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Efficacy of yoga for vasomotor symptoms: a randomized controlled trial

Newton, Katherine M. PhD1; Reed, Susan D. MD, MPH2; Guthrie, Katherine A. PhD3; Sherman, Karen J. PhD1; Booth-LaForce, Cathryn PhD4; Caan, Bette DrPH5; Sternfeld, Barbara PhD5; Carpenter, Janet S. PhD, RN, FAAN6; Learman, Lee A. MD, PhD7; Freeman, Ellen W. PhD8; Cohen, Lee S. MD9; Joffe, Hadine MD9; Anderson, Garnet L. PhD3; Larson, Joseph C. MS3; Hunt, Julie R. PhD3; Ensrud, Kristine E. MD, MPH10,11; LaCroix, Andrea Z. PhD3

doi: 10.1097/GME.0b013e31829e4baa
Original Articles
Editorial

Objective: This study aims to determine the efficacy of yoga in alleviating vasomotor symptoms (VMS) frequency and bother.

Methods: This study was a three-by-two factorial, randomized controlled trial. Eligible women were randomized to yoga (n = 107), exercise (n = 106), or usual activity (n = 142), and were simultaneously randomized to a double-blind comparison of ω-3 fatty acid (n = 177) or placebo (n = 178) capsules. Yoga intervention consisted of 12 weekly 90-minute yoga classes with daily home practice. Primary outcomes were VMS frequency and bother assessed by daily diaries at baseline, 6 weeks, and 12 weeks. Secondary outcomes included insomnia symptoms (Insomnia Severity Index) at baseline and 12 weeks.

Results: Among 249 randomized women, 237 (95%) completed 12-week assessments. The mean baseline VMS frequency was 7.4 per day (95% CI, 6.6 to 8.1) in the yoga group and 8.0 per day (95% CI, 7.3 to 8.7) in the usual activity group. Intent-to-treat analyses included all participants with response data (n = 237). There was no difference between intervention groups in the change in VMS frequency from baseline to 6 and 12 weeks (mean difference [yoga − usual activity] from baseline at 6 wk, −0.3 [95% CI, −1.1 to 0.5]; mean difference [yoga − usual activity] from baseline at 12 wk, −0.3 [95% CI, −1.2 to 0.6]; P = 0.119 across both time points). Results were similar for VMS bother. At week 12, yoga was associated with an improvement in insomnia symptoms (mean difference [yoga − usual activity] in the change in Insomnia Severity Index, 1.3 [95% CI, −2.5 to −0.1]; P = 0.007).

Conclusions: Among healthy women, 12 weeks of yoga class plus home practice, compared with usual activity, do not improve VMS frequency or bother but reduce insomnia symptoms.

From the 1Group Health Research Institute, Seattle, WA; 2Departments of Obstetrics/Gynecology and Epidemiology, University of Washington School of Medicine, Seattle, WA; 3Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA; 4School of Nursing, University of Washington, Seattle, WA; 5Division of Research, Kaiser Permanente Medical Program of Northern California, Oakland, CA; 6School of Nursing, Indiana University, Indianapolis, IN; 7Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN; 8Department of Obstetrics/Gynecology, University of Pennsylvania, Philadelphia, PA; 9Massachusetts General Hospital, Boston, MA; 10Department of Medicine, VA Medical Center, Minneapolis, MN; and 11Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.

Received April 8, 2013; revised and accepted May 29, 2013.

Parts of this manuscript were presented at the annual meeting of The North American Menopause Society on October 7, 2012, in Orlando, FL.

Funding/support: This study was funded by the National Institutes of Health as a cooperative agreement issued by the National Institute on Aging, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Center for Complementary and Alternative Medicine, Office of Research on Women’s Health, and grants U01AG032656, U01AG032659, U01AG032669, U01AG032682, U01AG032699, and U01AG032700 from the National Institute on Aging. At Indiana University, the project was partly funded by the Indiana Clinical and Translational Sciences Institute, grant UL1RR02571 from the National Institutes of Health, National Center for Research Resources, and Clinical and Translational Sciences Award.

Clinical trial registration: NCT01178892 (ClinicalTrials.gov).

Financial disclosure/conflicts of interest: K.M.N. has received research support from Integrated Diagnostics Inc L.A.L. is a consultant to a Data Monitoring Committee for Ariosa Diagnostics. E.W.F. has received research support from Forest Laboratories Inc and Bionovo Inc L.S.C. has served as a consultant to Noven Pharmaceuticals and has received research support from Astra-Zeneca Pharmaceuticals, Bristol-Myers Squibb, Cephalon Inc, GlaxoSmithKline, Ortho-McNeil Janssen, Pfizer Inc, and Sunovion Pharmaceuticals Inc H.J. has received grant support from Cephalon/Teva, is on the advisory board for Noven, and has done consulting for Sunovion. K.E.E. is a consultant to a Data Monitoring Committee for Merck, Sharp, and Dohme. All other authors have no direct conflicts of interest or financial disclosures relevant to this manuscript.

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Address correspondence to: Katherine M. Newton, PhD, Group Health Research Institute, Suite 1600, 1730 Minor Avenue, Seattle, WA 98101. E-mail: newton.k@ghc.org

© 2014 by The North American Menopause Society.