Updated 18 February 2016

Non-prescription medication and natural remedies for menopause


Unlike hormone therapy (HT), alternative remedies don’t have to conform to the strict requirements of the SA Medicines Control Council (MCC) 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.Black cohosh has been documented to cause liver damage in some women. IN the USA all black cohosh therapies 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.

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 symptoms 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 of menopause. They do not act like HT and are not as effective in relieving symptoms of menopause as HT.

Keep in mind that:

- Approved hormone therapies are available on prescription only

- Bio-identical hormone therapy (BHT) products 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 by pharmacists or BHT manufacturers that they can make customised bio-identical compound hormone (BCHT) products 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 the MCC.

Read more: 

What is menopause? 

Causes of menopause  

Treatment of menopause

Dr Carol Thomas MBChB (UCT) FCOG (SA) MMed (O&G) (UCT), Specialist Gynaecologist in private practice, Cape Town, Secretary South African Menopause Society and Director of the WomanSpace. March 2015.

(Previously reviewed by Dr Mike Davey, President of the South African Menopause Society, and Prof B. Schaetzing MD, FCOG (SA), FRCOG, PhD. Part-time Consultant, Dept of Obstetrics & Gynaecology, Faculty of Health Sciences, University of Stellenbosch)