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New research from Monash University’s School of Public Health and Preventive Medicine has found that nearly half a million Australian women aged 40-65 years could be using complementary and alternative medicines (CAMs) for menopausal symptoms, despite there being little evidence of their effectiveness and potential side-effects.
The research, the first of its kind in Australia to focus specifically on CAMs and CAM practitioners for the treatment of menopausal symptoms, found that 13 per cent of women aged 40-65 had used at least one CAM for their vasomotor symptoms (hot flushes and night sweats) in the previous four weeks to being surveyed. This is similar to the percentage of women of the same age using menopausal hormone therapy (MHT).
In 2002, concerns regarding the safety of menopausal hormone therapy triggered a dramatic decline in its use. Concurrently, the use of CAMs and consultation with CAM practitioners has grown. However, there is insufficient evidence to support the use of CAMs that are most visibly promoted for managing VMS, such as black cohosh and phytoestrogens.
Professor Susan Davis, Dr Roisin Worsley and other researchers said that if findings were applied to the 3.7 million Australian women aged between 40 and 65 years, an estimated 490,000 would have used CAMs for vasomotor symptoms (VMS) during the last month, and 303,000 would have consulted a CAM practitioner.
“According to the research, the most commonly used CAM for menopausal symptoms was phytoestrogens. Phytoestrogen supplements, either as food supplements or in concentrated tablet forms, have not been shown to be effective treatments for VMS,” Professor Davis said.
Evening primrose oil, ginseng and black cohosh were the next most common CAMs used for treatment of VMS, all of which appear to be no more effective than a placebo.
“CAMs such as ginseng can have markedly different effects on different people – some known side of ginseng effects include hypertension, diarrhoea and sleeplessness. In light of this lack of evidence and potential adverse effects, the continuation of use of CAMs for VMS cannot be supported, Professor Davis said.
Women at midlife are also likely to be taking other CAMs, such as fish oil and glucosamine, primarily to prevent cardiovascular disease and manage joint pain. However, the efficacy of these treatments remains controversial.
“Health care providers need to actively guide women in the management of VMS and other menopausal symptoms,” said Professor Davis. “More judicious use of supplements such as fish oil and glucosamine, particularly by older women, is needed until their efficacy and safety profiles are better understood.”