The effect of complementary and alternative therapy at menopause: Trick or treat?

Hot flushes affect approximately 75% of postmenopausal women and are one of the most distressing symptoms that women experience as they enter the menopause. The treatment of hot flushes is a common clinical challenge. A large body of data shows that HRT effectively relieves vasomotor symptoms by 80-90%, however, many patients may be unable or unwilling to undergo hormonal treatment. Publication of the results of the Women's Health Initiative (WHI) and the Million Women Study (MWS) has led to considerable uncertainties about the role of hormone replacement therapy (HRT) among health professionals and women. All of these concerns have generated interest in nonhormonal treatment and many women seek alternative strategies to relieve climacteric complaints. The use of complementary and alternative medicine (CAM) among menopausal women has increased in the last years. This growth highlights the need for a critical evaluation of the tolerability and effectiveness of these readily available therapies. This chapter provides an overview for the evidence underlying the commonly used non-hormonal therapies for menopausal symptoms in terms of their efficacy and safety when used for relief of menopausal-related symptoms.