Menopause is more than Hot Flashes: What is Missing in Homeopathic Research? A Narrative Review

Abstract

Background Menopausal complaints are frequently treated with homeopathy in daily practice worldwide. Recently, vasomotor symptoms have been understood to have implications as predictors of other important and long-term outcomes, causing increased risk of mortality and/or disability. Methods A comprehensive search of the literature was conducted to investigate whether homeopathic treatments for menopausal women with vasomotor symptoms have a positive effect on other important health outcomes associated with menopause, such as cardiovascular disease, neurocognitive impairment, metabolic and mood disorders, or osteoporosis. Results Though observational studies have shown encouraging results in reducing the severity and frequency of hot flashes in women treated with homeopathy, few randomized controlled trials have shown positive results. In most of the studies using homeopathy, the primary outcome is reduction in the frequency and severity of hot flashes, and other menopausal complaints are assessed secondarily as a part of the symptoms evaluated in the menopausal scales. Quality of life improves with homeopathic treatments for hot flashes, but there is scarce evidence of the effect of homeopathy on other health outcomes associated with menopause. Limited evidence exists in the case of menopausal women treated with individualized homeopathy for depression and metabolic disorders. Conclusion A more comprehensive approach for treating menopause in routine homeopathic practice constitutes a valuable opportunity to increase knowledge and high-quality research in this field. Future homeopathic research for menopause should be focused on well-designed, double-blind, placebo-controlled, randomized trials as well as on pragmatic trials to show whether homeopathic treatments for vasomotor symptoms can also improve outcomes that are well-known to increase the risk of mortality and/or disability.

Menopause: Questions and Answers for Improving Homeopathic Clinical Practice

“…Clinical studies on depression and metabolic disorders are limited. 10 Some studies in breast cancer survivors with symptoms of estrogen withdrawal have shown mixed [80][81][82] Studies using individualized homeopathy have reported more positive results as compared with combined homeopathic medicines. However, there has been insufficient description of how the homeopathic approach was performed, specifically in the case of individualized homeopathy, as well as the criteria for selecting potencies and dosage.…”

“…Nine randomized controlled trials (RCTs), six observational studies and two case reports have been published. 10 Though observational studies have shown encouraging results in reducing the severity and frequency of hot flashes in women treated with homeopathy, 7 , 78 few RCTs have shown positive results. 79 There is scarce evidence of the effect of homeopathy on other, previously stated, menopause-related chronic conditions (CVD, neurocognitive impairment or osteoporosis).…”

“…Other menopausal symptoms were assessed, as secondary outcomes, as a part of the symptoms evaluated in the menopause assessment scales, with only minor attention to their individual improvement. 10…”

“…Furthermore, it has been reported that there is insufficient research on the efficacy of homeopathy in other menopause-related chronic diseases. 10 Hence, improving the homeopathic clinical approach for menopause is fundamental for both research and clinical purposes. A complete medical history with a precise homeopathic case-taking, including all the assessment recommendations for evaluating menopausal women, would improve case reports which are essential in the development of homeopathy and as scientific tools to help generate hypotheses for research.…”

Refining Research in Homeopathy

“…1 2 A review article published in this issue of the journal refines that idea by re-considering the main clinical effect that should be the optimal focus of homeopathic practitioners' attention. 3 Thus, in the example of menopausal syndrome, one should think beyond hot flushes and night sweats to consider cardiovascular or bone disease, and metabolic or mood disorders, and then apply a relevant outcome measure such as blood pressure, bone mineral density, an index of metabolism or an assessment of cognitive health. While potentially enhancing a trial's model validity, there might also be a raised likelihood of finding a clinically significant effect of homeopathic treatment.…”