Exercise, Counseling Can Help Ease Menopausal Symptoms Caused by Breast Cancer Treatment

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A Dutch study has found that exercise and a type of counseling called cognitive behavioral therapy can help ease menopausal symptoms that often come during and after breast cancer treatment.

The research was published online on Oct. 8, 2012 by the Journal of Clinical Oncology. Read the abstract of “Efficacy of Cognitive Behavioral Therapy and Physical Exercise in Alleviating Treatment-Induced Menopausal Symptoms in Patients With Breast Cancer: Results of a Randomized, Controlled, Multicenter Trial.”

Breast cancer treatments such as chemotherapy, hormonal therapy, ovarian shutdown with medicine, and surgically removing the ovaries all can cause menopausal symptoms, including:

  • hot flashes
  • night sweats
  • vaginal dryness
  • trouble sleeping

These symptoms can be just annoying or quite severe.

Hormone replacement therapy (HRT) can help ease hot flashes and other menopausal symptoms, but women who’ve been diagnosed with breast cancer shouldn’t take HRT because it could promote the growth of hormone-receptor-positive breast cancer cells. Other medicines, such as antidepressants and sleep aids, can offer some relief for some women.

Researchers have studied the potential of many complementary and holistic treatments – acupuncture and yoga, for example – to help ease hot flashes and other menopausal symptoms. Still, many of the studies are small and the results have been mixed: some have shown that certain complementary and holistic treatments may help ease menopausal symptoms in some people. Earlier research has suggested that cognitive behavioral therapy can help women diagnosed with breast cancer better manage hot flashes. And other research suggests that exercise can rev up your sex life and improve your sleep.

In this study, the researchers wanted to see if combining cognitive behavioral therapy with exercise could help ease menopausal symptoms, as well as improve body image, emotional well-being, quality of life, and the sex lives of women who’d been treated for breast cancer.

All the women in the study were younger than 50, had received chemotherapy and/or hormonal therapy after breast cancer surgery, and had reported having troublesome menopausal symptoms. They were randomly split into four menopausal symptom treatment groups:

  • cognitive behavioral therapy (109 women)
  • exercise (104 women)
  • cognitive behavioral therapy and exercise (106 women)
  • a control group of women who were told they were on the waiting list for one of the other treatments (103 women)

The cognitive behavioral therapy treatment involved seven weekly group sessions that lasted for 90 minutes. During the sessions, the women learned relaxation techniques, as well as hot flash triggers and how to get better sleep.

The exercise program was a 12-week, home-based, self-directed program individually designed for each woman that involved 2.5 to 3 hours of exercise per week. A therapist helped each woman decide on a type of exercise (swimming, running, or biking, for example). The women were given heart rate monitors and shown how to use them so they could reach and maintain an appropriate target heart rate while exercising.

The women in the combined cognitive behavioral therapy/exercise program did both programs at the same time.

All the women completed questionnaires before the menopausal symptom treatment programs started, 12 weeks after the programs started, and 6 months after the programs started. The questionnaires asked about the women’s quality of life, physical well-being, emotional well-being, hot flashes, night sweats, sexual functioning and activity, body image, and other menopausal symptoms.

At both 12 weeks and 6 months after the programs, the women in the cognitive therapy, exercise, and combined cognitive therapy and exercise groups had:

  • less severe menopausal symptoms
  • better physical well-being

compared to the women in the control group.

The women who got cognitive behavioral therapy also reported:

  • less severe hot flashes and night sweats
  • more sexual activity

at both 12 weeks and 6 months after the program.

The frequency of the hot flashes and night sweats stayed about the same for these women. This means that the cognitive behavioral therapy sessions helped the women better manage the hot flashes and night sweats instead of making them less likely.

The results suggest that exercise and cognitive behavioral therapy can help ease menopausal symptoms and lead to better physical well-being. Cognitive behavioral therapy also seems to help women better manage hot flashes and night sweats so they’re less of a burden.

It’s interesting to know that the researchers reported many of the women didn’t complete the full cognitive behavioral therapy, exercise, or combined program (researchers call this “undercompliance”):

  • 58% of the women didn’t complete the full cognitive behavioral therapy program
  • 64% of the women didn’t complete the full exercise program
  • 70% of the women didn’t complete the full combined cognitive behavioral therapy/exercise program

While the results of the study are positive, they might be even more so if more women had completed the programs.

If you’re having troublesome menopausal symptoms because of breast cancer treatment and are considering various treatments, you may want to talk to your doctor about this study. Cognitive behavioral therapy and exercise are two techniques that have been shown to help women deal with hot flashes and other menopausal symptoms. Other techniques include yoga, massage, and meditation.

You can learn more about menopause and steps you can take to ease bothersome symptoms in the Breastcancer.org Managing Menopausal Symptoms pages.

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