Complementary therapies for menopausal symptoms

Menopause is the complete cessation of menstruation, occurring between the ages of 45 years and 55 years and is characterised by a progressive decline in oestrogen secretion and ovarian function. This deficiency in oestrogen can induce physiological and psychological changes, including hot flushes, sweating, mood and sleep disturbance, fatigue and urogenital dysfunction.

Many women have turned to complementary and alternative medicine (CAM) for relief from their menopausal symptoms. The prevalence of CAM use among menopausal women highlights the need for investigation into these interventions.

This clinical update focuses on the evidence from randomised clinical trials (RCTs) for the effectiveness of CAM therapies in the treatment of menopausal symptoms. Trials of CAM for menopausal symptoms are discussed in which the outcome measures relate to the physiological and/or psychological impact of menopause, whether by compendium scores, questionnaires or participant’s symptom diaries.

There is no compelling evidence for the efficacy of any complementary treatment for alleviating menopausal symptoms. The vast majority of trial data are concerned with herbal or plant-based preparations. There is reasonably good evidence that soy extracts and kava are effective for reducing menopausal symptoms with a caveat on the safety of kava. Black cohosh looks promising but better-quality research is required. Acupuncture, relaxation therapies and osteopathy may have some benefit. For the other therapies discussed, too little research has been carried out to make any positive statements about them.