Menopausal symptoms and alternative medicine

With the large number of women entering the perimenopausal and menopausal age range in the next decade, use of alternatives to standard hormone replacement therapy will increase. Women’s views of conventional hormone replacement and trends toward “complementary and alternative medicines” have contributed to an increased use of alternative treatments for menopausal symptoms. Growing media coverage and lay literature available on “natural” therapies for the climacteric are making it virtually impossible for practitioners to remain unfamiliar with the various regimens. Information on phytoestrogens, natural progesterones, mineral and vitamin supplements, herbal treatments, exercise, relaxation, acupuncture and homeopathy is flooding the market. Although alternatives to conventional hormone therapy are becoming mainstream, scientific evidence on the safety and efficacy of “natural” therapies is limited. Lack of standardization of alternative supplements and lack of regulation also make it difficult for both consumers and practitioners to evaluate these therapies. Well-designed, controlled studies are needed to obtain further information about these regimens. This, however, is no excuse for practitioners to be unaware of what products are available and their possible benefits and adverse effects. The evidence for various alternative therapies for menopausal symptoms is reviewed in both the lay and medical literature.