Herbal Product Use and Menopause Symptom Relief in Primary Care Patients: A MetroNet Study

Abstract

Primary care patients experiencing common menopausal symptoms are likely to use herbal products that are purported to provide menopause symptom relief, and many believe that these products improve their menopausal symptoms. Healthcare providers should be aware of patient's positive attitude, use patterns, and lack of disclosure of use of herbal medicines. Inquiry of herbal product use is another way for physicians to learn about patient self-medication of bothersome symptoms.

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“…Hormone replacement therapy (HRT) is the most effective treatment for the relief of menopause symptoms, yet many women have become reluctant to continue or commence HRT due fear of adverse risks 1 . Instead women seek alternative treatment options, particularly complementary and alternative therapies 2 .…”

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“…31,32 Even before the release of the WHI results in 2002 and 2004, many women discontinued HRT use early in their treatment because of fear of increased cancer risk, vaginal bleeding, and other health concerns or the inconvenience of taking a daily pill. 10,33,34 Consequently, interest in nonconventional modalities for treatment of menopausal symptoms continues to increase among GRANT ET AL. 522 patients.…”

“…7 There is abundant evidence that midlife women are using CAM either alone or in combination with hormone therapy for treatment of menopausal symptoms. 2,3,[8][9][10][11][12][13][14][15][16] Symptoms related to menopause are found worldwide, 17 and although some women experience very few, if any, emotional or physical complaints, others become debilitated by menopausal symptoms. 18 Reports suggest that up to 80% of women will experience some degree of physical or emotional symptoms during perimenopause and menopause, including vasomotor symptoms, vaginal dryness, sleep disturbances, changes in libido, mood changes, and fatigue.…”

“…19,20 Some women seek treatment from their healthcare providers for these complaints, whereas others never seek any treatment or seek alternatives to conventional therapies. 10,11,21 The early termination in 2002 of the main arm of the Women's Health Initiative (WHI) trial, an observational trial designed to assess the major health benefits of the commonly used combined hormone preparation, estrogen and progestin, sparked heightened interest in CAM approaches to menopausal symptom management. 22 The WHI data revealed an increased risk of breast cancer, heart attacks, strokes, and blood clots in women taking estrogen and progestin, and study investigators concluded that the risks of the hormone combination outweighed the benefits (fewer hip fractures and colon cancer) for prevention of disease.…”

“…23 There is little evidence of how physicians address these inquiries, but there is evidence that patients believe they are not receiving adequate advice from their providers regarding CAM therapies. 24 Several studies suggest that patients frequently do not inform their providers about their use of CAM 1,10,13 and that physicians generally underestimate patients' use of CAM. 25 There is disagreement across physician-based and patient-based studies about the percentage of physicians who inquire about their patients' CAM use, with some studies reporting over three quarters of physicians surveyed routinely asked their patients about CAM use 26,27 and others noting that few physicians routinely or consistently ask patients about CAM use.…”