Use of herbal remedies and supplements for the symptoms of menopause increased in 2002, when the Women's Health Initiative, a large study of menopausal women, showed that synthetic hormone treatments appear to increase the risk of breast cancer and heart disease. Research evaluating the efficacy of these alternative treatments is still being designed and performed. Before initiating use of herbs or supplements, always consult a qualified herbalist or practitioner and inform your physician of all treatments you are using.
History
Prior to 2002, physicians frequently recommended use of synthetic estrogen, such as Premarin, or synthetic progesterone, such as Provera, to manage the symptoms of menopause. After the Women's Health Initiative illuminated the risks associated with these treatments, prescriptions of synthetic hormone replacement declined from $57.9 million in 2004 to $40.4 million in 2009, while usage of complementary and alternative therapy surged to an estimated 80 percent of menopausal women.
Symptoms of Menopause
Natural menopause occurs when it has been 12 months since a woman's last normal menstrual period. The years surrounding that date can bring uncomfortable symptoms including hot flashes, night sweats, sleep disturbances, depression, vaginal dryness and memory loss. These issues result from declining activity of the ovaries leading to lower levels of estrogen and progesterone in the body. Any treatment for menopause seeks to minimize the impact of these symptoms on daily life.
Herbal Remedies
The most popular herbal remedies for menopause are black cohosh, dong quai, red clover, kava, ginseng and soy. Most of these are recommended to treat hot flashes, with varied results. Different preparations of herbal remedies may change the amount of active material available to the body. It is important to know the dose of active constituents delivered by an herbal product to avoid damaging the liver and to ensure maximal efficacy and safety.
Supplements
Non-herbal nutritional supplements are often used during menopause as well. Vitamin E is the most commonly used supplement for help with hot flashes, but scientific proof of its efficacy is lacking according to a review published in the journal "Maturitas" by the Department of Clinical Pharmacy at the University of California San Francisco's School of Pharmacy in 2010. The same study did find that using vitamins C, D, K and calcium are worthwhile for preserving bone density.
Natural or Bioidentical Hormone Replacement
Bioidentical hormone replacement therapy (bHRT) refers to supplemental hormones derived from plant material, such as progesterone from wild yam and estrogen from soy. Their safety has not yet been determined. The Holtorf Medical Group published a review of existing case studies and research in the journal "Postgraduate Medicine" in 2009 that found bHRT appears to bear less risk of breast cancer and heart disease than synthetic hormones and they appear to be more efficacious.
DHEA
Another popular choice for management of hot flashes and waning libido is DHEA. DHEA is a hormone made by the body that converts to testosterone and estrogen, but declines with age. Studies have not consistently supported the effectiveness of supplemental DHEA, and some concerns have been raised about its safety. Use of DHEA can increase the risk for developing hormone sensitive cancers, such as breast and prostate cancer. Always consult with a qualified physician before beginning hormone therapy.
Considerations
Herbal remedies and supplements have helped many women manage the symptoms of menopause, but natural substances are not always safe. For example, soy consumed as a food has not been reported to be unsafe in menopause, but extracts of soy used for long periods of time have been shown to thicken the lining of the uterus. Regulation of herbal and dietary supplements is difficult and complex. Always consult a qualified practitioner to make sure your choices are safe.
References
- New Hope 360: Supplements to manage menopause naturally
- "Maturitas"; A review of select vitamins and minerals used by postmenopausal women; Dennehy C, Tsourounis C; August 2010
- "Postgraduate Medicine"; The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?; Holtorf K.; January 2009
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