Study links relaxation method to reduced hot flashes

Although studies of the effects of relaxation techniques on menopause symptoms have yielded mixed results so far, a new report from Sweden comes down in favor of the approach as an alternative to hormone therapy.

Postmenopausal women trained to relax before and during the onset of hot flashes cut the frequency of those events in half during the three-month trial, researchers say. Women in a comparison group that got no treatments experienced little change in their symptoms.

“The results tell you that, yes, this seems to work,” said Kim Innes of West Virginia University, who has studied mind-body therapies for menopause symptoms but was not involved in the new study. “This was a moderate-sized trial that yielded promising - although not definitive - findings regarding the efficacy of applied relaxation,” she told Reuters Health.

In a review of more than a dozen previous clinical trials involving mediation, yoga and Tai Chi therapies, Innes concluded that these techniques may hold promise for relieving menopause symptoms, but it’s too soon to tell.

In the years just before and after menopause, fluctuating hormone levels can generate a wide variety of symptoms, among the most bothersome are sudden flushing, night sweats and insomnia.

Hormone replacement therapy is thought to help by stabilizing the fluctuations, but not all women can take hormones because of other health conditions or risk factors, and many don’t want to because of possible risks from the hormones themselves.

“A lot of women in Sweden do not want to or cannot use hormone therapy due to side effects,” said lead author of the new study Lotta Lindh-Åstrand of Linköping University.

So Lindh-Åstrand’s team set out to test the effects on menopausal hot flashes and quality of life of a method called applied relaxation that was developed in Sweden in the 1980s, based on type of psychotherapy called cognitive behavioral therapy.

The researchers recruited 60 healthy Swedish women and randomly assigned a little more than half to practice applied relaxation and the rest to a comparison group that received no treatment. The women, mostly in their fifties, had all stopped menstruating a year or more earlier but still experienced hot flashes and night sweats.

The 33 women in the therapy group learned how to focus on breathing and releasing muscle tension before and during hot flashes.

For the first week, the women observed and recorded what they felt before and during a hot flash or other menopausal symptom. Next, the women were encouraged to spend 15 minutes twice a day tensing and relaxing muscles from head to toe. Gradually, women learned how to decrease the time needed to relax by focusing on controlled breathing and not tensing the muscles. Toward the end of the study, the women were instructed to practice relaxation 20 times a day in 30-second sessions. The final “homework” exercise required the women to use these breathing and relaxation skills to quickly relax during a hot flash situation.

At the beginning of the study, all the participants experienced an average of 10 hot flashes a day. After three months, researchers report in the journal Menopause, the applied relaxation group had an average of four flashes a day while the comparison group averaged eight.

The researchers also found modest improvements in quality of life measures, including sleep problems and aches and pains, among women in the relaxation group, while the comparison group reported no changes.

Innes and other researchers said the mechanism behind mind-body therapies and their effect on menopausal symptoms is not completely understood, but it could be linked to the sympathetic nervous system, which is responsible for “fight or flight” responses as well as basic functions like heart rate, blood pressure and sweating.

Lindh-Åstrand and her colleagues warned that the results were not final and more research is needed.

“The next step,” Innes said, “would be a larger randomized controlled trial” that includes an active comparison, for instance, between relaxation techniques and physical exercise.

Such a study could help build a stronger argument for applied relaxation as a treatment, experts agreed.

Lindh-Åstrand stressed that relaxation techniques are not for everyone, especially for women who suffer from severe depression or anxiety. Women with these conditions could paradoxically feel more tense under the treatment, she said.

But for many women, she added, “this gives them a tool for managing hot flashes.”

“Over time, the women can be more self-confident because they know they can do something when the problem appears,” Lindh-Åstrand said.

SOURCE: Menopause, November 12, 2012.


Effects of applied relaxation on vasomotor symptoms in postmenopausal women: a randomized controlled trial Results: The number of hot flashes decreased by 5.0 per 24 hours in the applied relaxation group compared with 1.9 in the control group on the 12th week (P < 0.001) and still remained at the same level at the 3-month follow-up (P < 0.001). Health-related quality of life for vasomotor symptoms, sleep, and memory improved significantly on the 12th week measurement in the applied relaxation group compared with the control group. Salivary cortisol concentration was lowered markedly in the applied relaxation group on a single measurement but was otherwise mainly stable in both groups. Conclusions: Applied relaxation can be used to treat vasomotor symptoms in healthy postmenopausal women. Lindh-Åstrand, Lotta RN, PhD; Nedstrand, Elizabeth MD, PhD

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