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Alternatives for the menopause

There is a whole raft of reasons why women who suffer from menopausal symptoms do not wish to use hormone replacement therapy (HRT). These range from regarding the menopause as a natural transition, to thinking that osteoporosis or cardiovascular disease is not a threat to them individually, from an unwillingness to tolerate effects like breast tenderness or cyclical vaginal bleeding, to fear of cancer. It has been regularly remarked that only a small proportion of those women for whom HRT may be appropriate actually seek treatment, or accept it for long. Many women seek alternative, or 'natural' remedies. A new review has examined the scientific and lay literature for evidence regarding the evidence that these alternative remedies have any effect [ 1 ].


There was a broad and extensive search using several databases, including a consumer database in Toronto. A number of alternative remedies were included, ranging from nutritional supplements, herbal remedies, homeopathy and physical approaches.


For all but one remedy there was no convincing evidence, or no evidence at all. Those for which there was no evidence in the form of randomised placebo-controlled studies included any herbal remedy, homeopathy, chiropractic, massage, exercise, acupuncture or relaxation techniques. Food supplements like vitamin E and evening primrose oil were found to have no benefit over placebo.

But there was a story to be told for phytoestrogens, like those from Soya:

A hill of beans?

So does the evidence for phytoestrogens in Soya amount to more than a hill of beans? Certainly it is less than the quantity of evidence we might normally expect - large randomised trials, for example. But there is a story being told, with some biological plausibility and some epidemiological and clinical evidence. Most importantly, women who may wish to consider alternative treatments for menopausal symptoms know that someone has taken the time and trouble to sort out the best evidence available for them. Isoflavenoids extracted from Soya are now available in capsule form, to be used either as an alternative to eating large amounts of soya, or as a way of enhancing diets which already have some Soya content.


  1. MM Seidl, DE Stewart. Alternative treatments for menopausal symptoms. Systematic review of scientific and lay literature. Canadian Family Physician 1998 44: 1299-1308.

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