Treating menopause natural is not always better

While working at Washington Hospital Center in the United States (US) in 2002, I had the privilege of being involved in a very important research study. It was a landmark study examining the effects of the hormones oestrogen and progestin on post-menopausal women. The hormones chosen for the study were conjugated equine oestrogens and medroxyprogesterone acetate (sold as prempro or premele). Up to that point, based on other research, the medical community had great faith in this and similar hormones for the treatment of post-menopausal women.

Oestrogen was a wonder drug of sorts. However, all that came crashing down. In a private meeting, the researcher in charge of the study in my region explained that the study had to be stopped. The researchers did not consider it safe for women to continue the study.

As a result, many women stopped their hormone therapy and many more were afraid to begin treatment. Unfortunately, that meant that many women continued to or began to suffer from almost intolerable symptoms of menopause including hot flashes, night sweats, vaginal dryness and pain with intercourse. Women were and still are eager for safe and natural treatment.

Black cohosh and others

A few natural treatments of menopause have been discussed in medical literature. Black cohosh is effective for the treatment of menopausal symptoms, however, some references suggest that it should not be used longer than six months.

Although some women report improvement of symptoms with red clover, research studies do not consistently prove this treatment to be effective. Evening primrose and dong quai have not been proven to be effective but the research is limited. Ginseng has not been proven to improve symptoms such as hot flashes but it can improve mood and a woman's overall sense of well-being.

Plant products

Phyto-oestrogens are compounds found in plant products such as soy and tofu. They have oestrogen-like properties and some studies show that they improve menopausal symptoms. Unfortunately, other studies are contradictory and no firm conclusion can be made.

They may also lead to weight gain and breast tenderness and because of their oestrogen-like properties, they may not be safe for women with certain types of cancer. All of these treatments may have other side effects and since the data is limited, some of these effects may not be known.

Discuss options

Several years have passed since the initial news about the risks of hormone therapy, and that has allowed time for the information to be analysed and better understood. Certainly, hormone therapy like any medication, has risks, but it also has a number of proven benefits.

Like any medication, it is important that women affected by menopausal symptoms discuss their options with their physician for the best treatment to suit their needs. Natural is not always better.

Dr Monique Rainford is a consulting obstetrician and gynaecologist. Email: yourhealth@gleanerjm.com.