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Menopause is the time in a woman's life when she stops having menstrual periods permanently. It takes place around the age of 50 in most women. At the time of menopause, many changes occur in the body due to the decrease in estrogen (female hormone) levels. These changes can cause symptoms such as hot flashes and vaginal dryness.

Over the years, the changes also raise a woman's risk of serious health problems, including:

• the bone-thinning disease called osteoporosis
• high cholesterol
• heart disease

The most common treatment for menopausal symptoms is to give estrogen as a medication to make up for the body's reduced production of the hormone. This approach is known as hormone replacement therapy, or HRT. Recently, however, HRT has been associated with increased health risks in some studies, and although HRT is still recommended by many healthcare professionals if used with caution, many women choose not to use it.

Complementary therapies for menopausal symptoms are those that supplement or replace HRT. These may include plant products and other alternative health treatments.

What is the information for this topic?

Seven of the most common natural alternative therapies are outlined below. Before taking or using them, a woman should discuss options with her healthcare professional. While these therapies may help with certain symptoms, there are no long-term studies to show their effects on osteoporosis, heart disease, or cholesterol levels in the body.

1. Natural hormone replacement therapy (NHRT) uses compounds similar to hormones. These are found in soybeans and yams. The molecular structure of these compounds is modified to closely match human hormones. The effects of these specially prepared therapies are not definitely known. The effects of unopposed natural estrogens are unknown and there are concerns about the possibility of increased risk for uterine cancers with these estrogens.

2. Phytoestrogens are compounds that occur naturally in some plants, herbs, and seeds. Some of these compounds have properties like those of estrogen. Flaxseeds and soybeans contain phytoestrogens. They may be useful for some women in reducing hot flashes, night sweats, and vaginal dryness. Further studies are needed to show if they really work to reduce these symptoms and what the ideal dose may be. It is not known how phytoestrogens affect a woman's risk of osteoporosis or how they affect cholesterol levels.

• black cohosh appears to be helpful in reducing hot flashes, night sweats, headache, and vaginal dryness. Using black cohosh for up to 6 months is one of the treatments that has been recommended by the American College of Obstetrics and Gynecology. Its effect on osteoporosis, cholesterol, and heart disease risk is not known.
• chasteberry has been used to help reduce hot flashes, night sweats, and vaginal dryness. Studies are lacking, however, to prove its efficacy.
• ginseng may decrease fatigue and improve energy level. However, it has not been proven to be any more effective than placebo in the treatment of menopausal symptoms. Also, ginseng may interact with other drugs, such as warfarin, a blood thinner. Women with high blood pressure should avoid ginseng.
• St. John's wort may help to reduce hot flashes and night sweats. Larger studies are needed. Women must talk to their health care professional before taking this, however, since St. John's wort can interfere with some medicines such as antidepressants.
• valerian may help some women with anxiety, tension, or trouble sleeping but its efficacy has not been proven. It is best to take valerian for only a short period of time. It may interact in dangerous ways with other medicines, such as those used for high blood pressure.

4. Acupressure and acupuncture may be useful in easing menopausal symptoms. One study showed a marked decrease in menopausal symptoms with electrostimulation acupuncture but there was a similar decrease in symptoms when placebo acupuncture was used.

5. Biofeedback has been shown to reduce hot flashes by using special breathing techniques. It can also be used to help teach control of certain body functions. It may be useful for some women dealing with urinary incontinence, or involuntary urine loss.

6. Vaginal lubricants ease vaginal dryness. Water-based products are best. Products that contain alcohol or perfume may cause irritation in some women. Oil-based products, such as Vaseline, can also cause irritation.

7. Regular exercise has many benefits. It has even shown to decrease the frequency and intensity of hot flashes. Weight-bearing exercises, such as walking, can help slow bone loss from osteoporosis. Aerobic exercise, including biking or swimming, can lower the risk of heart disease. Activities such as these also improve a woman's overall sense of well-being.