A recent cross-sectional analysis in the multiethnic Study of Women ’s Health Across the Nation found that 53 % of the participants used some form of CAM ( excluding diet , vitamins , exercise , and prayer ) and that rates of use generally did not vary by menopausal status or by presence of vasomotor symptoms .
Significant improvements were also found in sleep quality ( P = 0.02 ) and
I n the wake of serious health concerns raised by the Women ’s Health Initiative and Heart and Estrogen/ progestin Replacement Study clinical trials , prescriptions for hormone therapy have declined dramatically , leaving many women without effective treatment for menopausal symptoms .
Several nonhormonal pharmacologic therapies have shown promise for reducing vasomotor symptoms , including selective serotonin reuptake inhibitors , gabapentin , and clonidine .
However , most are only modestly effective , and all have side effects that may limit their use .
A number of herbal therapies are marketed to women as being safe and effective in reducing menopausal symptoms , including phytoestrogens , black cohosh , dong quai , evening primrose oil , and red clover .
Still , interest in nonhormonal and particularly in complementary and alternative medicine ( CAM ) therapies for menopausal symptoms remains strong .
The term yoga is derived from the Sanskrit term yuj , meaning Bto yoke^ or Bto unite,^ and the goal of yoga has been described as uniting the body and mind to achieve enlightenment .
Yoga has become increasingly popular outside of India , with a 2008 survey of 5,050 people estimating that 7 % of US adults practice yoga .
Clinical trials have also demonstrated many potential health benefits of yoga , including reductions in blood pressure , dyslipidemia , and insulin resistance .
Although the exact mechanisms of hot flashes remain unknown , physiologic studies have demonstrated that heightened sympathetic nervous system activity plays an important role .
Small uncontrolled studies have shown that yoga increases heart rate variability and decreases oxygen consumption , heart rate , and blood pressure , all indicative of decreased sympathetic activity .
In addition to its biological effects , yoga may also have beneficial psychological effects that could lead women to find physical symptoms less bothersome and /or help them to cope better with changes during menopause .
In this issue of Menopause , Chattha and colleagues report results from one of the largest published trials of yoga for menopausal symptoms .
Despite the increasing popularity of yoga , a yoga intervention requiring 60 minutes of supervised instruction five times per week may not be practical for many Western women .
Cardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/progestin Replacement Study follow-up (HERS II).
CONTEXT The Heart and Estrogen/progestin Replacement Study ( HERS ) found no overall reduction in risk of coronary heart disease ( CHD ) events among postmenopausal women with CHD . However , in the hormone group , findings did suggest a higher risk of CHD events during the first year , and a decreased risk during years 3 to 5 . OBJECTIVE To determine if the risk reduction observed in the later years of HERS persisted and result ed in an overall reduced risk of CHD events with additional years of follow-up . DESIGN AND SETTING R and omized , blinded , placebo-controlled trial of 4.1 years ' duration ( HERS ) and subsequent unblinded follow-up for 2.7 years ( HERS II ) conducted at outpatient and community setting s at 20 US clinical centers . PARTICIPANTS A total of 2763 postmenopausal women with CHD and average age of 67 years at enrollment in HERS ; 2321 women ( 93 % of those surviving ) consented to follow-up in HERS II . INTERVENTION Participants were r and omly assigned to receive 0.625 mg/d of conjugated estrogens and 2.5 mg of medroxyprogesterone acetate ( n = 1380 ) , or placebo ( n = 1383 ) during HERS ; open-label hormone therapy was prescribed at personal physicians ' discretion during HERS II . The proportions with at least 80 % adherence to hormones declined from 81 % ( year 1 ) to 45 % ( year 6 ) in the hormone group , and increased from 0 % ( year 1 ) to 8 % ( year 6 ) in the placebo group . MAIN OUTCOME MEASURES The primary outcome was nonfatal myocardial infa rct ion and CHD death . Secondary cardiovascular events were coronary revascularization , hospitalization for unstable angina or congestive heart failure , nonfatal ventricular arrhythmia , sudden death , stroke or transient ischemic attack , and peripheral arterial disease . RESULTS There were no significant decreases in rates of primary CHD events or secondary cardiovascular events among women assigned to the hormone group compared with the placebo group in HERS , HERS II , or overall . The unadjusted relative hazard ( RH ) for CHD events in HERS was 0.99 ( 95 % confidence interval [ CI ] , 0.81 - 1.22 ) ; HERS II , 1.00 ( 95 % CI , 0.77 - 1.29 ) ; and overall , 0.99 ( 0.84 - 1.17 ) . The overall RHs were similar after adjustment for potential confounders and differential use of statins between treatment groups ( RH , 0.97 ; 95 % CI , 0.82 - 1.14 ) , and in analyses restricted to women who were adherent to r and omized treatment assignment ( RH , 0.96 ; 95 % CI , 0.77 - 1.19 ) . CONCLUSIONS Lower rates of CHD events among women in the hormone group in the final years of HERS did not persist during additional years of follow-up . After 6.8 years , hormone therapy did not reduce risk of cardiovascular events in women with CHD . Postmenopausal hormone therapy should not be used to reduce risk for CHD events in women with CHD
A recent cross-sectional analysis in the multiethnic Study of Women ’s Health Across the Nation found that 53 % of the participants used some form of CAM ( excluding diet , vitamins , exercise , and prayer ) and that rates of use generally did not vary by menopausal status or by presence of vasomotor symptoms .
Significant improvements were also found in sleep quality ( P = 0.02 ) and
I n the wake of serious health concerns raised by the Women ’s Health Initiative and Heart and Estrogen/ progestin Replacement Study clinical trials , prescriptions for hormone therapy have declined dramatically , leaving many women without effective treatment for menopausal symptoms .
Several nonhormonal pharmacologic therapies have shown promise for reducing vasomotor symptoms , including selective serotonin reuptake inhibitors , gabapentin , and clonidine .
However , most are only modestly effective , and all have side effects that may limit their use .
A number of herbal therapies are marketed to women as being safe and effective in reducing menopausal symptoms , including phytoestrogens , black cohosh , dong quai , evening primrose oil , and red clover .
Still , interest in nonhormonal and particularly in complementary and alternative medicine ( CAM ) therapies for menopausal symptoms remains strong .
The term yoga is derived from the Sanskrit term yuj , meaning Bto yoke^ or Bto unite,^ and the goal of yoga has been described as uniting the body and mind to achieve enlightenment .
Yoga has become increasingly popular outside of India , with a 2008 survey of 5,050 people estimating that 7 % of US adults practice yoga .
Clinical trials have also demonstrated many potential health benefits of yoga , including reductions in blood pressure , dyslipidemia , and insulin resistance .
Although the exact mechanisms of hot flashes remain unknown , physiologic studies have demonstrated that heightened sympathetic nervous system activity plays an important role .
Small uncontrolled studies have shown that yoga increases heart rate variability and decreases oxygen consumption , heart rate , and blood pressure , all indicative of decreased sympathetic activity .
In addition to its biological effects , yoga may also have beneficial psychological effects that could lead women to find physical symptoms less bothersome and /or help them to cope better with changes during menopause .
In this issue of Menopause , Chattha and colleagues report results from one of the largest published trials of yoga for menopausal symptoms .
Despite the increasing popularity of yoga , a yoga intervention requiring 60 minutes of supervised instruction five times per week may not be practical for many Western women .