What about natural and herbal remedies?  Some women should not to use HT due to the risks and some wish not to use HT due its annoying side-effects, including bloating, headache, nausea, breast tenderness and weight gain. HT should in any case only be considered if common sense to manage your symptoms and a practical approach doesn’t help. Some women would rather opt for natural and herbal remedies.

Unlike HT, alternative remedies don’t have to conform to the strict requirements of the SA Medicines Control Council before they’re made available to the public. They are not registered with the MCC and purity and testing are unknown. Research has proved beyond all doubt HT works, and works well. Unfortunately that can’t be said for alternative remedies. Some researchers believe plant oestrogen in the herb black cohosh and in soya (but not in soya tablets) can relieve hot flushes. Although some women swear by them, a new American study by the National Institutes of Health has once again proved plant oestrogen is nothing more than a placebo. People often assume medicines derived from plants are safe, but there’s no proof this is really the case. Some herbal medicines can have serious side effects, such as damaging your liver. They also interfere with the effects of other medication. Talk to your doctor before you start using them.

Black cohosh has been documented to cause liver damage in some women. IN the USA  all balck cohosh therpaies have a “black box” warning about potential liver toxicity.

It’s ironic: people who want to use natural remedies avoid HT, yet all oestrogen prescribed by doctors has a natural origin (either plant or animal). The oestrogen is adjusted slightly so it corresponds exactly with the oestrogen naturally produced by the human body. It’s so natural, the female body can’t distinguish between its own oestrogen and EHT.

In the USA, the trend towards natural remedies is so huge that the public’s expenditure on alternative therapies is approximately four times its contribution towards all pharmaceuticals.

More and more women are trying phyto-oestrogens derived from plants. Studies on phyto-oestrogen from the black cohosh specie Cimicifuga racemosa has shown relief of menopause symptoms, according to naturopath Dr Chase Webber. Phyto-oestrogens do not act in the same way as HT. It may relieve some of the menopause symptoms, with no additional health benefits.

Studies have also shown that high amounts of soya in the diet is effective to treat some menopause symptoms, but that phyto-oestrogen extracts from soya supplements are not. Other herbals that may be effective in providing some relief from menopause symtoms are Dong Quai (Aelica sinensis), licorice root (glycyrrhiza glabra) and chaste berry (vitex agnus castus).

The bottom line: Some natural remedies do relieve some symptoms. They do not act like HT and are not as effective in relieving symptoms of menopause as HT.

Read more details on the available natural and alternative products.

Natural oestrogen supplements

Natural oestrogen supplements are increasingly popular. These so-called phyto-oestrogens are derived from plants. Surprisingly, they have an affinity for the receptors in the human body which are designed to attract oestrogen-type molecules. But, this affinity for oestrogen receptors is much lower than that of human or other animal oestrogens.

Most experts agree that phyto-oestrogens can help with some of the symptoms of menopause such as hot flushes. The supplements which are most effective are black kohosh, genistein and soy-based products.

However, the evidence from clinical trials is that these supplements have little or no effect on other problems associated with menopause, such as a dry vagina, developing osteoporosis, an increased risk of heart disease or for improving brain function.

Another possible problem with them is that much higher doses of phyto-oestrogens are needed to control symptoms like hot flushes than are needed with conventional oestrogen-containing products. This means that certain oestrogen-sensitive cancers such as breast cancer may be worsened in women taking these products.

As with all therapies – conventional or otherwise – always discuss its use with your doctor.

Natural progesterone cream

Progest – a natural progesterone cream – is popular among some women. In 1990 a doctor claimed that progesterone absorbed through the skin was better than oestrogen in preventing and reversing osteoporosis.

However, this claim was not supported by clinical trials of the cream, even when it was used at two to four times the amount suggested by the manufacturer.

'Bio-identical' hormone therapy

According to claims by manufacturers bio-identical hormmones claim to do everything from helping menopausal women lose weight to preventing senility. They're touted as safer and sometimes even more effective than conventional hormone-replacement therapy. But experts warn that these claims are unproven and that the products are potentially dangerous There is little or no scientific and medical evidence to support claims that BHT is safer and as effective as HT. Many 'bioidentical hormone' formulations are not subject to oversight by the Medicines Control Council (MCC) and can be inconsistent in dose and purity..

Marketers of bio-identical hormones often say the products are identical to hormones produced by the body, and these "all-natural" pills, creams, lotions, and gels don't carry the risks of menopausal hormone therapies approved by the MCC.  

Keep in mind that:

• Approved hormone therapies are available on prescription only
• Bio-identicals will have the same risks as the products they're identical to -- namely a heightened risk of breast cancer and serious heart problems. There may be other, as-yet-unknown risks, as well.
• Beware of claims that bio-identical products can be made based on hormone levels measured from a woman's saliva sample. Hormone levels fluctuate constantly. Saliva tests aren't specific enough to determine drug dosages.
• No drug containing the hormone estriol (the weakest of the three estrogens produced by the body) has been approved by theMCC.  

 

Reviewed and updated by Dr Alan Alperstein, obestetrician and gynaecologists in Cape Town, in February 2011. 
Previously partly reviewed by Dr Mike Davey, President of the South African Menopause Society & Dr Tobie de Villiers, gynaecologist and committee member of both the South African Menopause and International Menopause Societies.  

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