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Exercise training reduces the frequency of menopausal hot flushes by improving thermoregulatory control

Bailey, Tom G. PhD; Cable, N. Timothy PhD; Aziz, Nabil MD; Dobson, Rebecca MD; Sprung, Victoria S. PhD; Low, David A. PhD; Jones, Helen PhD

doi: 10.1097/GME.0000000000000625
Original Articles

Objective: Postmenopausal hot flushes occur due to a reduction in estrogen production causing thermoregulatory and vascular dysfunction. Exercise training enhances thermoregulatory control of sweating, skin and brain blood flow. We aimed to determine if improving thermoregulatory control and vascular function with exercise training alleviated hot flushes.

Methods: Twenty-one symptomatic women completed a 7-day hot flush questionnaire and underwent brachial artery flow-mediated dilation and a cardiorespiratory fitness test. Sweat rate and skin blood flow temperature thresholds and sensitivities, and middle cerebral artery velocity (MCAv) were measured during passive heating. Women performed 16 weeks of supervised exercise training or control, and measurements were repeated.

Results: There was a greater improvement in cardiorespiratory fitness (4.45 mL/kg/min [95% CI: 1.87, 8.16]; P = 0.04) and reduced hot flush frequency (48 hot flushes/wk [39, 56]; P < 0.001) after exercise compared with control. Exercise reduced basal core temperature (0.14°C [0.01, 0.27]; P = 0.03) and increased basal MCAv (2.8 cm/s [1.0, 5.2]; P = 0.04) compared with control. Sweat rate and skin blood flow thresholds occurred approximately 0.19°C and 0.17°C earlier, alongside improved sweating sensitivity with exercise. MCAv decreased during heating (P < 0.005), but was maintained 4.5 cm/s (3.6, 5.5; P < 0.005) higher during heating after exercise compared with control (0.6 cm/s [−0.4, 1.4]).

Conclusions: Exercise training that improves cardiorespiratory fitness reduces self-reported hot flushes. Improvements are likely mediated through greater thermoregulatory control in response to increases in core temperature and enhanced vascular function in the cutaneous and cerebral circulations.

1Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK

2School of Health and Sport Sciences, University of the Sunshine Coast, Australia

3Department of Sports Science, Aspire Academy, Qatar

4Department of Gynaecology and Reproductive Medicine, Liverpool Women's Hospital, UK

5Department of Obesity and Endocrinology, University of Liverpool, UK.

Address correspondence to: Helen Jones, PhD, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK. E-mail:

Received 3 September, 2015

Revised 6 January, 2016

Accepted 6 January, 2016

Funding/support: Liverpool Primary Care Trust and National Health Service (NHS) Liverpool Clinical Commissioning Group.

Financial disclosure/conflicts of interest: None reported.

© 2016 by The North American Menopause Society.