Non-hormonal therapy of post-menopausal vasomotor symptoms: a structured evidence-based review.
BACKGROUND
Interest in non-hormonal therapies for the treatment of menopausal symptoms has increased since the publication of adverse effects of estrogen replacement therapy.


OBJECTIVE
To provide information on the efficacy of non-hormonal therapies for menopausal vasomotor symptoms based on evidence from published randomised controlled studies.


METHODS
The Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Alternative Therapies in Health and Medicine database (ATHMD) and Allied and Complementary Medicine database (AMED) were searched for randomised controlled trials in the English language reporting data on treatment of menopausal vasomotor symptoms. Trials including cancer breast patients were included.


RESULTS
Our search identified 58 randomised controlled trials of which 11 involved the use of clonidine, six for SSRIs, four for gabapentin, seven for black cohosh, seven for red clover, 18 for phytoestrogens, two for ginseng, one for evening primrose, one for dong quai and one for vitamin E. Most trials had methodological deficiencies.


CONCLUSIONS
There is evidence that clonidine, paroxetine, venlafaxine, gabapentin and black cohosh may be beneficial in the treatment of menopausal vasomotor symptoms in some women. Current evidence does not support the use of fluoxetine, red clover, phytoestrogens, Ginseng, evening primrose, dong quai and vitamin E. The side effects profile of these therapies should be considered.
Cheema
Deepti
D
Royal Worcestershire Hospital, Worcester, UK.
Coomarasamy
Arri
A
El-Toukhy
Tarek
T
D000588:Amines / Q000627:therapeutic use; D031885:Cimicifuga; D003000:Clonidine / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D005260:Female; D000077206:Gabapentin; D019584:Hot Flashes / Q000628:therapy*; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D048789:Phytoestrogens / Q000627:therapeutic use*; D008517:Phytotherapy; D010946:Plants, Medicinal; D016032:Randomized Controlled Trials as Topic; D029921:Trifolium; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D048789:Phytoestrogens; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D003000:Clonidine