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Alternative medicine

By Mayo Clinic staff

Many approaches have been promoted as aids in managing the symptoms of menopause, but few of them have scientific evidence to back up the claims. Some complementary and alternative treatments that have been or are being studied include:

  • Plant estrogens (phytoestrogens). These estrogens occur naturally in certain foods. There are two main types of phytoestrogens — isoflavones and lignans. Isoflavones are found in soybeans, chickpeas and other legumes. Lignans occur in flaxseed, whole grains, and some fruits and vegetables. Whether the estrogens in these foods can relieve hot flashes and other menopausal symptoms remains to be proved, but most studies have found them ineffective. Isoflavones have some weak estrogen-like effects, so if you've had breast cancer, talk to your doctor before supplementing your diet with isoflavone pills.
  • Bioidentical hormones. The term "bioidentical" implies the hormones in the product are chemically identical to those your body produces. However, compounded bioidentical hormones are not regulated by the Food and Drug Administration (FDA), so quality and risks could vary. But there are many FDA-approved bioidentical formulations available in a variety of strengths at the pharmacy — talk with your provider to see if any of these may be a good option for you.
  • Black cohosh. Black cohosh has been popular among many women with menopausal symptoms. But there's little evidence that black cohosh is effective, and the supplement can be harmful to the liver.
  • Yoga. Some studies show that yoga — a combination of controlled breathing, posing and meditation — and tai chi and qi gong — a series of slow movements and meditation — may be effective in decreasing the number of hot flashes in perimenopausal women. It's best to take a class to learn how to perform postures and the proper breathing techniques.
  • Acupuncture. Acupuncture may have some temporary benefit in helping to reduce hot flashes.

You may have heard of — or even tried — other dietary supplements, such as red clover, kava, dong quai, DHEA, evening primrose oil and wild yam (natural progesterone cream). Scientific evidence on effectiveness is lacking, and some of these products may be harmful.

Talk with your doctor before taking any herbal or dietary supplements for menopausal symptoms. The FDA does not regulate herbal products, and some can be dangerous or interact with other medications you take, putting your health at risk.

References
  1. Menopause. National Institute on Aging. http://www.nia.nih.gov/HealthInformation/Publications/menopause.htm. Accessed Dec. 7, 2012.
  2. Innes KE, et al. Mind-body therapies for menopausal symptoms: A systematic review. Maturitas. 2010;66:135.
  3. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Dec. 6, 2012.
  4. Nelson LM, et al. Clinical manifestation and evaluation of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/index. Accessed Jan. 1, 2013.
  5. Menopausal symptoms and complementary health practices. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/menopause/menopausesymptoms#hed2/. Accessed Dec. 7, 2012.
  6. Lindh-Astrand L, et al. Effects of applied relaxation on vasomotor symptoms in postmenopausal women: A randomized controlled trial. Menopause. 2012;20:1.
  7. Colpani V, et al. Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: A population-based study. Menopause. 2012;20:1.
  8. Warnecke E. What works? Evidence for lifestyle and nonprescription therapies in menopause. Australian Family Physician. 2011;40:286.
  9. Kelley KW, et al. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. Journal of the American Pharmacists Association. 2010;50:e106.
  10. For better sex: 3 ways to strengthen your pelvic floor. The Northern American Menopause Society. http://www.menopause.org/for-women/menopauseflashes/for-better-sex-3-ways-to-strengthen-your-pelvic-floor. Accessed Dec. 7, 2012.
  11. The North American Menopause Society. The 2012 hormone therapy position statement of The North American Menopause Society. Menopause. 2012;19:257.
  12. MenoNote: Vaginal dryness. The North American Menopause Society. http://www.menopause.org/publications/educational-materials-for-women/menonotes. Accessed Oct. 31, 2012.
  13. Welt CK, et al. Pathogenesis and causes of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/ index. Accessed Jan. 1, 2013.
  14. Welt CK, et al. Ovarian development and failure (menopause) in normal women. http://www.uptodate.com/ index. Accessed Jan. 1, 2013.
  15. Marnach ML (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 7, 2013.
  16. Faubion SS (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 11, 2013.
  17. Dickson GM. Menopause management: How you can do better. The Journal of Family Practice. 2012;61:138.
  18. Committee on Gynecological Practice and the American Society for Reproductive Medicine Practice Committee. Compounded bioidentical menopausal hormone therapy. ACOG. http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Gynecologic_Practice/Compounded_Bioidentical_Menopausal_Hormone_Therapy. Accessed Jan. 11, 2013.
DS00119 Jan. 24, 2013

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