Quality of Life ; No Stretch to Say Exercise Helps Some Menopausal Women

By Janet Caggiano

Afew weeks after Sandi Reese went off hormone replacement therapy, the hot flashes began. Then the mood swings hit.

“I didn’t like the way I was feeling,” said Reese, a 56-year-old Goochland County resident. “I went to my doctor and said, ‘I want to go back on HRT.’ She suggested exercise instead.”

It worked. Reese took to the treadmill for an hour each day, five times a week. In two weeks, the hot flashes subsided. Feelings of stress melted away.

“Exercise definitely helps the symptoms,” she said. “It’s been great. I know I wouldn’t be happy if I didn’t exercise.”

Reese is not alone in her belief that exercise can relieve menopausal symptoms. That link has been noted by fitness instructors and trainers who have seen the effect on hot flashes, insomnia, joint aches and weight gain often accompanying this phase of a woman’s life.

But it’s only now starting to get a closer look from researchers and from many women looking for natural ways to ease the symptoms of menopause. Fueling the scrutiny are recent questions about the safety of hormone replacement therapy and a National Institutes of Health panel calling for menopause to be “demedicalized.”

One analysis of 12 menopausal women in an eight-week strength training program found that almost half of the women felt less anxious and half had less aching, stiffness and irritability. Another, even smaller, study found that yoga helped reduce participants’ overall symptoms by 16 percent. Other researchers have found, however, that exercise programs produce little or no improvement of symptoms.

“The fact is that we know very little about the merits of exercise for menopausal symptoms,” says Dr. Wendy S. Klein, senior deputy director of the VCU Institute for Women’s Health. “It is a bit misleading to cite study of 12 women and assume that the findings are relevant and generalizable, or to cite anecdotal reports and imply that this is proof of effect.”

Lisa Martin, 51, of Midlothian, said, “The only thing that relieved my symptoms was hormones.” She said she stopped hormone replacement therapy years ago. “I’ve been exercising since I was 40. I do it because it’s a good thing to do for your body. But it doesn’t do a thing for my hot flashes.”

Yet the prevailing wisdom is that exercise can be a benefit to some women who experience menopausal symptoms — if not by actually reducing the frequency of hot flashes and other discomforts, then by generally improving their health.

“Exercise at any age, whether you are menopausal or not, is beneficial,” said Dr. Todd Billett, a partner at Virginia Physicians for Women. “It makes you feel good. So for stress and mood swings, exercise is a great thing. For hot flashes, though, I wouldn’t hang my hat on it.”

A combination of strength training, cardio workouts and stretching can ease some women’s symptoms, experts say, and it can decrease the risk of osteoporosis and heart disease, two common ailments among postmenopausal women.

One study, published last year in the Journal of the American College of Cardiology, followed 353 women through a four-year diet and exercise program and found it was able to slow the progression of menopause-related atherosclerosis.

Exercise also can battle the weight gain often caused by a slower metabolism.

“The health benefits of exercise go far beyond management of menopause symptoms,” says Dr. Carol Mangione, a University of California, Los Angeles professor of medicine and chair of the NIH panel. “In your early 50s is a time when lifestyle interventions can really change the trajectory of chronic disease and functional decline as you age.”

Her panel, an independent group of researchers, health professionals, methodologists and public representatives, was charged with assessing current research and literature on menopause. It reported that viewing menopause as more of an ailment than a normal life stage can lead to overuse of treatment programs such as hormone replacement therapy.

That therapy lost some of its appeal after the Women’s Health Initiative study in 2003 found that years-long use of estrogen and progestin causes a slight increase in a woman’s risk for heart attack, stroke and breast cancer, and that postmenopausal women who took hormones had no more relief from symptoms such as depression and low sexual function than those who didn’t.

The reports compelled some women, such as Reese, to try to wade through menopause “au naturel” and see if exercise could make a difference. For her, and for many other women, it has.

It’s not unusual to find women in various stages of menopause frequenting pilates, yoga and aquatics classes; the promise of an intense workout without the pounding of high-impact aerobics is often what draws them.

In her classes at Robious Sports and Fitness Center in Chesterfield County, fitness director Laurie Bald stresses cardiovascular and weight-bearing exercises to her clients. Good posture tends to decline during menopause, especially with osteoporosis, so Bald emphasizes the importance of core strength, upper body toning and resistance exercises. She also shares tips for combating insomnia.

“Many of them tell me that exercising helps reduce their symptoms of menopause,” she said. “I don’t know of any scientific proof, but I do know exercise will improve your attitude, no matter what your body is going through.”

She hopes others catch on to that fact. VCU’s Klein agrees.

“It is simple common sense that exercise is good for us in many ways and improves the quality of life,” she says. “The bottom line is that exercise is great for menopausal women, although it may or may not actually relieve hot flashes.”