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 .
Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trial
CONTEXT Despite decades of accumulated observational evidence , the balance of risks and benefits for hormone use in healthy postmenopausal women remains uncertain . OBJECTIVE To assess the major health benefits and risks of the most commonly used combined hormone preparation in the United States . DESIGN Estrogen plus progestin component of the Women 's Health Initiative , a r and omized controlled primary prevention trial ( planned duration , 8.5 years ) in which 16608 postmenopausal women aged 50 - 79 years with an intact uterus at baseline were recruited by 40 US clinical centers in 1993 - 1998 . INTERVENTIONS Participants received conjugated equine estrogens , 0.625 mg/d , plus medroxyprogesterone acetate , 2.5 mg/d , in 1 tablet ( n = 8506 ) or placebo ( n = 8102 ) . MAIN OUTCOMES MEASURES The primary outcome was coronary heart disease ( CHD ) ( nonfatal myocardial infa rct ion and CHD death ) , with invasive breast cancer as the primary adverse outcome . A global index summarizing the balance of risks and benefits included the 2 primary outcomes plus stroke , pulmonary embolism ( PE ) , endometrial cancer , colorectal cancer , hip fracture , and death due to other causes . RESULTS On May 31 , 2002 , after a mean of 5.2 years of follow-up , the data and safety monitoring board recommended stopping the trial of estrogen plus progestin vs placebo because the test statistic for invasive breast cancer exceeded the stopping boundary for this adverse effect and the global index statistic supported risks exceeding benefits . This report includes data on the major clinical outcomes through April 30 , 2002 . Estimated hazard ratios ( HRs ) ( nominal 95 % confidence intervals [ CIs ] ) were as follows : CHD , 1.29 ( 1.02 - 1.63 ) with 286 cases ; breast cancer , 1.26 ( 1.00 - 1.59 ) with 290 cases ; stroke , 1.41 ( 1.07 - 1.85 ) with 212 cases ; PE , 2.13 ( 1.39 - 3.25 ) with 101 cases ; colorectal cancer , 0.63 ( 0.43 - 0.92 ) with 112 cases ; endometrial cancer , 0.83 ( 0.47 - 1.47 ) with 47 cases ; hip fracture , 0.66 ( 0.45 - 0.98 ) with 106 cases ; and death due to other causes , 0.92 ( 0.74 - 1.14 ) with 331 cases . Corresponding HRs ( nominal 95 % CIs ) for composite outcomes were 1.22 ( 1.09 - 1.36 ) for total cardiovascular disease ( arterial and venous disease ) , 1.03 ( 0.90 - 1.17 ) for total cancer , 0.76 ( 0.69 - 0.85 ) for combined fractures , 0.98 ( 0.82 - 1.18 ) for total mortality , and 1.15 ( 1.03 - 1.28 ) for the global index . Absolute excess risks per 10 000 person-years attributable to estrogen plus progestin were 7 more CHD events , 8 more strokes , 8 more PEs , and 8 more invasive breast cancers , while absolute risk reductions per 10 000 person-years were 6 fewer colorectal cancers and 5 fewer hip fractures . The absolute excess risk of events included in the global index was 19 per 10 000 person-years . CONCLUSIONS Overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 5.2-year follow-up among healthy postmenopausal US women .  All-cause mortality was not affected during the trial . The risk-benefit profile found in this trial is not consistent with the requirements for a viable intervention for primary prevention of chronic diseases , and the results indicate that this regimen should not be initiated or continued for primary prevention of 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 .