From the National Center for Complementary and Alternative Medicine

For decades, hormone replacement therapy (HRT) — more recently called menopausal hormone therapy (MHT) — was conventional medicine's main treatment for menopausal symptoms. In 2002, findings from a large study called the Women's Health Initiative raised serious concerns about the long-term safety of MHT. These concerns are one reason that many women are turning to CAM therapies.

Very little well-designed research has been done on CAM therapies for menopausal symptoms. A small number of studies have been published, but they have had limitations (such as the way the research was done or treatment periods that may not have been long enough). As a result, the findings from these studies are not strong enough for scientists to draw any conclusions.

Also, many studies of botanicals have not used a standardized product (one that is chemically consistent). The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring a number of studies on botanicals — using products containing carefully-studied ingredients that are well standardized — and on other CAM therapies that have shown possible promise for reducing menopausal symptoms.

Because CAM products used for menopausal symptoms can have side effects and can interact with other botanicals or supplements or with drugs, research in this area is addressing safety as well as efficacy.

Although there is very little scientific evidence to support the effectiveness of CAM therapies for menopausal symptoms, it is possible that some CAM therapies may provide some relief to women during the menopausal transition. Here are two important points to keep in mind if you are considering these therapies:

• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.



• "Natural" does not automatically mean "safe." As noted earlier, botanical and other dietary supplements can interact with each other and with prescription and over-the-counter drugs, affecting how the body reacts. Supplements can pose other safety issues as well. Some have been found to be contaminated, contain unlabeled ingredients, or have different amounts of ingredients than are listed on the label.

Women who are looking for alternatives to MHT should be aware that CAM therapies are not their only option. Certain lifestyle changes can contribute to healthy aging, including during the menopausal transition. For example, quitting smoking, eating a healthy diet, and exercising regularly have been shown to reduce the risks of heart disease and osteoporosis.

NCCAM Publication No. D406
January 2008