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Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials.
Ann Intern Med. 2002 Nov 19; 137(10):805-13.AIM

Abstract

BACKGROUND

Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms. Randomized, controlled trials have evaluated the efficacy and short-term safety of these therapies.

PURPOSE

To review randomized, controlled trials of CAM therapies for menopausal symptoms in order to better inform practice and guide future research.

DATA SOURCES

Searches of MEDLINE for articles published from January 1966 through March 2002, of the Alternative and Complementary Database (AMED) of the British Library for articles published from January 1985 through December 2000, and of the authors' own extensive files. Search terms were hot flash/flush, menopause, and climacteric, combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine (TCM), Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch.

STUDY SELECTION

29 randomized, controlled clinical trials of CAM therapies for hot flashes and other menopausal symptoms were identified; of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies.

DATA EXTRACTION

Each author extracted information from half of the studies on the number of patients, study design, outcome measures, and results; the other author then checked these results.

DATA SYNTHESIS

Soy seems to have modest benefit for hot flashes, but studies are not conclusive. Isoflavone preparations seem to be less effective than soy foods. Black cohosh may be effective for menopausal symptoms, especially hot flashes, but the lack of adequate long-term safety data (mainly on estrogenic stimulation of the breast or endometrium) precludes recommending long-term use. Single clinical trials have found that dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flashes; two trials have shown that red clover has no benefit for treating hot flashes.

CONCLUSIONS

Black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms. Clinical trials do not support the use of other herbs or CAM therapies. Long-term safety data on individual isoflavones or isoflavone concentrates are not available.

Authors+Show Affiliations

Rosenthal Center for Complementary and Alternative Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, Box 75, New York, NY 10032, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

12435217

Citation

Kronenberg, Fredi, and Adriane Fugh-Berman. "Complementary and Alternative Medicine for Menopausal Symptoms: a Review of Randomized, Controlled Trials." Annals of Internal Medicine, vol. 137, no. 10, 2002, pp. 805-13.
Kronenberg F, Fugh-Berman A. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Ann Intern Med. 2002;137(10):805-13.
Kronenberg, F., & Fugh-Berman, A. (2002). Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Annals of Internal Medicine, 137(10), 805-13.
Kronenberg F, Fugh-Berman A. Complementary and Alternative Medicine for Menopausal Symptoms: a Review of Randomized, Controlled Trials. Ann Intern Med. 2002 Nov 19;137(10):805-13. PubMed PMID: 12435217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. AU - Kronenberg,Fredi, AU - Fugh-Berman,Adriane, PY - 2002/11/19/pubmed PY - 2002/11/28/medline PY - 2002/11/19/entrez SP - 805 EP - 13 JF - Annals of internal medicine JO - Ann Intern Med VL - 137 IS - 10 N2 - BACKGROUND: Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms. Randomized, controlled trials have evaluated the efficacy and short-term safety of these therapies. PURPOSE: To review randomized, controlled trials of CAM therapies for menopausal symptoms in order to better inform practice and guide future research. DATA SOURCES: Searches of MEDLINE for articles published from January 1966 through March 2002, of the Alternative and Complementary Database (AMED) of the British Library for articles published from January 1985 through December 2000, and of the authors' own extensive files. Search terms were hot flash/flush, menopause, and climacteric, combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine (TCM), Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch. STUDY SELECTION: 29 randomized, controlled clinical trials of CAM therapies for hot flashes and other menopausal symptoms were identified; of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies. DATA EXTRACTION: Each author extracted information from half of the studies on the number of patients, study design, outcome measures, and results; the other author then checked these results. DATA SYNTHESIS: Soy seems to have modest benefit for hot flashes, but studies are not conclusive. Isoflavone preparations seem to be less effective than soy foods. Black cohosh may be effective for menopausal symptoms, especially hot flashes, but the lack of adequate long-term safety data (mainly on estrogenic stimulation of the breast or endometrium) precludes recommending long-term use. Single clinical trials have found that dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flashes; two trials have shown that red clover has no benefit for treating hot flashes. CONCLUSIONS: Black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms. Clinical trials do not support the use of other herbs or CAM therapies. Long-term safety data on individual isoflavones or isoflavone concentrates are not available. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/12435217/Complementary_and_alternative_medicine_for_menopausal_symptoms:_a_review_of_randomized_controlled_trials_ DB - PRIME DP - Unbound Medicine ER -