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Research: KRONENBERG and co-workers
Listed in Issue 86
Abstract
KRONENBERG and co-workers, Rosenthal Center for Complementary and Alternative Medicine, College of Physicians and Surgeons, Columbia university, 630 West 168th Street, Box 75, New York, NY 10032, USA, review (58 references) the randomized controlled trials of complementary and alternative medicine for menopausal symptoms.
Background
Women use CAM therapies, especially soy bean products and herbs, for menopausal symptoms. A number of randomized controlled trials have evaluated the safety and efficacy of these medicines.
Methodology
Searches of Medline and the Alternative and Complementary Database of the British Library (AMED) were conducted, and the authors’ own clinical files were consulted. Search terms were hot flush, menopause, climacteric combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine, Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch.
Results
29 randomized controlled trials of CAM therapies were identified. Of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies. Soy seems to show modest benefit for hot flushes, but existing studies are inconclusive. Isoflavone preparations are less effective than soy foods. Black cohosh may be effective, but the lack of reliable long-term safety data precludes recommendation for prolonged use. Dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flushes, and two trials have shown that red clover has no effect.
Conclusion
Black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms, especially hot flushes. Other therapies are not at this time supported by controlled trials. Long-term safety data of isoflavones are needed.
References
Kronenerg F, Fugh-Berman A, et al. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Annals of Internal Medicine 137 (10): 805—813, Mar 2002.
Comment
Women using natural approaches to treat menopausal symptoms will be highly interested in seeing further research regarding the efficacy of the many products touted for these symptoms.
