“‘Natural therapy’, ‘complementary therapy’, ‘complementary medicine’ and ‘alternative therapy’ do not all mean the same thing, but they describe therapies and approaches to health and healing that are not considered parts of conventional, evidence-based (Western) medicine. The common catch-all term for all of these is ‘complementary and alternative medicine’ (CAM)”.²

“Only a small amount of research has been done on most mind and body practices for menopause symptoms. However, the limited evidence currently available suggests that some of these practices might help to relieve symptoms or make them less bothersome”.³

“Many approaches have been promoted as aids in managing the symptoms of menopause, but few of them have scientific evidence to back up the claims. Some complementary and alternative treatments that have been or are being studied include:

• Plant Estrogens (Phytoestrogens)…
• Bioidentical Hormones…
• Black Cohosh…
• Yoga…
• Acupuncture…
• Hypnosis…”.⁴

• “Alternative therapies, including cognitive behavioural therapy, may also improve hot flushes, nights sweats and other menopausal symptoms and can be considered in women who do not wish to take HRT or have contraindications to taking HRT”.⁵

• “Natural Products…
  • Phytoestrogens
  • Black Cohosh…
  • DHEA…
  • Dong Quai…
  • Vitamin E…
  • Other Natural Products…
• Mind and Body Practices…
  • Acupuncture…
  • Hypnotherapy…
  • Mindfulness Meditation…
  • Yoga…
• Other Complementary Approaches
  • Bioidentical Hormones…”.⁶

• “Lifestyle Measures…
• Tibolone…
• Antidepressants…
• Clonidine…
• Bioidentical or “Natural” Hormones
• Complementary Therapies…”.⁷

• “Cognitive Behavioural Therapy (CBT)…
• Herbal Treatments…
  • Black Cohosh…
  • St John’s Wort…
• Isoflavones and Soya Products (Plant substances found in the diet including red clover supplements)…
• Acupuncture…
• Non Hormonal Prescribed Treatments…
  • Selective Serotonin Re-uptake Inhibitors (SSRI) [fluoxetine, paroxetine, citalopram, sertraline] and the Serotonin Noradrenaline Re-uptake Inhibitor/Selective Serotonin Re-uptake Inhibitors (SSRI-SNRI) [venlafaxine]…
    • Gamma Aminobutyric Acid (Gabapentin)…
    • Clonidine…
• Treatments for breast cancer survivors…”.⁸

• “Complementary Therapy Use in Australia…
• Traditional Chinese Medicine (TCM) and Acupuncture…
• Alexander Technique…
• Herbal Medicine…
• Homeopathy…
• Nutrition…
• Osteopathy…
• Remedial Massage…”.⁹

“A. No over-the-counter (OTC) dietary supplement or herbal therapy has been found to be effective on menopause symptoms. If you still want to try a dietary supplement for your hot flashes, you must continue only with the appropriate oversight of your healthcare provider. Because normal FDA regulations for prescription or OTC drugs do not apply to dietary supplements, demonstrating safety is not required before a dietary supplement is put on the market. Although a number of manufacturers do employ rigorous quality-control measures, many products are not monitored for purity or levels of active ingredients”.¹⁰

“The types of herbs used to manage menopausal symptoms include: black cohosh, dong quai, evening primrose, hops, Korean ginseng, linseed (flaxseed), red clover, St John’s wort and wild yam. Some herbs are used more specifically for low sex drive (libido), such as tribulus, maca and horny goat weed, whereas others are more commonly used for insomnia, anxiety and fatigue, such as lemon balm, valerian and passionflower”.¹¹

• “Research suggests that certain black cohosh extracts and some combination products containing black cohosh may reduce some menopause symptoms. Most of the research has been on a single extract called Remifemin. Research on other black cohosh products has had inconsistent results. Guidelines released in 2015 indicate that there is a lack of consistent evidence for any benefit from black cohosh for menopause symptoms. But a 2017 review of recent research suggests that black cohosh extracts approved for treatment in Europe seem to decrease menopause symptoms”.¹²

“Natural therapies are often considered safe and harmless because they are ‘natural’.

However, this is simply not the case. Just as there are risks and unwanted side effects to conventional medical treatment such as painkillers and prescription drugs, there can be risks and unwanted side effects to natural therapies. Generally, the risks are smaller when it comes to natural therapies, but they are real and need to be respected”.¹³

• “No complementary medicine is as effective as oestrogen therapy for menopausal symptoms”.¹⁴

• “Women should be advised that implementing or maintaining a healthy lifestyle can improve menopause symptoms. A healthy diet (one low in saturated fat and salt and rich in calcium and vitamin D), stopping smoking, reducing alcohol intake and including regular exercise can be beneficial. Reducing caffeine intake may also improve symptoms”.¹⁵

1. “List the complementary health practices you use on your patient history form…
2. At each visit, be sure to tell your providers about what complementary health approaches you are using…
3. If you are considering a new complementary health practice, ask questions…
4. Don’t wait for your providers to ask about any complementary health practice you are using. Be proactive. Start the conversation”.¹⁶

• “What do you think are possible triggers for my hot flashes?
• Are there any lifestyle or dietary interventions that may diminish my symptoms?
• Should I consider medication for treatment of my symptoms? Hormonal or non-hormonal?
• If you are interested in hormonal therapy: Am I a good candidate for hormonal therapy, specifically are my cardiovascular and breast cancer risks low?
• Which lifestyle changes can I make that will decrease my menopause symptoms without medicine?
• Are there any alternative medicine treatments you would recommend I try for relief of my menopause symptoms?
• Are there any alternative medicines I should not use because they could interfere with medicines I take?”¹⁷

• “Tell all your health care providers—complementary and conventional—about all the health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care”.¹⁸