There are a range of complementary medicines and alternative therapies that some women try in relation to early menopause (EM), in particular for relief from hot flushes. These include Traditional Chinese Medicine (including herbal remedies and acupuncture), herbal and botanical remedies (e.g. black cohosh, phytoestrogens such as red clover, wild yam cream, evening primrose oil), progesterone cream, bioidentical compounded hormones, naturopathy, and massage. Some women may also try spiritual or religious approaches. There is limited information regarding the effectiveness and safety of many complementary medicines as compared with Hormone Replacement Therapy – to learn more, please see the Box at the end of this Talking Point.
Women’s views about complementary medicines and alternative therapies
The women we interviewed had varying views and attitudes towards complementary and alternative therapies for EM symptom relief. Some held positive views and valued both complementary and alternative therapies and ‘Western’ medicine. Several women commented favourably on the ‘holistic approach’ of practitioners of alternative medicine or ‘integrative’ practitioners who drew on both forms of medicine (See Women’s experiences with GPs). Linda appreciated her GP who was also trained in naturopathy and psychology: ‘she was brilliant because she was quite holistic in terms of her treatment and her ability to identify the flow on, the ripple effects or the potential impact of any treatment.’
Kirsty explained her attitude towards complementary and alternative therapies
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I’ve always had a history of looking outside of Western medicine for help with my health. I’ve had digestive issues, I’ve had serious asthma, I’ve had low immune system stuff going on in the past, I had pneumonia a few years back. And so I like to use complementary medicine as a way to complement the western medicine that I am taking and I actually value both equally. I also really appreciate non-western practitioners’ bedside manner and the way that they holistically look at the person.
Other women said concerns about conventional pharmaceutical medicine were the reason they had explored complementary and alternative therapies, including in relation to cancer treatments or Hormone Replacement Therapy (see Hormone-based medications for early menopause: Women’s knowledge and perspectives).
Sonia shared her reasons for trying Traditional Chinese Medicine together with dietary and lifestyle changes to help with her hot flushes.
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All through my life I had sought complementary medicine, unless I couldn’t, or unless they weren’t working. So I don’t eschew medical models completely, but if I can avoid it, or otherwise deal with it, I do. But the hot flushing was extreme, and I was 40 and very reticent to go on HRT at 40. And obviously there’s all sorts of studies all the time about HRT and its efficacy, so I just didn’t want to go down that path so early in my life.
Some women tried conventional and alternative therapies because they could not take HRT as a result of oestrogen sensitive cancer or because they found the side effects of HRT challenging.
Linda had EM following a hysterectomy for endometriosis at 33 then at 39 was diagnosed with oestrogen sensitive breast cancer and had to stop taking HRT. She described her experience of trying complementary and alternative therapies for hot flushes.
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I went through a stage where I tried everything, like, I was so desperate to find something that would help. And from diet and nutrition to, as I said before, the homeopathy and the naturopathy and the Chinese medicine [laughing] and the tai chi and the mindfulness. At some point you’ve got to go, “How much can I do?’”, “What’s actually going to make a difference?” And am I spending my life trying to find, searching for cures and making it more of a bigger deal than it is, as opposed to just trying to get on with life.
Maddy began taking bioidentical compounded hormones for spontaneous EM after a negative experience with conventional HRT, but was not ‘averse’ to trying conventional HRT again in future.
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He sent me off to endocrinologist, so she did some tests. So I’ve now not had a period regular for something like eight or nine months. I’ve had like two periods or something. So she did all these blood tests to check there wasn’t cancer or these other things and they all came back okay and she put me on an estrogen patch and about three days later, I had a massive migraine. I couldn’t cope with it. Getting back in to see her was really, really difficult so I just took it off.
Then I came across this other doctor. He’s a GP but he specialises in lots of other things. So I went and saw him for this and he’s quite expensive as well but he did all these tests on me and all these blood tests came back a couple of weeks later. And he said “Yep your estrogen’s really low and your progesterone’s low and DHEA and testosterone and we need to get you on some hormone treatment to make you feel better.”
And he did bioidentical hormones and I’d already tried that estrogen patch and I wasn’t going back to that. So he explained to me how it’s not good practice to give estrogen without progesterone and he does bioidentical and I went down that avenue because it just felt right for me. So I gave it a go.
When I went to that doctor, he only does bioidentical. If he did synthetic like the conventional, I don’t know. I guess I may have tried the other one, the synthetic version. I’m not quite sure. But it’s kind of what I was offered at that time. And I was quite good with that because of what happened with the estrogen patch. So that kind of worked for me. And then I even thought well I’ll try this and maybe switch later. Because the doctor that I see now does just normal HRT and if I want to switch over I can – which may be something I might do later on. I’m not sure. I’m not averse to doing it.
Several women expressed negative views about complementary and alternative therapies. Concerns included cost and the lack of ‘scientific’ evidence underpinning complementary and alternative therapies. Nancy, who had EM after an oophorectomy, had not considered having acupuncture for hot flushes because it was ‘too expensive’, particularly compared with her home country, China. Debra said she had not looked into complementary and alternative therapies for her symptoms of spontaneous EM because of her concern that they were not ‘rigorously tested.’
Although
Mary had tried progesterone cream and acupuncture, she was highly sceptical about complementary and alternative therapies as ‘prefers science’.
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When the symptoms of menopause were quite difficult to deal with, did you look into any kind of complementary or alternative treatments?
I read about the progesterone cream. I bought some of that online. I read – I dismissed all of the wild yam kind of rubbish as being a bit ‘woo’; a bit stupid. So I didn’t do that. But I did do progesterone cream. But it was so expensive and I didn’t buy anymore. [laughing] That was pretty much it I think in.
So no things like massages or acupuncture or any of that kind of thing?
No. I’m not really that way inclined. [laughing] I prefer science. [laughing]
Do you kind of doubt their effectiveness?
I think it’s a bit of a rip off actually and I think people believe all kinds of crap out there and I never was into the… I mean, I’ve had acupuncture done, but I’ve never really put that much weight into it or, all of the myriad of other therapies that are very expensive. I don’t really think have anything to them. [laughing]
A few women were not aware of complementary and alternative medicines for EM, including Eden who said taking alternative therapies ‘never occurred to me. I didn’t know there were [any].’
Trying complementary and alternative therapies
Complementary and alternative medicines and therapies were helpful for a few women. Sonia said Chinese herbs alleviated her hot flushes, Maddy found bioidentical hormones effective, and others said that massage or acupuncture helped them to relax.
Joanna described her experience of having acupuncture and Chinese herbs after EM induced by treatment for Hodgkin’s Lymphoma.
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A few people had suggested that acupuncture had helped – more so in people sort of managing, difficult, like, painful periods and things like that. And a few people had recommended me to one particular Chinese medicine and acupuncture practitioner and so I saw him. He gave me lots of herbal stuff to take and did the acupuncture. I think it had a bit of a calming effect on me but, like, it didn’t result in a spontaneous resumption of periods or anything. But I think I just sort of felt like, it was – maybe psychologically it just helped me to think that I was doing something that was a bit different and it relaxed me and it gave me time to think.
Several women commented that the benefits of complementary and alternative therapies were not significant enough to justify the cost.
Sylvia described her experience with different complementary and alternative therapies.
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I tried acupuncture; I tried some herbal sort of medication stuff; I tried just following a good diet. So I did some Googling and menopause diets and things. Tried combinations of, did some physio and exercise and some needling and cupping. And some of it – it had some slight positive impacts. It just made you more relaxed a little bit and less tension in your muscles and things. But it wasn’t like, lasting. It probably lasted, say, a week until you kind of went back again and the costs were starting to add up. So I’ve kind of pulled back.
Kirsty described her change of approach after several years of trying naturopathy and Traditional Chinese Medicine as well as conventional medicine for help with spontaneous EM.
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I also went and saw a naturopath who specialises in women’s fertility and women’s menopause and health. And I saw them and agin, they gave me a variety of herbs and teas and I gave them a good crack for a year. And again it was great to see them and to feel supported but it wasn’t helping me. And what I realised through that and through seeing medical specialists is that actually I started to have a dependency on medical specialists in general. Like I wanted them to continue to tell me that I was okay, and I guess, that affected my decision not to see many people except for maintenance or monitoring for the last five years because I felt like I’d started to grow dependent in terms of my fear around all of the things that could happen to my body because of low oestrogen at such an early age.
I felt that I had to keep seeing them for them to reassure me that we were doing everything in our power to stop that from happening. And so I didn’t feel like I had enough resources personally, that I was outsourcing my strength. So I made the decision to stop seeing them and to find personal ways of strengthening myself. So for example, instead of going and seeing a naturopath and spending those money on herbs, although I think naturopathy has a really important role to play in health, I now go and pay for a one hour massage. And actually, I find that having a one hour massage is much better for me. I relax, it’s good for my muscles, I come down from my head and back into my body. I walk away feeling a much happier person. I do yoga, I do other things. I’ve chosen to invest my money in other ways rather than investing it in seeing doctors and naturopaths and Chinese herbalists. So, again, I’ve tried to bring the strength into myself through exercise, through diet, and tried to empower myself personally so that I don’t have that dependency on other people telling me that everything is going to be okay.
Well as you do, especially when you’re feeling most vulnerable, you can really start to depend on other people to tell you constantly that you’re not going to die or that you’re not going to. I was aware – I was really mindful that that was happening, it wasn’t good for me and expensive. I work in a not-for-profit. My husband’s a freelancer. We don’t have a whole lot of cash to splash around on these things.
Spiritual approaches
A few women mentioned finding spiritual or religious approaches helpful alongside conventional medical treatment. Lydia appreciated ‘quiet times reading my bible’ while Vicki said Christian meditation had been ‘awesome’ for her ‘healing and recovery’. Describing her visit to an Umbanda spiritual healer in her home country in South America, Lorena joked that: ‘I went to speak with everybody [about early menopause] – from this world, from the other world, everybody!’
Sylvia described having a traditional Māori massage before having a hysterectomy for uterine cancer and knowing this would induce early menopause.
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My mum’s a twin, so her – my aunty also came down and she came with me to some of the appointments and she was the one actually who said to me – made me realise the significance of the decisions that I was making. Both her and my mum had – were in early menopause.
But they felt that there is a real spiritual connection to that part of your body, the uterus. And so they felt it was important to go and speak to a healer, like, a spiritual healer about, what that can possibly – might mean.
I remember going and it was extremely challenging. It’s a physical process so it’s kind of like a massaging process that you go through and it’s really difficult to describe. But, it’s meant to help you release any kind of tensions or any energies you might be holding on to from regret or loss or any of those sorts of things. And, it was weird but it was very painful. [laughing] That’s all I remember.
It’s your whole body. It starts from your toes all the way through to your head and they work from one side of your body through to the other. And it was a guy that did mine, but he does prayers the whole time. He speaks in Māori, sort of reaching out to the ancestors and talks to them about you as an individual and what he’s feeling and asks for their help to help him release those spiritual energies that might be trapped. The concept is that these energies are trapped inside of your – at a cellular level, so anyway, it’s all very weird and wonderful.
Safety and effectiveness of complementary medicines for early menopause – Clinical research evidence
Compared with HRT, complementary medicines are not as effective for hot flushes and also may not have other benefits of HRT such as positive effects on bone health. Bioidentical compounded hormones are not recommended by medical societies or the USA Food and Drug Administration due to concerns about safety – for more information please see the Australasian Menopause Society’s (AMS) Information Sheet Bioidentical Hormones for Menopausal Symptoms. For a summary of the research evidence on the effectiveness of these treatments, please see the AMS’s Information Sheet Complementary and Herbal Medicines for Hot Flushes.
Further information:
Talking Points (Women)
Talking Points (Health Practitioners)
Other resources