AMS Lifestyle and behavioural modifications for menopausal symptoms353.11 KB
Many women are interested in the potential of lifestyle and behavioural modifications to help with their menopausal symptoms. The evidence for the effectiveness of lifestyle changes is mixed and limited.
Lifestyle and behavioural modifications might not necessarily improve symptoms, but some may improve wellbeing and help women tolerate symptoms.
Maintaining healthy weight
Women often request information about weight gain and menopause. Although menopause does not cause weight gain, there is evidence that weight gain can increase the severity of vasomotor symptoms.
- Breast cancer survivors with post-diagnosis weight gain had a greater risk of reporting hot flushes than women who did not gain weight1.
- One study of 40 overweight/obese women showed that a 10% weight loss resulted in significant improvement in hot flushes, with a correlation between weight loss and reduction in hot flush frequency2.
Improving cooling through environmental control
Clinical evidence does not exist to support the efficacy of cooling interventions as treatment for vasomotor symptoms. Nonetheless, small core body temperature elevations can trigger vasomotor symptoms2,3,4, so it makes sense to propose environmental and lifestyle changes that lower core body temperature or that prevent it from rising. Suggested changes include:
- adjusting clothing
- dress in layers
- wear sleeveless blouses or tops
- wear clothing made of natural fibres that breathe
- avoid jumpers and scarves
- using a hand fan or electric fan as required
- keeping cooler at night
- lower the room temperature
- put a cold pack under the pillow
- turn the pillow over to the cool side when feeling warm
- use dual control electric blankets
- use a bed fan that blows air between the sheets
- drinking cool liquids such as iced water.
Avoiding triggers of vasomotor symptoms
Some women are able to identify triggers for their vasomotor symptoms. Avoiding these triggers may help women to manage symptoms, although this has not been tested in clinical trials. Potential triggers include:
- spicy foods
- smoking – has been reported as a risk factor for vasomotor symptoms5. Smoking cessation may help to alleviate mild symptoms but there are no clinical trials evaluating this intervention
- alcohol – can trigger hot flushes and some women find that their flushes are reduced when they avoid drinking alcohol.
Several studies have investigated whether exercise improves hot flushes, but the existing evidence does not show that exercise helps to reduce hot flushes or night sweats6.
Nonetheless, exercise has other benefits and may improve quality of life, cognitive functioning, depression, sleep patterns, fatigue, bone density, weight maintenance and cardiovascular disease. For guidelines on exercise, see the AMS information sheet Weight management and healthy ageing.
Mind- and body-based therapies and practices
Cognitive behaviour therapy
Group and individual cognitive behaviour therapy are both effective at reducing the impact of vasomotor symptoms and at improving sleep and general wellbeing. This approach could potentially be used in conjunction with other therapies for menopausal symptoms1,7.
There is mixed evidence that yoga is effective for the management of vasomotor symptoms and sleep disturbance1,7.
Slow, deep abdominal breathing for 15 minutes twice daily may reduce feelings of anxiety that can occur with hot flushes but this practice does not reduce the severity of hot flushes8.
Poor quality studies have yielded inconsistent results regarding the effect of relaxation on vasomotor symptoms.
There have been limited studies on hypnosis for hot flushes, but a recent carefully conducted trial showed that hypnosis was more effective than an attention control comparison9. Hypnosis also improved sleep and hot flush interference in this study.
Small studies of acupuncture as a treatment for hot flushes have shown mixed results. A recent large Australian study did not show any benefit for hot flushes compared to sham acupuncture10. A thorough review of all the studies on acupuncture for hot flushes and night sweats in breast cancer patients did not show any overall benefit for acupuncture10,11.
Magnetic therapy, reflexology, chiropractic interventions
There is no evidence that women benefit when they use these therapies7.
- Caan BJ, Emond JA, Su HI, Patterson RE, Flatt SW, Gold EB, Newman VA, Rock CL, Thomson CA, Pierce JP. Effect of postdiagnosis weight change on hot flash status among early-stage breast cancer survivors. J Clin Oncol 2012 30:1492–97. doi:10.1200/JCO.2011.36.8597.
- Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause 2015 22(11):1155–72; quiz 73–4.
- Freedman RR, Norton D, Woodward S, Cornelissen G. Core body temperature and circadian rhythm of hot flashes in menopausal women. J Clin Endocrinol Metab 1995 80:2354–58.
- Freedman RR, Woodward S. Core body temperature during menopausal hot flushes. Fertil Steril 1996 65:1141–44.
- Gold EB, Sternfeld B, Kelsey JL, et al. Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40–55 years of age. Am J Epidemiol 2000 152:463–73.
- Daley A, Stokes-Lampard H, Macarthur C. Exercise for vasomotor menopausal symptoms. Cochrane Database Syst Rev 2011 5:CD006108. doi: 10.1002/14651858.CD006108.pub3.
- Cancer Australia. Management of menopausal symptoms in women with a history of breast cancer. Available at: https://canceraustralia.gov.au/publications-and-resources/clinical-practice-guidelines/menopausal-guidelines.
- Carpenter JS, Burns DS, Wu J, Otte JL, Schneider B, Ryker K, Tallman E, Yu M. Paced respiration for vasomotor and other menopausal symptoms: a randomised controlled trial. J Gen Intern Med 2013 28:193–200.
- Elkins GR, Fisher WI, Johnson AK, Carpenter JS, Keith TZ. Clinical hypnosis in the treatment of postmenopausal hot flashes: a randomized controlled trial. Menopause 2013 20:291–8. doi: 10.1097/GME.0b013e31826ce3ed
- Ee C, Xue C, Chondros P, Myers SP, French SD, Teede H, Pritta M. Acupuncture for menopausal hot flashes: a randomized trial. Ann Intern Med 2016 164:146–54.
- Rada G, Capurro D, Pantoja T, Corbalán J, Moreno G, Letelier LM, Vera C. Non-hormonal interventions for hot flushes in women with a history of breast cancer. Cochrane Database Syst Rev 2010 9:CD004923.
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Content updated May 2019