Effects of herbal preparations on symptom clusters during the menopausal transition

Ismail, R.; Taylor-Swanson, Lisa; Thomas, Arthur N.; Schnall, Janet G.; Cray, Lori; Mitchell, Ellen Sullivan; Woods, Nancy Fúgate

doi:10.3109/13697137.2014.900746

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…While hormone replacement therapy (HRT) effectively reduces vasomotor symptoms associated with the decrease of estrogen levels during menopause, results of the Women's Health Initiative (WHI) trial indicated that the benefits of HRT did not outweigh the risks 3 , as estrogen alone would increase risks of stroke and venous thromboembolism (VTE), and together with progestin could incur additional risks of causing breast cancer and heart attack. As a result, the role of HRT has been limited to treat postmenopausal symptoms at minimal dose and duration, and more efficacious and better tolerated alternatives to decrease menopausal symptoms are still being sought 4 – 6 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review

2014

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ObjectiveTo perform a meta-analysis examining the efficacy of phytoestrogens for the relief of menopausal symptoms.MethodsMedline, Cochrane, EMBASE, and Google Scholar databases were searched until September 30, 2013 using the following key words: vasomotor symptoms, menopausal symptoms, phytoestrogens, isoflavones, coumestrol, soy, red clover. Inclusion criteria were (1) randomized controlled trial (RCT), (2) perimenopausal or postmenopausal women experiencing menopausal symptoms, (3) intervention with an oral phytoestrogen. Outcome measures included Kupperman index (KI) changes, daily hot flush frequency, and the likelihood of side-effects.ResultsOf 543 potentially relevant studies identified, 15 RCTs meeting the inclusion criteria were included. The mean age of the subjects ranged from 49 to 58.3 and 48 to 60.1 years, respectively, in the placebo and phytoestrogen groups. The number of participants ranged from 30 to 252, and the intervention periods ranged from 3 to 12 months. Meta-analysis of the seven studies that reported KI data indicated no significant treatment effect of phytoestrogen as compared to placebo (pooled mean difference = 6.44, p = 0.110). Meta-analysis of the ten studies that reported hot flush data indicated that phytoestrogens result in a significantly greater reduction in hot flush frequency compared to placebo (pooled mean difference = 0.89, p < 0.005). Meta-analysis of the five studies that reported side-effect data showed no significant difference between the two groups (p = 0.175).ConclusionPhytoestrogens appear to reduce the frequency of hot flushes in menopausal women, without serious side-effects.

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Section: Introductionmentioning

confidence: 99%

Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review

2014

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“…1–3, 8–10 These co-occurring symptoms are typically not assessed or are considered secondary outcomes, with few trials specifically targeting more than one symptom. 6, 7, 11, 12 Research shows that symptoms act synergistically and that the impact of co-occurring symptoms on an individual is multiplicative rather than additive. 9, 13 Thus, addressing multiple co-occurring symptoms is vital to improving midlife women’s quality of life.…”

Section: Introductionmentioning

confidence: 99%

MsFLASH participants’ priorities for alleviating menopausal symptoms

et al. 2015

Self Cite

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Objective To describe self-reported menopausal symptom priorities and their association with demographics and other symptoms among participants in an intervention trial for vasomotor symptoms (VMS). Methods Cross-sectional study embedded in the MsFLASH 02 trial, a three by two factorial design of yoga vs. exercise vs. usual activity and omega-3-fatty acid vs. placebo. At baseline, women (n=354) completed hot flash diaries, a card sort task to prioritize symptoms they would most like to alleviate, and standardized questionnaires. Results The most common symptom priorities were: VMS (n=322), sleep (n=191), concentration (n=140), and fatigue (n=116). In multivariate models, (1) women who chose VMS as their top priority symptom (n=210) reported significantly greater VMS severity (p=0.004) and never smoking (p=0.012) and (2) women who chose sleep as their top priority symptom (n=100), were more educated (p≤0.001) and had worse sleep quality (p<0.001). ROC curves identified sleep scale scores that were highly predictive of ranking sleep as a top priority symptom. Conclusions Among women entering an intervention trial for VMS and with relatively low prevalence of depression and anxiety, VMS was the priority symptom for treatment. A card sort may be a valid tool for quickly assessing symptom priorities in clinical practice and research.

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“…A 2012 Cochrane review of randomized controlled trials assessing black cohosh versus placebo or other treatments found that black cohosh did not significantly reduce hot flashes or menopausal symptom scores, whereas hormone treatment (compared to black cohosh) reduced symptom scores significantly [ 13 ]. A 2015 extensive review of effects of herbal preparations on symptom clusters in menopause suggested that black cohosh had a significant effect on hot flashes [ 22 ], but this observation was based on qualitative review of the research, rather than the more rigorous quantitative methods used in the Cochrane review of randomized trials [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Black cohosh has been suspected of being linked to liver disorders, although cases are rare and can seldom be attributed directly to black cohosh [ 14 ]. Evidence on safety of black cohosh from the Cochrane review was inconclusive because of inadequate reporting [ 13 ], and the more recent review suggested that the incidence of adverse effects associated with black cohosh did not differ from those associated with placebo [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

A survey of the availability in Canadian pharmacy chains of over-the-counter natural health products for menopause symptoms

Croden

Ross

Yuksel³

et al. 2015

BMC Complement Altern Med

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BackgroundMenopause is a natural phase in a woman’s aging process, characterized by the cessation of menstruation. Women who are going through the menopause transition can experience physiological symptoms that significantly impact their quality of life. Concern about adverse effects of traditional hormone therapy often leads women to purchase over-the-counter (OTC) natural health products (NHPs). The goal of this study was toinvestigate the range of OTC NHPs for menopause available to Canadian women, and the packaging information they can access to make self-management decisions.MethodsEdmonton stores belonging to each of nine Canadian pharmacy chains were visited to identify NHPs marketed for the relief of menopausal symptoms. Details were extracted from the packaging: a) product name and manufacturer, b) Health Canada license number, c) medically active ingredients, d) claims of efficacy, e) contra-indications and warnings, and f) daily cost. Data were entered and analyzed using Microsoft Excel.ResultsWe identified 20 OTC NHP menopausal products, 19 of which had Health Canada license numbers. Twenty-eight medically active ingredients were identified, with the most common being black cohosh (in 14 products) and soy isoflavones (n = 7), chaste tree (n = 5), and dong quai (n = 3). Most products claimed they would relieve vasomotor symptoms, including hot flashes (n = 14) and night sweats (n = 10). Each product had a labeled contraindication for at least one specific condition. Costs per recommended daily dose ranged from $0.07 to a maximum of $2.50 (CAD$).ConclusionNatural health products for menopausal symptoms are easily available to Canadian women. The lack of clear evidence of product efficacy makes the need for easily accessible, balanced information on this topic important for women to make well informed choices.

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Effects of herbal preparations on symptom clusters during the menopausal transition

Cited by 7 publications

References 48 publications

Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review

Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review

MsFLASH participants’ priorities for alleviating menopausal symptoms

A survey of the availability in Canadian pharmacy chains of over-the-counter natural health products for menopause symptoms

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