Alternative medicine

By Mayo Clinic Staff

In addition to conventional therapies, many women transitioning toward menopause want to know more about complementary and alternative approaches to treating symptoms. Researchers are looking into these therapies to determine their safety and effectiveness, but evidence is still often lacking.

Some of the options studied include:

  • Black cohosh. This herb extract is used by some women to treat hot flashes and other menopausal symptoms. A recent in-depth review of studies found there was not enough evidence to support its use. Black cohosh can be harmful to the liver, and it may not be safe for women with or at risk of breast cancer.
  • 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. There are also plant-derived compounds that have estrogen-like properties. Isoflavone supplements generally come from soy or red clover. Lignans come mainly from flaxseed. Studies on phytoestrogens — whether from food or supplements — conflict on whether they help reduce menopausal symptoms. Studies also conflict on whether it's possible that phytoestrogens could increase the risk of breast cancer or interfere with the effectiveness of tamoxifen.
  • 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.
  • Dehydroepiandrosterone (DHEA). This is a natural steroid produced by your adrenal gland that can be purchased as a dietary supplement. Recent research has found no evidence to support its use, and there are some concerns about possible harmful effects.

Low-risk complementary therapies, such as acupuncture, yoga and paced breathing may help reduce stress and improve psychological well-being. However, research on the ability of acupuncture and exercise to decrease hot flashes is inconclusive. There is evidence that relaxation helps reduce stress, which may in turn help improve symptoms of hot flashes.

Talk with your doctor before taking any herbal or dietary supplements for perimenopausal or 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.

April 20, 2013