Herbal Alternatives to HRT
Deciding whether to use hormone replacement therapy (HRT) after menopause is a difficult decision many women face as they age. Research has shown that HRT is very effective for relieving menopausal symptoms such as hot flashes and vaginal dryness. It also can reduce the risk of osteoporosis. However, there also are known health risks and uncertainties about long-term use. Recent research has demonstrated that long-term use of estrogen in combination with progestin results in more risks than benefits.
HRT study finds risks
On July 9, 2002, the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health announced that they would stop a major clinical study of the type of postmenopausal hormone therapy in which estrogen is combined with progestin. The study, a part of the Women's Health Initiative, found increases in breast cancer, cardiovascular disease, stroke and blood clots in study participants who were taking estrogen plus progestin compared to women taking placebo pills.
There were noteworthy benefits of estrogen plus progestin, including fewer cases of hip fractures and colon cancer, but on balance the harm was greater than the benefit. In the study were 16,608 postmenopausal women aged 50 to 79 years old.
Find out more about the Women's Health Initiative study and HRT from Dr. Norine Nazareth, M.D., internal medicine, with Advanced Healthcare
Alternatives need further study
According to a 1997 study conducted by the North American Menopause Society, more than 30% of women use acupuncture, natural estrogen(s), herbal supplements, or so-called plant estrogens (phytoestrogens). At this time, there is not enough scientific evidence to determine whether these therapies are beneficial. In addition, we do not have sufficient information to show whether these therapies are as safe or safer than conventional drugs being used for menopausal symptoms, osteoporosis or heart disease.
Botanical products containing or acting like estrogens may provide some of the benefits of estrogen in relieving menopausal symptoms. For example, studies have suggested that soy food products can benefit women with mild hot flashes. Some limited research provides conflicting results on the safety and effectiveness of herbal products - such as ginseng, black cohosh, and dong quai - that are marketed for menopausal symptoms. Currently, the National Center for Complementary and Alternative Medicine (NCCAM) is funding research on several botanicals that have shown promise for reducing menopausal symptoms including black cohosh, red clover, hops, dong quai, flax seed and dietary soy.
Talk with your doctor
Herbal therapies may have adverse side effects or exhibit harmful interactions with other medications. Consumers should always discuss their use of herbs and dietary supplements with their health care provider.
Alternative therapies may or may not be helpful in relieving menopausal symptoms. More research is needed to define the benefits and risks. The cost of alternative therapies such as dietary supplements is usually not covered by insurance.
Talk to your doctor to decide how to best manage your menopause. Think about your symptoms and how much they bother you. You also need to consider your medical history - your risk of heart disease, osteoporosis and breast cancer. Remember that your decisions are never final. You can, and should, review them with your doctor every year during your checkup. You can see a gynecologist, geriatrician, general practitioner or internist.
Source: National Institutes of Health
