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Alternative therapy – an alternative to HRT

Doctors say that women going in for alternative therapies to treat menopausal symptoms instead of the regular hormone replacement therapy are at the risk of harming themselves.//

The Royal College of Obstetricians and Gynaecologists also cautioned that the therapies may not be very effective. Though, there is some proof that alternative therapies reduce hot flushes, there is also a risk of stomach upset and rashes.

Symptoms of menopause like hot flushes and mood swings can be treated with the traditional HRT. However, the risk of and development a blood clot on the lungs, increases.

This study investigates complementary therapies and their effectiveness in clinical studies. Of the more than 200 existing remedies, valuable scientific research has been conducted on only a few.

Alternative therapies are used along with or instead of HRT by around 40% of the women seeking treatment for menopausal symptoms. A 50 – 60% decrease in symptoms was observed with alternative therapies while traditional HRT showed 80 – 90% decrease, according to the paper.

Therapies like red clover and soy have been studied better than other therapies and they seem to be beneficial in treating symptoms. There was conflicting evidence over others. Oestrogenic compounds - plant forms that mimic the effect of the hormone oestrogen in the body- are found in some of the herbal remedies, which may affect women with breast cancer. 'The herb black cohosh has been associated with liver toxicity and in one case a patient consequently needed a liver transplant after a serious harmful reaction. According to the report, contaminants like mercury, arsenic lead and pesticides are also a cause of concern.

Richard Warren, honorary secretary of the RCOG, said: "The current interest and enthusiasm directed towards alternative treatments for menopausal symptoms is understandable, but the full risks and benefits of these alternatives are still unknow n.

"Each case needs to be considered individually. In women with specific risk factors, a clinician should weigh up the advantages and disadvantages of alternative therapies compared to those of traditional HRT.” "Interactions with commonly used medications such as warfarin and anti-depressants can cause potentially fatal results."

A spokesman for Prince Charles' Foundation for Integrated Health, set up to promote the use of complementary medicine in mainstream health care, agreed that more research was needed into such therapies. "Our view is that we support the report that more research needs to be done."

Consultant gynaecologist Nick Panay, of Queen Charlotte's Hospital, London, and co-author of the report, said “Many women use alternatives to HRT to help control menopausal symptoms believing them to be safer and 'more natural'. But in many cases appropriate research into their safety has not been done. I'm a strong supporter of an integrated approach using lifestyle, alternatives and HRT but it must be evidence-based to confirm both efficacy and long-term safety.”

Mr Panay, who is patron of the Daisy Network, which supports women going through premature menopause, said, “Women who find their doctor lacks knowledge about treatments or is unhelpful should not put up with it. They should ask to be referred to a health professional who is interested and has expertise in the menopause.” he added.

Nutritionist Maryon Stewart, of the Women's Nutritional Advisory Service, said, “The report is a step in the right direction, but 'wholly inadequate'”. She said “It deals with diet in just a few lines when there is so much to it than that. Even the Government's own National Diet and Nutrition Surveys show many of us have nutritional inadequacies that can affect brain chemistry and hormonal function. There is clearly a need for more research and funding into alternative treatments, which the Government should provide.

“HRT is no longer a treatment option for life - everyone agrees it should be given in the minimum dose for the least amount of time to those that suffer severe symptoms - and women are left confused. One of the main problems is that many doctors are inadequately trained on the alternatives to HRT and women are left to fend for themselves”.

“In particular, it said some products could carry a slight risk of minor, transient adverse events, such as gastrointestinal upsets and rashes” she said.


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