Abstract
Menopausal symptoms are associated with deterioration in physical, mental, and sexual health, lowering women’s quality of life (QoL). Our study objective is to examine the effect of exercise on QoL in women with menopausal symptoms. After initially identifying 1306 studies published on PubMed, Web of Science, Scopus, and Cochrane Library before June 2020, two researchers independently selected nine randomized controlled trials (RCTs) in which any type of exercise was compared with no active treatment. We assessed the risk of bias in the included studies using the Cochrane risk-of-bias 2.0 tool for RCTs and computed the converged standardized mean difference with a 95% confidence interval. We found evidences for the positive effects of exercise on physical and psychological QoL scores in women with menopausal symptoms. However, there was no evidence for the effects of exercise on general, social, and menopause-specific QoL scores. The most common interventions for women with menopausal and urinary symptoms were yoga and pelvic floor muscle training (PFMT), respectively. In our meta-analyses, while yoga significantly improved physical QoL, its effects on general, psychological, sexual, and vasomotor symptoms QoL scores as well as the effect of PFMT on general QoL were not significant. Our findings suggest that well-designed studies are needed to confirm the effect of exercise on QoL in women with menopausal symptoms.
Highlights
Menopause, which is defined as the permanent cessation of menstrual periods [1] and categorized into premenopausal, perimenopausal, and postmenopausal stages [2], can either occur naturally, generally between the ages of 42 and 58 years [2], or be induced by medical treatments [3]
81 publications including (1) eight non-randomized controlled trials (RCTs); (2) twelve unavailable full texts; (3) four conference abstracts; (4) six non-English articles; (5) five studies combining exercise with other interventions; (6) one study in which both the intervention and the control groups performed exercises; (7) one study using active treatment control group; (8) three studies not providing quality of life (QoL) quantitative outcomes; (9) six studies of menopausal women that did not mention any menopausal symptoms as inclusion criteria; (10) five studies published as different perspectives of the same project with the included studies; (11) 30 studies having a combination of the aforementioned reasons
Of the nine articles included in the qualitative synthesis, the study by Mercier et al [24] was excluded as it is a single-arm study conducted as a substudy of an RCT
Summary
Menopause, which is defined as the permanent cessation of menstrual periods [1] and categorized into premenopausal, perimenopausal, and postmenopausal stages [2], can either occur naturally, generally between the ages of 42 and 58 years [2], or be induced by medical treatments [3]. There is a great variety of menopausal symptoms, of which the four most frequently reported by middle-aged women are vasomotor symptoms (i.e., night sweats and hot flashes), difficulty sleeping/insomnia, vaginal dryness/dyspareunia, and adverse mood/depression [4]. These symptoms may last for years in the postmenopausal period [1]. Existing evidence suggests that as many as 85% of menopausal women experience at least one hot flash, large differences were found with respect to the frequency, severity, and duration of hot flashes [5]. A significant negative relation between menopausal symptoms and quality of life (QoL) in middle-aged women has been observed in several national [8,9]
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