Many of us gravitate towards natural health products to address common health problems; this can be seen in the $2 billion-plus value of the local supplements industry. Menopause is no exception. Tauranga GP and menopause practitioner Dr Linda Dear surveyed 4000 Kiwi women which revealed, that 44% of women had tried supplements for menopause symptoms and 25% had used herbal treatments. By contrast, only 31% had tried HRT (hormone replacement therapy).
But evidence on herbal and other supplements for menopause symptoms remains thin. According to the North American Menopause Society, which released a position statement on non-hormonal treatments for menopause earlier this year, there are a few supplements with “limited or inconsistent evidence of benefit” such as soy foods, pollen extract and probiotics. Many however lack any demonstrated evidence of benefit, including some big-name products that are commonly marketed as helpful: black cohosh, wild yam, evening primrose, chasteberry, maca, ginseng and omega-3. The society does not recommend any supplements, or cannabinoids such as CBT oil, for which it says there’s a lack of evidence right now.
With all supplements for menopause, there’s a strong placebo response – some studies have found up to a 50% effect. This may be why some women, as Dear reports, “swear by” their natural treatments.
She’s not in the habit of discouraging her patients from any treatments they believe are working, though she points out that nothing has been shown to work as well as HRT in the research.
“What doctors do a lot is just poo-poo everything that’s not pharmaceutical. And yes, we’re all supposed to be evidence-based… but I think it drives a lot of people away from us as well.”
Dear says she works in line with the evidence, and does not recommend any supplements for menopause symptoms, “but sometimes women’s bodies don’t care about science. They just break the rules.”
“This is about finding whatever’s right for that woman. And it might be something that doesn’t tick all the science boxes, but she’s feeling better. So for me that that’s the biggest outcome I’m looking for. Even if that means she’s using something that I don’t know how it’s working… but it’s working for her.”
Dear’s survey revealed that the effectiveness of natural treatments was limited: 24% of respondents said they’d found supplements helpful, and 28% said the same of herbal treatment. Exercise was rated helpful by 42% of women, and HRT came out strongly on top at 80%.
There are some supplements Dear sometimes recommends for general health for women, including omega-3 and pre and probiotics.
“I think vitamin D is not a bad thing to optimise. Magnesium – I haven’t got a problem with that; it can be helpful for sleep and anxiety and migraines.”
Iron can be useful too. “A lot of the women I see, their ferritin is just rubbish, so I often say either increase your iron intake with food or consider a supplement that doesn’t upset your gut.”
There’s one aspect of the natural health world Dear describes as “maybe a bit sharky and a bit snakey” that she can’t stand – hormone tests.
“I can’t stand the salivary progesterone tests, the urine tests and the Dutch tests. Someone’s making a lot of money out of those, and they’re nonsense. I’m very clear with everybody about that. Take whatever you want to take, but don’t bother with these nonsense tests for bodily fluids. That really is just ripping women off. And I’ll say that till I die.”
This article was originally published on 8 August 2023.
