Menopausal quality of life: RCT of yoga, exercise, and omega-3 supplements.
OBJECTIVE
The purpose of this study was to determine the efficacy of 3 nonhormonal therapies for the improvement of menopause-related quality of life in women with vasomotor symptoms.


METHODS
We conducted a 12-week 3 × 2 randomized, controlled, factorial design trial. Peri- and postmenopausal women, 40-62 years old, were assigned randomly to yoga (n = 107), exercise (n = 106), or usual activity (n = 142) and also assigned randomly to a double-blind comparison of omega-3 (n = 177) or placebo (n = 178) capsules. We performed the following interventions: (1) weekly 90-minute yoga classes with daily at-home practice, (2) individualized facility-based aerobic exercise training 3 times/week, and (3) 0.615 g omega-3 supplement, 3 times/day. The outcomes were assessed with the following scores: Menopausal Quality of Life Questionnaire (MENQOL) total and domain (vasomotor symptoms, psychosocial, physical and sexual).


RESULTS
Among 355 randomly assigned women who average age was 54.7 years, 338 women (95%) completed 12-week assessments. Mean baseline vasomotor symptoms frequency was 7.6/day, and the mean baseline total MENQOL score was 3.8 (range, 1-8 from better to worse) with no between-group differences. For yoga compared to usual activity, baseline to 12-week improvements were seen for MENQOL total -0.3 (95% confidence interval, -0.6 to 0; P = .02), vasomotor symptom domain (P = .02), and sexuality domain (P = .03) scores. For women who underwent exercise and omega-3 therapy compared with control subjects, improvements in baseline to 12-week total MENQOL scores were not observed. Exercise showed benefit in the MENQOL physical domain score at 12 weeks (P = .02).


CONCLUSIONS
All women become menopausal, and many of them seek medical advice on ways to improve quality of life; little evidence-based information exists. We found that, among healthy sedentary menopausal women, yoga appears to improve menopausal quality of life; the clinical significance of our finding is uncertain because of the modest effect.
Departments of Obstetrics and Gynecology and Epidemiology, University of Washington School of Medicine, Seattle, WA. Electronic address: reeds@u.washington.edu.
Susan D
SD
Reed
Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA.
Katherine A
KA
Guthrie
Group Health Research Institute, Seattle, WA.
Katherine M
KM
Newton
Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA.
Garnet L
GL
Anderson
School of Nursing, University of Washington, Seattle, WA.
Cathryn
C
Booth-LaForce
Division of Research, Kaiser Permanente Northern California, Oakland, CA.
Bette
B
Caan
School of Nursing, Indiana University, Indianapolis, IN.
Janet S
JS
Carpenter
Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
Lee S
LS
Cohen
Klein Buendel, Inc, Golden, CO.
Andrea L
AL
Dunn
Department of Medicine, VA Medical Center, and Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
Kristine E
KE
Ensrud
Departments of Obstetrics and Gynecology and Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA.
Ellen W
EW
Freeman
Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA.
Julie R
JR
Hunt
Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, MA.
Hadine
H
Joffe
Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA.
Joseph C
JC
Larson
Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN.
Lee A
LA
Learman
Essential Yoga Therapy, Fall City, WA.
Robin
R
Rothenberg
Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Nutritional Sciences, Cornell University, Ithaca, NY.
Rebecca A
RA
Seguin
Group Health Research Institute, Seattle, WA.
Karen J
KJ
Sherman
Division of Research, Kaiser Permanente Northern California, Oakland, CA.
Barbara S
BS
Sternfeld
Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA.
Andrea Z
AZ
LaCroix
D000328:Adult; D019587:Dietary Supplements; D004311:Double-Blind Method; D015444:Exercise / Q000523:psychology*; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008593:Menopause / Q000187:drug effects / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome; D015013:Yoga / Q000523:psychology*
D015525:Fatty Acids, Omega-3
exercise; menopause; omega-3; quality of life; randomized controlled trial; yoga