Do alternative therapies work to treat menopausal symptoms?

Of the 80 per cent of women who develop symptoms during menopause, many will experiment with complementary and alternative medicines (CAMs) as well as lifestyle changes to treat their symptoms, said Tami Shandro, a University of Alberta family physician, Women and Children’s Health Research Institute member and menopause clinic team member at the Lois Hole Hospital for Women.

“The success of those will vary from woman to woman. And while they may help, most women should lower their expectations around menopause symptom improvements obtained by CAMs,” she said.

CAMs are not well researched, and the studies that have been done tend to only look at vasomotor symptoms such as hot flashes, flushing and night sweats, explained Shandro.

“And women may not find hot flashes and night sweats the most distressing menopausal symptom they experience,” she added. “In fact, symptoms may also include mood changes, not being able to sleep, cognitive difficulties such as memory concerns, decreased concentration, ‘brain fog,’ vaginal dryness, joint and muscle pain, weight gain, fatigue and heart palpitations.”

If women find their symptoms so severe that they are interfering with their quality of life—and 20 per cent of women with menopause symptoms will—they should not delay seeking medical attention, added Shandro.

“Symptoms can last, on average, seven to 11 years. Women should not struggle with these in silence. There are various medical treatments that may be available in addition to hormone therapy.”

For those who wish to explore CAMs for mild symptoms, Shandro reviewed the evidence of the most common ones her patients use.

The lowdown on CAM options

There is evidence that phytoestrogenslike isoflavones and lignans—which are plant compounds with estrogen-like properties found in soy, flaxseed and red clover—may reduce milder hot flashes and sweats, said Shandro.

“There isn’t strong evidence to back up the effectiveness of hypnosis and cognitive behaviour therapy (CBT) for menopausal symptoms,” she added.

“As well, acupuncture has not consistently shown a beneficial effect.”

Shandro does not recommend therapies such as black cohosh and St. John’s Wort, as they have been associated with adverse effects and interactions with medications.

“Weight reduction and mindfulness-based stress reduction may be helpful to improve overall health,” she noted. “However, there just isn’t supporting evidence that they help with menopausal symptoms.”

Similarly, although exercise and yoga are healthy lifestyle choices, neither have been proven to reduce menopausal symptoms.

Shandro said more data from larger randomized trials are needed to confirm the effectiveness and safety of CAMs for menopause symptoms.

When symptoms are severe

“Again, I want to emphasize that women should not hesitate to seek help from their doctors for their menopause symptoms, especially when they are severe,” she said.

“By the time we see women with severe symptoms in the Menopause Clinic, they’ve tried one or several complementary and alternative (CAM) therapies, with minimal success.”

Hormone therapy is not the only medical option conventional medicine offers, added Shandro.

“Although, new data and re-analysis of older studies by women’s age show that for most women with severe symptoms, the potential benefits of hormone therapy are many and the risks are few.”

In women without health risks, “fear of using the only treatment shown to have a lasting effect for severe symptoms—hormone therapy—delays relief,” said Shandro.

Finally, she added that the clinic does prescribe low dose anticonvulsant and antidepressant medications because there is evidence they help reduce some menopausal symptoms.

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