Menopause

Complementary therapies

With uncertainty about the use of HRT, complementary therapies have become a popular ‘natural’ alternative to prescription medicines. Pharmacies, supermarkets, health food shops and internet websites offer a wide variety of herbal remedies including red clover, agnus castus and St Johns Wort, which claim to help relieve menopausal symptoms.

Yet, unlike conventional medicines, complementary therapies are not officially regulated and may be potentially dangerous. Recent research, for example, suggests a possible link between black cohosh and liver damage. Because so little scientific research has been done on the effectiveness and safety of these products, the NHS does not recommend the ‘use of any complementary therapies for menopausal symptoms’.

Despite the controversy about their use, many women had used complementary approaches to try to alleviate their symptoms.

Why women try complementary therapies
Some women were understandably wary about trying complementary therapies. They talked about being ‘very cautious about taking drugs’, or about the side effects they’d experienced while taking herbal remedies. One woman tried St Johns Wort for depression but found it gave her ‘terrible headaches’.

Yet while often reluctant to take hormone replacement therapy (HRT) (see ‘Hormone replacement therapy (HRT)’), many women we talked with felt that herbal remedies offered a safer and more ‘natural’ alternative to prescription medication, as well as giving them a sense of control over their symptoms. One woman preferred complementary therapies because they didn’t ‘mess my system up’; another said ‘it can’t hurt’ to drink sage tea.

While women discussed the pros and cons of hormone replacement therapy (HRT) with their doctor before deciding whether or not to take it, their decision to try herbal remedies was often more relaxed (see ‘Consulting the doctor’). Some women tried herbal remedies on the suggestion of their GP; others felt their GP didn’t seem to know much about these products or was reluctant to recommend them. One woman’s doctor warned her of the possible risks, ‘you don’t know what you’re putting into your body with all those natural supplements’. Most women, however, did not consult their doctor but had bought products on the recommendation of friends, or after reading about them in magazines or on the internet.

What herbal remedies do women take?
Evening primrose oil, black cohosh, red clover and sage promise to relieve hot flushes; St Johns Wort offers an alternative to antidepressants; valerian is said to reduce anxiety; ginkgo biloba may improve memory; and agnus castus may help regulate hormone fluctuations and premenstrual tension. Dietary supplements containing phytoestrogens, such as soy isoflavones, have a weak oestrogen effect which may help reduce hot flushes and other menopausal symptoms. Some products contain a mixture of supplements formulated to meet the needs of menopausal women.

Some women bought herbal products over-the-counter or via the internet, others consulted alternative therapists who offered a more individualised and holistic approach. One woman saw a herbalist at a clinic where she works and is now taking a ‘tonic that supports the menopause’; another saw a complementary health person who ‘did lots of testings, connecting things to my toes and to my finger tips’ before prescribing creams and tablets.

What women think of herbal remedies
Women tried all sorts of herbal remedies. Some found relief in the short-term, but benefits were not always sustained, particularly when symptoms got worse. One woman said that valerian capsules worked ‘really well’ for helping her get off to sleep but were ‘not so good’ when she woke up during the night with hot sweats (see ‘Sleep’, ‘Hot flushes and night sweats’). A sage infusion eased another woman’s hot flushes for about three months but then had no effect.

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Some women found no effect at all from herbal remedies. One tried red clover for a few months after going off HRT but found it ‘didn’t make any impact whatsoever’. Some women had been taking remedies for years unsure whether or not they were helping them. One woman felt ‘pretty sure’ evening primrose oil helped her hot flushes, but realised that this might be a ‘placebo effect’.

Women acknowledged that the success or otherwise of these products depends on their commitment. Some blamed themselves for not being ‘diligent enough’, admitting that if herbal remedies didn’t work immediately they gave up. Those who did persevere found complementary therapies very expensive and beyond the reach of many people. One woman talked about paying £120 for an initial consultation with a Chinese herbalist for acupuncture and herbal remedies; another paid ‘50 Euros per session including remedies’ for a consultation with a homeopath.

Acupuncture, homeopathy and other alternative treatments
Other complementary therapies such as acupuncture and homeopathy are also offered as an approach to symptom relief. One woman had an acupuncture session once a month for six months which she found relaxing. Although her sweats improved for a few months, they came back again and she found that overall acupuncture ‘didn’t make any dramatic difference’. Another woman tried craniosacral therapy, acupuncture, cognitive behavioural therapy (CBT), and yoga to manage her anxiety; all without success (see Donna's interview below).

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When complementary therapies fail
When faced with distressing symptoms which interfered with their daily lives, some women said they turned to HRT or other prescription medication rather than persevere with complementary approaches (see ‘Hormone replacement therapy (HRT)’ and ‘Non-HRT and lifestyle options’). One woman wanted to manage the menopause herself without ‘resorting to drugs’ but turned to her GP for advice when natural remedies failed to relieve her symptoms; another was prescribed temazepam for insomnia after valerian failed to restore her sleep (see ‘Sleep’). Other women chose to put up with symptoms or relied on their own coping strategies (see ‘Hot flushes and night sweats’).

With complementary therapies freely available, the decision on whether or not to use them is an individual one. For some women they may be an alternative to HRT and may help relieve symptoms in the short-term, but the NHS does not recommend their use (see NHS Choices information on menopause). At present there is no medical evidence that complementary therapies really work, and the quality of products used, their long-term safety, side effects and interactions with other medications are uncertain.

Last reviewed February 2015.

Last updated February 2015.

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