All women eventually experience menopause. When they do, several will have to cope with varying symptoms, such as hot flashes, vaginal dryness, reduced libido, and mood swings. To prevent or attenuate these manifestations, experts suggest improving several life habits: exercising regularly, stopping smoking, keeping an active sex life, loosing some weight and drinking less alcohol, for example. Hot flashes affect 50 to 80% of menopausal women and are often mentioned as the main discomfort of this transitional phase. Still, several options can be considered to alleviate the symptoms. First, factors that trigger hot flashes should be identified and avoided. It could be spicy foods, hot beverages, inside or outside temperature that is too hot, prolonged sun exposure, hot baths or showers, abrupt temperature changes or synthetic clothing. Women with severe menopausal symptoms may find that lifestyle changes are not enough to relieve their symptoms. These women should consider hormone therapy to cope with the negative symptoms of menopause and to help keep their bones healthy. Unfortunately, an increased risk of breast cancer, venous embolism and other cardiovascular events associated with hormone therapy may counter its benefits. Still, hormone therapy remains a safe alternative for short-term treatment of menopausal symptoms in most women.
Because of the controversy surrounding hormone therapy, more and more women are seeking natural products to improve their quality of life. However, data on the long-term efficacy and safety of natural products are lacking. Here is a quick review of the products marketed to treat menopause for which some form of positive scientific data exist. Black cohosh (Actea racemosa, Cimicifuga racemosa) is a recognized treatment of menopausal symptoms in Europe. The medical community generally accept that extracts from this plant are mildly effective against hot flashes. Experts suggest taking a standardized extract that provides 1 mg of triterpene glycosides per 20 mg (such as Remifemin®) twice a day. Up to four weeks of therapy may be necessary to see results. Ginseng (Panax ginseng, Panax quinquefolius) is used in traditional Chinese medicine to improve the global health of menopausal women. It appears to improve wellness and general health but not hot flashes. Ginseng is associated with many drug interactions. Consequently, you should always check with your pharmacist before taking it. St John’s Wort efficacy in mild to moderate depression is generally recognized, but only one study was done specifically on menopausal women. Study results suggest that this product (900 mg per day) may improve psychological and vasomotor (hot flashed, sweating, dizziness) symptoms. St John’s Wort is also associated with several significant drug interactions. Always talk to your physician or pharmacist before using it. Dietary phytoestrogens, more specifically isoflavones, are found in legumes, mainly soy, and have a chemical structure similar to the estrogens produced by the human body. The fact that Asian women have to cope with far less hot flashes than Occidental women suggest that regular consumption of soy products (tofu, soy beverages, soy proteins, etc.) may alleviate menopausal symptoms. Flax seeds and red clover extracts are also good sources of phytoestrogens. The long-term safety of these products is not established, but they do not appear to be associated with any specific toxicity. They can however interact with other drugs. Always use them with caution.
Other approaches, such as acupuncture and relaxation, may also improve menopausal women’s feeling of wellbeing.
If you are taking medication on a regular basis, tell your pharmacist and physician about your wish to use natural products since many are associated with drug interactions. Physicians and pharmacist can help menopausal women deal with their condition: don’t hesitate to talk to them!