Alternative medicine

In addition to conventional therapies, many women transitioning toward menopause want to know more about complementary and alternative approaches to treating symptoms. Researchers are looking into these therapies to determine their safety and effectiveness, but evidence is still often lacking.

Some of the options studied include:

• Black cohosh. This herb extract is used by some women to treat hot flashes and other menopausal symptoms. There's not enough evidence to support its use. Experts also are unsure of what risks taking black cohosh poses. Some studies have suggested that black cohosh was harmful to the liver, but other studies found no evidence that this is true. Researchers also question whether the herb extract is safe for women with or at risk of breast cancer.

• Phytoestrogens. These estrogens occur naturally in certain foods. Two main type of phytoestrogens are isoflavones and lignans. Isoflavones are found in soybeans and other legumes and red clover. Lignans occur in flaxseed, whole grains, and some fruits and vegetables. There are also plant-derived compounds that have estrogen-like properties.

  Studies on phytoestrogens — whether from food or supplements — conflict on whether they help reduce menopausal symptoms. Studies also conflict on what beneficial impact, if any, phytoestrogens may have on breast cancer risk.

• Bioidentical hormones. The term "bioidentical" implies that the hormones in the product are chemically identical to those your body produces. However, compounded bioidentical hormones aren't regulated by the U.S. Food and Drug Administration (FDA), so quality and risks could vary. There's also no evidence that compounded bioidentical hormones are safer or more effective than conventional hormone therapy.
• Dehydroepiandrosterone (DHEA). This natural steroid produced by your adrenal gland is available as a dietary supplement and has been used by some to reduce pain during intercourse due to vaginal atrophy. But evidence on its effectiveness is mixed, and there are some concerns about possible harmful effects.

Talk with your doctor before taking any herbal or dietary supplements for perimenopausal or menopausal symptoms. The FDA does not regulate herbal products, and some can be dangerous or interact with other medications you take, putting your health at risk.

Low-risk complementary therapies that may help reduce stress and improve psychological well-being include:

• Acupuncture. Research on acupuncture for decreasing hot flashes is inconclusive, but promising.
• Relaxation techniques. Yoga and meditation, for example, can help reduce stress, which may in turn help improve menopausal symptoms.