Clinical Question: Is exercise an effective therapy for vasomotor symptoms in post-menopausal women?

Setting: Outpatient (any)

Study Design: Randomized controlled trial (nonblinded)

Synopsis: Observational studies have associated exercise with less risk of vasomotor symptoms. These investigators randomized 173 overweight postmenopausal women to a moderate-intensity exercise intervention or a control intervention of stretching exercises for one year. Mass mailings and advertisements were used to recruit women. Eligible women had not used hormone therapy in the six months before enrollment. The researchers logged compliance of 74 percent of the prescribed frequency of five days per week, and 76 percent of the prescribed 225 minutes per week during the study period. Allocation was concealed, and analysis was by intention to treat. Participants in the exercise group were instructed in a moderate-intensity recreational activity.

The groups did not differ in the presence of “any menopausal symptom” at baseline or during the 12 months of the study. The women who exercised had a greater risk for moderate or severe hot flushes than did the control patients over time (P for trend = .02). The groups had similar rates of depressive symptoms, night sweats, and sleep problems. Memory problems were reported less frequently in the exercise group, but this was statistically significant only in the subgroup of women who entered menopause within the past five years.

Bottom Line: Exercise does not decrease vasomotor symptoms in postmenopausal women. Women should be encouraged to exercise, but not with the expectation that it will alleviate their hot flushes. (Level of Evidence: 1b)