First let's establish this: menopause is a natural state, not a disease. It begins to happen at around age 47 for most women, and continues until a woman has not had a menstrual period for 12 months. The average age that women have their last period is 51. But this can happen much earlier for some women, and later for others.
During the menopause years, a woman's levels of the hormone estrogen slowly decrease. Symptoms of menopause include:
- Hot flashes, night sweats, severe perspiring (these are called vasomotor symptoms)
- Vaginal dryness, which can lead to painful intercourse
- Difficulty sleeping
Other symptoms that women report when they're approaching menopause include:
- Mood swings and changes, such as irritability and anxiety
- Problems concentrating or remembering things
- Loss of ability to control urination
- Painful, stiff joints
Some women have very few symptoms, or very mild symptoms, and menopause doesn't give them much trouble. Others find menopause quite difficult
Until very recently, many doctors prescribed estrogen to help control menopausal symptoms for a large portion of their menopausal patients. This was called HRT, or hormone replacement therapy. But a landmark study in 2002 found that HRT increased the risk of breast cancer, didn't provide the cardiovascular benefits that had been expected and increased the risk of blood clots.
Doctors do still prescribe HRT, which is now more likely to be called MHT, or menopausal hormone therapy, to relieve symptoms for some patients. But they're much more cautious about it, and they prescribe it for far fewer women, usually for a shorter period of time. This has put many women, who strongly relied on HRT, in the position of looking for non-prescription alternatives for symptom relief.
There are alternative treatments available, but before you try any of them, be sure to talk with your doctor first. Botanicals and supplements can interact with prescription and over-the-counter medications. Additionally, your doctor may think that some of these alternatives may not be appropriate for you, based on your health profile.
Here are some of the common alternative treatments for menopause symptom relief and what a panel of experts from the National Center for Complementary and Alternative Medicine has to say about them:
Black cohosh: It's been said that this herb can relieve hot flashes. However, there's conflicting information from very recent studies. One, from the Annals of Internal Medicine, says that black cohosh is not effective. The other, from the Journal of Agriculture and Food Chemistry, says that it is effective. If you're interested in trying it, talk with your doctor. One important warning: black cohosh may interfere with certain cancer treatments. It really is important to talk with your doctor before trying this or any other "natural" product.
Red clover: There's no good evidence from reliable studies saying that red clover reduces hot flashes. And there is some concern that it might have harmful effects on tissue that's hormone-sensitive, such as the breast and uterus.
Dong quai: There's no strong evidence, so far, that this herb is effective.
Ginseng: The NCCAM panel concluded that ginseng may be helpful in the treatment of mood symptoms and sleep disturbances, but not in controlling hot flashes.
Kava: First of all, it's important to note that the Food and Drug Administration has issued a warning that kava has the potential to damage the liver. There's been some evidence that kava can help decrease anxiety, but not that it can help with hot flashes.
Soy (tofu, tempeh, miso, edamame): There continue to be negative and positive results regarding the effects of soy on hot flashes. Additionally, there have been some studies suggesting soy can increase the risk of breast cancer. Experts differ. Some say that small amounts of soy every day could be beneficial. Others disagree. The best thing is to talk to your doctor about the risks and possible benefits of soy before you make any decisions about it.
In addition to herbs and supplements, don't forget about some of the basic lifestyle factors that can help improve hot flash symptoms, such as:
—A daily stress-reduction practice, such as deep breathing, yoga, t'ai chi, qigong, meditation
Annals of Internal Medicine, 19 December 2006; Journal of Agriculture and Food Chemistry, 26 December 2006; National Center for Complementary and Alternative Medicine