Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women.
OBJECTIVE
To review the literature on alternative over-the-counter (OTC) therapies for the treatment of hot flashes in menopausal women.


METHODS
A literature search was conducted using PubMed, International Pharmaceutical Abstracts, and Medline from inception to June 2010, combining the term hot flash individually with black cohosh, isoflavones, red clover, soy, vitamin E, ginseng, dong quai, evening primrose oil, wild yam, kava, and melatonin. All publication types including human participants and published in English were eligible for review. These articles, relevant abstracts, and additional references were used to collect pertinent data.


METHODS
Clinical trials comparing the above single-ingredient agents with placebo or active treatment were selected. In addition, only studies assessing the effects of these single-ingredient agents on vasomotor symptoms in menopausal women were included.


RESULTS
Since the Women's Health Initiative and Heart and Estrogen/Progestin Replacement Study II, women have sought lifestyle changes and other drug therapies as alternatives to menopausal hormone therapy to relieve hot flashes associated with menopause. The currently available literature is conflicting in regard to efficacy and does not support the use of alternative OTC therapies for hot flash management associated with menopause. In addition, long-term safety data are lacking for any of these therapies.


CONCLUSIONS
Women should be encouraged to implement therapeutic lifestyle changes to assist them with hot flash management. Based on the current literature, alternative OTC therapies do not have consistent, beneficial data to support their use in hot flash management.
Kelley
Kristi W
KW
School of Pharmacy, Auburn University, Alabama, USA. watsokm@auburn.edu
Carroll
Dana G
DG
D002986:Clinical Trials as Topic; D000529:Complementary Therapies; D004347:Drug Interactions; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D019584:Hot Flashes / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008593:Menopause; D004366:Nonprescription Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D008517:Phytotherapy; D040242:Risk Reduction Behavior; D013997:Time Factors
D004366:Nonprescription Drugs