Make a donation

Complementary/alternative therapies for menopausal women

Introduction

The majority of women experience a natural menopause (sometimes called the 'change of life') when the periods finish, usually around the age of 51 years. During the years when women are having periods, the ovaries produce eggs and the female hormones oestrogen and progesterone. As women approach the menopause, there are few remaining eggs in the ovaries and those that remain are less likely to develop. Fewer eggs are released and less of the hormones are produced, until the ovaries finally stop working and periods stop. Sometimes the menopause is accompanied by uncomfortable symptoms. These symptoms are caused by fluctuating and lower levels of oestrogen.

Whilst some women are happy to use conventional treatment such as HRT, others may wish to consider complementary/alternative therapies. Complementary therapies complement conventional medical practices and are not usually used on their own while alternative methods are replace conventional medicine with other options.

Complementary therapies

These have become a popular accompaniment to conventional medicine and many women use them, although limited scientific research has been done to support their effect or indeed their safety. They may help with the troublesome symptoms but they are unlikely to have any effect on bones or the heart and blood system.

The choice of complementary/alternative therapies is confusing; so many different ones exist. Those that have been reported as being helpful in the menopause include massage, aromatherapy, reflexology, herbalism, homeopathy and acupuncture. It is important that each woman finds a complementary therapy that seems right for her.

Treatments

Acupuncture

There have been studies that show acupuncture may be beneficial in reducing hot flushes but more research needs to be undertaken.

Aromatherapy

There are currently no trials related to the effectiveness of this method of managing symptoms but some women do find that it is beneficial and some studies suggest a reduction in anxiety.

Ayurveda

This is an ancient Indian holistic approach to health and includes a variety of treatments by herbs, detoxification and massage. Practitioners are likely to be found in Asian communities.

Homeopathy

Homeopathy consists of the use of minute doses of a medicine which has matching characteristics to the patient's symptoms, to stimulate healing processes and reduce or eliminate the symptoms and the disorder. Studies have shown a beneficial effect on menopausal symptoms. Try to get good quality advice from a trained homeopatist – often there will be a GP in your practice or area that has been trained.

Reflexology

Reflexology or zone therapy is an approach to health which involves a method of treatment using massage to reflex areas found most commonly in the feet and the hands which are linked to other areas and organs of the body. Symptoms relief has been shown in some studies although there is little research.

Herbal treatments

Whilst this may seem as a more natural method of managing period and menopausal symptoms, and products are widely available both in this country and others, there is no effective reporting of side effects.

Not only are some very costly but there is no regulation over them and the content and quality is not always reliable and may contain potent chemicals even though many people believe that herbs are natural and therefore not harmful. Be cautious and buy reputed brands. Be especially careful of Chinese Medicines, which have been found to contain small amounts of active drugs, and cases of kidney toxicity have been documented.

Herbal therapies therefore should be used with caution and in agreement with your GP.

Agnus Castus

This is a compound known as Chasteberry and has been used effectively traditionally. There have been studies, reported in the British Medical Journal which have shown its value for the treatment of Pre-menstrual Tension/Syndrome. It has a hormone regulating effect and is particularly useful in the peri-menopausal phase to help settle the hormone fluctuations but is only useful if other hormones are not already being taken. Caution must be applied due to the possibility of an interaction between oral contraception and HRT.

Black Cohosh

A North American traditional herb has been used for a diverse range of ailments including relieving menstrual pains. It is thought to contain phytoestrogens. Black Cohosh is also very useful for the emotional symptoms of menopause as well as mood swings and depression. It has been found by some women to assist with hot flushes and can help to reduce blood pressure. However, there have been mixed results by studies that have done research on the effects on black cohosh. One study of 340 women reported a benefit of black cohosh but smaller studies have found the supplements to be no better than a placebo. There is a possibility of interaction with BP treatment and should be used with caution by those who are sensitive to aspirin. It is important to discuss this with your GP, especially if you are having treatment or are taking other medications and it is not advised for women with a history of breast cancer.

Evening primrose oil/sunflower oil

These are used particularly for relief of breast soreness or pain. They have also been found to relieve hot flushes and there are some reports of benefit in mood swings. Use the 240mg tablets with GLA (gamma linoleum acid) for 2 to 3 months and then reduce the dose. However, there may be side effects of headaches, nausea and skin rash. An interaction with anti inflammatory drugs such as beta blockers, anti coagulants, or anti psychotics is possible.

Ginkgo Biloba

Also known as Memory Tree, this herbal treatment is probably one of the oldest medicinal herbs. Today Ginkgo extracts are widely prescribed, increasing arterial and having an effect as a result on memory circulation. It should not be taken with Aspirin or Warfarin.

St John's Wort

Hypericum perforatum or commonly known as "Nature's Prozac" which acts when the herb's monoamine oxidase (MAO) inhibits neurotransmitters in the brain to have an anxiety reducing and anti-depressant effect. Some studies show it to be as effective as some traditional anti-depressants but better tolerated and without the side effects. It may be useful for women suffering mild to moderate anxiety and depressive symptoms at the menopause.

St John's Wart should not be taken during pregnancy and regular use may increase sensitivity to sunlight. Check with your pharmacist if taking other medications such as digoxin, the oral contraceptive pill, migraine drugs, anti-asthma (theophylline) and anti-epileptic drugs, warfarin, cyclosporin, HIV drugs and others and do not take with other anti depressant drugs. There are also some foods to be avoided.

Sage

This herb can be taken as a tea or as an extract to help with hot flushes having some effect on regulating hormones. It should not be taken if there is a problem with other hormones or if taking tamoxifen.

Valerian

Valerian root is effective as a relaxant and sedative and is used for insomnia, irritability and tension with few side effects usually associated with sleeping and tranquillising drugs.

Ailment	Herbal Treatment
Anxiety	Valerian, St Johns Wort
Breast soreness	Evening Primrose
Circulation	Gingko Biloba, ginger
Depression	St Johns Wort
Dysmenorrhoea	Black Cohosh
Hot Flushes	Black Cohosh, Red Clover, Sage
Insomnia	Valerian
Memory	Gingko Biloba
PMS and mood swings	Agnus Castus, Black Cohosh

Lifestyle changes

If you are reluctant to try HRT or any alternative therapies it is important to note that a personal change in lifestyle may have a positive effect on the frequency and severity of symptoms.

Exercise and stress-management strategies can also have a positive effect on mood and help reduce symptoms of menopause.

Exercise

An exercise program should include a combination of aerobic, weight-bearing, strengthening and flexibility exercise. Exercise has been proven to improve mild symptoms of anxiety and depression and can improve mood, speed up the metabolism and improve sleep. Also, an exercise program that includes a combination of exercises can help prevent cardiovascular disease, have a positive impact on bone mass and can help prevent falls and conditions like arthritis.

Stress-management

A person's individual coping mechanisms play a large role in stress management. Part of the reason women may be so stressed is because they play many roles in their families and lives such as caregiver, social support and bread winner. In order to cope with these varied roles it is important to learn how to manage stress. For example, people can learn how to change negative thinking patterns by reading self-help books or consulting a therapist. Another ideal way to manage stress is by participating in yoga, massage, relaxation/meditation, Tai Chi and exercise.

Dietary changes

There are some foods that are likely to trigger flushes typically caffeine, alcohol and spicy food and it would be worth avoiding these to see if symptoms improve.

There has been an interest in the effect of multivitamins and mineral supplements on menopausal symptoms over several decades. Although there is no published data, anecdotally some women have reported a benefit from a daily multivitamin and mineral supplement. A good varied diet with at least five portions of fresh fruit and vegetables, together with brown bread and whole grain products daily will probably provide all the necessary vitamins and minerals and this is advised for a healthy heart. Calcium and vitamin D supplements have been shown to reduce osteoporosis. One thousand grams of calcium daily halved the rate of bone loss leading to a reduction in hip fracture risk of 22% compared to other women. Most studies show that a daily calcium intake of 1500mg is necessary in postmenopausal women not taking HRT, to preserve bone health.

It is curious that cultures around the world that have traditional diets containing large amounts of soy, beans and lentils have fewer menopausal symptoms. Although there are probably a number of reasons, genetics, lifestyle, climate, education and psychology, diet does seem also to play a role as these foods contain large amounts of phytoestrogens.

Phytoestrogens

Phytoestrogens or plant oestrogen in our diet can be taken either by increasing dietary intake or from supplements but this would involve the ingestion of large amounts of legume food plants. Red Clover is an excellent source of all the different isoflavones and it is thought to regulate fluctuating hormone levels and help with menopausal symptoms such as hot flushes.

There are many different types of phytoestrogens, but the group that is thought to be most significant is isoflavones. Isoflavones have a very, very weak oestrogen effect compared to women's natural oestrogen, so before the menopause when they are competing with high levels of oestrogens, they have an anti oestrogen effect. But after the menopause if the diet contains enough they have a cumulative oestrogen effect. The effect of phytoestrogens on menopausal symptoms is still debatable.

And finally… always keep your doctor informed. As many women are becoming interested in alternative approaches, new research and information on alternatives is becoming available, which will provide greater choice and more effective treatments.

Useful contacts

Aromatherapy Consortium

Website: www.aromatherapy-regulation.org.uk

Email: aromatherapy-regulation.info.org.uk

Ayurveda Holistic Centre

Website: www.ayurvedahc.com

Ayurvedic Medical Association UK

Tel: 01908 617089

17 Bronham Mill, Gilford Park, Milton Keynes MK14 5KP

British Acupuncture Council

Tel: 020 8735 0400

Email: info@acupuncture.org.uk

63 Jeddo Road, London W12 9HQ

British Reflexology Association

Tel: 01886 821207

Email: bra@britreflex.co.uk

Monks Orchard, Whitbourne, Worcester WR6 5RB

National Association of Aromatherapy

Website: www.aocuk.net

PO Box 19834, London SE25 6WF

The Complementary Medical Association

Website: www.the-cma.org.uk

The National Institute of Medical Herbalists

Tel: 01392 426022

Website: www.nimh.org.uk

56 Longbrook Street, Exeter, Devon EX4 6AH

Society of Homeopaths

Tel: 01604 621400

2 Artizan Rd, Northampton NN1 4HU

Print this page
[printer friendly version]

Download this factsheet
[PDF, 73KB]