of the study showed that moderate-intensity exercise, compared with usual activity, was associated with modest but insignificant improvements in sleep quality, insomnia symptoms, and depressive symptoms but had no significant effect on the frequency or bother of vasomotor symptoms. Women in the exercise group had 2.4 fewer vasomotor symptoms in a 24-hour period at week 12; in comparison, women in the usual-activity group had 2.6 fewer vasomotor symptoms in the same time period. Women in both study groups reported that their vasomotor symptoms were slightly less bothersome at 12 weeks, with both study groups having a mean reduction of 0.5 on a 4-point scale for vasomotor menopausal symptom bother.
   
Race and initial fitness level had a small effect on the results. White women in the exercise group had some improvement in their hot flashes compared with white women in the usual-activity group, but this difference did not occur among African American women. In addition, women who had a higher level of fitness at baseline achieved a greater improvement in their hot flashes with exercise.

Pertinent Points:
- There is strong evidence that moderate-intensity aerobic exercise does not improve vasomotor symptoms in perimenopausal or postmenopausal women who are sedentary.
- Regular exercise may help improve sleep quality, insomnia, and depression in midlife sedentary women.
 

References:

1. Sternfeld B, Guthrie K, Ensrud KE, et al. Efficacy of exercise for menopausal symptoms: a randomized controlled trial. Menopause. 2013: doi: 10.1097/GME.0b013e31829e4089.
2. MsFlash Web site. Available at: msflash.org. Accessed August 15, 2013.
3. Daley A, Stokes-Lampard H, Macarthur C. Exercise for vasomotor menopausal symptoms. Cochrane Database Syst Rev. 2011;5:CD006108. doi: 10.1002/14651858.CD006108.pub3.