Effects of mind-body therapies on symptom clusters during the menopausal transition and early postmenopause: a systematic review.

Author: Woods NF, Mitchell ES, Schnall JG, Cray L, Ismail R, Taylor-Swanson L, Thomas A.
Conference/Journal: Climacteric.
Date published: 2013 Aug 12
Other: Word Count: 267


ABSTRACT Aims: Although most women experience symptom clusters during the menopausal transition and early postmenopause, investigators reporting clinical trial effects for hot flashes often omit co-occurring symptoms. Our aim was to review controlled clinical trials of mind-body therapies for hot flashes and at least one other co-occuring symptom from these groups: sleep, cognitive function, mood, and pain. Methods: An experienced reference librarian performed an extensive search of PubMed/Medline, CINAHL Plus, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, AMED, and Alt-Health Watch for randomized controlled trials reported in English between 2004 to July 2011. Of 1193 abstracts identified, 58 trials examining effectiveness of therapies for hot flashes and at least one additional co-occuring symptom of interest were identified. Results: Eight trials (10 publications) examined relaxation, yoga, or exercise. Physical activity/exercise trials (6) yielded mixed results; only one significantly reduced hot flashes and mood symptoms. Of 2 relaxation therapy trials, only mindfulness-based stress reduction training reduced sleep and mood symptoms and had within-group treatment effects on hot flashes. Yoga (1 trial) significantly reduced hot flashes and improved cognitive symptoms more than exercise, and also had within-group effects on sleep and pain symptoms. Conclusions: Studies of mind-body therapies for hot flashes increasingly measure multiple symptom outcomes, but few report treatment effects in ways that allow clinicians to consider symptom clusters when prescribing therapies. Future studies need to measure and report results for individual symptoms or group like symptoms together into subcales rather than use subscales with mixed dimensions. Trials with larger numbers of participants are essential to allow evaluation of these therapies on multiple co-occurring symptoms.
PMID: 23937432

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