The International Menopause Society defines menopause as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is recognised to have occurred after 12 consecutive months of amenorrhoea, for which there is no obvious physiological or pathological cause. This article will outline, and evaluate the evidence for, the range of non-hormonal options available for managing the menopause.
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References
1.
Al-SafiZ. A.SantoroN. (2014) Menopausal hormone therapy and menopausal symptoms. Fertility and Sterility101(4): 905–915. doi: 10.1016/j.fertnstert.2014.02.032.
2.
BartonD. L.LoprinziC. L.QuellaS. K.SloanJ. A.VeederM. H.EgnerJ. R.NovotnyP. (1998) Prospective evaluation of vitamin E for hot flashes in breast cancer survivors. Journal of Clinical Oncology16(2): 495–500.
3.
BorrelliF.ErnstE. (2008) Black cohosh (Cimicifuga racemosa) for menopausal symptoms: A systematic review of its efficacy. Pharmacology Research58(1): 8–14. doi: 10.1016/j.phrs.2008.05.008.
4.
BorrelliF.ErnstE. (2010) Alternative and complementary therapies for the menopause. Maturitas66(4): 333–343. doi: 10.1016/j.maturitas.2010.05.010.
5.
BNF 67 September 2014–March 2015. BMJ Group Publishing. ISBN: 9780857110855.
6.
ChenoyR.HussainS.TayobY.O'BrienP. M.MossM. Y.MorseP. F. (1994) Effect of oral gamolenic acid from evening primrose oil on menopausal flushing. British Medical Journal308(6927): 501–503.
7.
CoopeJ.WilliamsS.PattersonJ. S. (1978) A study of the effectiveness of propranolol in menopausal hot flushes. British Journal of Obstetrics and Gynaecology85(6): 472–475.
8.
DaleyA. J.Stokes-LampardH. J.MacarthurC. (2009) Exercise to reduce vasomotor and other menopausal symptoms: A review. Maturitas63(3): 176–180. doi: 10.1016/j.maturitas.2009.02.004.
9.
ErkkolaR.VervarckeS.VansteelandtS.RompottiP.de KeukeleireD.HeyerickA. (2010) A randomized, double-blind, placebo-controlled, cross-over pilot study on the use of a standardized hop extract to alleviate menopausal discomforts. Phytomedicine17(6): 389–396. doi: 10.1016/j.phymed.2010.01.007.
10.
FreemanE. W.GuthrieK. A.CaanB.SternfeldB.CohenL. S.JoffeH.LaCroixA. Z. (2011) Efficacy of escitalopram for hot flashes in healthy menopausal women: A randomized controlled trial. Journal of the American Medical Association305(3): 267–274. doi: 10.1001/jama.2010.2016.
11.
GoldbergR. M.LoprinziC. L.O'FallonJ. R.VeederM. H.MiserA. W.MailliardJ. A.BurnhamN. L. (1994) Transdermal clonidine for ameliorating tamoxifen-induced hot flashes. Journal of Clinical Oncology12(1): 155–158.
12.
GordonP. R.KerwinJ. P.BoesenK. G.SenfJ. (2006) Sertraline to treat hot flashes: A randomized controlled, double-blind, crossover trial in a general population. Menopause13(4): 568–575. doi: 10.1097/01.gme.0000196595.82452.ca.
13.
HeyerickA.VervarckeS.DepypereH.BrackeM.de KeukeleireD. (2006) A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas54(2): 164–175. doi: 10.1016/j.maturitas.2005.10.005.
14.
JacobsA.WegewitzU.SommerfeldC.GrossklausR.LampenA. (2009) Efficacy of isoflavones in relieving vasomotor menopausal symptoms - a systematic review. Molecular Nutrition and Food Research53(9): 1084–1097. doi: 10.1002/mnfr.200800552.
15.
Kelly, C. M., Juurlink, D. N., Gomes, T., Duong-Hua, M., Pritchard, K. I., Austin, P. C., … Paszat, L. F. (2010). Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: A population based cohort study. British Medical Journal, 340, c693. doi: 10.1136/bmj.c693.
16.
KomesaroffP. A.BlackC. V.CableV.SudhirK. (2001) Effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women. Climacteric4(2): 144–150.
17.
LoprinziC. L.KuglerJ. W.SloanJ. A.MailliardJ. A.LaVasseurB. I.BartonD. L.ChristensenB. J. (2000) Venlafaxine in management of hot flashes in survivors of breast cancer: A randomised controlled trial. Lancet356(9247): 2059–2063. doi: 10.1016/S0140-6736(00)03403-6.
18.
LucasE. A.WildR. D.HammondL. J.KhalilD. A.JumaS.DaggyB. P.ArjmandiB. H. (2002) Flaxseed improves lipid profile without altering biomarkers of bone metabolism in postmenopausal women. Journal of Clinical Endocrinology and Metabolism87(4): 1527–1532. doi: 10.1210/jcem.87.4.8374.
19.
MaD. F.QinL. Q.WangP. Y.KatohR. (2008) Soy isoflavone intake increases bone mineral density in the spine of menopausal women: Meta-analysis of randomized controlled trials. Clinical Nutrition27(1): 57–64. doi: 10.1016/j.clnu.2007.10.012.
20.
Marjoribanks, J., Farquhar, C., Roberts, H., … Lethaby, A. (2012). Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Systematic Review, 7, CD004143. doi: 10.1002/14651858.CD004143.pub4.
21.
NelsonH. D.VescoK. K.HaneyE.FuR.NedrowA.MillerJ.HumphreyL. (2006) Nonhormonal therapies for menopausal hot flashes: Systematic review and meta-analysis. Journal of the American Medical Association295(17): 2057–2071. doi: 10.1001/jama.295.17.2057.
Rees, M. (2009). Alternative treatments for the menopause. Best Practice & Research Clinical Obstetrics and Gynaecology, 23, 151–161. doi: 10.1016/j.bpobgyn.2008.10.006.
27.
RossouwJ. E.AndersonG. L.PrenticeR. L.LaCroixA. Z.KooperbergC.StefanickM. L.Writing Group for the Women's Health InitiativeI. (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results From the Women's Health Initiative randomized controlled trial. Journal of the American Medical Association288(3): 321–333.
28.
SassariniJ.KrishnadasR.CavanaghJ.NicolA.PimlottS. L.FerrellW.LumsdenM. A. (2014) Venlafaxine alters microvascular perfusion, [(1)(2)(3)I]-beta-CIT binding and BDI scores in flushing postmenopausal women. Maturitas77(3): 267–273. doi: 10.1016/j.maturitas.2013.12.003.
29.
SassariniJ.LumsdenM. A. (2013) Non-hormonal management of vasomotor symptoms. Climacteric16(S1): 31–36. doi: 10.3109/13697137.2013.805525.
30.
StearnsV.BeebeK. L.IyengarM.DubeE. (2003) Paroxetine controlled release in the treatment of menopausal hot flashes: A randomized controlled trial. Journal of the American Medical Association289(21): 2827–2834. doi: 10.1001/jama.289.21.2827.
31.
Suvanto-LuukkonenE.KoivunenR.SundstromH.BloiguR.KarjalainenE.Haiva-MallinenL.TapanainenJ. S. (2005) Citalopram and fluoxetine in the treatment of postmenopausal symptoms: A prospective, randomized, 9-month, placebo-controlled, double-blind study. Menopause12(1): 18–26.
32.
ZiaeiS.KazemnejadA.ZareaiM. (2007) The effect of vitamin E on hot flashes in menopausal women. Gynecologic and Obstetric Investigation64(4): 204–207. doi: 10.1159/000106491.