human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective This study aims to determine the efficacy of yoga in alleviating vasomotor symptoms ( VMS ) frequency and bother . Methods This study was a three-by-two factorial , r and omized controlled trial . Eligible women were r and omized to yoga ( n = 107 ) , exercise ( n = 106 ) , or usual activity ( n = 142 ) , and were simultaneously r and omized to a double-blind comparison of & ohgr;-3 fatty acid ( n = 177 ) or placebo ( n = 178 ) capsules .  Yoga intervention consisted of 12 weekly 90-minute yoga classes with daily home practice . Primary outcomes were VMS frequency and bother assessed by daily diaries at baseline , 6 weeks , and 12 weeks . Secondary outcomes included insomnia symptoms ( Insomnia Severity Index ) at baseline and 12 weeks . Results Among 249 r and omized women , 237 ( 95 % ) completed 12-week assessment s. The mean baseline VMS frequency was 7.4 per day ( 95 % CI , 6.6 to 8.1 ) in the yoga group and 8.0 per day ( 95 % CI , 7.3 to 8.7 ) in the usual activity group . Intent-to-treat analyses included all participants with response data ( n = 237 ) . There was no difference between intervention groups in the change in VMS frequency from baseline to 6 and 12 weeks ( mean difference [ yoga − usual activity ] from baseline at 6 wk , −0.3 [ 95 % CI , −1.1 to 0.5 ] ; mean difference [ yoga − usual activity ] from baseline at 12 wk , −0.3 [ 95 % CI , −1.2 to 0.6 ] ; P = 0.119 across both time points ) . Results were similar for VMS bother . At week 12 , yoga was associated with an improvement in insomnia symptoms ( mean difference [ yoga − usual activity ] in the change in Insomnia Severity Index , 1.3 [ 95 % CI , −2.5 to −0.1 ] ; P = 0.007 ) . Conclusions Among healthy women , 12 weeks of yoga class plus home practice , compared with usual activity , do not improve VMS frequency or bother but reduce insomnia symptoms Objective The aim of this study was to assess whether aerobic training affects menopausal symptoms in recently postmenopausal sedentary women . Methods Symptomatic women aged 45 to 63 years ( N = 176 ; 3 - 36 months since last menstruation ) were r and omly assigned to an aerobic training or a control group . The intervention included unsupervised aerobic training for 50 minutes four times weekly for 24 weeks , whereas the control group attended health lectures twice a month . Symptoms were reported twice a day using a mobile phone . The perceived disturbance of menopausal symptoms ( night sweats , mood swings , irritability , depressive mood , headache , vaginal dryness , and urinary symptoms ) was evaluated on a scale from 1 ( low ) to 5 ( high ) . Multilevel mixed-effect ordinal regression models were based on 17,000 responses during 24 weeks . Results One hundred fifty-four women continued until the end of the study ( 88 % compliance rate ) . Baseline prevalence was as follows : night sweats , 50 % to 60 % ; irritability and depression , 20 % to 25 % ; mood swings , 25 % to 30 % ; headache and urinary problems , 15 % to 20 % ; and vaginal dryness , 10 % to 15 % . The prevalence of all symptoms except vaginal dryness decreased among intervention groups . According to multilevel mixed-effect ordinal regression analysis , night sweats and mood swings ( P < 0.001 ) and disturbance of the mood swings ( P < 0.001 ) and irritability ( P < 0.001 ) were reduced more among the women in the intervention group than in the control group . Conclusions In sedentary women , aerobic training for 6 months may decrease the typical menopausal symptoms , especially night sweats , mood swings , and irritability Objective The practice of yoga has been proven to have positive effects on reducing  insomnia . Studies have also shown its effects on reducing climacteric symptoms . To date , however , no studies that evaluate the effects of yoga on postmenopausal women with a diagnosis of insomnia in a r and omized clinical trial have been conducted . The aim of this study was to evaluate the effect of yoga practice on the physical and mental health and climacteric symptoms of postmenopausal women with a diagnosis of insomnia . Methods Postmenopausal women not undergoing hormone therapy , who were 50 to 65 years old , who had an apnea-hypopnea index less than 15 , and who had a diagnosis of insomnia were r and omly assigned to one of three groups , as follows : control , passive stretching , and yoga . Question naires were administered before and 4 months after the intervention to evaluate quality of life , anxiety and depression symptoms , climacteric symptoms , insomnia severity , daytime sleepiness , and stress . The volunteers also underwent polysomnography .  The study lasted 4 months . Results There were 44 volunteers at the end of the study . When compared with the control group , the yoga group had significantly lower posttreatment scores for climacteric symptoms and insomnia severity and higher scores for quality of life and resistance phase of stress . The reduction in insomnia severity in the yoga group was significantly higher than that in the control and passive-stretching groups . Conclusions This study showed that a specific sequence of yoga might be effective in reducing insomnia and menopausal symptoms as well as improving quality of life in postmenopausal women with insomnia In the present study , 40- to 60-year-old women with climacteric symptoms were placed on a 12-week structured education and exercise program to ascertain the effects of this program on climacteric symptoms , quality of life ( QOL ) , and attitude towards exercise .  A total of 35 women served as subjects . Twenty women were enrolled in an educational and exercise program that involved learning about menopause and participating in physical activity at least three times a week ( Group E ) . For comparison , the other 15 women did not participate in this program and were instructed to refrain from exercising during study period ( Group C ) . The effects of the 12-week interventional program on climacteric symptoms , QOL , and attitude towards exercise were thereby investigated . The program demonstrated significant effects on climacteric symptoms in terms of Kupperman index and psychosomatic symptoms , especially paresthesia and nervousness . In other words , climacteric symptoms improved significantly in Group E. Furthermore , scores for QOL and attitude towards exercise improved in Group E after the 12-week program ; however , these trends did not reach statistical significance . Hence , the 12-week structured education and exercise program was shown to be effective in alleviating climacteric symptoms BACKGROUND The relationship between menopausal symptoms and bone mineral density ( BMD ) was examined in 290 premenopausal women , ages 44 - 50 years , participating in a r and omized clinical trial of a dietary and exercise intervention : The Women 's Healthy Lifestyle Project . METHODS Information on hot flashes ( presence , absence ) , menstrual cycles ( irregular , regular ) and menstrual flow per period ( variable , same ) over the past 6 months was collected at entry . Participants reporting at least one menopausal symptom were classified as symptomatic and compared to those having no symptoms . Bone mineral density ( BMD ) at the lumbar spine ( L1-L4 ) , total hip and whole-body were made at baseline and at 30 months using a dual-energy X-ray absorptiometer ( Hologic QDR 2000 densitometer ) . RESULTS Baseline BMD at the spine , hip and whole-body were significantly reduced in women reporting menopausal symptoms compared to asymptomatic women , after adjustment for age , weight and intervention status ( all p < 0.05 ) . Women with irregular menstrual cycles had greater annualized rates of bone loss at the spine and hip than asymptomatic women ( spine , -0.77 (1.6)% per year vs. -0.19 (1.0)% per year , p = 0.0043 ; hip , -0.37 (1.1)% per year vs. -0.04 (1.0)% per year , p = 0.061 ) , after adjustments for age , percent change in weight , intervention status , and baseline BMD . Similar findings were not found for whole-body BMD . CONCLUSIONS These results suggest that menopausal symptoms are useful for the effective identification of premenopausal women at higher risk of low BMD and perhaps , of osteoporosis In the 1990s , two r and omised clinical trials started in Sc and inavia addressing whether hormone replacement therapy ( HRT ) is safe for women with previous breast cancer . We report the findings of the safety analysis in HABITS ( hormonal replacement therapy after breast cancer -- is it safe ? ) , an open r and omised clinical trial with allocation to either HRT or best treatment without hormones . The main endpoint was any new breast cancer event . All analyses were done according to intention-to-treat . Until September , 2003 , 434 women were r and omised ; 345 had at least one follow-up report . After a median follow-up of 2.1 years , 26 women in the HRT group and seven in the non-HRT group had a new breast-cancer event . All women with an event in the HRT group and two of those in the non-HRT group were exposed to HRT and most women had their event when on treatment . We decided that these findings indicated an unacceptable risk for women exposed to HRT in the HABITS trial , and the trial was terminated on Dec 17 , 2003 Background : Many women experience detriments in mental health during the menopausal transition . Physical activity may attenuate these adverse outcomes but few studies investigating such effects exist . Purpose : This study examined the effects of a 4-month r and omized controlled exercise trial on mental health outcomes in 164 previously low-active middle-aged women ( M age=49.9 ; SD=3.6 ) . Methods and Results : Participants completed body composition and fitness assessment and a battery of psychological measures at the beginning and end of a 4-month r and omized controlled exercise trial with three arms : walking , yoga , control . The results indicated that walking and yoga were effective in enhancing positive affect and menopause-related QOL and reducing negative affect . Women who experienced decreases in menopausal symptoms across the trial also experienced improvements in all positive mental health and QOL outcomes and reductions in negative mental health outcomes . Whether menopausal symptoms increased or decreased across the trial appeared to be determined in part by whether there were increases or decreases in cardiorespiratory fitness . Conclusions : Physical activity appears to enhance mood and menopause-related QOL during menopause , however , other aspects of mental health may be affected only as a result of reduction in menopausal symptoms . Increasing cardiorespiratory fitness could be one way to reduce menopausal symptoms INTRODUCTION Women in the menopausal stage of life usually have climacteric symptoms of  hot flashes ,  back pain , sleeplessness , night sweats and increased risk of cardiovascular disorders . Although physical exercises have been documented to favourably alleviate some of these problems , there 's a paucity of knowledge of their effects on menopausal women in Nigeria . OBJECTIVES This study investigated the effect of a twelve-week Endurance Exercise Programme ( EEP ) on quality of life(QOL ) and menopausal symptoms in these women . METHODS Participants were purposively recruited and assigned into perimenopausal and postmenopausal groups based on history of thier last menstrual period and from each of these groups r and omized into : perimenopausal exercise group ( PEMEG ) , postmenopausal exercise group ( POMEG ) , perimenopausal control group ( PEMCG ) postmenopausal control group ( POMCG ) .  Quality of life ( QOL ) , Menopausal symptoms - Back Pain ( BP ) and hot flashes ( HF ) among other variables , were evaluated at baseline and 4 weekly intervals . EEP consisted of a 10-station circuit of muscular and cardiovascular endurance , flexibility , coordination , abdominal and pelvic floor muscle exercises . RESULTS One hundred and seventy five menopausal women , mean age 52.3 + /- 4.1 years . Significant changes occurred between baseline and end of 12th week mean values of PEMEG for QOL : 565.9 + /- 108.8 vs 725.0 + /- 42.9 and BP 4.42 + /- 1.7 vs 1.00 + /- 0.0 . ( p= 0.000 ) . Also , in POMEG : QOL 558.3 + /- 127.7 vs 736.5 + /- 44.8 ; and BP 5.37 + /- 1.48 vs 1.88 + /- 1.18 ( p=0.000 ) . Significant changes in QOL and BP did not occur in the control groups . CONCLUSION Routine participation in endurance exercise programme is recommended for menopausal women for improved QOL Abstract Background and objective . To estimate whether aerobic training has an effect on frequency of hot flushes or quality of life . Design . A r and omized controlled trial . Participants and setting . Symptomatic , sedentary women ( n = 176 ) ,  
    Output:
    
agent
Evidence was insufficient to show whether exercise is an effective treatment for vasomotor menopausal symptoms .
One small study suggested that HT is more effective than exercise .
Evidence was insufficient to show the relative effectiveness of exercise when compared with HT or yoga
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective This study aims to determine the efficacy of yoga in alleviating vasomotor symptoms ( VMS ) frequency and bother . Methods This study was a three-by-two factorial , r and omized controlled trial . Eligible women were r and omized to yoga ( n = 107 ) , exercise ( n = 106 ) , or usual activity ( n = 142 ) , and were simultaneously r and omized to a double-blind comparison of & ohgr;-3 fatty acid ( n = 177 ) or placebo ( n = 178 ) capsules .  Yoga intervention consisted of 12 weekly 90-minute yoga classes with daily home practice . Primary outcomes were VMS frequency and bother assessed by daily diaries at baseline , 6 weeks , and 12 weeks . Secondary outcomes included insomnia symptoms ( Insomnia Severity Index ) at baseline and 12 weeks . Results Among 249 r and omized women , 237 ( 95 % ) completed 12-week assessment s. The mean baseline VMS frequency was 7.4 per day ( 95 % CI , 6.6 to 8.1 ) in the yoga group and 8.0 per day ( 95 % CI , 7.3 to 8.7 ) in the usual activity group . Intent-to-treat analyses included all participants with response data ( n = 237 ) . There was no difference between intervention groups in the change in VMS frequency from baseline to 6 and 12 weeks ( mean difference [ yoga − usual activity ] from baseline at 6 wk , −0.3 [ 95 % CI , −1.1 to 0.5 ] ; mean difference [ yoga − usual activity ] from baseline at 12 wk , −0.3 [ 95 % CI , −1.2 to 0.6 ] ; P = 0.119 across both time points ) . Results were similar for VMS bother . At week 12 , yoga was associated with an improvement in insomnia symptoms ( mean difference [ yoga − usual activity ] in the change in Insomnia Severity Index , 1.3 [ 95 % CI , −2.5 to −0.1 ] ; P = 0.007 ) . Conclusions Among healthy women , 12 weeks of yoga class plus home practice , compared with usual activity , do not improve VMS frequency or bother but reduce insomnia symptoms Objective The aim of this study was to assess whether aerobic training affects menopausal symptoms in recently postmenopausal sedentary women . Methods Symptomatic women aged 45 to 63 years ( N = 176 ; 3 - 36 months since last menstruation ) were r and omly assigned to an aerobic training or a control group . The intervention included unsupervised aerobic training for 50 minutes four times weekly for 24 weeks , whereas the control group attended health lectures twice a month . Symptoms were reported twice a day using a mobile phone . The perceived disturbance of menopausal symptoms ( night sweats , mood swings , irritability , depressive mood , headache , vaginal dryness , and urinary symptoms ) was evaluated on a scale from 1 ( low ) to 5 ( high ) . Multilevel mixed-effect ordinal regression models were based on 17,000 responses during 24 weeks . Results One hundred fifty-four women continued until the end of the study ( 88 % compliance rate ) . Baseline prevalence was as follows : night sweats , 50 % to 60 % ; irritability and depression , 20 % to 25 % ; mood swings , 25 % to 30 % ; headache and urinary problems , 15 % to 20 % ; and vaginal dryness , 10 % to 15 % . The prevalence of all symptoms except vaginal dryness decreased among intervention groups . According to multilevel mixed-effect ordinal regression analysis , night sweats and mood swings ( P < 0.001 ) and disturbance of the mood swings ( P < 0.001 ) and irritability ( P < 0.001 ) were reduced more among the women in the intervention group than in the control group . Conclusions In sedentary women , aerobic training for 6 months may decrease the typical menopausal symptoms , especially night sweats , mood swings , and irritability Objective The practice of yoga has been proven to have positive effects on reducing  insomnia . Studies have also shown its effects on reducing climacteric symptoms . To date , however , no studies that evaluate the effects of yoga on postmenopausal women with a diagnosis of insomnia in a r and omized clinical trial have been conducted . The aim of this study was to evaluate the effect of yoga practice on the physical and mental health and climacteric symptoms of postmenopausal women with a diagnosis of insomnia . Methods Postmenopausal women not undergoing hormone therapy , who were 50 to 65 years old , who had an apnea-hypopnea index less than 15 , and who had a diagnosis of insomnia were r and omly assigned to one of three groups , as follows : control , passive stretching , and yoga . Question naires were administered before and 4 months after the intervention to evaluate quality of life , anxiety and depression symptoms , climacteric symptoms , insomnia severity , daytime sleepiness , and stress . The volunteers also underwent polysomnography .  The study lasted 4 months . Results There were 44 volunteers at the end of the study . When compared with the control group , the yoga group had significantly lower posttreatment scores for climacteric symptoms and insomnia severity and higher scores for quality of life and resistance phase of stress . The reduction in insomnia severity in the yoga group was significantly higher than that in the control and passive-stretching groups . Conclusions This study showed that a specific sequence of yoga might be effective in reducing insomnia and menopausal symptoms as well as improving quality of life in postmenopausal women with insomnia In the present study , 40- to 60-year-old women with climacteric symptoms were placed on a 12-week structured education and exercise program to ascertain the effects of this program on climacteric symptoms , quality of life ( QOL ) , and attitude towards exercise .  A total of 35 women served as subjects . Twenty women were enrolled in an educational and exercise program that involved learning about menopause and participating in physical activity at least three times a week ( Group E ) . For comparison , the other 15 women did not participate in this program and were instructed to refrain from exercising during study period ( Group C ) . The effects of the 12-week interventional program on climacteric symptoms , QOL , and attitude towards exercise were thereby investigated . The program demonstrated significant effects on climacteric symptoms in terms of Kupperman index and psychosomatic symptoms , especially paresthesia and nervousness . In other words , climacteric symptoms improved significantly in Group E. Furthermore , scores for QOL and attitude towards exercise improved in Group E after the 12-week program ; however , these trends did not reach statistical significance . Hence , the 12-week structured education and exercise program was shown to be effective in alleviating climacteric symptoms BACKGROUND The relationship between menopausal symptoms and bone mineral density ( BMD ) was examined in 290 premenopausal women , ages 44 - 50 years , participating in a r and omized clinical trial of a dietary and exercise intervention : The Women 's Healthy Lifestyle Project . METHODS Information on hot flashes ( presence , absence ) , menstrual cycles ( irregular , regular ) and menstrual flow per period ( variable , same ) over the past 6 months was collected at entry . Participants reporting at least one menopausal symptom were classified as symptomatic and compared to those having no symptoms . Bone mineral density ( BMD ) at the lumbar spine ( L1-L4 ) , total hip and whole-body were made at baseline and at 30 months using a dual-energy X-ray absorptiometer ( Hologic QDR 2000 densitometer ) . RESULTS Baseline BMD at the spine , hip and whole-body were significantly reduced in women reporting menopausal symptoms compared to asymptomatic women , after adjustment for age , weight and intervention status ( all p < 0.05 ) . Women with irregular menstrual cycles had greater annualized rates of bone loss at the spine and hip than asymptomatic women ( spine , -0.77 (1.6)% per year vs. -0.19 (1.0)% per year , p = 0.0043 ; hip , -0.37 (1.1)% per year vs. -0.04 (1.0)% per year , p = 0.061 ) , after adjustments for age , percent change in weight , intervention status , and baseline BMD . Similar findings were not found for whole-body BMD . CONCLUSIONS These results suggest that menopausal symptoms are useful for the effective identification of premenopausal women at higher risk of low BMD and perhaps , of osteoporosis In the 1990s , two r and omised clinical trials started in Sc and inavia addressing whether hormone replacement therapy ( HRT ) is safe for women with previous breast cancer . We report the findings of the safety analysis in HABITS ( hormonal replacement therapy after breast cancer -- is it safe ? ) , an open r and omised clinical trial with allocation to either HRT or best treatment without hormones . The main endpoint was any new breast cancer event . All analyses were done according to intention-to-treat . Until September , 2003 , 434 women were r and omised ; 345 had at least one follow-up report . After a median follow-up of 2.1 years , 26 women in the HRT group and seven in the non-HRT group had a new breast-cancer event . All women with an event in the HRT group and two of those in the non-HRT group were exposed to HRT and most women had their event when on treatment . We decided that these findings indicated an unacceptable risk for women exposed to HRT in the HABITS trial , and the trial was terminated on Dec 17 , 2003 Background : Many women experience detriments in mental health during the menopausal transition . Physical activity may attenuate these adverse outcomes but few studies investigating such effects exist . Purpose : This study examined the effects of a 4-month r and omized controlled exercise trial on mental health outcomes in 164 previously low-active middle-aged women ( M age=49.9 ; SD=3.6 ) . Methods and Results : Participants completed body composition and fitness assessment and a battery of psychological measures at the beginning and end of a 4-month r and omized controlled exercise trial with three arms : walking , yoga , control . The results indicated that walking and yoga were effective in enhancing positive affect and menopause-related QOL and reducing negative affect . Women who experienced decreases in menopausal symptoms across the trial also experienced improvements in all positive mental health and QOL outcomes and reductions in negative mental health outcomes . Whether menopausal symptoms increased or decreased across the trial appeared to be determined in part by whether there were increases or decreases in cardiorespiratory fitness . Conclusions : Physical activity appears to enhance mood and menopause-related QOL during menopause , however , other aspects of mental health may be affected only as a result of reduction in menopausal symptoms . Increasing cardiorespiratory fitness could be one way to reduce menopausal symptoms INTRODUCTION Women in the menopausal stage of life usually have climacteric symptoms of  hot flashes ,  back pain , sleeplessness , night sweats and increased risk of cardiovascular disorders . Although physical exercises have been documented to favourably alleviate some of these problems , there 's a paucity of knowledge of their effects on menopausal women in Nigeria . OBJECTIVES This study investigated the effect of a twelve-week Endurance Exercise Programme ( EEP ) on quality of life(QOL ) and menopausal symptoms in these women . METHODS Participants were purposively recruited and assigned into perimenopausal and postmenopausal groups based on history of thier last menstrual period and from each of these groups r and omized into : perimenopausal exercise group ( PEMEG ) , postmenopausal exercise group ( POMEG ) , perimenopausal control group ( PEMCG ) postmenopausal control group ( POMCG ) .  Quality of life ( QOL ) , Menopausal symptoms - Back Pain ( BP ) and hot flashes ( HF ) among other variables , were evaluated at baseline and 4 weekly intervals . EEP consisted of a 10-station circuit of muscular and cardiovascular endurance , flexibility , coordination , abdominal and pelvic floor muscle exercises . RESULTS One hundred and seventy five menopausal women , mean age 52.3 + /- 4.1 years . Significant changes occurred between baseline and end of 12th week mean values of PEMEG for QOL : 565.9 + /- 108.8 vs 725.0 + /- 42.9 and BP 4.42 + /- 1.7 vs 1.00 + /- 0.0 . ( p= 0.000 ) . Also , in POMEG : QOL 558.3 + /- 127.7 vs 736.5 + /- 44.8 ; and BP 5.37 + /- 1.48 vs 1.88 + /- 1.18 ( p=0.000 ) . Significant changes in QOL and BP did not occur in the control groups . CONCLUSION Routine participation in endurance exercise programme is recommended for menopausal women for improved QOL Abstract Background and objective . To estimate whether aerobic training has an effect on frequency of hot flushes or quality of life . Design . A r and omized controlled trial . Participants and setting . Symptomatic , sedentary women ( n = 176 ) ,  
    Output:
    