Menopause: Relaxation good therapy for hot flushes

Seven out of every ten women undergoing menopause have at some point experienced problems with hot flushes and sweating. For one in ten women, the problems lasted five years or longer, primarily causing discomfort in social situations and insomnia.

The background to this is not known. What is known is that the decreasing amounts of the female hormone estrogen -- which occurs after menopause -- affects the brain's heat regulation centre in the hypothalamus.

Medication with estrogen has proven to have a good effect. At the end of the 1990s, Swedish doctors prescribed hormone tablets to around 40% of women with moderate to severe symptoms. But since new observations have shown that the treatment increased the risk of breast cancer and cardiovascular disease, their use has decreased drastically. Today, the number of women with menopausal problems receiving estrogen is down to 10%.

The situation triggered an interest in alternative forms of treatment. For her doctoral thesis, Women's Clinic consultant Elizabeth Nedstrand arranged a study where a group of women were randomly assigned to three different treatments alongside estrogen: acupuncture, exercise, and applied relaxation -- a method based on cognitive behaviour therapy developed by psychologist Lars-Göran Öst.

The results were so interesting that a larger randomised study around the effects of applied relaxation began n in 2007. 60 women who saw a doctor for moderate to severe symptoms occurring at least 50 times a week -- but who were otherwise completely healthy -- were randomly assigned to two groups: one had ten sessions of group therapy and the other received no treatment whatsoever. The results are now being published by Nedstrand and Lotta Lindh-Åstrand in the scientific journal Menopause.

Nedstrand herself conducted the therapy, which is based on learning to find the muscle groups in one's body and getting the body to relax with the help of breathing techniques.

"The participants were given exercises to practice daily at home. The goal was for them to learn to use the method on their own and to be able to manage their own symptoms.

During the intervention period and for three months thereafter, the women kept a diary of their hot flushes. They also had to fill out a "quality of life" survey on three occasions, in addition to submitting a saliva sample for analysis of the stress hormone cortisol.

The results were striking. The women in the treatment group reduced the number of hot flushes per day from an average of 9.1 to 4.4; the effect remained for three months after the last therapy session. The numbers in the control group also decreased, but only from 9.7 to 7.8.

The women in the therapy group also reported improved quality of life as regards memory and concentration, sleep, and anxiety. On the other hand, there were no statistically significant differences in stress hormone secretion.

"The study confirms that applied relaxation can help women with menopausal troubles. My hope is that women can be offered this treatment in primary care and from private health care providers," Nedstrand says.