Phytotherapy in the Management of Menopause-Associated Vasomotor Symptoms

Abstract

Introduction: Menopause is the permanent cessation of menstruation for at least 12 consecutive months which results from the loss of ovarian follicular activity. Although it is a normal and natural part of aging occurring on average at age of 51 years, most menopausal women develop symptoms, which may deteriorate their quality of life for around one third of their life span (given the mean female life expectancy in Bulgaria of 78 years). The most common complaints are the vasomotor symptoms (VMS: hot flashes and night sweats). Hormone therapy was the gold standard of care for menopausal symptoms before the release of the Women`s Health Initiative. Afterwards, women became reluctant or anxious to use hormone therapy and sought natural non-hormonal alternatives.Materials and Methods: An analysis of accessible articles in scientific web databases (PubMed, ScienceDirect and Google Scholar) on the problem was conducted. Collected data considering evidence in alleviating vasomotor symptoms by popular herbal remedies was further reviewed and summarized.Results: Botanical supplements are considered to act through a number of different mechanisms of action including estrogenic, progestogenic, and/or serotonergic pathways that might mimic the actions of endogenous substances. But clinical studies of the main herbal drugs used to alleviate vasomotor symptoms either did not suggest significant efficacy (as not being superior to placebo) or were limited, and inconsistent, or show different improvements: in well-being, depression, health scores. Thus, patients should be informed to be cautious of possible side effects notwithstanding the general perception of that something is safe if it is of natural origin. In case of adverse reactions, women should be referred to specialists for reconsideration of their therapy.Conclusion: To conclude, as the evidence for phytotherapeutic menopausal VMS relief is both scarce and unconvincing, there is definitely a continued need for further work on the effectiveness and long-term safety of herbal medicinal products