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July 23, 2001 -- Long gone are the days when women suffered through hot flashes and night sweats in silence and chalked it up to the dreaded "change of life."
Today, in addition to the hormone medications available to help relieve menopausal symptoms, there are a wide range of so-called "alternative therapies," many of which are thousands of years old.
One of the best known of these is soy, which is found in products ranging from milk and yogurt to burgers. Soy is found in plants but has similarities to the female hormone estrogen. Soy and several other alternative therapies have become so popular among menopausal women that the American College of Obstetrics and Gynecology recently issued a paper to its members to help them advise women about effectiveness, side effects, and other issues.
"The challenge has come from women seeking information," says Maida Taylor, MD, principal author of the paper. "[There is] a tremendous cash outlay by women and a tremendous marketing onslaught from the manufacturers of alternative therapies. All of this has raised the bar and put it as a challenge to us to look into these things more thoroughly."
Two widely advertised herbal products, RemiFemin Menopause and Estroven, contain extract of black cohosh, a member of the buttercup family. ACOG says black cohosh has been proven effective for hot flashes and night sweats, but the longest studies have only looked at use of the herb for six months.
For hot flashes and night sweats, soy also may be an effective short-term treatment, says ACOG, but the group cautions that large amounts of soy can interfere with hormone replacement therapy and may be potentially dangerous for women with a history of an estrogen-dependent cancer of the breast, uterus, or ovaries.
Taylor, an associate clinical professor of obstetrics, gynecology, and reproductive medicine at the University of California, San Francisco, reminds us that herbal therapies are not regulated like drugs are, so manufacturers can make health claims about their products without having to do studies to back up those claims.
She says women often go to their doctors with a "shopping bag" full of herbal remedies and need help narrowing down what they should take and how much of it they need.
"Consumers definitely want a physician who is willing to consider herbal treatments," says Geoffrey Redmond, MD. "They're not turning away from standard medicine, but they want to be able to explore these options."
Redmond, an endocrinologist with the Hormone Center of New York in Manhattan, is an advocate of soy. He says there are no obvious side effects from eating it.
"I can't say there isn't a small subgroup where it's [not recommended], but I certainly think that there is no reason to be alarmed about it and there is a lot of reason to think that it's very healthy," he tells WebMD.
Other common alternative therapies for menopausal symptoms are wild yam and the Chinese herb Dong Quai as well as evening primrose oil and St. John's wort. Taylor cautions, however, that studies on these products are limited, so women should choose herbal treatments carefully and not consider them safe simply because they are "natural."
Redmond says women who get an improved sense of well-being from alternative menopause therapies should be encouraged and supported by their doctors. However, he reminds that hormone replacement is often prescribed to menopausal women not only to relieve hot flashes and night sweats but also to protect their bones from osteoporosis as they age.
Therefore, he advises women who choose alternative therapies to have their bone density checked regularly and to talk to their doctors about getting adequate amounts of calcium and vitamin D in their diet.