Applied relaxation as treatment of vasomotor symptoms in postmenopausal women

Abstract: Vasomotor symptoms often disturb the night sleep and may lead to tiredness and mood disturbances. Many women who suffer from vasomotor symptoms ask for medical help and are often prescribed hormonal treatment. During the last years the popularity of HRT among women and doctors has decreased, probably because of the findings of long-term risks of HRT on breast cancer and the fact that the positive effects on cardiovascular health has not been confirmed in prospective randomized studies. The most effective treatment for hot flushes is HR T but for various reasons there is a need for developing alternative treatments. Relaxation therapy and behavioral therapies have been suggested for vasomotor symptoms but there are few randomized, controlled studies in this field, especially in women with breast cancer.The general aim of this thesis was to evaluate a technique in behavior therapy, applied relaxation, as a possible treatment of vasomotor symptoms in healthy women and women treated for breast cancer.The specific aims were:• to assess if stress coping differed between postmenopausal women, who wanted therapy for vasomotor symptoms and postmenopausal women without symptoms and to assess if stress coping changed when women with vasomotor symptoms received estrogen therapy. 18 women were recruited to the target group and 17 women to the comparison group• to evaluate if training applied relaxation for 12 weeks would decrease the number ofvasomotor symptoms and to evaluate if applied relaxation for 12 weeks would affect wellbeing in postmenopausal women seeking medical advice for vasomotor symptoms. 30 postmenopausal women were recruited and randomized to applied relaxation or estrogen therapy. In this study we also aimed to compare applied relaxation and estradiol as treatment of vasomotor symptoms in healthy postmenopausal women and also to compare the effects of applied relaxation and estradiol on wellbeing in healthy postmenopausal women• to evaluate if applied relaxation or electro-acupuncture for 12 weeks would decrease the number of vasomotor symptoms in postmenopausal women treated for breast cancer and to evaluate if applied relaxation or electro-acupuncture for 12 weeks would affect wellbeing in postmenopausal women treated for breast cancer. 38 women with breast cancer and with moderate to sever vasomotor symptoms were recruited.The main results were: Postmenopausal women bothered by vasomotor symptoms had significant lower stress coping ability measured with SCI, than women without symptoms.Eleven out of 12 healthy postmenopausal women randomised to treatment with applied relaxation had a mean decrease of flushes about 77% six months after end of therapy. The reduction was significant and persisted six months after end of therapy. General psychological wellbeing and mood were significantly ameliorated in healthy postmenopausal women treated with applied relaxation.Ten out of 14 breast cancer treated women randomised to treatment with applied relaxation had a mean decrease of flushes with 78 %. General psychological wellbeing was significantly ameliorated and this phenomenon appeared after the flushes were significantly reduced. Both the significant reduction of flushes and significantly ameliorated wellbeing persisted 6 months after end of therapy.In summary: This thesis shows that that behavioral therapy with applied relaxation significantly decreases flushes and ameliorates general psychological wellbeing in postmenopausal women bothered by climacteric symptoms. Therefore we suggest that applied relaxation is a viable alternative treatment of vasomotor symptoms in healthy postmenopausal women and in women treated for breast cancer.