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Alternative Therapies May Not Ease Menopause Symptoms

nefit in relieving menopause symptoms. In the four qualifying studies of black cohosh, the root of a native North American shrub, one large study showed an overall improvement in several symptoms, while three did not show any benefit for hot flashes. The studies of energy, mind-body and other types of therapies suggested few benefits for these treatments for menopause-related symptoms.

Many of the studies had a large placebo effect, meaning that even women who were not assigned to receive active therapy still reported improvement in their symptoms. "The large placebo effect is consistent with preexisting work of menopausal hormonal therapies," the authors write. "A study of estrogen compared with placebo reported a 50 percent improvement in frequency of hot flashes in the placebo group. The placebo effect likely plays an important role in the expanding number of dietary supplements marketed to menopausal women."

Because many women are using alternative and complementary therapies to treat their symptoms, often without telling their physicians, additional rigorous studies are needed to identify which of these treatments are safe and effective, the authors write. In the meantime, "the most important thing that the health professionals can do for symptomatic menopausal women is to encourage open communication that allows patients to disclose treatments they are using," they conclude. "Women value partnership, choice and shared decision making. Because there is no universal menopausal presentation or treatment, it is essential that health care professionals provide accurate information and options for midlife women." (Arch Intern Med. 2006;166:1453-1465. Available pre-embargo to the media at www.jamamedia.org.)

Contact: Christine Decker

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JAMA and Archives Journals

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