Non-Pharmacologic Treatments for Menopause: A Q&A with Iris Tong, M.D.

Posted Tuesday, January 15, 2013

As many as 80 percent of women experience side effects related to menopause, or the time when a woman stops having her monthly period. While many women rely on medications to ease their discomfort, at least half of all menopausal women turn to herbal and complementary therapies to relieve their symptoms.

Iris Tong, MD, director of Women’s Primary Care at the Women’s Medicine Collaborative, outlines the advantages and limitations of both medication and non-pharmacologic treatments for postmenopausal symptoms in the current issue of The Obstetrician & Gynaecologist.

Q. What are the most common side effects of menopause?

A. The most common menopausal symptoms are hot flashes, sleep disturbance and vaginal dryness. Some women may also experience joint pain, urinary incontinence, lower sex drive, as well as changes in memory, concentration and mood.

Q. There’s been some controversy over hormone replacement therapy (HRT) as a treatment for menopause symptoms. Can you explain?

A. HRT is very effective in treating certain menopausal symptoms, particularly hot flashes and vaginal dryness. However, HRT has been associated with a higher risk of breast cancer and blood clots, and, in certain women, HRT is associated with a higher risk of cardiac events and stroke. Despite these risks, HRT may still be a treatment option for some women. Women should discuss this option with their health care provider.

Q. You point out that there are also a number of herbal and complementary therapies available to help women manage their menopause symptoms. What are they?

A. Soy, black cohosh and red clover may be helpful for women who are experiencing hot flashes and should be taken as recommended.

Q. Are there certain women who should not pursue these treatment options?

A. Soy, black cohosh and red clover contain phytoestrogens, which interfere with the chemotherapy agent tamoxifen and can theoretically stimulate breast tissue. Therefore, women who are currently taking tamoxifen, have a personal history of breast cancer or are at high risk for breast cancer should avoid these herbal agents.

Q. Are there any long-term health effects related to menopause?

Menopausal women are at higher risk for cardiac disease and osteoporosis. Women with osteoporosis have bone loss that can lead to bone fractures. However, lifestyle modifications such as eating healthy, exercising regularly and quitting smoking will decrease the risks for cardiac disease and osteoporosis. Women should speak to their health care provider about specific lifestyle modifications they can make to reduce their risk for cardiac disease and osteoporosis.

Filed under: Women's Medicine Collaborative,