Complementary and Alternative Therapies for Menopause

Natural menopause occurs gradually when your ovaries cease producing the hormone estrogen, signaling the end of your reproductive years. On average, menopause occurs between the ages of 45 and 55 (the average age is 51). The decrease in estrogen produces symptoms, such as hot flashes, night sweats, and vaginal symptoms.

Not every woman experiences menopausal symptoms. In fact, a few women have no symptoms at all. Others may have mild symptoms that barely affect their lives, while others are hindered by symptoms severe enough to dramatically change their day-to-day activities.

The good news is that there are a variety of things you can do to relieve the symptoms of menopause. In many cases, simply changing your diet or incorporating exercise into your lifestyle can help. You may wish to consider nonprescription complementary and alternative treatments as well.

What dietary changes might affect my menopausal symptoms or other health risks?

As your estrogen hormone supply gradually diminishes, you may experience a weight redistribution to your central abdominal area and an increase in your cholesterol levels. Menopause may also increase your risk of heart disease and osteoporosis (weak bones).

For optimum health and well-being during menopause, focus on eating a balanced diet. A healthy diet not only minimizes the additional health risks of menopause, it can also reduce some of the physical and psychological symptoms. Be sure to talk to your physician before beginning a new diet program.

Choose as many fresh, natural foods as possible.
To reduce the risk of heart disease, lower your cholesterol through a low fat, high fiber diet. Ask your physician if a cholesterol-lowering medication is necessary.
To reduce cholesterol, add ground flax seed and/or flax seed oil, which are high in omega 3 fatty acids, to your diet. (Whole flax seed does not work.)
Oats, psyllium (Metamucil), pectin and guar gum can help reduce cholesterol and also prevent constipation.
Fiber also improves blood sugar levels in diabetics and helps with weight loss.
To help avoid reductions in bone mass, avoid excessive amounts of caffeine, alcohol and some carbonated drinks.

Can exercise improve my symptoms or decrease my risks?

Weight bearing (antigravity) exercises such as walking or weight training can slow bone loss. Any type of regular exercise can help decrease mild to moderate depression and often can be as effective as taking medication.

Can stress reduction help?

Studies have shown that meditation can improve sleep and reduce anxiety, blood pressure and hot flashes by 50 percent.

How effective are complementary and alternative treatments?

Complementary and alternative treatments such as vitamins, minerals, herbs and other supplements may help relieve your menopause symptoms; however, there is limited data on their effectiveness. Be sure to discuss any alternative or complementary treatments with your physician as some, especially herbs, can interact with medications or cause bleeding problems during surgery.

Vitamin E might decrease hot flashes (400 mg twice daily). One study of people over age 60 showed an increased risk of death among older people who took more than 400 units of vitamin E daily. Clinical trials on safety and effectiveness continue.
Calcium (with vitamin D and magnesium) is important to prevent osteoporosis. Combining exercise with calcium supplements (400 mg calcium three times daily) is more effective than either calcium or exercise alone.
Gugulipid (an extract of the myrrh tree) might lower total cholesterol, LDL and triglycerides (250 mg to 500 mg three times daily).
Red yeast rice (1200 mg twice daily with meals) has been shown to lower cholesterol as much as prescription drugs but is no longer available commercially. As with prescription cholesterol medication, it is important to have periodic liver enzyme tests. Websites promoting this supplement have substituted policosanol products (a sugarcane derivative) but few studies show its efficacy.
Black cohosh is the herb most widely studied for relief of menopausal symptoms. Eighty mg taken twice daily might provide relief of hot flashes and should be taken with meals but for no more than six months.
The herb kava has been shown to improve anxiety and depression (100 mg three times daily).
The herb ginkgo biloba might enhance mental sharpness by increasing blood flow to the brain (400 mg three times daily with meals).
The herb valerian might be an effective sleep aid (400 mg to 1000 mg at bedtime). Few adverse events have been reported. Long-term safety data is not available.
A cup of chamomile tea can be an effective sleep aid.
Red clover and Dong Quai were not shown to be effective in treating menopausal symptoms, night sweats and hot flashes.

Is eating soy an effective alternative for hormone replacement therapy?

Soy is rich in phytoestrogens (plant estrogens), particularly isoflavones. Studies show diets high in soy reduce vaginal dryness, hot flashes and might reduce breast and prostate cancer. Studies of soy-based diets also show a decrease in total cholesterol of nine percent and a decrease in LDL cholesterol of 21 percent.

Soy also inhibits bone loss, but not as well as medications designed for this purpose. Soy might be an option for women who cannot or will not use HRT, reloxifene or alendronate (medications which prevent and treat bone loss). Soy might also be a safer alternative to HRT for women with a history of cancer since plant estrogens do not stimulate cell production in the breast or uterus.

It is difficult to get enough phytoestrogen and isoflavones to get relief of menopausal symptoms by eating tofu or other soy products. You would have to eat three packages of tofu daily to get 200 mg of isoflavones, which equals a half dose (.3 mg) of Premarin (an estrogen supplement).

However, it takes less soy to improve heart health. You would need only 25 g of soy protein daily to reduce your risk of heart disease. Good sources of soy include soybeans (about 3 oz uncooked or roasted or 6.3 oz green soy beans contains 25 g of soy protein), soy flour (about 1.5 oz), soy milk (20-50 oz), tempeh (about 6 oz), some meat substitutes (about 4.5 oz) and tofu (6.7 oz).

There is no research that shows soy (fermented or not) to be dangerous to health despite recent publicity.