Alternative menopause treatments are failing womens’ health needs

For many of the 3.7 million women aged 40 to 65 years in Australia, who account for 14% of the population, menopause presents a more than uncomfortable health challenge.  But it turns out the alternative medicines you’ve been turning to are not only not delivering results, they’re being seen as concerning.

Have you used alternative therapies to treat menopause symptoms or other symptoms?

Use of oestrogen for the relief of menopausal vasomotor symptoms (VMS) (eg, hot flushes, night sweats) was common until 2002, when concerns about the safety of menopausal hormone therapy (MHT) arising from a Women’s Health Initiative study  triggered a dramatic decline in the prescription of MHT. Concurrently, the use of complementary and alternative medicine (CAM) has grown considerably, with one Australian study reporting that most women presenting to a menopause clinic had used CAMs for their menopausal symptoms.

However, there is insufficient evidence to support the use of alternative medicines that are most visibly promoted for managing menopausal symptoms, such as black cohosh and phytoestrogens.  Women at midlife are also likely to be taking other alternative therapies to manage other menopausal symptoms that could be doing them damage.

The current prevalence of the use of alternative therapy specifically for menopausal symptoms in Australia is not known so this report uncovers some significant insights.

In this large, representative, cross-sectional sample of Australian women aged 40–65 years, they found that 13.22% had used at least one alternative therapy for menopause symptoms (ie hot flushes and night sweats), similar to the proportion of women of this age who were using MHT. More than one in 10 women using hormone therapy also used a alternative therapy for menopausal symptoms. We also found that a third of study participants reported the use of alternative therapies for other symptoms.

Alternative medicine use for menopausal symptoms was highest in perimenopausal and early postmenopausal women, with the prevalence in these groups close to one in five. These women, compared with premenopausal and older postmenopausal women, also reported the most severe menopausal symptoms. Applying these findings to the 3.7 million Australian women aged 40–65 years would mean that 490 000 women had used alternative therapies for menopause symptoms in the past month, and 303 000 would have consulted a specifically recognised alternative therapy practitioner for menopausal symptoms in the past year. In addition, 883 000 women would have taken fish or krill oil and 438 000 would have taken glucosamine in the past month.

The three most prevalent treatments among those surveyed included:

• Phytoestrogens  (6.29%),
• Evening primrose oil (3.91%)
• Ginseng (1.73%)

But the study uncovered that phytoestrogens, the most commonly used alternative medicine for VMS, have not been shown to be effective for treating menopausal symptoms, either as food supplements or as concentrated tablets.

“Evening primrose oil, black cohosh and ginseng, the other commonly used CAMs for VMS, overall appear to be no more effective than placebo” according to the report prepared by the leader of the study, Susan Davis. “Importantly, CAMs such as ginseng will have varying effects according to the species used and potency and bioavailability of the formulation.The effects are not always desirable, with the known side effects of ginseng including hypertension, diarrhoea, sleeplessness, mastalgia with diffuse mammary nodularity, skin eruptions and vaginal bleeding.”

“Given the lack of evidence regarding benefit of CAMs for alleviating VMS, as well as the potential adverse effects and their high cost, the continuing use of these CAMs for this purpose cannot be supported”.

And she didn’t stop there. Ms David went on to declare her concerns around some of the more common alternative therapies used by the older generation. “We found that the prevalence of use of CAMs for other symptoms was high among older Australian women, with fish or krill oil and glucosamine the most commonly used. Fish oil is promoted for a wide range of conditions, most notably for preventing cardiovascular disease. Fish oil inhibits platelet aggregation and has been associated with a modest increase in bleeding time, but there has been controversy regarding its efficacy in preventing cardiovascular disease. Glucosamine, taken alone or in combination with other supplements such as chondroitin, is most commonly used for arthralgia. However, the United Kingdom’s National Institute for Health and Care Excellence does not recommend the use of glucosamine or chondroitin for the management of osteoarthritis.  Recent studies linking glucosamine to β-cell dysfunction and decreased insulin secretion raise concern, particularly in the context of high usage of this CAM by older people”.

Do these findings about alternative therapies reflect your experiences with them? What alternative treatments do you use?