title: A survey of the availability in Canadian pharmacy chains of over-the-counter natural health products for menopause symptoms.
abstract: BACKGROUND
  Menopause is a natural phase in a woman's aging process, characterized by the cessation of menstruation. Women who are going through the menopause transition can experience physiological symptoms that significantly impact their quality of life. Concern about adverse effects of traditional hormone therapy often leads women to purchase over-the-counter (OTC) natural health products (NHPs). The goal of this study was toinvestigate the range of OTC NHPs for menopause available to Canadian women, and the packaging information they can access to make self-management decisions.
  
  
  METHODS
  Edmonton stores belonging to each of nine Canadian pharmacy chains were visited to identify NHPs marketed for the relief of menopausal symptoms. Details were extracted from the packaging: a) product name and manufacturer, b) Health Canada license number, c) medically active ingredients, d) claims of efficacy, e) contra-indications and warnings, and f) daily cost. Data were entered and analyzed using Microsoft Excel.
  
  
  RESULTS
  We identified 20 OTC NHP menopausal products, 19 of which had Health Canada license numbers. Twenty-eight medically active ingredients were identified, with the most common being black cohosh (in 14 products) and soy isoflavones (n = 7), chaste tree (n = 5), and dong quai (n = 3). Most products claimed they would relieve vasomotor symptoms, including hot flashes (n = 14) and night sweats (n = 10). Each product had a labeled contraindication for at least one specific condition. Costs per recommended daily dose ranged from $0.07 to a maximum of $2.50 (CAD$).
  
  
  CONCLUSIONS
  Natural health products for menopausal symptoms are easily available to Canadian women. The lack of clear evidence of product efficacy makes the need for easily accessible, balanced information on this topic important for women to make well informed choices.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, 5S131 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3 V9, Canada. jcroden@ualberta.ca.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Croden
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, 5S131 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3 V9, Canada. sue.ross@albertahealthservices.ca.
authors.forename: Sue
authors.initials: S
authors.lastname: Ross
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, 3-171 Edmonton Clinic Health Academy, 11405 - 87 Avenue NW, Edmonton, AB, T6G 1C9, Canada. nese.yuksel@ualberta.ca.
authors.forename: Nese
authors.initials: N
authors.lastname: Yuksel
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, 5S131 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3 V9, Canada. bsydora@ualberta.ca.
authors.forename: Beate C
authors.initials: BC
authors.lastname: Sydora
mesh_terms: D029969:Angelica; D029971:Angelica sinensis; D002170:Canada; D031885:Cimicifuga; D003132:Commerce; D004348:Drug Labeling; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D007529:Isoflavones / Q000627:therapeutic use; D008593:Menopause; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010594:Pharmacies; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D010946:Plants, Medicinal; D012648:Self Care; D013025:Glycine max; D011795:Surveys and Questionnaires; D013546:Sweating; D020950:Vitex
chemical_list: D004365:Drugs, Chinese Herbal; D007529:Isoflavones; D004366:Nonprescription Drugs; D010936:Plant Extracts; C044613:angelicae sinensis extract