34 MENOPAUSE SYMPTOMS

The way phytoestrogenic herbs act in our body varies from person to person, and there is also a sex difference, with women appearing to metabolize them more efficiently. The estrogenic activity of the various isoflavones varies greatly. Medical specialists do not yet know which one is the most biologically active form.

Observational studies discovered the rich-in-phytoestrogenic herbs diet of middle age Asian women was the main cause for their lack of hot flashes and other menopausal symptoms. It was also pointed out that the most significant eating habit is the high quantity of soy. Soy contains high levels of isoflavones, which may account for raising the natural declination of estrogen hormones produced by the changes of menopause.

As a result of these observational studies, isoflavones are marketed as food supplements and drinks, and also as nonprescription-requiring natural hormone replacement therapy.

It is possible that by supplementing the diet with phytoestrogenic herbs we can improve disease profiles which involve estrogen imbalance. Herbs traditionally recommended for menopausal symptoms include black and blue cohosh, red clover, evening primrose oil, chasteberry, among others.

However, it is reported that 70% of the patients who use complementary therapy do not reveal this to their "traditional" primary care physician because they either do not consider it a medicine or fear primary care physician disapproval. When deciding to take complementary therapies, patients frequently base their decisions on anecdotal reports of success in the lay literature more than information from scientific experiments. Many women who are unwilling to take traditional ERT see herbal therapies as natural and, therefore, preferable to "unnatural" prescription medication, despite the fact that traditional ERT is often derived from natural sources such as mare's urine. Herbal and plant-derived therapies are frequently considered safer, although there are no government standards controlling their quality. While herbal supplements may be effective, they may also be dangerous, mixed with contaminants, or have unknown or adverse effects.

A recent review article on these herbs and supplements reveals that the scientific evidence is scant regarding their safety and efficacy. Few randomized controlled trials have been done investigating their use and these trials show that none have proved better than placebo.

Some small studies examine the role of phytoestrogenic herbs in the prevention of menopausal symptoms. Evidence for the potential health benefits of phytoestrogenic herbs is increasing. However, the clinically proven health benefits of prescribed ERT far outweigh those of phytoestrogenic herbs. Therefore, there is insufficient evidence to recommend the use of phytoestrogenic herbs in place of traditional ERT, or to make recommendations to women about specific phytoestrogenic herbs.