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Yoga of Awareness Program for Menopausal Symptoms in Women at High Risk for Breast Cancer
Women at high risk for breast cancer currently have limited options for the treatment of troublesome menopausal symptoms such as hot flashes, fatigue, insomnia and mood disturbances. Furthermore, many breast cancer prevention strategies, such as tamoxifen, frequently induce or exacerbate menopausal symptoms. Yoga is an increasingly popular approach to stress management which holds promise for reducing these symptoms. Controlled trials have documented the benefits of Yoga on stress and symptoms associated with a variety of conditions such as lymphoma, hypertension, and multiple sclerosis. However, its effects on menopausal symptoms have yet to be investigated. The aim of this randomized controlled trial is to evaluate the efficacy of an innovative intervention, the Yoga of Awareness Program, by testing 2 hypotheses: 1) That women in the intervention will show significantly greater improvements in menopausal symptoms and psychological well being than women in a wait-list condition; and 2) That greater time spent in Yoga practice will predict reductions in menopausal symptoms. Data will be collected from 80 women who are at high risk for breast cancer and actively experiencing hot flashes. Women will be randomized to either immediate entry into the Yoga intervention condition, or a wait-list control. Yoga of Awareness is an 8-week group program specifically designed to address menopausal symptoms. We expect that the Yoga practices (gentle physical postures, metered breath, meditation, and group interchange) will improve menopausal symptoms and well being through inducing deep bodily relaxation, eliciting a sense of refreshed vitality, and cultivating acceptance of unpleasant momentary experiences rather than struggling ineffectually to eliminate them. Outcomes collected pre-, post- and 3 months after the intervention will include (a) daily reports of menopausal symptoms (e.g., hot flashes, fatigue), beneficial processes (e.g., relaxation, acceptance), and time spent in home Yoga practice; and (b) a battery consisting of clinician ratings of menopausal symptoms, and self-report questionnaires assessing menopause-specific quality of life, mood, and psychological growth. If this pilot study shows the Yoga protocol is effective, we will apply to NCI for a more comprehensive multi-institutional trial. Findings from this study could also lead to a greater integration of Yoga methods into the medical management of menopause for all women.
Women at high-risk for breast cancer have few treatment options for troublesome menopausal symptoms such as hot flashes, fatigue, and insomnia. Their predicament is made more difficult by the fact that many therapies for preventing breast cancer, such as tamoxifen, often aggravate menopausal symptoms. Yoga is an increasingly popular activity which some women find very helpful for menopausal symptoms. Though earlier studies have shown Yoga to be beneficial in reducing stress and symptoms for patients with a variety of medical conditions, so far there have been no studies of Yoga for menopausal symptoms. This study’s purpose is to test an innovative Yoga program, called Yoga of Awareness, to find out how effective it is for improving menopausal symptoms and well being among women at high risk for breast cancer. In this program, women meet in a group for 8 weeks to learn and practice a variety of Yoga methods, including gentle physical postures and breathing and meditation exercises. The program is designed to help with menopausal symptoms by producing a sense of deep bodily relaxation and refreshed vitality in women, and by helping them to accept their current experiences rather than constantly struggling to eliminate symptoms. To test the Yoga program, 80 women who are at high risk for breast cancer and actively experiencing hot flashes will be recruited and randomly divided into 2 groups. One group will receive the Yoga program right away, and the other group will wait 6 months before receiving the program. Both groups will continue to receive their usual medical care. During these 6 months, information about menopausal symptoms and well being will be collected from both groups of women at 3 points: before, immediately after, and 3 months after the first group receives the Yoga program. When results from the 2 groups are compared, we expect women who received the Yoga program will have greater reductions in hot flashes, fatigue, and other menopausal symptoms, and greater improvements in positive mood and other aspects of well being, then those waiting to receive the program. We also expect that women who practice Yoga more will have the best improvements in menopausal symptoms. If this study shows the Yoga program is effective, it will allow us to apply to the National Cancer Institute for a more complete study of its benefits. Our results could also lead to wider general use of Yoga for the medical management of menopause.