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Menopause Symptoms -- Herbs No Help?
July 24, 2006 -- There's no proof any of the alternative or complementary herbal therapies used by women for menopausal symptoms help -- at least not in English-language scientific literature.
That's the conclusion of Oregon Health & Science University researcher Ann Nedrow, MD, and colleagues. Nedrow and colleagues looked in 1,432 studies for evidence any nonmedical treatment might work.
They found 70 studies that met scientific standards, but none that had evidence proving an alternative or complementary therapy relieves any symptom of menopause. This doesn't mean the therapies don't or can't work. It only means there's no proof they do.
"Lifestyle modification and mind-body techniques may have high safety profiles and result in additional health benefits," Nedrow and colleagues conclude. "Many alternative therapies used by menopausal women, such as massage, aromatherapy, yoga, and ayurvedic therapy, need to be studied in randomized, controlled trials," they say.
Types of Therapies
Nedrow and colleagues note five categories of alternative/complementary therapies:
- Biologically based therapies. These include botanicals, animal-derived products, fatty acids, vitamins, minerals, probiotics, diets, and functional foods.
- Mind-body therapies. These focus on the ways emotional, mental, social, spiritual, and behavioral factors affect health.
- Energy therapies. These try to make use of real energies, such as electromagnetic forces, or hypothetical energies, such as life-force energy.
- Manipulative and body-based therapies. These include chiropractic, osteopathy, massage, and other techniques.
- Whole medical systems. These involve medical systems outside Western medicine, such as traditional Chinese medicine and ayurvedic medicine.
The problem with most studies of these techniques, Nedrow and colleagues find, is they are small and have various methodological problems making their results difficult to reproduce. These problems include nonstandardized study populations, varying definitions of menopause, nonstandardized outcome measures, and nonstandardized biological therapies.
For example, one trial showed a benefit for a brand of black cohosh, as did earlier German studies. But other studies found no benefit -- and the various studies can't be compared directly.
The biggest problem, however, is the placebo effect, which is particularly strong for menopausal symptoms. In a study of hormone therapy for hot flashes, for example, half of the women getting fake treatment said their symptoms improved.
Nedrow and colleagues note that 42% of Americans used some kind of alternative medicine in the last year. Menopausal symptoms are one of the most common reasons for seeking these treatments. Yet 70% of menopausal women using them don't tell their doctors.
The researchers say more high-quality research is needed. Until then, they urge doctors to create an atmosphere in which menopausal women feel free to discuss any treatments they may be using.
Nedrow and colleagues report their findings in the July 24 issue of Archives of Internal Medicine.
Menopause Guide
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
Ob-Gyn Laura Corio talks about the importance of exercise during menopause.
