Non-hormonal therapy of post-menopausal vasomotor symptoms: a structured evidence-based review |
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Authors: | Deepti Cheema Arri Coomarasamy Tarek El-Toukhy |
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Institution: | (1) Royal Worcestershire Hospital, Worcester, UK;(2) The Assisted Conception Unit, Guy’s and St. Thomas Hospital, 4th Floor Thomas Guy House, St Thomas Street, SE1 9RT London, UK |
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Abstract: | Background Interest in non-hormonal therapies for the treatment of menopausal symptoms has increased since the publication of adverse
effects of estrogen replacement therapy.
Objective To provide information on the efficacy of non-hormonal therapies for menopausal vasomotor symptoms based on evidence from
published randomised controlled studies.
Methods The Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Alternative Therapies in Health and Medicine database (ATHMD)
and Allied and Complementary Medicine database (AMED) were searched for randomised controlled trials in the English language
reporting data on treatment of menopausal vasomotor symptoms. Trials including cancer breast patients were included.
Results Our search identified 58 randomised controlled trials of which 11 involved the use of clonidine, six for SSRIs, four for gabapentin,
seven for black cohosh, seven for red clover, 18 for phytoestrogens, two for ginseng, one for evening primrose, one for dong
quai and one for vitamin E. Most trials had methodological deficiencies.
Conclusion There is evidence that clonidine, paroxetine, venlafaxine, gabapentin and black cohosh may be beneficial in the treatment
of menopausal vasomotor symptoms in some women. Current evidence does not support the use of fluoxetine, red clover, phytoestrogens,
Ginseng, evening primrose, dong quai and vitamin E. The side effects profile of these therapies should be considered. |
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Keywords: | Menopause Vasomotor symptoms Hormone replacement therapy Non-hormonal Complimentary Herbal and alternative therapy |
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