Effect of aerobic training on hot flushes and quality of life—a randomized controlled trial

Figures & data

Figure 1. Participant flow in a randomized aerobic training trial.

Table I. Base-line characteristics and quality of life in the intervention and control groups. QoL was estimated by means of the Short Form-36 quality of life (SF-36) score and the menopause-specific quality of life score (Women's Health Questionnaire (WHQ)).

	Intervention n = 74	Control n = 77	P for difference^a	Missing (intervention, control)
Age, y	54.5 ± 3.8	54.2 ± 3.7	0.73	–
University degree, %	24.3	26.0	0.82	–
Employed, %	83.6	77.6	0.36	1, 1
Smoker or occasional smoker, %	18.1	11.7	0.27	2, 0
Weight, kg	70.5 ± 11.4	71.7 ± 12.5	0.56	–
Body mass index, kg/m^2	26.3 ± 4.0	26.9 ± 4.3	0.42	–
Follicle-stimulating hormone (FSH), mmol/L	65.4 ± 21.2	60.2 ± 24.1	0.16	–
Thyroid-stimulating hormone (TSH), mmol/L	2.40 ± 1.96	2.72 ± 1.82	0.28	–
Weekly frequency of hot flushes, %
<29.5	31.9	37.8
30–49.5	31.9	23.0
>50	36.2	39.2	0.48	5, 3
Health-related quality of life
SF-36 physical component score
Physical functioning	90 (20–100)	90 (40–100)	0.39	–
Role–physical	100 (0–100)	100 (0–100)	0.44	1, 1
Bodily pain	67.5 (0–100)	67.5 (22.5–100)	0.30	1, 0
General health	65 (10–95)	65 (25–100)	0.72	1, 0
SF-36 mental component score
Vitality	65 (5–95)	60 (0–90)	0.28	–
Social functioning	87.5 (25–100)	87.5 (12.5–100)	0.33	1, 0
Role–emotional	100 (0–100)	100 (0–100)	0.60	1, 1
Mental health	76 (4–100)	76 (24–100)	0.46	–
Menopause-specific quality of life score (WHQ)
Depressed mood	0.14 (0–0.86)	0.14 (0–0.86)	0.18	–
Somatic symptoms	0.43 (0–1)	0.43 (0–0.86)	0.84	2, 1
Memory/concentration	0.67 (0–1)	0.67 (0–1)	0.44	1, 0
Vasomotor symptoms	1.00 (0–1)	1.00 (0–1)	0.54	2, 1
Anxiety/fears	0.13 (0–1)	0.25 (0–0.75)	0.59	–
Sexual behaviour	0.33 (0–1)	0.33 (0–1)	0.63	15, 26
Sleep problems	0.33 (0–1)	0.67 (0–1)	0.30	0, 0
Menstrual symptoms	0.33 (0–1)	0.33 (0–1)	0.73	2, 1
Attractiveness	0.00 (0–1)	0.00 (0–1)	0.53	3, 1

^aDifferences between groups were tested by Student's t test (continuous variables, normal distributions), the Mann–Whitney U test (continuous variables, non-normal distributions), or the chi-square test (categorical or dichotomized variables). Values are shown as means ± SD, medians and ranges, or percentages.

Table II. Women's Health Questionnaire and SF-36 health-related quality-of-life scores among the intervention and control groups—6 month intervention scores and change from base-line to end.

	End intervention	Control	P^a	Change intervention	Control	P^a
Health-related quality of life
SF-36 physical component score
Physical functioning	89.0 (13.5)	87.1 (14.8)	0.33	2.67 (10.8)	20.64 (9.38)	0.049
Role–physical	81.4 (29.3)	77.3 (33.5)	0.48	5.14 (27.9)	23.95 (30.0)	0.017
Bodily pain	69.4 (21.1)	70.2 (24.9)	0.65	0.72 (19.0)	23.08 (21.4)	0.32
General health	66.9 (21.1)	65.1 (20.0)	0.55	3.01 (12.3)	20.45 (12.1)	0.065
SF-36 mental component score
Vitality	66.9 (18.9)	58.3 (23.8)	0.023	5.72 (14.2)	20.13 (16.3)	0.062
Social functioning	86.0 (19.6)	79.9 (25.1)	0.17	3.25 (19.1)	1.62 (20.9)	0.82
Role–emotional	85.6 (27.1)	78.4 (31.9)	0.12	6.85 (25.4)	3.07 (34.9)	0.46
Mental health	78.1 (15.9)	72.7 (17.6)	0.021	3.51 (11.9)	0.25 (13.2)	0.097
Menopause-specific quality of life score (WHQ)
Depressed mood	0.12 (0.20)	0.22 (0.21)	<0.001	20.07 (0.16)	20.02 (0.15)	0.023
Somatic symptoms	0.42 (0.30)	0.41 (0.26)	0.96	20.04 (0.23)	20.02 (0.17)	0.64
Memory/concentration	0.49 (0.35)	0.50 (0.38)	0.84	20.03 (0.30)	20.07 (0.34)	0.53
Vasomotor symptoms	0.83 (0.32)	0.85 (0.28)	0.92	20.10 (0.37)	20.05 (0.25)	0.30
Anxiety/fears	0.17 (0.26)	0.19 (0.22)	0.25	20.04 (0.16)	20.02 (0.17)	0.82
Sexual behaviour	0.38 (0.35)	0.43 (0.34)	0.39	20.02 (0.27)	20.02 (0.24)	0.94
Sleep problems	0.37 (0.33)	0.45 (0.30)	0.072	20.08 (0.28)	20.05 (0.26)	0.28
Menstrual symptoms	0.26 (0.29)	0.31 (0.32)	0.32	20.08 (0.25)	20.05 (0.29)	0.47
Attractiveness	0.17 (0.30)	0.30 (0.39)	0.041	20.10 (0.31)	20.01 (0.28)	0.062

^aP for difference between the groups; Mann–Whitney test.

Figure 2. Observed weekly frequencies (%) and 95% confidence intervals of day-time (left) and night-time (right) hot flushes based on mobile phone questionnaire during 24 weeks of intervention.

Table III. Number of responses to phone-based diary and observed frequency (%) of hot flushes by intervention month and group. Estimated proportion of hot flushes from multilevel mixed logistic regression.

	Intervention group				Control group
Month	Responses	Number of responses with hot flushes	Observed proportion of responses with hot flushes (%)	Estimated proportion of hot flushes from mixed model	Responses	Number of responses with hot flushes	Observed proportion of responses with hot flushes (%)	Estimated proportion of hot flushes from mixed model
Night-time hot flushes:
1 (base-line)	1513	867	57.3	56.1	1518	920	60.6	59.7
2	1719	948	55.1	54.3	1712	1018	59.5	58.6
3	1629	843	51.7	53.2	1576	863	54.8	58.1
4	1611	795	49.3	52.6	1581	872	55.2	55.6
5	1552	780	50.3	48.5	1503	866	57.6	54.3
6 (end)	1314	624	47.5	46.0	1361	716	52.6	54.0
Mixed model for night-time hot flushes:
P (group at base-line) = 0.88.
P (month) = 0.001.
P (group × month) = 0.012.
Day-time hot flushes:
1 (base-line)	1314	951	72.4	68.2	1339	952	71.1	68.5
2	1626	1080	66.4	67.1	1640	1151	70.2	69.1
3	1537	970	63.1	66.5	1542	978	63.4	67.8
4	1495	964	64.5	67.2	1446	936	64.7	67.3
5	1386	931	67.2	66.2	1463	1014	69.3	66.6
6 (end)	1208	840	69.5	66.6	1292	861	66.6	65.7

Mixed model for day-time hot flushes:

P (group at base-line) = 0.18

P (month) = 0.005

P (group × month) = 0.61

Table IV. Changes in quality of life (WHQ and SF-36 scores) by frequency of aerobic training sessions (from phone-based diary and heart rate belt information). Intervention group women (n = 78). Significance between the frequency groups tested with non-parametric Kruskal–Wallis test.

Change (base-line to 6 month) in:	Low (1–49 sessions)	Medium (50–72 sessions)	High (>72 sessions)	P
	n = 24	n = 24	n = 26
SF-36	Mean (SD)	Mean (SD)	Mean (SD)
Physical functioning	2.34 (11.3)	2.13 (13.2)	3.46 (8.0)	0.80
Role–physical	0.00 (22.1)	6.25 (28.8)	9.00 (32.2)	0.58
Bodily pain	3.04 (12.4)	−4.58 (19.1)	3.56 (22.9)	0.21
General health	0.83 (11.6)	0.63 (13.1)	7.40 (11.4)	0.096
Vitality	9.44 (13.0)	5.35 (15.9)	2.63 (13.4)	0.27
Social functioning	1.56 (23.4)	0.00 (16.5)	8.00 (16.5)	0.22
Role–emotional	6.94 (31.1)	5.56 (16.1)	8.00 (27.7)	0.99
Mental health	2.71 (12.6)	3.50 (11.9)	4.27 (11.7)	0.95
WHQ
Depressed mood	0.01 (0.17)	20.12 (0.16)	−0.09 (0.14)	0.03
Somatic symptoms	−0.04 (0.23)	0.04 (0.23)	−0.11 (0.20)	0.12
Memory/concentration	20.03 (0.34)	20.06 (0.25)	−0.02 (0.31)	0.85
Vasomotor symptoms	−0.04 (0.36)	20.15 (0.35)	−0.13 (0.40)	0.52
Anxiety/fears	0.02 (0.07)	−0.05 (0.16)	−0.08 (0.20)	0.056
Sexual behaviour	−0.03 (0.22)	−0.03 (0.28)	−0.01 (0.32)	0.98
Sleep problems	−0.03 (0.17)	−0.11 (0.21)	−0.10 (0.41)	0.46
Menstrual symptoms	0.05 (0.23)	−0.16 (0.26)	−0.12 (0.20)	0.01
Attractiveness	−0.13 (0.22)	−0.04 (0.44)	−0.13 (0.22)	0.38

Missing number of responses: low: SF-36 1, WHQ 5; medium: SF-36 0, WHQ 5; high: SF-36 4, WHQ 16.

Table V. Aerobic training-related variables (fitness and body composition) at base-line, after 6 months intervention, and change between base-line and 6 months. Differences between groups were tested by t test.

	Base-line intervention	Control	P	End intervention	Control	P	Change intervention	Control	P
VO2 (mL/kg/min)	31.7 (5.4)	31.5 (4.8)	0.845	32.6 (5.2)	31.4 (5.2)	0.167	0.77 (2.22)	20.16 (1.83)	0.008
DXA
fat mass (kg)	27.2 (8.8)	28.3 (8.9)	0.413	26.1 (8.6)	27.8 (8.8)	0.262	20.90 (1.99)	20.48 (2.10)	0.219
lean (muscle mass, kg)	40.1 (4.3)	40.2 (4.9)	0.917	40.6 (4.1)	40.3 (4.6)	0.705	0.57 (1.16)	0.15 (1.34)	0.046

Missing values: Intervention: base-line 2, 0, and 0; end: 10, 5, and 5; change: 11, 5, and 5; Control: base-line –; end: 4, 3, and 3; change: 4, 3, and 3.

DXA = dual X-ray absorptiometry; VO₂ = volume of oxygen consumption.