Herbs Rival Hormones as Most Popular Menopause Treatment

STANFORD, Calif., June 16 ? Herbal remedies are fast approaching hormone therapy as the most-favored treatment by women suffering from menopause symptoms, researchers here said.

Of nearly 800 women surveyed, 37% reported the use of hormone therapy to treat menopause symptoms while 31% reported using herbal remedies such as ginko biloba, ginseng, St. John's wort, or black cohosh, said Jun Ma, M.D., Ph.D., of Stanford.

An additional 13% of women reported they had used soy supplements for menopause symptom relief, Dr. Ma and colleagues said in the May/June issue of Menopause: the Journal of the North American Menopause Society.

Although 71% of women said their ob-gyn or primary care physician was their most-trusted source of information about menopause symptom management and alternative therapies, 45% also said the information provided by their doctors was conflicting and confusing.

More than 20% said their doctors had not given them adequate information about alternative therapies for menopause symptoms. This lack of effective communication may be why so many women are turning to alternative remedies with little or no scientific evidence behind them, the researchers said.

The study used data gathered in a 2004 online survey of 781 U.S. women ages 40 to 60. The study sample was drawn from the Knowledge Network, a group of U.S. households recruited by random telephone dialing. The households are given free Internet access in exchange for members' participation in online surveys. Key findings include:

• More than 90% of women reported ever having experienced a menopause symptom, and 79% were currently suffering symptoms, most commonly headaches, sleeplessness, mood swings, and weight gain.
• Nearly 60% of women who had been using hormone therapy discontinued it. In this group, the most common reasons for stopping were concern about potential health risks (50%), physician advice to stop (33%), and negative media reports (30%). More than one reason could be cited.
• Overall, 29% of the women were aware of the results of the Women's Health Initiative study. The much-publicized 2002 study linked hormone therapy to increased risk for heart attacks, stroke, and breast cancer.
• Among women aware of the study, 36% had discussed it with their doctor, 44% viewed hormone therapy has having more risks than benefits, 20% viewed hormone therapy as having fewer risks than benefits, and 36% did not know.
• The most widely cited reasons for choosing an herbal product were concern about hormone therapy safety (55%) and the desire to use a "natural" product (45%).

"Although hormone therapy remains the most effective therapy for the management of menopause symptoms, the new concerns about the therapy have left a vacuum for millions of menopause-age women," the authors said. They noted that nearly three-quarters (74%) of women who stopped hormone therapy were not taking any other kind of treatment.

However, "use of alternative therapies, herbal products, and soy supplements in particular has become notably more prevalent and is quickly approaching the prevalence of hormone therapy use," they said.

"This is a turbulent time for those practicing gynecology and primary care and for women already experiencing or approaching menopause," the authors said. "The Women's Health Initiative findings have made it incumbent on healthcare professionals to discuss the health risks and benefits of hormone therapy and to consider alternative strategies to control menopause symptoms."

More specifically, the authors suggest that physicians periodically review the literature and consult practice guidelines in order to be able to inform patients which alternative therapies are supported by scientific evidence, which have data that suggest concern about side effects, and those for which evidence is inconclusive or lacking.

"Although it is challenging, health professionals are the best qualified to examine available scientific information and provide up-to-date recommendations to their patients," they said.