Elsevier

Maturitas

Volume 68, Issue 2, February 2011, Pages 174-178
Maturitas

What women want? Exercise preferences of menopausal women

https://doi.org/10.1016/j.maturitas.2010.11.011Get rights and content

Abstract

Background

Many menopausal women are keen to find alternatives to HRT; exercise might be useful in this regard but more trial evidence is required. Before we conduct such trials however, it is important to understand the exercise preference of these women so that appropriate exercise interventions can be developed for inclusion in such trials.

Aim

To investigate the exercise preferences of menopausal women and to examine the association between exercise levels, BMI, and hot flushes/night sweats in this population.

Method

Participants were women aged 46–55 years from eight diverse general practices in Birmingham. A postal questionnaire containing items about demographics, lifestyle behaviours, weight, height, menopausal status, frequency of hot flushes/night sweats and preferences for exercise was sent to all eligible women.

Results

1693/2776 (61.0%) of women replied. The majority (75.9%) of respondents stated that exercise was an acceptable intervention. The most commonly chosen option for delivery of exercise interventions was by one-to-one consultations with a fitness advisor, followed by DVD sent by post. Telephone based interventions and e-Health interventions (i.e. Internet and mobile phone text messages) were the interventions least chosen. There was also an overwhelming choice for walking as a mode of exercise. A series of two factor analyses of covariance indicated exercise participation and BMI were not significantly related to frequency of hot flushes/night sweats in symptomatic menopausal women.

Conclusion

Menopausal women have strong preferences to receive exercise interventions that involve one-to-one contact with a fitness advisor or by exercise DVD. The use of more recent technology to deliver exercise interventions was highly unpopular. These findings should be considered in future studies when planning exercise interventions with this population.

Introduction

Many menopausal aged women experience vasomotor symptoms. In the past, hormone replacement therapy (HRT) was frequently used to mange these symptoms, but many women are now reluctant to use it and doctors are more cautious about prescribing HRT due to reports linking its use to adverse health outcomes [1], [2]. This has led to an increased need to evaluate alternative or non-pharmacological interventions. One intervention that has gained some attention is exercise, although evidence supporting its effectiveness has been equivocal. Both the Royal College of Obstetricians and Gynaecologists in the United Kingdom [3] and the North American Menopause Society [4] have advised that exercise is considered for symptom management, despite the fact there is little evidence from randomised controlled trials (RCTs) to directly support this advice. The Cochrane Library systematic review of exercise in the management of vasomotor symptoms [5] was unable to make any recommendations due to a lack of trials and concluded there was a need for a high quality definitive RCT before any conclusions could be made.

At present however, it is not appropriate to design and undertake a robust RCT. There is limited evidence about whether exercise would be an acceptable treatment to symptomatic menopausal women; and if so, what potential sources of assistance or support to become active would be preferred, and what type(s) of exercise would be appealing and/or efficacious. There is limited information [6] on whether these women would be prepared to consider exercise as treatment, and whether doctors are currently recommending exercise as treatment. The feasibility and acceptability of exercise as a treatment for women with (HF/NS) may not be similar to other groups of women because exercise typically causes acute responses, such as heat and perspiration, the very symptoms these women are trying to avoid. Moreover, it is also possible that exercise may exacerbate HF/NS, rather than prevent or reduce them. This might be true particularly for overweight/obese women who may be at increased risk for HF/NS [7].

Finding ways of successfully increasing exercise participation levels is a complex issue. The Medical Research Council (MRC) in the UK [8] has highlighted the importance of ‘accumulating wisdom from empirical evidence’ in their framework for development and evaluation of RCTs for complex interventions to improve health care. The MRC have also commented that it is essential to clarify, as far as possible, the important components of an intervention before embarking on a definitive RCT. In the context of exercise interventions, issues such as the frequency, timing and methods of organising and delivering components are likely to be critical in determining the subsequent effectiveness of an intervention. In addition, efforts to promote exercise are likely to be most effective if they address the needs and interests of the target group since it is unlikely that ‘one size will fit all’. A more comprehensive understanding of preferred activities and sources of assistance should improve efforts to foster increased exercise and minimise attrition in subsequent intervention studies in menopausal women.

The primary purpose of this study was to provide a comprehensive assessment of the exercise programme preferences of menopausal women, focussing on those experiencing vasomotor symptoms. In addition, it was important to investigate whether menopausal women were prepared to consider exercise as a treatment for HF/NS if advised to do so by their doctor or another health professional. Lastly, we aimed to examine the potential variability between current exercise levels, BMI and HF/NS.

Section snippets

Patients and procedures

There are 71 practices within the sampling primary care trust (PCT). Half (n = 35) of practices in the PCT were approached; 9 (26%) agreed to participate and 1 later withdrew their interest due to other practice commitments. Thus, participants were recruited from eight general practices in urban and suburban location in the West Midlands, UK that varied in geographical location, proportion of listed patients from ethnic minority groups, Index of Multiple Deprivation (IMD) [9] score and practice

Distribution of the study questionnaire

The distribution of IMD rank scores showed that of women invited to participate in the study, 32.6% (n = 904) lived in quartile one (most deprived communities), 16.0% (n = 443) in quartile two, 24.0% (n = 665) in quartile three and 27.5% (n = 764) in quartile four (least deprived) score areas.

Characteristics of the study population

The response rate was 61.0% (n = 1693/2776). The mean age of respondents was 50.3 years (SD = 2.8), of whom 35.0% were premenopausal, 14.2% perimenopausal, 39.0% were postmenopausal, with the remainder of unknown

Discussion

Our data show that most menopausal women would choose physical activity interventions to be delivered by fitness advisors in the form of one-to-one consultations, which is broadly consistent with studies involving other populations, such as cancer patients [11], [12]. Indeed, many successful exercise trials [13], [14] have used a one-to-one exercise consultation approach. Exercise promoting DVD was also a popular choice amongst participants.

It was interesting to note that all of the telephone

Contributions

AD conceived the study design, performed data collection, drafted the manuscript and performed the statistical analyses. All authors commented on the design of the study questionnaire. All authors read and approved the final manuscript.

Competing interests

The authors declare they have no competing interests.

Funding

Amanda Daley is supported by a National Institute for Health Research Senior Research Fellowship (Career Scientist Award). The views expressed in this publication are those of the authors and not necessarily those of the NHS, The National Institute for Health Research or the Department of Health.

Provenance and peer review

Peer review was directed independently of Margaret Rees (one of the authors and Editor in Chief of Maturitas) by Prof Martina Doeren.

Ethical approval

This study was approved by the South Birmingham Local Research Ethics Committee.

Acknowledgement

We would also like to thank the practices that agreed to assist with the study and those patients who returned their questionnaires.

References (28)

  • E.B. Gold et al.

    Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40–55 years of age

    Am J Epidemiol

    (2000)
  • N.C. Campbell et al.

    Designing and evaluating complex interventions to improve health care

    BMJ

    (2007)
  • Office of the Depuety Prime Minister. The English Indices of Deprivation 2004: Summary (revised); 2006. Available at:...
  • M.S. Hunter et al.

    A psychological analysis of menopausal hot flushes

    Br J Clin Psychol

    (1995)
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