As menopause approaches, many women seek relief from alternative therapies, including plant-based therapies that mimic natural estrogens such as phytoestrogens. But are they really effective? A recent meta-analysis by Dr. Taulant Muka et al of Erasmus University Medical Center, Rotterdam, Netherlands, assessed the efficacy of phytochemicals in treating hot flashes, vaginal dryness and night sweats and found them to induce “modest” reductions in the symptoms.
Several studies and randomized controlled trials have been performed to assess the safety and efficacy of plant-based therapies. Published in JAMA recently, the current systematic review and meta-analysis aimed to rigorously quantify the effects of plant-based therapies on ubiquitous menopausal symptoms. The review analyzed more than 60 studies including 6,6,53 post-menopausal women opting for alternative therapy including phytoestrogen interventions (such as dietary and supplemental soy isoflavones) and herbal remedies (such as pycnogenol: an extract from pine bark, and ERr 731: an extract from the plant species Rheum rhaponticum). The researchers noted a modest reduction in the number of daily hot flashes and vaginal dryness. However, there was no improvement in or reduction in the number of night sweats. The review lacked data from other complimentary therapies such as acupuncture, black cohosh (a North-American herb), St. John’s wart, and Chinese herbal medicine (such as dong quai). This lack of data kept the researchers from drawing a robust conclusion.
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“When it comes to Western countries, the dietary intake of isoflavones is very small, around 2 mg per day,” says Muka, while women in Asian countries eat 25-50 mg per day.”
Menopause heralds the end of woman’s reproductive age. In menopause, your ovaries no longer produce eggs and estrogen and progesterone – two hormones essential for fertility. Menopause is a natural phenomenon but can also occur as a response to surgery, treatment or a disease. When menopause is elicited by an unnatural phenomenon, it is called induced or surgical menopause or premature ovarian failure. The process starts at around age 51, however, some women may experience an early onset in their 40s. Menopause is manifested by a plethora of symptoms, including, mood swings, decreased libido, vaginal dryness, night sweats, hot flashes and insomnia.
While HRT can keep the “menopausal blues” at bay, it does increase the risk of breast cancer and cardiovascular disease – a health menace that prompted many women to turn to complimentary therapy.
Complimentary therapy includes botanicals, i.e., herbal remedies and nutritional supplements containing soy, black cohosh and flax seeds. Although research findings are contradictory, botanicals have been said to relieve menopausal symptoms. Phytoestrogens, or substances found in plant-based foods, have estrogen-like effects and are helpful in fighting conditions secondary to estrogen-deficiency, such as hot flashes, vaginal dryness, insomnia and night sweats. An example of phytoestrogens is isoflavones that is found naturally in soy, soybeans and tofu.
Black cohosh is another botanical available widely in North America. It offers a short-term (six months) management of menopausal symptoms and is mild and virtually free of side-effects. Furthermore, evening primrose oil and dong quai are two other botanicals that are claimed to treat hot flashes and night sweats, however they are not devoid of side-effects and should be used cautiously.
Nutritional supplements to fight off menopausal symptoms include; fish oil, red clover, omega-3 fatty acids, rice brain oil, ginseng, calcium, wild yam, licorice root, gotu kola, sage, passion flower, sarsaparilla, chaste berry, ginkgo biloga, and valerian root.
The systematic review in question could not draw a definitive conclusion and recommendation. Dr. Muka and colleagues concluded that further rigorous studies are needed to determine the association of plant-based therapies with menopausal symptom rectification.
Moreover, while first to systematically analyze the literature on complimentary therapies including phytoestrogens and their efficacy in menopause, the review had several limitations; publication bias could affect the final outcome of the review, the quality of studies, as agreed by the reviewers themselves, was suboptimal and heterogeneous.
Overall, while the study does vouch for the safety and efficacy of phytoestrogens and herbal remedies in rectifying vaginal dryness and hot flashes of menopause, its limitations warrant further investigation in the form of large-scale studies.