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The symptoms associated with perimenopause and menopause stimulate a healthy concern about wellness and motivate women to undertake appropriate interventions to lower health risks associated with menopause. Interest in alternative medicine can be viewed simply as a natural extension of interest in nutrition, exercise, and other behavioral, nonpharmacologic interventions directed at maintaining well-being. Unfortunately, many of the alternatives promoted and touted as substitutes for HRT do not offer any substantiated health benefits.
According to the North American Menopause Society, nonhormonal interventions commonly used for menopause include a healthy diet, exercise, vitamins, and calcium supplements. The North American Menopause Society also indicates that more than 30% of women use acupuncture, natural estrogen, herbal supplements, or so-called plant estrogens (8). Alternative therapies to conventional HRT include botanical products, vitamins and minerals, unconventional hormones and steroids sold over-the-counter as nutritional supplements or as cosmetics, and nonproprietary single and combination estrogen and progestin preparations custom blended by compounding pharmacies.
Most studies of menopausal interventions, including phase-III clinical trials of estrogenic drugs, show a 20–30% response rate in placebo groups.
Unconventional interventions need to be studied in well-controlled trials before their use can be supported. Documentation of efficacy is essential because these products should yield effective results of a magnitude large enough to warrant their costs, which are substantial.
Botanical Medicine
Up to one half of drugs commonly used today are either plant products or phytochemicals that were initially isolated from botanical material but are now synthesized by chemical processing techniques. Outside of pharmaceutical preparations, plants are used therapeutically in the form of herbs, oils, pills, teas, or tinctures (see box). In addition, currently used products include highly concentrated extracts of phytochemicals, synthetic derivatives, and even steroids like dehydroepiandrosterone (DHEA) and androstenedione, which are classified as food supplements because they are produced from plant precursor sterols. |
