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Menopause

Complementary therapies for menopausal symptoms

For some women who are uncertain about the use of HRT or do not want to use it. complementary therapies have become a popular ‘natural’ alternative to prescription medicines. Pharmacies, supermarkets, health food shops and internet websites offer a wide variety of herbal remedies including red clover, agnus castus and St Johns Wort, which claim to help relieve menopausal symptoms.

Yet, unlike conventional medicines, complementary therapies are not officially regulated and may be potentially dangerous. Recent research, for example, suggests a possible link between black cohosh and liver damage. Because so little scientific research has been done on the effectiveness and safety of these products, the NHS does not recommend their use.

 

Rhonda stopped taking black cohosh when she found it was unsuitable for women who had had breast...

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Age at interview: 46
Sex: Female
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You mentioned you used some alternative remedies, black cohosh and so on. How long did you use them for?

Probably about six months and then, the black cohosh is absolutely disgusting so I just stopped taking that.

Was that in tablet form?

Yeah, you can get it in tablet or liquid, and it was just horrible. Then I found out if you’ve had breast cancer you shouldn’t take it so anyway I stopped that. Then I went on to sage, I had the sage tincture, so I was just dripping dropping that into some water and drinking that. My Mum started taking that as well so we used to compare notes but I don’t think it did anything for me personally. I tried the different menopause tablets you could get but I can’t remember the names of them now; my Mum’s also tried them and I didn’t find that had any affect either. And I just thought, “No, at the end of the day I just need to think about what the trigger points are when I’m eating and really just try and curb it that way”.

Yet while often reluctant to take hormone replacement therapy (HRT) (see ‘Hormone replacement therapy (HRT)’), many women we talked with felt that herbal remedies offered a safer and more ‘natural’ alternative to prescription medication, as well as giving them a sense of control over their symptoms. One woman preferred complementary therapies because they didn’t ‘mess my system up’; another said ‘it can’t hurt’ to drink sage tea.

 

Denise thought herbal remedies would be ‘better than going on chemicals’ but wonders what trials...

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Age at interview: 53
Sex: Female
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Have you ever tried any of the over-the-counter remedies, herbal remedies for your symptoms?

My doctor actually did mention a couple, black cohosh I think and another couple which names I can’t remember which of course you try because you think, “Well, that’s great. That would be much better than going onto chemicals if you like or medication in that form”. I didn’t notice much difference at all perhaps because you need to take them a long time and again the symptoms being so general the easing of the symptoms is also so general you suddenly realise you’re maybe not being quite so tired, or it’s not like flicking a switch. So for those homeopathic remedies I really didn’t notice anything in particular.

It would be nice to know if there was maybe more homeopathic remedies that are successful if you like. Because I mean you read on the internet, I mean I know that they say that such and such is great and all the rest but I don’t know what trials have been done or not done. And maybe some of it’s in your mind as well but it would be quite nice to know. It was suggested to me to use them as a first resort which I thought was quite good. Sometimes the very fact of taking something is good in itself. But perhaps more work on that would be useful.

While women discussed the pros and cons of hormone replacement therapy (HRT) with their doctor before deciding whether or not to take it, their decision to try herbal remedies was often more relaxed (see ‘Consulting the doctor’). Some women tried herbal remedies on the suggestion of their GP; others felt their GP didn’t seem to know much about these products or was reluctant to recommend them. One woman’s doctor warned her of the possible risks, ‘you don’t know what you’re putting into your body with all those natural supplements’. Most women, however, did not consult their doctor but had bought products on the recommendation of friends, or after reading about them in magazines or on the internet.
 

Beverley ignored the prescription her doctor wrote for HRT and tried herbal remedies instead

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Age at interview: 50
Sex: Female
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And I was offered the treatment, when you’re menopausal they give you these tablets to take.

HRT?

HRT. But I decided not to take them and I went to Asda and I looked to see what they had for menopause and I actually took vitamins and whatever they recommended for menopause.

You decided not to go on HRT. Can you tell me why you decided not to?

I wanted to try natural things or try something else. I went, my local store is Asda, and I just went and looked to see what they had on their shelves. And they did have lots of things that you could take. Whether or not they assisted me or not I don’t know but for me while I was taking them my menopause was manageable. I didn’t get to the stage when I wanted to pull my hair out or it was just manageable.

 
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Joyce's doctor had 'never heard of' soy isoflavones and felt that herbal remedies were unlikely...

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Age at interview: 48
Sex: Female
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Once I knew that I was perimenopausal and I’d got some hot flushes, I take quite a lot of supplements and so it’s something that I would kind of naturally do if I thought there was going to be some benefit. What I don’t know is how effective they actually were because I didn’t have any most of the time. I would take them most days, I’d have a packet in my drawer at work, in my desk, and I’d have some at home so most days I’d remember to take them. It was interesting when I said, “Oh I’ve been taking a natural remedy called soy isoflavones,” that the GP said, “I’ve never heard of that.” Which I found quite interesting actually. And I don’t know whether that sort of says something about the medical profession or maybe her as an individual but her view was that over-the-counter natural sort of plant or herbal remedies are unlikely to have a major impact. And certainly on the anxiety and the mental side she was absolutely right, they didn’t.

What herbal remedies do women take?
Evening primrose oil, black cohosh, red clover and sage promise to relieve hot flushes; St John's Wort offers an alternative to antidepressants; valerian is said to reduce anxiety; ginkgo biloba may improve memory; and agnus castus may help regulate hormone fluctuations and premenstrual tension. Dietary supplements containing phytoestrogens, such as soy isoflavones, have a weak oestrogen effect which may help reduce hot flushes and other menopausal symptoms. Some products contain a mixture of supplements formulated to meet the needs of menopausal women.

 

Rachel’s friend suggested an over-the-counter herbal treatment to help her anxiety and depression

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Age at interview: 51
Sex: Female
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Oh it’s been dreadful. It’s been absolutely dreadful. I have felt depressed, I have felt like I’m near to tears I have felt generally unwell and like I’m unable to think things through, I’m unable to make my own decisions. I think it was about early part of last year that’s how I was feeling like I’d just generally wanted to and I did, I broke down into tears and think what the Hell’s going on with me. I think one day I just drove round to a girlfriend’s house and I said, “I don’t know what the Hell’s happening to me” and she explained her story and that girlfriend suggested she was taking like, well it’s not a vitamin I suppose, but it was like something. It’s a form of tablet that you could buy over-the-counter. And in this tablet it had certain things like red leaf clover and these sorts of things that are supposed to help you whilst you’re going through the menopause. So off she went and she bought me a bottle of this and then I started to take it and I must admit I don’t know if it was a mind over matter thing but I must admit about a week after starting to take them that that depression that I was experiencing started to lift. But I don’t know whether or not it was mind over matter because I’m not taking them anymore.

How long did you take them for?

I took them for three months.

And do you remember the name?

Meno something.

 

Rose uses herbal remedies to help her hot flushes, memory, dry skin and brittle nails

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Age at interview: 50
Sex: Female
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But what I now do is control the symptoms using evening primrose and isoflavones. I’ve actually been on isoflavones for about five years because interestingly I’ve read that the Japanese women have little or no problems with the menopause, allegedly because of the high fish diet but again read that you have to have a lifetime of that sort of diet really for that to be effective. So I have been on the isoflavones about five years and whether they help or not I don’t know, but they certainly, the hot flushes at the moment which are my biggest problem are much reduced to what they were and they’re bearable. The evening primrose I find just keeps my hair and nails and skin reasonably nice. I suffer, my nails went extremely brittle, my hair started going very thin, my skin was going very dry, taking evening primrose, quite a high dosage, I find has helped with that. I take sage, which again is for the hot flushes and ginseng biloba which is to help with memory and concentration.

Some women bought herbal products over-the-counter or via the internet, others consulted alternative therapists who offered a more individualised and holistic approach. One woman saw a herbalist at a clinic where she works and is now taking a ‘tonic that supports the menopause’; another saw a complementary health person who ‘did lots of testings, connecting things to my toes and to my finger tips’ before prescribing creams and tablets.

 

Sandra consulted a Chinese herbalist who prescribed tablets. She couldn’t understand the...

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Age at interview: 47
Sex: Female
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Tell me about the consultation with the Chinese man.

When I went in, he couldn’t speak a word of English so he had to have an interpreter but he took my pulses first of all and after he took those he looked at my tongue. Then he asked me if I was stressed or depressed in myself. I mean everybody’s stressed to a certain degree so you’re always going to say that. He asked me the type of work I do, the type of lifestyle and he said that my system wasn’t working properly. He more or less was asking me did I suffer with a lot of headaches as well at the time and again everybody has their days. The consultation wasn’t long and it was just a case of him saying, “I think you are [menopausal]”. He didn’t actually turn around and say, “You are. I think you are" that’s what he said and that’s when he started to recommend these different tablets.

What were the tablets?

I’ve got them in my bag. What they were they’re like, it’s a little sachet of twenty very very small tablets you take the two sachets twice a day and then there’s another load of tablets which are supposed to help take the heat out of your body and you take ten three times a day. They are very good because once they’ve got into your system and if you keep taking them on a regular basis they do help. And then the little bottles of drink which I have, you take two of those, one in the morning you’re supposed to take but I take them both of night time to help me sleep and it’s just like they do really relax you and it’s like knock you out sort of thing, they’re very good the drinks. But I’m not sure what these little, the twenty odd little packets are supposed to be doing.

Did the doctor or the herbalist explain to you what was in them?

They did explain to me and they give you a chart because all these tablets, all the instructions on how to take them are all in Chinese and of course I wanted to know what was inside them.

And I do remember going along to another Chinese place in [town] and asking them. Again I took all the packets that I’d got from this previous gentleman and I took them and I asked them to explain again to me what the different ones were but they said, “You don’t want to take any of those”, and again it was you want to come in here and we can offer you this that and the other. They’re all trying to sell their own services but again I couldn’t understand why they wouldn’t tell me when all I was asking was what they were for really and trying to look on the internet and trying to type in certain words, trying to pick off certain words from the boxes you don’t know what the Chinese equivalent is you see.

What women think of herbal remedies
Women tried all sorts of herbal remedies. Some found relief in the short-term, but benefits were not always sustained, particularly when symptoms got worse. One woman said that valerian capsules worked ‘really well’ for helping her get off to sleep but were ‘not so good’ when she woke up during the night with hot sweats (see ‘Sleep’, ‘Hot flushes and night sweats’). A sage infusion eased another woman’s hot flushes for about three months but then had no effect.

 

Rose evaluates the usefulness of herbal remedies for her symptoms

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Age at interview: 50
Sex: Female
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That’s very difficult to be perfectly honest because I think if your symptoms are fairly minor they do help. And I will assess that in that I ran out of sage about two weeks ago and within a week I noticed that the hot flushes had increased. And I’m just waiting for the next lot to come through. So there’s no doubt that sage does help. In the same way when I ran out of evening primrose, it’s only about a week that I notice that suddenly my nails start to go brittle again and my skin starts to dry. So I know that those two help me personally. The ginseng biloba I take for focusing and concentration I don’t know. I can’t honestly say that I’ve noticed any difference when I run out of that so I don’t know whether that helps at all. I continue to take it in the hope that it does. But certainly the sage has helped and again the isoflavones I don’t know if it’s five years worth of those that has enabled me to give up on the HRT because they are having some longer term impact now or whether I would have just got to this stage because five years on I’m coming through the other side. And maybe I would have got to this stage anyway. And because it’s only a long term benefit I’ve never stopped taking those, I make sure I’ve always got a healthy supply.

 

I think in my own mind I’ve come to the conclusion that if your symptoms aren’t too severe I preferred to use the natural supplements and I’m quite convinced that they’ve helped me. When my symptoms got much worse and more severe they didn’t. So I think I’ve come to the conclusion in my mind they may help women who are going through a menopause that isn’t too severe and I think they helped me to begin with and I think they help me maintain a healthy system now. I don’t think they’re the answer if you get such severe symptoms that I got for a period of three to four years.

Some women found no effect at all from herbal remedies. One tried red clover for a few months after going off HRT but found it ‘didn’t make any impact whatsoever’. Some women had been taking remedies for years unsure whether or not they were helping them. One woman felt ‘pretty sure’ evening primrose oil helped her hot flushes, but realised that this might be a ‘placebo effect’.

 

Cheryl took evening primrose oil and magnesium for a couple of years without success

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Age at interview: 54
Sex: Female
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I was recommended, yes I think in fact, yes recommended by the GP first, so this must have been after when I think probably when I saw her when I was 46, and she recommended evening primrose and then I’m trying to think of the other one, the name’s gone, oh gosh that’s another sign of ageing isn’t it. What is the name of the tablet, oh she put me on magnesium as well that’s another one, so it was the evening primrose, the magnesium and I think there was something else and it’s slipped my mind and I can’t think what it is. But I didn’t find anything helpful.

Did you take them for long?

A couple of years. Yes, but I didn’t find it actually helpful.

Women acknowledged that the success or otherwise of these products depends on their commitment. Some blamed themselves for not being ‘diligent enough’, admitting that if herbal remedies didn’t work immediately they gave up. Those who did persevere found complementary therapies very expensive and beyond the reach of many people. One woman talked about paying £120 for an initial consultation with a Chinese herbalist for acupuncture and herbal remedies; another paid ‘50 Euros per session including remedies’ for a consultation with a homeopath.

 

Barbara spent £200 to see a complementary therapist for a consultation and a supply of 'natural' progesterone cream

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Age at interview: 52
Sex: Female
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Now, because it didn’t work for me I’m not saying that it’s not going to work for somebody else and I know as I say certain things, [partner] took some herbal Chinese herbal things and you know she felt quite comfortable taking them and she felt they helped. The creams didn’t work for me but I’m very impatient. I take it one night and if it’s not working the following day I think, “This is expensive and it’s not working. And a lot of people can’t afford complementary health.

It’s expensive isn’t it?

It is. You go for the consultation then you have the treatment. I mean mine down in [city] were £200 each time.

What for the treatment?

For the consultation. The initial consultation and then the cream at first and then I went down again, the second time wasn’t [as expensive] because you’re not as long. I think the second time was about £100, just over £100.

Acupuncture, homeopathy and other alternative treatments
Other complementary therapies such as acupuncture and homeopathy are also offered as an approach to symptom relief. One woman had an acupuncture session once a month for six months which she found relaxing. Although her sweats improved for a few months, they came back again and she found that overall acupuncture ‘didn’t make any dramatic difference’. Another woman tried craniosacral therapy, acupuncture, cognitive behavioural therapy (CBT), and yoga to manage her anxiety; all without success (see Donna's interview below).

 

Geraldine speaks highly of her homeopath. She sees her two or three times a year

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Age at interview: 49
Sex: Female
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I just told her that I was having trouble with PMS and she said, “Well, what are the symptoms?” And very simply, “What do you feel like? What are you feeling? What exactly do you feel like?” I mean we discussed in depth, I mean even now when I go to see her I’d usually be there two or three times a year, and I would be there for about half an hour. At first, it would have been longer obviously. I mean, she knows me well now.

And what did she prescribe?

Oh, wee wee tablets, I don’t know. I’m just one of these people that I think, “Well, a professional, I trust her as a professional.” And then she’ll give me, and that I’m the same myself. I'll I do my best with people and she will and I mean I know it can’t do me any harm. So if it had been to the GP and it was drugs and things I would have been checking to see what are the side-effects of this and things but.

What one tablet or a number of tablets or?

Once a month well, no sorry not once a month, once I would take stuff usually it’s you take something, when you go to see her, you take something that night, something the next morning and then just whenever the effects of that wear off, which can be I mean if everything’s going normally it’s about every three months or so. Always repeat the dose but that’s. And it changes now and again. The remedy as she calls it, at times will change.

If you had to sum up, how does her approach differ from the GP’s approach?

The essence of it is it’s holistic really. And she’s not just interested in your physical symptoms, she wants to know about, “How does that feel and what’s that doing to you?” And all that. Just to sum up, to me it is holistic really.

When complementary therapies fail
When faced with distressing symptoms which interfered with their daily lives, some women said they turned to HRT or other prescription medication rather than persevere with complementary approaches (see ‘Hormone replacement therapy (HRT)’ and ‘Non-HRT and lifestyle options’). One woman wanted to manage the menopause herself without ‘resorting to drugs’ but turned to her GP for advice when natural remedies failed to relieve her symptoms; another was prescribed temazepam for insomnia after valerian failed to restore her sleep (see ‘Sleep’). Other women chose to put up with symptoms or relied on their own coping strategies (see ‘Hot flushes and night sweats’).

 

When complementary therapies had little effect on her depression Donna took an antidepressant ...

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Age at interview: 47
Sex: Female
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And I work in alternative health, so I tried to do whatever I could think of to manage this anxiety for myself, and through alternative health. So, I went to see a craniosacral therapist which I do anyway actually. I find that a very calming treatment but it would only last for a few hours and then I’d be back into this anxiety state. I went to see an acupuncturist, and that didn’t seem to help me at all - lots of people had experience that this worked with anxiety, I didn’t find that helpful.

 

I went to see a cognitive behavioural therapist as well, because again that seems to be the latest theory that CBT manages anxiety. However, what I found helpful about it was somebody didn’t think that I was going mad because I felt like I was crazy, and that was the most beneficial aspect, but I think when you have such chronic anxiety and you’re not able particularly to think rationally, and CBT is a very rational model and I didn’t find that it helped me manage the anxiety. So I was doing yoga, that was helpful, but I felt like I needed to be doing it every couple of hours, and so this, and I was continuing to work but feeling very out of control, and in the end after about, this was about three months of trying to, oh, also I was taking St. John’s Wort, and that I felt was having an effect, but not quickly enough.

 

And because I’m on my own, and I needed to work, I felt like I needed to find a faster solution, and all of the time I was going to see my GP and eventually I agreed to try antidepressants [citalopram]. I was really adamant that I didn’t want to, mainly because I work in alternative health and it just felt like a big no no, I couldn’t, I felt kind of fraudulent about taking antidepressants and working as a therapist, and it was a big issue for me, so I delayed, I delayed taking them really for about three or four months. And then things were so chronic that by that point, that I then took five weeks off work, I couldn’t, I was quite paranoid, I was probably quite depressed by then because I’d tried everything I could think of to manage the symptoms and I wasn’t managing them. And I wasn’t having a social life because I couldn’t cope, even going to the shops was difficult. So fortunately for me the first antidepressant I tried worked.

With complementary therapies freely available, the decision on whether or not to use them is an individual one. For some women they may be an alternative to HRT and may help relieve symptoms in the short-term, but the NHS does not recommend their use (see NHS Choices information on menopause). At present there is no medical evidence that complementary therapies really work, and the quality of products used, their long-term safety, side effects and interactions with other medications are uncertain.



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Last reviewed July 2018.

Last updated July 2018.

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