Effects of exercise on vasomotor symptoms in menopausal women: a systematic review and meta-analysis

Abstract

The frequency and severity of menopausal vasomotor symptoms negatively impact quality of life. This systematic review evaluates the potential of exercise to relieve the subjective frequency and severity of vasomotor symptoms. We searched four databases to identify randomized controlled trials (RCTs) that evaluated the effect of structured exercise (e.g. aerobic training) on the severity and/or frequency of vasomotor symptoms in menopausal women. Two reviewers independently screened records for eligibility, extracted data and assessed risks of bias and evidence certainty using the Cochrane tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE). When suitable, data were pooled using random-effect meta-analyses. We appraised 21 RCTs involving 2884 participants. Compared to no-treatment control, exercise significantly improved severity of vasomotor symptoms (10 studies, standardized mean difference [SMD] = 0.25; 95% confidence interval [CI]: 0.04 to 0.47, p = 0.02, very low certainty of evidence); the effect size was attenuated when studies with a high risk of bias were excluded (SMD = 0.11, 95% CI: −0.03 to 0.26, p = 0.13). No significant changes in vasomotor frequency were found between exercise and control (SMD = 0.14, 95% CI: −0.03 to 0.31, p = 0.12, high certainty of evidence). In conclusion, exercise might improve vasomotor symptom severity. Future rigorous RCTs addressing the limitations of current review are warranted to explore the optimal exercise prescription principles to target the severity of vasomotor symptoms.

摘要

绝经血管舒缩症状的频率和严重程度对生活质量有负面影响。本系统综述评估了运动缓解血管舒缩症状的主观频率和严重程度的潜力。我们搜索了四个数据库, 设计了随机对照试验(RCT）评估结构性运动(例如有氧训练)对绝经期妇女血管舒缩症状的严重程度和/或频率的影响。两名评审员独立筛选合格记录, 提取数据, 并使用Cochrane工具和推荐等级的评估、制定与评价（GRADE）评估了偏倚风险和证据的确定性。在合适的情况下, 采用随机效应荟萃分析法对数据进行汇总。我们评估了21项RCTs, 涉及2884名参与者。与无治疗对照组相比, 运动能显著改善血管舒缩症状的严重程度（10项研究, 标准差[SMD]=0.25；95%置信区间[CI]：0.04到0.47, P=0.02, 证据的确定性很低）；当排除了有高偏倚风险的研究后, 效应量有所减弱（SMD=0.11, 95%CI：-0.03到0.26, P=0.13）。在运动组和对照组之间没有发现血管舒缩频率的显著变化（SMD = 0.14, 95% CI：-0.03 to 0.31, p =0.12, 证据的高度确定性）。总之, 运动可以改善血管舒缩症状的严重程度。未来需要进行严格的RCT, 以解决目前综述的局限性, 探索针对血管舒缩症状严重性的最佳运动处方原则。

Keywords:

• Hot flashes
• night sweats
• aerobic exercise
• training
• menopause

Potential conflict of interest

The authors report there are no competing interests to declare.

Source of funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.