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Mature Women's Centre Victoria General Hospital

Treatment Induced Menopause

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Complementary/Alternative Therapies
Alternative or complementary therapies consist of herbal or “natural” remedies. People that favour complementary therapies believe that they act on the body in a gentler fashion when compared to more conventional hormone replacement therapy. Caution must be used, however, as these remedies are not always subject to controlled manufacturing processes, and the quantity and quality of active ingredients can vary from one bottle to the next. Usually, manufacturers of these products do not have to conduct scientific studies to prove their claims, and therefore cannot guarantee that their therapies will be effective nor harmless. Look for a "DIN" (Drug Information Number) or "NPN" (Natural Product Number) on the label. These numbers tell consumers that the products have been reviewed for safety, quality, and health claims by Health Canada. Most herbs do interact with certain drugs (both prescription and over-the-counter). It is important that you tell your health care provider if you are using complementary therapies.

Some complementary therapies used for treatment induced menopause are:

Black Cohosh: has been studied extensively by the scientific community. The most consistent evidence is for a specific commercial product called "Remifemin". Remifemin, a brand name of Black Cohosh has been used in Europe for many years in the management of menopausal symptoms. Black Cohosh appears to decrease hot flashes by its estrogen like properties, however long term studies are limited. Currently Black cohosh is not recommended for women with existing breast cancer or who are at high risk of developing breast cancer. Recent reports have linked some serious forms of liver disease with the possible use of black cohosh. It is important that your doctor monitors your liver function tests if you are using this product.

Evening Primrose Oil: has been found to be ineffective in reducing hot flushes and night sweats.

Ginkgo Biloba: is believed to help in the treatment of short-term memory loss, headache, possibly fatigue, and cognitive disorders such as depression. Gingko leaf extract is the recommended form however, even when taken in typical doses, side effects such as headache, dizziness, constipation and allergic skin reaction may occur. Spontaneous bleeding can be a severe side effect and therefore Ginkgo Biloba needs to be discontinued for at least 2 weeks prior to any surgery. Other severe adverse interactions have been found when gingko is taken with prescribed medications so consultation with your health care provider prior to taking gingko biloba is recommended.

Plant Estrogens or Phytoestrogens: many studies that evaluate the effectiveness of phytoestrogens, as found in soy based foods such as tofu are ongoing. The inclusion of soy, as a low fat source of protein, has its benefits for lowering cholesterol levels. The effect of soy on menopausal symptoms has been shown to have variable results and its effect on bone health has yet to be determined. Soybeans and soy products such as tofu, miso, soy flour, and soy drinks are good sources of phytoestrogens. Other sources include vegetable, fruits, and whole grains. You may find the regular inclusion of these foods in your diet helpful.

Vitamin E: there have been no clinical trials using vitamin E supplementation for postmenopausal symptoms. Fat-soluble vitamins such as vitamin E may be dangerous in doses higher than 400 I.U. per day, therefore discuss the use of vitamin E with your health care provider.

Know what herb or vitamin you are taking, and its side effects. Your Pharmacist, or a reputable herbalist, can be an excellent resource. As some complementary therapies may interact with prescribed treatment, always advise your health care provider of any therapies you are using.

Other Therapies
Many other complementary or alternative therapies exist and may be helpful in controlling symptoms. Some therapies that have been used by women for menopausal symptom control include acupuncture, massage therapy, and paced breathing techniques. Other drug therapies have been used successfully in managing menopausal symptoms and may be considered as options.

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