Home' Trinidad and Tobago Guardian : March 19th 2016 Contents A24
body & soul
Guardian www.guardian.co.tt Saturday, March 19, 2016
Are you a woman in mid life struggling with
menopause symptoms like hot flushes and night
If you re using complementary and alternative
medicines like phytoestrogens, evening primrose oil,
black cohosh or ginseng to help, you re wasting your
money, the authors of one study say (Medical Journal
of Australia, 2015). It s estimated nearly 500,000
women a month in Australia are using these medicines
to control so-called vasomotor symptoms like night
sweats, vaginal dryness and hot flushes says Dr Roisin
Worsley, from Monash University s School of Public
Health and Preventive Medicine, who co-authored
the study. (Vasomotor symptoms relate to constriction
or dilation of blood vessels and are generally regarded
as "the most bothersome" of menopause problems.)
"But none of these [remedies] have been proven
in scientific studies to actually be of any benefit,"
The study was the first to provide good quality
data on how many Australians suffer these problems
and what they are doing about it. While some com-
plementary therapies for menopause problems have
not been as well researched as others, black cohosh
and phytoestrogens at least have been the subject
of multiple high quality studies known as randomised
controlled trials and meta-analyses, Worsley says.
"There really was no evidence of any benefit."
Most alternative menopause therapies may also
cause shorter term side effects including nausea,
headache and upset stomach. Some known side
effects of ginseng include hypertension, diarrhoea
Phytoestrogens can cause some vaginal bleeding
as well," she says. So what does work? The most
effective remedy "by far" for menopause symptoms
is hormone replacement therapy (HRT). "It will
reduce hot flushes by 80 per cent in most people,"
for instance, Worsley says. "It s really amazing how
quickly it works as well."
But women and doctors alike were scared off HRT
after research findings released in 2002 suggested it
increased the risk of breast cancer. The fear was
understandable because "it was very scary evidence
at the time". But the original analysis of study data
was misleading because it focused on older women
(average age 69) and those taking hormones for longer
This is because the original study set out to inves-
tigate a different question: whether oestrogen therapy
could help prevent heart disease and dementia in
older women. While the analysis showed HRT was
linked to a raised risk of breast cancer, blood clots
and strokes, "these were older women, who had
already developed some forms of disease anyway".
Now the data has been reanalysed to work out the
effect of the hormones on women who "actually
want to use hormone therapy for their hot flushes".
These are younger women (usually in their early 50s)
who use hormones for a shorter period of time---
and the conclusions are different. "The reanalysis of
the old data suggests the benefits of hormone therapy
[for menopause symptoms] outweigh the risks for
short-term use in healthy women."
Current guidelines say women should take the
lowest dose of HRT for the shortest amount of time
possible, but can use it for up to five years. However,
all women should discuss their individual risk and
personal preference with their doctor. But treatments
other than hormone therapy do exist and if women
want to try them, Worsley thinks that s "completely
reasonable". They include low-dose antidepressants
The key is to get good advice about options, some-
thing that can be tricky as it is very hard for GPs
to stay up to date. "It s a really complicated topic
and it s been changing rapidly over the last decade."
She suggests seeking out a "really good GP who s
therapies not the best choice
got an interest in women s health" or ask for a referral
to a specialist who deals with menopausal symptoms.
These are often gynaecologists or hormone specialists.
There are also some lifestyle measures that can help.
YOUR DAILY HEALTH
News and advice
really work to
symptoms, says a
new study; hormone
is still the best bet.
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