Some plant-based therapies associated with modest improvement in menopausal symptoms

An analysis of more than 60 studies suggests that some plant-based therapies are associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats, according to a study appearing in the June 21 issue of JAMA.

Medical treatments for symptoms associated with menopause are available, including hormone replacement therapy. However, given the potentially negative health consequences of hormone replacement therapy on cardiovascular health and breast cancer, 40 percent to 50 percent of women in Western countries choose to use complementary therapies, including plant-based therapies. A broad range of plant-based therapies may improve menopausal symptoms. These therapies include the oral use of phytoestrogens such as dietary soy isoflavones and soy extracts; herbal remedies such as red clover and black cohosh; and Chinese and other medicinal herbs. Although associations of these therapies with menopausal symptoms have been evaluated in randomized trials, most of these studies were limited by sample size, a short follow-up period, suboptimal quality, and inconsistent findings.

Taulant Muka, M.D., Ph.D., of Erasmus University Medical Center, Rotterdam, the Netherlands, and colleagues, in collaboration with the University of Cambridge, conducted a review and meta-analysis of randomized clinical trials that assessed plant-based therapies and the presence of hot flashes, night sweats, and vaginal dryness. The researchers identified 62 studies (6,653 women) that met criteria for inclusion in the analysis.

Use of phytoestrogens was associated with a decrease in the number of daily hot flashes and vaginal dryness score between the treatment groups but not in the number of night sweats. Individual phytoestrogen interventions such as dietary and supplemental soy isoflavones were associated with improvement in daily hot flashes and vaginal dryness score. Several herbal remedies, but not Chinese medicinal herbs, were associated with an overall decrease in the frequency of vasomotor symptoms. There was substantial variation among the available studies in terms of scientific rigor and quality.

"Because of general suboptimal quality and the heterogeneous nature of the current evidence, further rigorous studies are needed to determine the association of plant-based and natural therapies with menopausal health," the authors write.