Alternatives to HRT

Here at The Menopause Hub we’re strong believers in the efficacy of HRT. However, as with all things medical there are always other options available to you. Some work better than others and all work differently depending on the individual. Below are some of the more popular complementary therapies available, it may be down to a little bit of trial and error to find out which, if any, will make a difference to you, but you should always bear in mind that most of these therapies have not been subject to the scientific rigour involved in testing prescribed medication.

PHYTO-OESTROGENS

Photo-oestrogens are a group of plant based molecules that get their name because they deliver an oestrogen like effect. They came to prominence in the 1990’s when studies suggested that Japanese menopausal women suffered significantly fewer hot flushes than their western counterparts. There is slight evidence to show than they also suffer a lower incidence of breast cancer, cardiovascular disease and osteoporosis. Soy preparations are now available on the market in the form of pills or capsules at doses of 50-100mg per day.

RED CLOVER

Trifolium Pratense, or Red Clover to you and I, is marketed as a dietary supplement and contains additional chemical elements that are not present in soy and therefore it may have a different biological activity. However despite the fact that some women use it for the treatment of hot flushes, any of the studies that have examined it in doses of 40-160mg per day have shown that it has no significant effects on the incidence or severity of hot flushes. As with many complementary therapies, it proves difficult to conduct effective research due to the difference in preparations and the absorption and metabolisation variance between individuals.

BLACK COHOSH

Despite sounding like the name of a 90’s Goth band, Black Cohosh is actually a plant that has long been used by Native Americans for the treatment of gynaecological conditions. The treatment of menopausal signs and symptoms are the primary therapeutic application of the plant and it is the main ingredient in the over the counter preparation Remifemine. Its biologically active component is attributed to a number of chemicals called tryterpine glycosides, however it is recommended that its use is limited to six months due to the uncertainty about its possible long term side effects.

DONG QUAI

Often called ‘the female ginseng’ Dong Quai is a herb native to eastern Asia and China. Indicated for painful menses, irregular menstruation and a supportive herb for menopausal complaints, it’s the second best selling herb in China. Here in the west it has become popular as a herb for treating menopausal symptoms. Unfortunately it is also one of the first alternative therapies to which potential adverse effects has been attributed as it mimics the effects, though to a lesser extent, of the blood thinning drug warfarin.

EVENING PRIMROSE OIL

Another favourite of Native Americans, they consumed the leaves, roots and seed pods of Evening Primrose as food and used extracts from it to treat a number of conditions. Today the flowers and seeds are pressed to create an oil that is high in omega 6 fatty acid, gamma linolaeic acid (GLA) and essential polyunsaturated fatty acids, which convert into prostaglandins. Although there are a number of studies in which Evening Primrose Oil has been shown to successfully treat eczema and other skin conditions with few side effects it appears to have no benefit in the treatment of hot flushes.