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Menopause health centre

Are herbal and complementary medicines an alternative for HRT?

By David McNamee

BMJ Group News

Herbal medicine

A new review investigates whether herbal and complementary treatments can be safe and effective treatments for women who might experience side effects from conventional menopausal treatments, such as hormone replacement therapy (HRT).

What do we know already?

The menopause is a normal stage of every woman’s life that occurs after she has her final menstrual period. But the symptoms of menopause can be distressing for some women. These symptoms include hot flushes, disturbed sleep, urinary infections, vaginal dryness, and depression. There’s also an increased risk of heart disease and osteoporosis in women who have been through the menopause.

HRT is an effective treatment for symptoms of the menopause. But some women experience side effects, so it’s not recommended for everybody. Possible side effects from HRT include an increased risk of getting breast cancer, or a blood clot in your lungs, or having a stroke.

So there’s some interest in whether herbal or complementary medicines could work as an alternative to HRT. This new review looked at the evidence for whether or not they work.

What does the new study say?

The review found that non-prescription treatments are already quite popular for treating menopausal symptoms. Between 50 and 75 percent of women who have been through the menopause have used them to treat hot flushes.

The review found the most evidence that soy, red clover, and black cohosh are non-prescription treatments that work for the symptoms of the menopause.

Soy and red clover are plants which contain oestrogen, the female hormone which the body loses when a woman goes through the menopause. So these treatments work in a similar way to HRT by replenishing oestrogen levels.

The review didn’t find any significant side effects from these herbal treatments. But the author of the review recommends them only for women who haven’t had breast cancer themselves, and aren’t at risk of breast cancer. This is because the plant form of oestrogen, which is contained in herbals like soy, may interfere with treatments such as tamoxifen, which is used to treat breast cancer.

In addition, the review recommends that women also try treatments called behaviour modification for hot flushes and disturbed sleep. This means practising things like breathing exercises, giving up smoking, drinking less alcohol, and taking regular exercise. The review found that these were effective in relieving hot flushes, and improving sleep patterns and mood swings.

How reliable are the findings?

This review looked at earlier studies of the effects of herbal and complementary therapies treating menopausal symptoms. This type of study, which pools the results of several other studies, can often produce reliable results. But there haven’t been many good-quality studies in this area, so this review isn’t conclusive.

What does this mean for me?

If you’re a woman going through the menopause, then you may be interested in discussing these alternative treatments with your doctor.

Published on January 11, 2013

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