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Alternative medicine
By Mayo Clinic staffA variety of alternative medicines are used to treat vaginal dryness and irritation associated with menopause, but few approaches are backed by evidence from clinical trials. Interest in complementary and alternative medicine is growing and researchers are working to determine the benefits and risks of various alternative treatments for vaginal atrophy. Here are some of the approaches under investigation:
- Black cohosh. Black cohosh is an herbal supplement that's often used to treat menopausal symptoms, particularly hot flashes. But it doesn't seem to work for vaginal atrophy. A yearlong trial of about 350 women experiencing menopausal symptoms was published by the North American Menopause Society. The trial compared black cohosh and other herbal supplements with a sham pill (placebo). The investigators found that the herbal supplements including black cohosh were not effective in treating vaginal atrophy.
- Isoflavones. These are plant-derived compounds that have estrogen-like properties (phytoestrogens). The supplements are usually extracted from soy and red clover. They may be helpful for certain menopausal symptoms, including vaginal atrophy, but the evidence is still slim. Be careful using phytoestrogen supplements if you have an increased risk of a disease or condition that's affected by hormones, such as uterine fibroids, endometriosis, or breast, uterine or ovarian cancer. Also, be cautious if you're already taking a medication that increases your level of estrogen, such as birth control pills, hormone therapy or tamoxifen.
- Vitamin D. There's some evidence that vitamin D may help relieve vaginal dryness, although more study is needed. Vitamin D also helps your body absorb calcium, which can help prevent bone loss associated with menopause. You can get vitamin D from sunlight, fortified milk, breakfast cereals and other fortified foods, and supplements.
- Dehydroepiandrosterone (DHEA). This is a natural steroid produced by your adrenal gland that's converted into estrogen and testosterone. With aging, the level of DHEA declines in women, suggesting this depletion may have something to do with age-related problems. Some studies show that intravaginal DHEA tablets help to reverse vaginal atrophy without increasing levels of circulating estrogen. But these positive results need to be duplicated before they can be considered standard therapy.
References
- Bachmann G, et al. Diagnosis and treatment of vaginal atrophy. http://www.uptodate.com/patients/index.html. Accessed Aug. 6, 2010.
- The North American Menopause Society. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause Society. 2007;14:357.
- MacBride MB, et al. Vulvovaginal atrophy. Mayo Clinic Proceedings. 2010;85:87.
- Palacios S. Managing urogenital atrophy. Maturitas. 2009;63:315.
- Suckling JA, et al. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database of Systematic Reviews. 2006:CD001500.
- Archer DF. Efficacy and tolerability of local estrogen therapy for urogenital atrophy. Menopause. 2010;17:194.
- Reed SD, et al. Vaginal, endometrial, and reproductive hormone findings: Randomized, placebo-controlled trial of black cohosh, multibotanical herbs and dietary soy for vasomotor symptoms: The Herbal Alternatives for Menopause (HALT) study. Menopause. 2008;15:51.
- Mehta A, et al. Vulvovaginal complaints. Clinical Obstetrics and Gynecology. 2008;51:549.
- Labrie F, et al. Intravaginal dehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy. Menopause. 2009;16:907.
- Panjari M, et al. DHEA for postmenopausal women: A review of the evidence. Maturitas. 2010;66:172.
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