Menopausal Symptoms and treatments

Menopause is the permanent cessation of menstruation in women. Menopause can occur naturally or be caused by surgery, chemotherapy or radiotherapy.

Key points

* Symptoms usually considered menopause may be related to aging in general.
* Menopause is a normal part of aging and should not be considered a disease.
* There is very little scientific evidence of high quality on the effectiveness and safety of long-term CAM therapies for menopausal symptoms. More research is needed.
* Tell your health care providers about health of all complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordination and safe care.
About Menopause

A woman said to have completed natural menopause when she has not had a period of 12 consecutive months. For American women, this generally occurs around age 51 or 52. The menopause occurs immediately if the uterus or both ovaries are removed surgically, or if the ovaries are damaged in treating cancer with radiation or certain drugs.

Common symptoms during the menopausal transition

Some women experience symptoms that are related to menopause and decreased activity of the ovaries. Others may be related to aging in general.

The scientific evidence of a link with the menopause is strongest for the following symptoms:

* Hot flashes and night sweats (also called vasomotor symptoms, because it involves the dilation of blood vessels)
* Sleep problems
* Vaginal dryness, which can lead to painful intercourse and other sexual problems.

It is unclear if the following symptoms due to menopause, other factors that can come with aging, or a combination of menopause and the following factors:

* Problems thinking or remembering things
* Urinary incontinence
* Physical complaints such as fatigue and joint pain or stiff
* Changes in mood such as depression, anxiety and / or irritability.

The panel of experts assembled for the NIH State-of-the-science conference noted that menopause is a normal part of aging and women said that menopause should not be "medicalized" (or treated as a disease ).

Hormonal replacement therapy for menopause symptoms

For decades, hormone replacement therapy (HRT), most recently known as hormone therapy for menopause (MHT), was the main treatment of conventional medicine for menopausal symptoms. In 2002, the results of a large study called the Women's Health Initiative raised serious concerns about the long-term safety of MHT.
* Six-botanicals black cohosh, dong quai root, ginseng, kava, red clover, and soybeans
* DHEA (dehydroepiandrosterone), a dietary supplement.

Few well-designed research has been done treatments for menopausal symptoms. A few studies have been published, but they have limitations (such as how the research was done or treatment periods that may not have been long enough). Consequently, the results of these studies are not strong enough for scientists to draw conclusions. Also, many studies of botanicals have not used a standardized product (ie, which is chemically compatible).
Botanicals

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Black cohosh (Actaea racemosa, Cimicifuga racemosa). This herb has received more scientific attention for its possible effects on menopausal symptoms than have other plants. Studies on its effectiveness in reducing hot flashes have had mixed results. A study funded by NCCAM and the National Institute on Aging found that black cohosh, used alone or with other plants, failed to relieve hot flashes and night sweats in postmenopausal women or those approaching menopause. Other research suggests that black cohosh does not act like estrogen once was thought.

United States Pharmacopeia Experts recommend that women should stop using black cohosh and consult alternative health care if they have a liver disorder or symptoms of liver problems such as abdominal pain, dark urine or jaundice . There have been several reports of cases of hepatitis (liver inflammation), as well as liver failure among women taking the black cohosh. It is not known if black cohosh was responsible for these problems. Although such cases are very rare, and the evidence is not definitive, scientists are worried about the possible effects of black cohosh on the liver.
* Dong Quai (Angelica sinensis). One randomized clinical study of Dong Quai has been done. Researchers do not have to be useful in reducing hot flashes. Dong Quai is known to interact with and increase activity in the body, blood-thinning medicine warfarin. This may cause bleeding complications among women taking the drug.
* Ginseng (Panax ginseng or Panax quinquefolius). The panel concluded that ginseng may help with certain symptoms of menopause symptoms such as mood and sleep disorders, and his overall sense of well-being. However, it was not considered useful for hot flashes.
* Kava (Piper methysticum). Kava may decrease anxiety, but there is no evidence that it reduces hot flashes. It is important to note that kava has been associated with liver disease. The FDA issued a warning for patients and providers about kava because of its potential to damage the liver.
* Red clover (Trifolium pratense). The group said that five controlled studies found no conclusive evidence that uniforms or extract of red clover leaf to reduce hot flashes. Clinical studies in women report few side effects and no serious health problems were discussed in the literature. However, there are a few precautions. Some studies have raised concerns that red clover, which contains phytoestrogens, could have adverse effects on hormone-sensitive tissues (eg in the breast and uterus). (See box below for more information on phytoestrogens.)
* Soy. The scientific literature includes both positive and negative on the extracts of soy for hot flashes. When taken for short periods of time, soy extracts appear to have little or no serious side effects. However, the long-term use of soy extracts has been associated with thickening of the lining of the uterus.