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Can exercise, yoga, or Omega-3 reduce hot flashes?

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Many women who suffer from hot flashes are searching for non-hormonal methods to treat them. Three new studies evaluating the treatment of hot flashes with exercise, yoga, or omega-3 fatty acids were published on April 1 in the journal Menopause.

The exercise study had the goal of determining whether exercise could reduce hot flashes and other menopausal symptoms. The study group comprised 148 late perimenopausal and postmenopausal sedentary women from three different locations who suffered from frequent hot flashes. The women were randomly assigned to an exercise program (106 women) or usual activity (142 women). The women in the exercise group participated in individual facility-based aerobic exercise training three times per week for 12 weeks. The frequency and level of distress of hot flashes were recorded in daily diaries at baseline and on weeks 6 and 12. The investigators compared differences between the two groups in regard in changes in frequency and level of distress of hot flashes, sleep symptoms (Insomnia Severity Index and Pittsburgh Sleep Quality Index), and mood (Patient Health Questionnaire-8 and Generalized Anxiety Disorder-7 questionnaire).

The investigators found that at the end of week 12, changes in hot flash frequency in the exercise group (average change: −2.4 episodes) and level of distress (average change on a four-point scale: −0.5) were not significantly different from those in the control group (hot flash frequency: −2.6; level of distress: −0.5 points). The exercise group reported a greater improvement in insomnia symptoms, subjective sleep quality, and depressive symptoms; however, the differences were small and not statistically significant when data were adjusted for multiple comparisons. Results were similar when only women that were fully compliant with the exercise program were included.

The authors concluded that their findings furnished strong evidence that 12 weeks of moderate-intensity aerobic exercise did not alleviate hot flashes but may result in small improvements in sleep quality, insomnia, and depression in menopausal sedentary women.

The yoga study had the goal of determining whether yoga alleviated the frequency and degree of distress from hot flashes. The study comprised 355 women who were randomly assigned to one of three groups: yoga (107 women), exercise (106 women), or usual activity (142). The women were simultaneously randomized to a double-blind comparison of omega-3 fatty acid (177 women) or placebo (178 women) capsules. The women in the yoga group participated in 12 weekly 90-minute yoga classes with daily home practice. The primary outcomes measurements were hot flash frequency and degree of distress assessed by daily diaries at baseline, 6 weeks, and 12 weeks. The secondary outcome measurements insomnia symptoms (Insomnia Severity Index) at baseline and 12 weeks.

The investigators found that among 249 randomized women, 237 (95%) completed their 12-week assessments. The average baseline hot flash frequency was 7.4 per day in the yoga group and 8.0 per day in the usual activity group. The final analysis included all women with response data (237 women). There was no difference between the intervention groups in the change in hot flash frequency from baseline to 6 and 12 weeks (average difference ((yoga − usual activity) from baseline at 6 weeks: −0.3); average difference (yoga − usual activity) from baseline at 12 weeks: −0.3)). The results were similar for hot flash frequency and degree of distress. At week 12, yoga was associated with an improvement in insomnia symptoms (average difference (yoga − usual activity) in the change in Insomnia Severity Index: 1.3.5 to −0.1).

The authors concluded that among healthy women, 12 weeks of yoga class plus home practice, compared with usual activity, did not improve hot flash frequency or degree of distress; however, it reduced insomnia symptoms.

The omega-3 fatty acid study had the goal of determining whether of omega-3 fatty acids could reduce the frequency or degree of distress from hot flashes in perimenopausal and postmenopausal women. The researchers conducted a randomized trial that compared 177 women who received omega-3 fatty acids or 178 women who received a placebo. They were simultaneously randomly assigned to yoga (107 women), aerobic exercise (106 women), or their usual physical activity (142 women). The participants in the omega-3 group received 1.8 grams of omega-3 daily for 12 weeks. Each capsule contained ethyl eicosapentaenoic acid (425 mg), docosahexaenoic acid (100 mg), and other omega-3s (90 mg). The primary outcome measurements were hot flash frequency and degree of distress. Secondary outcome measurements included sleep quality (Pittsburgh Sleep Quality Index), insomnia symptoms (Insomnia Severity Index), depressive symptoms (Physician’s Health Questionnaire-8), and anxiety (Generalized Anxiety Disorder-7).

The investigators found that the average baseline frequency of hot flashes per day was 7.6. After 12 weeks, the reduction in hot flash frequency with omega-3 was −2.5; however, this decrease did not significantly differ from that of the women who received the placebo (−2.7). The relative difference was 0.3 fewer hot flashes per day. Changes in degree of distress from hot flashes at 12 weeks were also similar between the two groups; there was no relative difference on a four-point scale. Omega-3s compared with placebo showed no improvement in self-reported sleep or mood.

The authors concluded that among healthy, sedentary perimenopausal and postmenopausal women, a 12-week treatment with omega-3 does not improve hot flash frequency, degree of distress from hot flashes, sleep, or mood compared with placebo.

Take home message:

These studies found that yoga and exercise did not reduce hot flashes; however, they did improve sleep quality and mood. In addition, omega-3 fatty acids did not reduce hot flashes or improve sleep quality and mood. The improvement in sleep quality and mood justifies participation in an exercise program and/or yoga. In addition, these activities promote health. Despite the fact that omega-3 fatty acids did not reduce hot flashes or improve sleep quality and mood, they are a component of a healthy diet.

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