A Cochrane review [Abstract] 1 included 5 studies including a total of 733 women. In the comparison of exercise versus no active treatment (three studies, n = 454 women), there was no difference between groups in frequency or intensity of vasomotor symptoms (SMD -0.10, 95% CI -0.33 to 0.13; 3 trials, n=454 women, I²= 30%, low-quality evidence). Nor was a difference found when compared with yoga (SMD -0.03, 95% CI -0.45 to 0.38;2 trials, n=279, I²= 61%, low-quality evidence). It was not possible to include one of the trials in the meta-analyses; this trial compared three groups: exercise plus soy milk, soy milk only and control; results favoured exercise relative to the comparators, but study numbers were small. One trial compared exercise with HT, and the HT group reported significantly fewer flushes in 24 hours than the exercise group (mean difference 5.8, 95% CI 3.17 to 8.43, 14 participants). None of the trials found evidence of a difference between groups with respect to adverse effects, but data were very scanty.
An RCT 5 included 65 women with a 15-week resistance-training program. The mean number of moderate or severe hot flushes per day at baseline was 7.1; there were no baseline differences between groups. The frequency of hot flushes decreased more in the intervention group than in the control group (mean difference -2.7, 95% CI -4.2 to -1.3). The mean percentage change was -43.6% (-56.0 to -31.3) in the intervention group and -2.0% (-16.4 to -12.4) in the control group.
Another trial 2 randomly assigned symptomatic women aged 45 to 63 years (n=176; 3-36 months since last menstruation) to an aerobic training or a control group. The intervention included unsupervised aerobic training for 50 minutes 4 times weekly for 24 weeks, whereas the control group attended health lectures twice a month. Symptoms (night sweats, mood swings, irritability, depressive mood, headache, vaginal dryness, and urinary symptoms) were reported twice a day using a mobile phone. The prevalence of all symptoms except vaginal dryness decreased among intervention groups. According to multilevel mixed-effect ordinal regression analysis, night sweats and mood swings (P < 0.001) and disturbance of the mood swings (P < 0.001) and irritability (P < 0.001) were reduced more among the women in the intervention group than in the control group.
A cohort study 3(n=95) was made 4 years after this RCT. There was a trend of improved physical functioning (OR 1.41; 95% CI 1.00 to 1.99) as compared with women in the control group. In addition, women in the intervention group had higher odds of good role functioning (OR 1.21; 95% CI 0.88 to 1.67), physical health (OR 1.33; 95% CI 0.96 to 1.84) and general health (OR 1.14; 95% CI 0.81 to 1.62), relative to women in the control group. In a 4-year follow-up study 4 The women in the exercise group had a higher probability of improved Hot Flush Score (HFScore), i.e. a decrease in HFScore points, adjusted for hormone therapy (OR 0.95; 95% CI 0.90 to 1.00) than women in the control group at the 4-year follow-up. After additional adjustment for sleep quality, the result approached statistical significance at HFScore≥13 with women in the exercise group. Women who had the least amount of hot flushes, HFScore<13, benefited most from exercise.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by imprecise results (limited study size for each comparison).
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