Alternative Menopause Treatments



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Editors
Kathryn Martin, MD
JoAnn Pinkerton, MD
Richard Santen, MD



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What is menopause?

Menopause marks the end of a woman’s menstrual periods. Levels of the hormones estrogen and progesterone go up and down in the years leading up to menopause, then decline. Symptoms (what you feel) may include hot flashes (also called hot flushes) and night sweats, disturbed of options for treating menopausal symptoms. These include estrogen—still the most effective treatment for many menopausal symptoms—non-estrogen prescription drugs, and complementary and alternative medicine (CAM).

What is CAM?

CAM refers to practices and products that are not usually thought to be part of mainstream medicine. CAM includes herbs and other plant-based treatments (botanicals), non-botanical supplements, and mind-body therapies. Some women use only CAM, and others use CAM with mainstream treatments. Most CAM treatments are safe, but some can interfere with the action of other medicines.

What about CAM treatments for menopausal symptoms?

Many CAM treatments are available (see table). Some women find them helpful, but research studies have not proved that most CAM treatments are more effective than placebo. A placebo is an inactive substance designed to resemble the treatment under study.

Some CAM treatments may have serious side effects, even when they are labeled “natural.” The U.S. Food and Drug Administration does not regulate dietary supplements. Therefore, they might contain more or less of the active ingredients than are listed on the label. CAM treatments can interfere with other medicines. Talk with your health care provider before you try CAM treatments or if you already use CAM.

In general, most doctors know less about CAM than about conventional medicine. Researchers continue to study the safety and effectiveness of CAM treatments for menopausal symptoms.

CAM Treatments: What the Science Says

Botanical Supplements

  • Black cohosh — Not proved to relieve menopausal symptoms more than placebo
    Cautions and Side Effects: Not for women with liver disease; can cause headaches and stomach upset
  • Dong quai — Does not reduce hot flashes more than placebo
    Cautions and Side Effects: Not for women who take warfarin, a blood thinner; may include other untested herbs
  • Evening primrose — No effect on menopausal symptoms; may help breast tenderness
    Cautions and Side Effects: Can cause headaches and stomach upset
  • Ginseng — May help improve sleep, mood, and sense of well-being; not proved to relieve hot flashes or improve memory or concentration
    Cautions and Side Effects: Can cause headaches and stomach upset
  • Kava — May help relieve anxiety; not shown to help other menopausal symptoms
    Cautions and Side Effects: Possible link between kava and liver damage
  • Phytoestrogens (estrogen-like substances in cereal, soy, vegetables, and herbs)— Soy supplements may help hot flashes but not proved; red clover not proved to relieve hot flashes more than placebo
    Cautions and Side Effects: May not be for women with conditions affected by hormones (such as breast, ovarian, or uterine cancer); consult your doctor before taking phytoestrogens
  • Valerian — May help insomnia but effects not proved
    Cautions and Side Effects: Can cause headaches, dizziness, stomach upset, and fatigue the morning after use

Non-botanical Supplements

  • Melatonin — Can help older people fall asleep and may help others overcome insomnia
    Cautions and Side Effects: May be safe when used short term at recommended doses
  • Vitamin E — Not proved to relieve hot flashes
    Cautions and Side Effects: May interact with other medications

Mind-Body Therapies

  • Acupuncture — May help some women with insomnia, mood swings, or hot flashes
  • Homeopathy (highly diluted natural substances intended to stimulate the body to heal itself) — Not proved to help symptoms more than placebo
  • Magnet therapy — Not shown to relieve pain or hot flashes
    Cautions and Side Effects: Can interfere with medical devices such as pacemakers
  • Paced breathing — May provide relief of hot flashes when done for 20 minutes three times a day
  • Relaxation therapies (including massage, meditation, and yoga) — May relieve stress, insomnia, and fatigue
    Cautions and Side Effects: Massage may not be safe for women with certain health problems, such as advanced osteoporosis
  • Reflexology (pressure or massage applied to the feet) — Not shown to relieve hot flashes

Questions to ask your doctor

  • Which lifestyle changes can I make that will decrease my menopause symptoms without medicine?
  • Are there any alternative medicine treatments you would recommend I try for relief of my menopause symptoms?
  • Are there any alternative medicines I should not use because they could interfere with medicines I take?
  • Does my health insurance plan cover the cost of any alternative medicine treatments?
  • Should I see an endocrinologist to help me with my menopause symptoms?