- American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 141: management of menopausal symptoms. Obstetrics and Gynecology. 2014;123(1):202–216.
- Carmody J, Crawford S, Salmoirago-Blotcher E, et al. Mindfulness training for coping with hot flashes: results of a randomized trial. Menopause. 2011;18(6):611–620.
- Cramer H, Peng W, Lauche R. Yoga for menopausal symptoms—a systematic review and meta-analysis. Maturitas. 2018;109:13–25.
- Dodin S, Blanchet C, Marc I, et al. Acupuncture for menopausal hot flushes. Cochrane Database of Systematic Reviews. 2013;(7):CD007410. Accessed at www.cochranelibrary.comLink to External Link Policy on February 17, 2016.
- Ee C, Xue C, Chondros P, et al. Acupuncture for menopausal hot flashes. A randomized trial. Annals of Internal Medicine. 2016;164(3):146–154.
- Elkins GR, Fisher WI, Johnson AK, et al. Clinical hypnosis in the treatment of postmenopausal hot flashes: a randomized controlled trial. Menopause. 2013;20(3):291–298.
- Files JA, Ko MG, Pruthi S. Bioidentical hormone therapy. Mayo Clinic Proceedings. 2011;86(7):673–680.
- Goodman NF, Cobin RH, Ginzburg SB, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of menopause. Endocrine Practice. 2011;17(Suppl 6):1–25.
- Kelley KW, Carroll DG. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. Journal of the American Pharmacists Association. 2010;50(5):e106–e115.
- Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database of Systematic Reviews. 2012;(9):CD007244. Accessed at www.cochranelibrary.comLink to External Link Policy on February 17, 2016.
- Lethaby A, Marjoribanks J, Kronenberg F, et al. Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database of Systematic Reviews. 2013;(12):CD001395. Accessed at www.cochranelibrary.comLink to External Link Policy on February 17, 2016.
- Scheffers CS, Armstrong S, Cantineau AEP, et al. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database of Systematic Reviews. 2015;(1):CD011066. Accessed at www.cochranelibrary.comLink to External Link Policy on February 17, 2016.
- The North American Menopause Society. Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause. 2015;22(11):1155–1172.
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Complementary Health Approaches
Complementary approaches can be classified by their primary therapeutic input ; Nutritional , Psychological or Physical .
Complementary Health Approaches for menopause symptoms
The Safety of Complementary Health Approaches
- Phytoestrogens, herbs, and other dietary supplements haven’t been clearly shown to relieve menopause symptoms.
- Research on hypnotherapy and mindfulness meditation is in its early stages, but some studies have had promising results.
- Acupuncture has not been shown to be more effective than simulated acupuncture for relieving hot flashes.
- Yoga seems to be at least as effective as other types of exercise in relieving menopause symptoms.
- The evidence doesn’t support claims that custom-mixed (compounded) bioidentical hormones are more effective than conventional hormone therapy.
- Dietary supplements may have side effects or interact with drugs, and little is known about their long-term safety.
- Psychological and/or physical approaches such as acupuncture, hypnosis, meditation, and yoga generally have good safety records.
- Custom-mixed bioidentical hormones haven’t been shown to be safer than other forms of hormone therapy, and their content may vary from batch to batch.
What the Science Says About Complementary Health Approaches for Menopause Symptoms
Nutritional Approaches
Complementary approaches can be classified by their primary therapeutic input (how the therapy is taken in or delivered), which may be:
- Nutritional (e.g., special diets, dietary supplements, herbs, probiotics, and microbial-based therapies).
- Psychological (e.g., meditation, hypnosis, music therapies, relaxation therapies).
- Physical (e.g., acupuncture, massage, spinal manipulation).
- Combinations such as psychological and physical (e.g., yoga, tai chi, dance therapies, some forms of art therapy) or psychological and nutritional (e.g., mindful eating).
Nutritional approaches include what the National Center for Complementary and Integrative Health (NCCIH) previously categorized as natural products, whereas psychological and/or physical approaches include what was referred to as mind and body practices.
Many nutritional approaches such as dietary supplements have been studied for menopause symptoms. However, none has clearly been shown to be helpful. There’s little information on the long-term safety of dietary supplements, and some can have harmful side effects or interact with drugs. The sections below give more detail about several dietary supplements studied for menopause symptoms.
Phytoestrogens
- Phytoestrogens are substances from plants that have chemical structures similar to those of the female hormone estrogen. The isoflavones found in soy and red clover are examples of phytoestrogens. Flaxseed is another phytoestrogen source.
- Studies that tested isoflavones from soy or red clover for their ability to relieve menopause symptoms have had inconsistent results. Studies of flaxseed products found them to be no more effective than a placebo (an inactive substance) in reducing hot flashes.
- Phytoestrogens appear to be safe for short-term use, but their long-term safety hasn’t been established. Because phytoestrogen supplements may have effects like those of the hormone estrogen, they may not be safe for women who shouldn’t take estrogen.
Black Cohosh
- Black cohosh is an herb native to North America. The roots and rhizomes (underground stems) of the plant are used in dietary supplements.
- Studies that tested black cohosh for menopause symptoms have had inconsistent results. A 2012 research review concluded that there’s not enough evidence to support its use for menopause symptoms.
- Black cohosh generally has only mild side effects, if any. However, rare cases of liver damage—some of them very serious—have been reported in people taking commercial black cohosh products. It’s uncertain whether black cohosh was responsible for the liver damage. Nevertheless, people with liver disorders should consult a health care provider before taking black cohosh products. Anyone who develops symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice, while taking black cohosh should stop using it and consult a health care provider.
DHEA
- Dehydroepiandrosterone (DHEA) is a substance that’s naturally made in the body, where it’s converted into the hormones testosterone and estrogen. DHEA production decreases as people grow older, but the significance of this change, including whether it affects aging and menopause symptoms, is unclear.
- It’s uncertain whether DHEA is useful in treating menopause symptoms.
- The long-term safety of taking DHEA supplements is unknown. Some evidence suggests that even short-term use of these supplements may have harmful effects, including liver damage.
Dong Quai
- In traditional Chinese medicine, the herb dong quai is often used for women’s health problems, including menopause. However, very little research has been done on dong quai for menopausal symptoms, so no conclusions can be reached about its effects.
- Dong quai may interact with the anticoagulant (blood-thinning) drug warfarin (Coumadin).
Vitamin E
- A few studies have suggested that vitamin E supplements might be helpful for menopause symptoms. However, the amount of research is small, and the effect is also small. For example, in one study, women taking vitamin E averaged one fewer hot flash per day.
- Vitamin E, in the high doses found in supplements, may increase the risk of bleeding (including strokes due to bleeding in the brain) and interact with anticoagulant (blood-thinning) medications such as warfarin (Coumadin).
Other Dietary Supplements
Other dietary supplements that have been studied for menopause symptoms include evening primrose oil, ginseng, kava, melatonin, and wild yam. However, very little research has been done on these products for menopausal symptoms, so no conclusions can be reached about their effectiveness. Kava supplements have been linked to a risk of severe liver disease.
References
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