| |
The use of complementary therapies is a popular choice for the management of menopausal symptoms. Some over-the-counter therapies sold to treat menopause include phytoestrogens, wild yam creams and herbal medicines. Complementary therapies also include homoeopathy, traditional Chinese medicine and acupuncture, massage, aromatherapy and kinesiology.
It is important to make an informed decision about the type of treatment you choose. Don’t self-prescribe any medicine, including complementary medicines. Always seek advice and treatment from a qualified and reputable practitioner.
Be advised by your doctor and other health care providers, as some complementary treatments can interact with other medications and cause side effects.
Complementary therapies, HRT and menopause
Many women are troubled by menopausal symptoms such as vaginal dryness, hot flushes, night sweats and psychological symptoms. Women in the menopausal age group are high users of complementary therapies to help manage their symptoms.
Menopause also speeds up bone loss due to the reduction in oestrogen, which can increase a woman’s risk of osteoporosis and bone fracture. Hormone replacement therapy (HRT) has been shown to significantly reduce both menopausal symptoms and fractures related to osteoporosis. However, the use of HRT as a preventive measure to reduce fracture risk is controversial. Updated evidence has shown HRT to be an appropriate ‘first line’ therapy for postmenopausal women with an increased risk for fracture who are under the age of 60. However, commencing HRT after the age of 60 is not recommended as the first option for preventing osteoporotic-related fracture.
Complementary therapies that may reduce your risk of osteoporosis include calcium supplementation and some exercise programs. Some other popular therapies, including phytoestrogens and the herb black cohosh, may have some effect on bone-forming mechanisms but have not been proven to reduce the risk of osteoporosis.
Remember that no therapy can replace regular physical activity (30 minutes of moderate exercise daily) and a healthy diet. Both are essential to good health, including reducing your risk of cardiovascular disease and diabetes.
Phytoestrogens
Phytoestrogens are plant compounds that are similar in chemical makeup to the female sex hormone oestrogen, but much lower in strength. They act at the oestrogen receptor sites in a woman’s body, which may reduce menopausal symptoms in some women.
Phytoestrogens can be found in foods and also in supplements. The three types of phytoestrogens and their dietary sources include:
- Isoflavones – good sources include soy products, beans (such as lima beans, chickpeas and lentils) and red clover.
- Lignans – good sources include fruit, vegetables and grains, and oilseeds such as linseed.
- Coumestans – good sources include sprouting seeds such as alfalfa.
Some women will have some symptom relief from consuming phytoestrogens as part of a balanced diet and in quantities equivalent to those in an Asian diet.
Some concern has been raised about a link between soy products and breast cancer. There is no evidence to suggest that consumption of soy foods in amounts consistent with an Asian diet is detrimental to breast health. However, women who are at high risk for breast cancer or are breast cancer survivors are advised not to take highly processed soy supplements (such as soy protein isolate, isoflavone-rich soy extracts or isoflavone capsules) as these preparations seem to act differently in the body than foods made from soy beans or soy flour.
Wild yam creams
There is no medical evidence to support the claim that wild yam creams can ease menopausal symptoms. Traditionally, wild yam was not used as a cream but taken orally. Most herbalists specialising in the management of perimenopausal women do not prescribe or recommend wild yam cream, yet it remains a popular over-the-counter remedy for women who self-prescribe.
Wild yam creams were originally marketed as containing progesterone, but this is not the case. Although wild yams contain a compound called diosgenin, which can be used to synthesise progesterone, the diosgenin has to be chemically changed in the laboratory.
Herbal medicines
More research on the effectiveness of herbal preparations to manage the symptoms of menopause is needed. The best way to use herbal medicines is to be prescribed by a trained natural therapist. A herbalist or naturopath may prescribe one of many remedies to help manage an individual woman’s menopausal symptoms, such as remedies for sleep disturbance, mood changes or libido, as well as remedies for hot flushes and night sweats.
Herbs are medicines and should be treated with respect and caution. Some complementary medicines, such as St John’s Wort, may also interact with other medications you may be taking, causing potentially harmful side effects.
Generally a prescription is tailor-made to suit the woman’s individual needs, rather than the ‘one-size fits all’ formulas available over the counter.
Evening primrose oil
Despite the popularity of evening primrose oil for the management of menopausal symptoms, it has been shown to be no better than taking a dummy pill for the treatment of hot flushes.
Black cohosh
Black cohosh (Cimicifuga racemosa) was used traditionally by North American Indians to ease menopausal symptoms and menstrual cramps. Studies have shown that black cohosh is useful in reducing symptoms associated with menopause, including hot flushes. In Australia, remedies containing black cohosh can be sold in pharmacies, supermarkets, health food stores and other outlets.
Concerns about black cohosh and liver damage have been well-publicised. While there does appear to be an association between the use of black cohosh and liver damage, it is thought to be very rare. In 2008 the warning advice required on medicine labels for black cohosh was changed to better inform consumers about the risk and how to recognise the early signs of liver damage.
If you take black cohosh, it is important to seek medical attention as soon as you detect any signs of liver damage. Symptoms of liver disease can include jaundice (yellowing of the skin or whites of the eyes), dark urine, nausea, vomiting, diarrhoea, weight loss, unusual tiredness, appetite loss, fever, bloated abdomen or abdominal pain.
Progesterone creams
Progesterone is a female sex hormone that also declines after menopause. Medical science accepts that menopausal symptoms are due to falling oestrogen levels and there is a popular belief that an incorrect ratio of progesterone to oestrogen is the cause. To date, there is no medical evidence to support the theory that supplementing the body’s progesterone levels with progesterone creams can ease menopause symptoms or reduce the risk of osteoporosis.
The main use of progesterone is to protect the lining of the uterus in women using oestrogen. Progesterone products are now available on prescription only. They are sometimes combined with other biological hormones including oestrogens and testosterone in creams or lozenges as a form of hormone therapy.
Caution for women on hormone therapy
Some women who use combined hormone replacement therapy (oestrogen plus progesterone) may decide to substitute progesterone creams for the progestogen component of their hormone therapy. This can increase the risk of cancer in the uterine lining (endometrium), because not enough progesterone is absorbed through the skin from these creams.
A study published in The Lancet found that progesterone creams applied to the skin don’t increase the amount of progesterone levels in the blood to any significant degree and do not protect the endometrium.
Seek reputable information
There is a lot of information available about complementary or ‘alternative’ menopause treatments. Not all information you may read will come from a reliable source. Many of the remedies that are promoted to women are not recommended by natural therapists or have been shown to be ineffective.
Complementary therapies are often based on traditional knowledge. Some have not been subjected to the same vigour of testing that clinical trials for pharmaceutical medicines are subjected to. For this reason, their effectiveness has not been as strongly proven. However, the increasing use of complementary therapies has begun to fuel scientific research and there is now scientific evidence about the safety and effectiveness of some therapies.
Where to get help
- Your doctor
- Complementary therapist
- The Jean Hailes Foundation for Women’s Health Tel. 1800 151 441
- Australasian Menopause Society www.menopause.org.au
- Women’s Health Victoria Tel. (03) 9662 3755
- National Herbalists Association of Australia Tel. (02) 8765 0071
- Australian Natural Therapists Association Tel. 1800 817 577
- Australian Traditional Medicine Society Tel. (02) 9809 6800
- Medicines Line Tel. 1300 888 763
Things to remember
- Complementary therapies for the management of menopausal symptoms are popular for some women.
- Many of these therapies have not been subjected to clinical trials, so their effectiveness has not been proven.
- Popular therapies include phytoestrogens, progesterone creams, wild yam creams and herbal medicine.
- When using natural therapies, it is advisable to seek the advice of a trained natural therapist.
You might also be interested in:
Bowen therapy.
Chinese herbal medicine.
Menopause.
Menopause - hormone replacement therapy.
Menopause - premature (early) menopause.
Menstrual cycle.
Nutrition - women's extra needs.
Soybeans.
Want to know more?
Go to More information for support groups, related links and references.
|  |
|
