The hot flashes, the night sweats, the vaginal dryness and the sleep disturbances...no wonder about 40% of women are seeking medical advice to help them cope with their menopausal symptoms. As more and more women and health care providers shy away from the traditional estrogen treatment because of its possible associated risks, complementary and alternative treatments are becoming increasingly popular. Millions of dollars are sp such as soy-based products and black cohosh as well as mind-body or behavioral therapies like magnets, yoga, exercise, or relaxation practices.
It turns out, however, that the efficacy of these treatments relies a great deal on whether or not you believe them to work. Anne Nedrow, M.D. and colleagues 1 reviewed 70 previously completed studies of complementary and alternative therapies used to treat menopause-related symptoms. Their findings, printed in the July 24 issue of Archives of Internal Medicine, showed that a strong placebo effect was about the only consistent result. Included in the techniques studied were herbal supplements, acupuncture, massage, visualization techniques, and listening to sonic waves. Some of the therapies resulted in an improvement over no treatment when women were asked to rate symptoms such as hot flash frequency, sleep disturbance, sexual dysfunction, and quality-of-life changes; however, often the improvement was almost equivalent to the improvement experienced by the placebo group.
A strong placebo effect is not limited to complementary and alternative menopausal treatments. The review also cites the results of previous studies done on estrogen hormone treatments compared to placebo in which the placebo group reported a 50% reduction in hot flash frequency.
Research regarding the safety and adverse effects of these alternative therapies has lagged behind their growing popularity. The moderate effectiveness of some alternative treatments for menopauses worst symptoms has lead many women to seek out herbs and minerals that, unlike pharmaceuticals, are not stringently regulated by the FDA. There are no requirements for their purity or dosage, and the negative effects and drug interactions of these supplements are not yet well studied or recorded. Mind-body or behavioral treatments for menopausal symptoms such as reflexology, exercise, yoga, and breathing techniques carry fewer risks since they do not involve the ingestion of any substance.
Women should be encouraged to have open discussions with their health care providers about the many possible therapies available. It is important that the risks of treatments be weighed with the possible benefits, and ultimately a woman should chose a treatment she feels confident in, because sugar pill or soy protein, your odds of finding relief may be about the same.
(1) Oregon Evidence-based Practice Center and Oregon Health and Science University in Portland
