Download: Complementary Medicines and Therapies: Options for Menopausal Symptoms  | Fact Sheet

MAIN POINTS

• Complementary medicine is used to describe a wide range of healthcare medicines, therapies (forms of treatment that do not involve medicines) and other products that are not generally considered as part of conventional medicine.
• Some complementary medicines may help with mild symptoms, but overall more evidence is needed.
• To assure safety, ideally complementary medicines should be prescribed by a health professional trained in their use.
• Always inform your doctor if you are using complementary medicines, and ensure your health practitioner has checked for any interactions that might affect other medications.
• Avoid buying online products – their safety cannot be guaranteed.
• Bioidentical compounded hormone therapies cannot be recommended because their safety is unknown.
• No complementary medicine is as effective as oestrogen therapy for menopausal symptoms.

Complementary medicine and therapies (CM&T) is a broad term used to describe a wide range of health care medicines, therapies and other products that are not generally considered as part of conventional medicine (National Health and Medical Research Council). Some women think about using CM&T to manage their menopausal symptoms because they do not want to use prescribed medications or are unable to use them. If you are thinking about using CM&T, ask your doctor if it will affect other medications you might be taking. Some CM&T are promoted as natural and safe with little evidence the therapy works. Often there is no way to know if CM&T are safe or uncontaminated, especially if bought online. Your doctor can help you to understand the benefits and risks of a CM&T. The table provides a summary of commonly used CM&T for menopausal symptoms.

The traffic light colours indicate:

Red - Do not use (insufficient evidence that it works and/or safety concerns)

Orange -  Use with caution (may work but safety concerns)

Green - OK to use (some evidence that it works and safe for most women)

Medicine/Therapy	Symptom	Comments	Rec'n*
Botanical/herbal/Vitamin supplements
Vitamin E	Hot flushes	Vitamin E can decrease the number of hot flushes by 1-2 per day.
St John’s Wort	Mood symptoms	Can improve mood and may help with mild depression. This therapy interacts with many prescription medicines.
Soy isoflavones or phyto-oestrogens	Menopausal symptoms	May help hot flushes. Not helpful for sleep.
Wild yam cream or progesterone cream	Endometrial (lining of the uterus) protection	No evidence that it is effective.
Red clover	Menopausal symptoms	Can slightly reduce the frequency of hot flushes. Post menopausal women may see a greater reduction.
Omega-3 supplements	Hot flushes	No evidence that effective for menopausal symptoms but can lower high triglycerides.
Black cohosh	Menopausal symptoms	There are different forms of Black Cohosh and some extracts (isopropanolic) may be beneficial. There are possible safety concerns.
Evening primrose oil	Hot flushes	No evidence that it is effective.
Ashwagandha	Menopausal symptoms	Insufficient evidence of benefit and concerns for gastrointestinal and liver side effects.
Mind-body therapies
Acupuncture	Hot flushes	May be effective at reducing frequency and severity of hot flush versus a placebo, but not compared to sham acupuncture.
Cognitive behavioural therapy	Menopausal symptoms	Can help some women with menopausal symptoms (sleep/ hot flushes/mood).
Hypnosis	Menopausal symptoms	Hypnosis might be helpful for some women.
Yoga	Menopausal symptoms	Yoga might be helpful for some women.
Homeopathy	Menopausal symptoms	No evidence that is it effective.
Other
Bioidentical compounded hormone therapy	Menopausal symptoms	Do not take it if you can’t take prescribed menopausal hormone therapy (MHT) or hormone replacement therapy (HRT) for safety reasons.

* Rec'n = Recommendation