Menopause (cont.)Medical Author:
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MDMelissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology. Medical Editor:
William C. Shiel Jr., MD, FACP, FACR
William C. Shiel Jr., MD, FACP, FACRDr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology. In this Article
Alternative medical therapies for menopausePlant estrogens (phytoestrogens, isoflavones)Isoflavones are chemical compounds found in soy and other plants that are phytoestrogens, or plant-derived estrogens. They have a chemical structure that is similar to the estrogens naturally produced by the body, but their effectiveness as an estrogen has been estimated to be much lower than true estrogens. Their estrogen potency has been estimated to be only 1/1000 to 1/100,000 of that of estradiol, a natural estrogen. Two types of isoflavones, genistein and daidzein, are found in soy beans, chick peas, and lentils, and are considered to be the most potent estrogens of the phytoestrogens. Some studies have shown that these compounds may help relieve hot flashes and other symptoms of menopause. In particular, women who have had breast cancer and do not want to take hormone therapy (HT) with estrogen sometimes use soy products for relief of menopausal symptoms. However, some phytoestrogens can actually have anti-estrogenic properties in certain situations, and the overall risks of these preparations have not yet been determined. For example, researchers have shown that long-term use of phytoestrogens in postmenopausal women led to an overgrowth of the tissues lining the uterus (endometrial hyperplasia) which can be a precursor to cancer. There is also a perception among many women that plant estrogens are "natural" and therefore safer than HT, but this has never been proven scientifically. Further research is needed to fully characterize the safety and potential risks of phytoestrogens. Vitamin ESome women report that vitamin E supplements can provide relief from mild hot flashes, but scientific studies are lacking to prove the effectiveness of vitamin E in relieving symptoms of menopause. Taking a dosage greater than 400 international units (IU) of vitamin E may not be safe, since some studies have suggested that greater dosages may be associated with cardiovascular disease risk. Black CohoshBlack cohosh is an herbal preparation that has been popular in Europe for the relief of hot flashes. This herb has become more and more popular in the U.S., and the North American Menopause Society does support the short-term use of black cohosh for treating menopausal symptoms, for a period of up to six months, because of its relatively low incidence of side effects when used short term. However, there have still been very few scientific studies done to establish the benefits and safety of this product. Research is ongoing to further determine the effectiveness and safety of black cohosh. A large study known as the Herbal Alternatives for Menopause Trial (HALT) tested the effectiveness of different herbal or alternative ingredients versus estrogen therapy or placebo for the relief of menopausal symptoms. After one year of therapy, there was no significant reduction in the frequency or severity of hot flashes in women receiving any of the herbal preparations (including a group who received black cohosh) when compared to placebo at any of the follow-up times (3, 6, and 12 months). Other alternative therapiesThere are many supplements and substances that have been advertised as "natural" treatments for symptoms of menopause, including licorice, dong quai, chasteberry, and wild yam. Scientific studies have not proven the safety or effectiveness of these products. Reviewed by William C. Shiel Jr., MD, FACP, FACR on 3/5/2013 Patient CommentsViewers share their comments
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