Complementary and hormonal therapy for vasomotor symptom relief: a conservative clinical approach.
Vasomotor symptoms are the most common menopausal symptom experienced by women and the leading reason menopausal women seek health care advice. The recent shift towards a more conservative use of hormone therapy (HT) during menopause has prompted the need for treatment regimens to be individualized according to symptom severity. Our objective was to develop a new algorithm that enables practitioners to customize treatment regimens according to symptom severity. In order to develop a comprehensive treatment algorithm, we conducted a literature review and considered the findings from recently published treatment guidelines from around the world. We also evaluated the results of systematic reviews investigating the efficacy and safety of complementary and alternative medicines. We found a growing trend away from prescription HT in women with mild to moderate symptoms and an increasing trend toward lifestyle modification and the use of complementary and alternative medicines. On the basis of these findings, we have developed an algorithm that accounts for symptom severity. The algorithm presented here provides treatment options based on symptom severity and a comprehensive approach for integrating lifestyle modifications and complementary therapies with prescription treatment regimens.
Nachtigall
Lila E
LE
Department of Obstetrics and Gynecology, NYU School of Medicine, New York, NY, USA.
Baber
Rodney J
RJ
Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, Australia.
Barentsen
Ronald
R
Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands.
Durand
Nancy
N
Department of Obstetrics and Gynecology, University of Toronto, Toronto ON, Canada.
Panay
Nick
N
Queen Charlotte's and Chelsea Hospital, London, England.
Pitkin
Joan
J
Clinical and Research Unit Northwick Park and St Mark's Hospital, Harrow, England.
van de Weijer
Peter H M
PHM
Department of Obstetrics and Gynaecology, Gelre Teaching Hospital, Apeldoorn, The Netherlands.
Wysocki
Susan
S
National Association of Nurse Practitioners in Women's Health, Washington DC, USA.
D000465:Algorithms; D031885:Cimicifuga; D003663:Decision Trees; D015914:Estrogen Replacement Therapy; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D048789:Phytoestrogens; D008517:Phytotherapy; D010946:Plants, Medicinal; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D013025:Glycine max; D029921:Trifolium
D048789:Phytoestrogens