Trick or treat

Alternative therapies for menopause

During menopause, oestrogen levels drop, leading to a number of unpleasant symptoms.
The transition to menopause can significantly affect women’s quality of life, with many willing to try anything to alleviate the hot flushes, night sweats, decline in libido, backaches and other symptoms that result from their drop in oestrogen levels.
Hormone replacement therapy (HRT) is the most effective treatment for the relief of menopause symptoms and works by topping up declining oestrogen levels with a synthetic version of the hormone. It’s effective around 80 per cent to 90 per cent of the time.
HRT comes with a small increase in the risk of breast cancer and blood clots. But due to the severity of the menopausal symptoms, many women believe the benefits of HRT outweigh the relatively small risks associated with the treatment. Being overweight, for instance, carries a far higher risk of developing breast cancer compared with the risks associated with taking HRT for less than five years.
A large clinical trial published a decade ago sparked widespread fears that HRT could cause cancer, stroke and heart disease. While the risks are now considered to have been overstated, they led to a dramatic decline in the use of hormone therapy.
As many as 60 per cent of women between the age 50 to 60 now use complementary and alternative treatments.
But while manufacturers are quick to claim to provide a wide array of benefits to menopausal women, in many instances, there’s little scientific evidence to show they work. Let’s look at what the science has to say about the safety and efficacy of these products.
Phytoestrogens are plant-derived compounds with a similar structure to human oestrogen, but are not as potent as the synthetic hormones used in HRT.

Red clover
Red clover is a plant compound that contains four different isoflavones (formononetin, biochanin A, daidzein, and genistein). It is available as a tablet, tea, or in liquid form and is widely used by menopausal women.
The data is mixed on the effectiveness of red clover to reduce menopausal symptoms. Some studies suggest it delivers no improvement over placebo while others report decreased frequency of hot flushes. There have been no reported safety issues with taking red clover.

So, what’s the verdict?
Although some complementary and alternative therapies may have been used for many years with reports of great success, there is little scientific data to prove their efficacy.
And when studies have been undertaken, they’re of varying quality. Differences in findings across studies of the same product may be due to less-than-optimal trial design, variation in products and composition of products used, inadequate dosing, the length of treatment and small population size.
There’s no doubt that more clinical trials are required to ascertain the effectiveness of such methods in treating menopausal symptoms. In the meantime, exercise caution when taking complementary therapies and talk to your doctor about how they’ll interact with other medications you’re taking.
Just because they’re natural, doesn’t mean they’re risk-free.
* This article by Vasso Apostolopoulos and Lily Stojanovska was first published in The Conversation.