Alternative medicine

It is important to examine the claim that herbal remedies help relieve menopausal symptoms.[59] Some botanical sources, referred to as phytoestrogens, do not simply mimic the effects of human steroidal estrogen but exhibit both similar and divergent actions. The ultimate actions of these compounds in specific cells is determined by many factors including the relative levels of the estrogen receptors ER alpha and beta and the diverse mix of coactivators and corepressors present in any given cell type. Thus they have been described to act somewhat like selective estrogen receptor modulators (SERMs). Effects vary according to the phytoestrogen studied, cell line, tissue, species and response being evaluated [60].

Systematic reviews of intervention studies question the validity of the proposed benefits of phytoestrogen supplementation, with little data in postmenopausal women to support a role for phytoestrogens as an alternative for conventional HT [61]. Femarelle is a mixture of DT56a soy derivative and ground flaxseed at a ratio of 3:1, for oral administration. Each capsule contains 344 mg soy and 108 mg flaxseed — altogether 430 mg powder. It is being promoted for the treatment of menopause and prevention of bone loss and has also been described as having SERM qualities,[62] thereby reducing the safety risks involved in estrogenic-like treatments[citation needed]. In 2008 the European Food Safety Authority concluded that “a cause and effect relationship has not been established between the consumption of Femarelle® and increased BMD, increased bone formation, or decreased risk of osteoporosis or other bone disorders in post-menopausal women.”[63].

In the area of complementary and alternative therapies, acupuncture and acupressure treatments are promising. Numerous studies indicate positive effects, especially on hot flashes[64][65] [66] but also others[67] showing no positive effects of acupuncture regarding menopause.

There are regular claims that soy isoflavones are beneficial concerning menopause. However, one study[68] indicated that soy isoflavones did not improve or appreciably affect cognitive functioning in postmenopausal women.

Other remedies which work in some studies, but in other studies[citation needed] appear to be no better than a placebo [69],[70], include red clover isoflavone extracts and black cohosh. Black cohosh (Cimicifuga racemosa, also known as Actaea racemosa) is a North American native plant. It has common usage internationally for the treatment of hot flushes and sweats experienced by postmenopausal women. However, study results do not support a benefit of black cohosh for the treatment of menopausal symptoms [70]. Black cohosh has been associated with reports of acute liver toxicity [71] and a concern has been raised regarding the stimulation of pre-existing breast cancer based on an animal study.[72].