What about herbal remedies?
There are many
"herbal" products for sale that claim to help menopausal symptoms. These
products are not regulated through the same government system as drugs, so
there is little research to back up their claims. In addition, most have
to be taken routinely, are not covered by insurance, and can become costly
over time. Any herbal remedies for menopause should be thoroughly
discussed with your health care provider. You should tell your provider if
you are taking any other medications, since some of the herbal products
can have harmful interactions with other drugs.
However, there
are some products that seem to help some women. Soy and soy products have
been used for the alleviation of menopausal symptoms due to their high
concentration of phytoestrogens. Phytoestrogens are plant-derived
compounds that possess estrogenic activity, and therefore could have some
of the same effects as HRT, but their long-term safety has not been
adequately studied. There is limited, and sometimes conflicting, research
on the safety and effectiveness of many other popular herbal products that
claim to help menopause, including ginseng, black cohosh, dong quai, and
evening primrose.
Recently, the
American College of Obstetricians (ACOG) issued the following guidelines
on the most popular "alternative" medicines for menopause:
- Soy and
Isoflavones (plant estrogens found in beans, particularly soybeans)
- High isoflavone intake (about 50 grams of soy protein per day) may be
helpful in the short term (2 years or less) in relieving hot flashes and
night sweats. Taken over the long term, it also may have beneficial
effects on cholesterol and bones. While safe in dietary amounts, the
consumption of extraordinary amounts of soy and isoflavone supplements
may interact with estrogen and may be harmful to women with a history of
estrogen-dependent breast cancer and possibly to other women as
well.
- St.
John's wort - May be helpful in the short-term (2 years or less) to
treat mild to moderate depression in women (when given in doses of less
than 1.2 milligrams a day.) A recent study showed it is not effective in
treating severe depression. It also can increase skin sensitivity to the
sun and may interfere with prescription antidepressants.
- Black
cohosh - May be helpful in the short term (6 months or less) to
treat hot flashes and night sweats. It seems to be extremely safe,
although studies have been small and brief, none longer than six
months.
- Chasteberry (also known as monk's pepper, Indian spice,
sage tree hemp, and tree wild pepper) - This may inhibit prolactin, a
natural hormone that acts on the breast. It is touted for breast pain
and premenstrual syndrome. There are very few studies in menopausal
women. A study of women with premenstrual syndrome found they reported
improvements in mood, anger, headache, breast fullness, but not bloating
and other symptoms.
- Evening
primrose - This plant produces seeds rich in gamma-linolenic acid,
which some experts believe is the nutritionally perfect fatty acid for
humans. Although evening primrose capsules are taken for breast pain,
bladder symptoms and menopausal symptoms, there is little or no evidence
that they work. The one high quality study of effects on hot flashes
found that evening primrose was no better than placebo.
- Dong
quai - A study aimed at reducing hot flashes found that dong quai
was not better than placebo - although the 4.5-gram dose used in the
study was lower than that typically given in Chinese medicine. The herb
is potentially toxic. It contains compounds that can thin the blood,
causing excessive bleeding, and make the skin more sensitive to sun,
possibly increasing skin cancer risk.
- Valerian
root - This has traditionally been used as a tranquilizer and
sleeping aid. But the U.S. Pharmacopoeia, which sets manufacturing
standards for medicines, does not support its use, and there have been
reports of heart problems and delirium attributed to sudden withdrawal
from valerian.
- Ginseng - Most of the many types of ginseng (including
Siberian, Korean, and American, white and red), are promoted for
relieving stress and boosting immunity. A study of menopausal women by
the leading ginseng manufacturer found the product did not relieve hot
flashes but did improve women's sense of well being. Analyses of ginseng
products have found a troubling lack of quality control: some contained
little or no ginseng, contained large amounts of caffeine, or were
tainted by pesticides or lead.
- Wild and
Mexican yam - There are no published reports that show wild and
Mexican yam cream is effective in helping menopausal symptoms. The
hormones in wild and Mexican yam do not have any estrogenic or
progestational properties, so they are not expected to help women with
these symptoms.
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