Zdravniški Vestnik (Dec 2008)

MENOPAUSE AND NATURAL HEALING

  • Lucija Vrabič Dežman

Journal volume & issue
Vol. 77, no. SUPPIII

Abstract

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BACKGROUND For several decades, gynecologists have been successfully using various forms of hormonalreplacement therapy (HRT) for treating climacteric symptoms. After 2002, when the expertand the general public learned about the undesired side effects of hormonal replacementtherapy, the interest in such forms of therapy has been reduced, and as a consequence, theinterest in natural healing has increased.Some plants contain phytoestrogens, which are structurally and/or functionally similar toestrogen and which can have agonistic, partly agonistic and antagonistic interactions with estrogen receptors. Among the more familiar sources of phytoestrogens are soya, redclover, ginseng, dong quai, evening primrose seed oil, and they are marketed as food supplements for ameliorating climacteric symptoms. Very few relevant clinical studies havebeen done on the effectiveness of the above-mentioned food supplements in eliminatingclimacteric symptoms and they have not conclusively demonstrated their positive effect.Any beneficial effects are usually attributed to the placebo effect. The most promising arethe soya preparations, as clinical data proves their effectiveness in reducing blood lipids.Estimating their effectiveness in eliminating climacteric symptoms is made difficult because of varying compositions and doses of isoflavones in them. There is more evidence supporting the effectiveness and safety of the unique medication made from the rhizome ofthe medicinal plant Cimicifuga racemosa (Black Cohosh), which has been on the marketsince 1956. The exact mechanism of the natural medication made of CR is not known, butit is attributed to the properties of a vegetative SERM (Selective Estrogen Receptor Modulator) and central activity through dopamine and serotonin receptors has been proven. Thismedication has been subject to the most clinical trials of all natural medications in generaland it was tested on more than 3800 patients. Its effectiveness is proven compared toplacebo and it is also very effective compared to HRT. The effects of long-term use and theexact mechanism remain unknown. CONCLUSIONS The studies could not decisively confirm the effectiveness of various phytoestrogens inamelioration of climacteric symptoms. Most studies have proven the effectiveness of thenatural medication made of Cimicifuga racemosa and its safe short-term use. Gynecologists should be familiar with the basics of phytotherapy and the results of clinical studiesin this field in order to confidently advise women to use the natural medications in caseswhere despite the climacteric symptoms they cannot or will not use HRT, consequentlygreatly reducing the quality of their lives. In cases where climacteric symptoms are mild tomoderate, some menopausal societies around the globe suggest trying natural medicationfirst, and only later implementing HRT