Women being treated for cancer often experience menopause quite suddenly with common symptoms, such as hot flashes, amplified more than had menopause occurred naturally. A new Australian study suggests that the intensity and volume of physical activity could mitigate some of those symptoms.
Menopause symptoms may arise as the result of radiotherapy to the pelvic field, surgical removal of the ovaries, or systemic chemotherapy. When such procedures occur in premenopausal or perimenopausal women, they often result in sudden and sometimes irreversible menopause that is accompanied by more frequent and severe menopause symptoms. Various cancer-treating endocrine therapies, such as the use of tamoxifen, can also amplify symptoms, especially hot flashes.
The study involving nearly 300 women sought to investigate the association between self-reported physical activity and menopause symptoms. In addition, the researchers evaluated whether intervention targeting lifestyle behavior could improve changes in physical activity levels and menopause symptoms.
Results suggest that menopause symptoms are less severe in women with medium to high levels of physical activity than in women with low levels of such activity. The intervention, however, was not determined to play a role in increasing physical activity in women being treated for breast, reproductive, or blood cancers. Although this is not the first study to examine the association of physical activity with menopause symptoms, it is the first to look specifically at the volume and intensity of physical activity.
Severe menopause symptoms, including poor mental well-being, are associated with a sedentary lifestyle and low physical activity, even in women experiencing natural menopause. Researchers of the current study additionally found that women being treated for breast cancer, for example, who experience worse menopause symptoms are less likely to engage in health-promoting behaviors.
On the basis of study results, researchers suggest that an increased focus on exercise training should be part of the long-term maintenance program for women after cancer treatment.
Objective: This randomized controlled trial tested a digitally-delivered whole-of-lifestyle program for women previously treated for cancer. We investigated (1) associations between self-reported physical activity (PA) and menopausal symptoms and (2) if the intervention was associated with beneficial changes in PA and menopausal symptoms.
Methods: Women were randomized to intervention (n = 142) or control (n = 138). The intervention targeted lifestyle behavior including PA. Self-reported PA (International Physical Activity Questionnaire - Short Form) and menopausal symptom (Green Climacteric Scale, GCS) data were collected at baseline, with measures repeated at 12 weeks (end of intervention) and 24 weeks (to assess sustainability). Generalized estimating equation models explored associations between PA and GCS scores. Mixed-effects generalized equation models analyzed changes within and between groups in PA and GCS scores.
Results: Total GCS scores were 1.83 (95% CI: 0.11-3.55) and 2.72 (95% CI: 1.12-4.33) points lower in women with medium and high levels of PA, respectively, than in women with low levels of PA. Total average GCS scores were 1.02 (0.21-2.26) and 1.61 (0.34-2.87) points lower in those undertaking moderate or vigorous intensity PA, respectively. Time spent walking, and performing moderate and vigorous PA were not different between intervention and control. The average GCS decrease of 0.66 points (95% CI: 0.03-1.29; p time = 0.03) over 24 weeks was not different between groups.
Conclusion: This exploratory study established a stepwise association between moderate and vigorous PA and a lower total menopausal symptom score. The intervention did not appear to increase self-reported PA in women treated for early stage breast, reproductive, and blood cancers.
Tom G Bailey, Gregore I Mielke, Tina S Skinner, Debra Anderson, Janine Porter-Steele, Sarah Balaam, Leonie Young, Alexandra L McCarthy. Physical activity and menopausal symptoms in women who have received menopause-inducing cancer treatments: results from the Women's Wellness After Cancer Program. Menopause . 2020 Nov 23. doi: 10.1097/GME.0000000000001677. Online ahead of print.