Menopause
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Alternative Therapies for Menopausal Symptoms

Given the health concerns about hormone therapy, some women have been turning to herbal products to treat their menopausal symptoms. However, "natural" doesn't always mean safe.

Be careful. Some of these products may help as short-term treatment, others may not work at all, and some may even hurt you. These substances may also interact with any medication you are taking. Like prescription drugs, herbal products may have side effects and can cause allergic reactions. However, unlike prescription drugs, herbal products are not regulated by the Food and Drug Administration, so their safety is unclear. Also, since some of these compounds act like estrogen, they may be associated with the same risks as hormone therapy. Always talk with your doctor before taking any supplement or herbal remedy.

With most herbs and supplements, few studies have been done. Often these studies are too small and too few to make any kind of claim that the product does what it is supposed to do without harming you.

Herb Use Does it work? Warnings
Black cohosh Hot flashes, night sweats, mood swings, irritability, vaginal dryness, palpitations and occasional sleeplessness related to menopausal symptoms According to a task force from the American Academy of Obstetricians and Gynecologists (ACOG), black cohosh has no significant effect on menopausal vasomotor symptoms such as hot flashes. Do not take this without talking to your doctor. Side effects from high doses of black cohosh can include dizziness, headaches, visual disturbances, vomiting, seizures, nausea, sweating, constipation, low blood pressure, slow heartbeats, weight gain, loss of bone mass and liver damage.

This herb should be avoided by people with hormone-sensitive conditions such as breast cancer, uterine cancer and endometriosis.

Safety during pregnancy and breastfeeding has not been established.
Dong quai Hot flashes, vaginal dryness, spotting and irregular bleeding, increasing energy and fighting fatigue Evidence that says this works is not clear. There are no reliable long-term studies of side effects. Can cause upset stomach, headache, dizziness and weight gain

High doses may increase sensitivity to sunlight. Dong quai should not used during pregnancy or while breastfeeding.

Dong quai can interact with warfarin and increase the risks of blood-thinning medications. Do not take this if you are taking hormone medications such as tamoxifen and oral contraceptives.
Wild yam Vaginal dryness No scientific evidence shows that this offers any relief of menopausal symptoms. Wild yam contains dioscorin, which can be dangerous. So you must stay in the recommended dose. This substance can interact with estradiol, a hormone in the body.
Asian ginseng Used to treat depression and other menopausal symptoms Evidence does not prove health claims. Studies that have been done are poor or were based on animals, not humans. The National Center for Complementary and Alternative Medicine is funding research on this herb. May act like estrogen. Usually well-tolerated. Should not take more than three months.

May cause allergic reactions. Common side effects may be headache, nervousness, upset stomach and trouble sleeping. May cause high blood pressure. Do not take if you have high blood pressure

May affect blood clotting

May lower blood sugar so should not be taken by people with diabetes or hypoglycemia.

Can cause vaginal bleeding in postmenopausal women

May alter the effect of medications in the body
Evening primrose oil May reduce the number of hot flashes and their intensity Available studies show it is not helpful in relieving menopausal symptoms. Considered safe if used correctly. Side effects are rare and mild. May cause nausea, stomach pain and headache.

May cause seizures and should not be taken by people with seizure disorders.

May cause allergic reactions

Can interact with ceftrazidime, certain chemotherapy treatments, cyclosporine, NSAIDs and phenothizines

Should not be taken during pregnancy or breastfeeding.
Red clover Hot flashes Study shows no evidence that red clover is effective in treating hot flashes or other menopausal symptoms. No serious side effects have been reported. Women with a history of breast cancer should not take this. Women taking medications related to hormones such as estrogen and oral contraceptives should avoid this.

May also increase the risk of bleeding and may interact with blood thinners such as warfarin or aspirin

May cause breast tenderness, weight gain and endometrial hyperplasia (increased risk of uterine cancer)

Should not be taken during pregnancy or breastfeeding.
Soy
Foods include milk, curd, nuts and even the bean itself. It's also available in pill form, which includes extracts of the isoflavones found in the bean.
Hot flashes, night sweats, breast tenderness, headaches and nausea Some studies show that soy helps in the short term (2 years), while others show no evidence of effectiveness against menopausal symptoms. May not be safe for women at risk for estrogen-induced cancers, such as breast cancer. Other potential side effects include upset stomach, loose stool and diarrhea.

External Sources

Berkeley Wellness Letter

National Center for Complementary and Alternative Medicine

University of Maryland

American College of Obstetricians and Gynecologists

National Institutes of Health, National Library of Medicine, Medline Plus

This article was reviewed and updated June 2007.

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Tue, Dec 2, 2008



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