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Weight loss may be an appealing way to ease hot flashes

By Krystnell Storr

NEW YORK (Reuters Health) - Women will try, and stick to, a weight loss plan if it promises to ease their hot flashes, a small new study suggests.

“Most of the women, that is over 80 percent, said that the potential to reduce hot flashes increased their motivation to lose weight,” said Gary Elkins, a professor and director of the Mind-Body Medicine Research Laboratory at Baylor University in Waco, Texas.

“I think that speaks volumes about how distressing hot flashes can be for women,” added Elkins, who was not involved in the study.

Researchers still don’t understand the role fat tissue plays in the frequency of hot flashes associated with menopause. Since body fat plays a part in manufacturing estrogen, some experts have suggested that excess weight could protect against the hormone-related disturbances of the menopausal transition. Others have found evidence it might make them worse.

In the years leading up to menopause, a woman’s ovaries start shutting down their production of eggs and of the hormone estrogen. Estrogen has important functions throughout the body and brain, including, researchers believe, in regulating the control of body temperature.

Up to 70 percent of women experience hot flashes, which can include night sweats, after menopause, according to Rebecca Thurston, a psychiatry professor at the University of Pittsburgh School of Medicine in Pennsylvania, and her coauthors on the new study.

The only proven treatment for hot flashes is hormone replacement therapy, which can be costly and comes with health risks. Two antidepressants have been approved for treating menopausal symptoms, and some research has suggested that lifestyle changes such as diet, exercise, meditation or relaxation practices may help some women.

"Since women have few methods to manage their hot flashes, we have been developing approaches that women can use to reduce their hot flashes that do not require use of medications,” Thurston told Reuters Health.

Thurston and her team decided to see if a weight loss program would be an acceptable hot flash treatment and to get a sense of whether it would actually provide relief.

They recruited 40 women who were overweight or obese, reported having four or more hot flashes a day and wanted to lose weight.

The women were randomly split into two groups. Those in the weight loss group received instruction on how they could improve their weight by managing their calories and creating exercise goals.

The comparison group was put on a waiting list to receive the weight loss intervention six months later, at the end of the experiment.

Along with having the participants fill out a questionnaire about their hot flashes, the researchers took baseline weight measurements at the beginning and at the end of the study.

Women kept diaries to track their hot flashes, and at certain times during the study, each woman in the weight loss group wore a sensor that measured her skin temperature to provide a physical measurement of hot flash frequency.

By the end of six months, 83 percent of women in the weight loss group were still in the study, and 94 percent of them said they were satisfied with the program, according to the results in the journal Menopause.

Women in the weight loss group lost an average of 19 pounds and almost 5 percent of their body fat, the researchers found. And the women who lost weight also said they were experiencing fewer hot flashes at the end of the study period.

There was evidence that the women who lost the most weight had the greatest reduction in hot flashes, the researchers point out.

There was little change in weight or hot flashes in the comparison group.

“This is important for multiple reasons,” Dr. Vanessa Barnabei at the University of Buffalo School of Medicine and Biomedical Sciences, who was not involved in the study, told Reuters Health.

She said hot flashes impact a significant number of women and for some, it can affect their quality of life. Barnabei also pointed out that in the U.S. where a significant portion of the population is considered to be obese, weight loss strategies, such as this are important.

Elkins noted that even though the weight loss program appeared to be very beneficial, weight loss alone is unlikely to be a fully effective treatment for menopausal symptoms.

The study team did not track the women’s hormone levels and cannot determine whether weight loss itself accounts for the improvements some of the women experienced.

The researchers did adjust their calculations for the possibility that some women’s hot flashes will decrease over time. “Given that hot flashes are dynamic and can change just due to natural history this is important,” Thurston said.

"With respect to the actual role that weight loss may have played versus some other aspects of the intervention, such as psychological factors, the fact that the amount of weight loss was correlated with changes in hot flashes supports the idea that it was indeed the weight loss that was important for changes in hot flashes," she said.

"Mood did not improve with the intervention, which would argue against psychological factors accounting for the effects," Thurston said.

The findings are not definitive, but they are suggestive, she noted. "I would say that our data points to a potentially promising intervention women can use themselves, but it requires further study."

“Hot flashes are a serious problem for many women. They are more than a simple annoyance and can be very severe, lasting for years. Safe and effective ways of reducing hot flashes and improving women’s health are needed,” Elkins said.

SOURCE: http://bit.ly/1xZUWeX Menopause, online June 23, 2014.

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