Management of Menopause Symptoms

Natural Supplements

Limited data show possible benefit for vasomotor symptoms in the general population with black cohosh, but randomized trials in breast cancer survivors show no benefit 1, 2
High dose vitamin E (800 IU/day) has shown limited efficacy in reducing hot flashes for those with mild vasomotor symptoms, but supplemental vitamin E at >400 IU/day has been linked with an increase in all-cause mortality 2, 3
A review of 11 clinical trials found only 3 of 8 studies with treatment lasting 6 weeks showed modest improvement in hot flashes with soy isoflavones, and most benefits disappeared after 6 weeks 4, 5

Several studies in women with cancer or female survivors have shown acupuncture to be a safe and effective option for managing vasomotor symptoms, with equivalent or better results compared to venlafaxine or gabapentin 1, 6
A randomized trial in 355 healthy perimenopausal and postmenopausal women found that yoga improved quality of life associated with menopause, including improvement in vasomotor symptoms 1, 6
Evidence that exercise helps manage hot flashes in postmenopausal women is inconclusive, but physical activity should be recommended given beneficial effects on overall health 1, 6

Hot flashes may be more severe in overweight women and smokers, and weight loss of ≥10% of body weight may help eliminate hot flash symptoms in overweight women 3, 7
Identifying personal triggers through a hot flash diary and environmental modifications such as dressing in layers, keeping rooms cool, and using cold packs can help manage hot flashes 3, 7

Pharmacological options (SSRIs, SNRIs, gabapentin, clonidine) generally show greater efficacy than natural supplements for managing vasomotor symptoms, and hormone therapy remains the most effective treatment for vasomotor symptoms but carries risks that must be weighed against benefits 1, 2, 6