title: 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.
  
  
  OBJECTIVE
  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.
  
  
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  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%).
  
  
  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.
authors.affiliation: Primary Care Clinical Sciences, College of Medicine and Dentistry, Learning Centre Building, Universitiy of Birmingham, Birmingham, England, UK, B15 2TT.
authors.forename: Amanda
authors.initials: A
authors.lastname: Daley
authors.forename: Helen
authors.initials: H
authors.lastname: Stokes-Lampard
authors.forename: Christine
authors.initials: C
authors.lastname: Macarthur
mesh_terms: D000529:Complementary Therapies; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D019584:Hot Flashes / Q000628:therapy*; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D013543:Sweat Gland Diseases / Q000628:therapy*; D013546:Sweating; D016138:Walking; D015013:Yoga