Hot flashes, insomnia, mood swings, and the other symptoms of menopause can be unpleasant and difficult to manage. Hormone therapy (HT) can help in the short term, but long-term HT can increase a woman's risk of breast cancer, stroke, and heart attacks.
Instead, many women opt for dietary supplements. But do they work? Supplements are rarely tested thoroughly, and their manufacturers make health claims that aren't always backed up by science.
In the following article, we use the latest research to break down the most commonly used supplements for menopause.
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What it is: The extract of the root of the black cohosh plant.
The evidence: Despite the plant's widespread use, a 2008 review concluded that there is insufficient evidence for black cohosh's effectiveness in treating menopausal symptoms. Another review published in 2010 found that unspecified black cohosh "preparations" decreased hot flash symptoms by 26 percent.
The bottom line: More evidence is needed to confirm the effects of black cohosh, both positive and negative. It has been linked to liver damage and other side effects, so as with all supplements, don't take it without consulting a physician.
What it is: An herb, also known as Chinese angelica, that is said to mimic estrogen in the body.
The evidence: The use of dong quai for menopause symptoms has not been studied extensively, and the results have largely been negative. A controlled trial conducted in 1997 found that dong quai was no better than placebo in treating symptoms such as hot flashes; more recently, a 2008 study in Hong Kong found no significant difference from a placebo in the treatment of menopausal symptoms.
The bottom line: Claims that dong quai acts like estrogen in the body are not supported by research.
What it is: Oil extracted from the seeds of a yellow-flowered plant. An omega-6 essential fatty acid (gamma-linolenic acid) is the active ingredient.
The evidence: According to a 2009 review in American Family Physician, only one placebo-controlled trial of evening primrose oil in menopausal women has been conducted. In the study, the women took eight capsules of the oil daily for six months, but the capsules were no better than placebo at treating menopausal flushing.
The bottom line: Evidence to support the use of evening primrose oil for menopause is still lacking.
What it is: The extract of the leaves of the ginkgo plant (also known as the maidenhair tree).
The evidence: Ginkgo has traditionally been used to improve memory, concentration, and mood, all of which can dip during menopause. However, two 2009 studies showed that ginkgo had no effect on cognitive function. As for mood, a 2007 review found no evidence of ginkgo's effectiveness for that purpose in postmenopausal women.
The bottom line: Despite the popularity of ginkgo, little efficacy has been demonstrated for memory or mood enhancement.
What it is: An Asian herb that has been used in traditional medicine for centuries.
The evidence: A 1999 study found that 200 milligrams of ginseng a day boosted mood and general well-being in women undergoing menopause, while another study, conducted earlier this year, concluded that Korean red ginseng was successful in improving sexual arousal in menopausal women.
Research suggests, however, that ginseng can contribute to heart problems in some women.
The bottom line: Ginseng has shown potential for treating menopausal symptoms, but it carries some potentially serious side effects.
What it is: The flower clusters of the Humulus lupulus plant.
The evidence: Only one controlled trial has been conducted on the potential effects of 8-PN, an estrogenic compound found in hops, and it concluded that the compound "exerted favorable effects" on hot flashes and other menopausal symptoms. Other research suggests that another hops derivative, xanthohumol, may have anti-inflammatory properties.
The bottom line: The research on hops and menopause is very limited, although some evidence suggests the supplement may have health benefits.
What it is: An extract of a legume that contains substances (isoflavones) that mimic estrogen. It is found in products such as Promensil.
The evidence: A 2006 review in the Journal of the American Medical Association looked at six trials examining Promensil and hot flash frequency (two trials were of "poor" quality). The supplement outperformed placebo in just one. However, a 2009 study did suggest that it can help lower cholesterol in postmenopausal women.
The bottom line: The research on the efficacy of red clover isoflavones is limited and inconclusive.
What it is: A protein found in foods such as tofu, edamame, and soy milk. Contains isoflavones, which are believed to have estrogen-like effects in the body.
The evidence: A 2009 review of randomized controlled trials said there is "no conclusive evidence" for the benefits of soy isoflavones on the frequency and severity of hot flashes. It also suggested that some of the studies might be unreliable due to quality concerns.
The bottom line: Taking soy isoflavone supplements (or altering your diet to include more soy) isn't likely to relieve your menopause symptoms.
What it is: A yellow-flowered plant, Hypericum perforatum.
The evidence: St. John's wort can help treat mild depression, but its effect on other symptoms of menopause--such as sleep problems--isn't proven. One three-month study did show that compared to a placebo group, perimenopausal women taking St. John's wort experienced a better quality of life as well as fewer sleep problems.
The bottom line: Although St. John's wort is a proven remedy in mild depression, more research is needed to confirm its effectiveness in treating other menopause symptoms.
What it is: A vitamin found naturally in nuts, vegetable oils, and green leafy vegetables.
The evidence: In a 2009 study, vitamin E outperformed placebo in reducing hot flashes among breast cancer patients. However, the study said the reduction had a marginal clinical impact. Another clinical trial that studied the efficacy of vitamin E for hot flashes showed that women taking it experienced one less hot flash per day than those on a placebo.
The bottom line: Study results have been encouraging, but vitamin E seems to have a relatively minor effect on hot flashes.
What it is: The extract of pale-brown vine native to North America.
The evidence: Often labeled a natural source of estrogen, little scientific evidence exists to support efficacy for treating menopausal symptoms. A 2001 study suggested that short-term topical use was free from side effects but provided little relief from menopausal flushing or night sweats.
The bottom line: There is no evidence to support the use of wild yam extract to treat menopausal symptoms.