Methods: Participants, aged from 45 to 64, reporting cessation of menstrual cycles with natural causes for more than 12 consecutive months and scored with any menopausal symptoms on the Greene Climacteric Scale (GCS) were eligible for participation. Participants were randomly assigned to either an intervention group or a waiting-list control group. The intervention group underwent a home-based slow breathing assisted with biofeedback device 20 minutes twice daily for 4 weeks, and participants in the control condition will participate the same breathing training after a four-week waiting period. The primary outcome measures are menopausal symptoms using the Greene Climacteric Scale (GCS). The secondary outcome measures are autonomic functions expressed by blood pressure, heart rate and time-domain heart rate variability. Data were collected before breathing training (baseline), week 4, and week 8. All analysis were by Intention to treat.
Results: A total of 324 community women were screened, and 54 postmenopausal women with mean age of 56.09±4.31 year-old participated. Postmenopausal psychological symptoms were positively associated with somatic and vasomotor symptoms (r=.45 and r=.69, respectively, all p<.001) but not associated with autonomic functions (all p>.05). Results of the regressions indicated that hot flashes was associated with increased anxious and depressed symptoms (β=.366, p=.007 and β=.449, p=.001, respectively) whereas somatic symptoms also result in more anxious and depressed symptoms (β=.617 and β=.711, respectively, all p<.001). Adjusting for baseline pNN50, hot flashes and somatic symptoms, the intervention group (n=24) showed significant decreased menopausal symptoms, including the total scores, anxious, depressed and psychological symptoms, after the four-week breathing training (p<.001, p=.009, p=.001 and p=.002, respectively) and keep descending after a four-week follow-up but without statistical significance (all p>.05). The waiting-list controls (n=30) also showed significant decreased menopausal symptoms in total scores, anxious, depressed and psychological symptoms after the same four-week breathing training (p<.001, p=.002, p<.001 and p<.001, respectively). Pooled participants (n=52) with the four-week breathing training also showed decreased menopausal symptoms, in all factor domains (all p<.01). No significant results were found on any autonomic functions, neither in the intervention group nor the waiting-list controls (all p>.05).
Conclusion: We confirm that a four-week home-based breathing training assisted with biofeedback has a beneficial impact on menopausal symptoms, especially the anxious and depressed symptoms, among community menopausal women. Our home-based breathing training is recommended to popularize for community menopausal women to practice at home.