FONDO:
Approximately two thirds of women who reach menopause develop menopausal symptoms, primarily hot flashes. Hormone therapy long was considered the first-line treatment for vasomotor symptoms. However, given the results of the Women’s Health Initiative (WHI), many women are reluctant to use exogenous hormones for symptomatic treatment and are turning to botanicals and dietary supplement (BDS) products for relief. Despite the fact that there is limited scientific evidence describing efficacy and long-term safety of such products, many women find these natural treatments appealing. Perimenopausal and postmenopausal women are among the highest users of these products, but 70% of women do not tell their healthcare providers about their use. Compounding this issue is the fact that few clinicians ask their patients about use of BDS, largely because they have not been exposed to alternative medical practices in their training and are unfamiliar with these products.
MÉTODOS:
Este artículo revisa los ingredientes botánicos y los suplementos dietéticos que se utilizan comúnmente en la menopausia (como el cohosh negro, el trébol rojo y los productos de soya), así como los datos disponibles sobre la eficacia y la seguridad. Se realizaron búsquedas en la base de datos MEDLINE desde 1966 a diciembre 2004 mediante términos relacionados con BDS y síntomas de la menopausia para mujeres perimenopáusicas o posmenopáusicas. También se buscaron resúmenes de reuniones relevantes, así como libros de referencia y sitios web sobre suplementos de hierbas. Se utilizaron ensayos controlados aleatorios (ECA), si estaban disponibles; se utilizaron ensayos abiertos y estudios de grupos de comparación cuando los ECA no estaban disponibles.
RESULTS AND CONCLUSIONS:The evidence to date suggests that black cohosh is safe and effective for reducing menopausal symptoms, primarily hot flashes and possibly mood disorders. Phytoestrogen extracts, including soy foods and red clover, appear to have at best only minimal effect on menopausal symptoms but have positive health effects on plasma lipid concentrations and may reduce heart disease. St. John’s wort has been shown to improve mild to moderate depression in the general population and appears to show efficacy for mood disorders related to the menopausal transition. Other commonly used botanicals have limited evidence to demonstrate safety and efficacy for relief of symptoms related to menopause.
