For many of my patients, hormone therapy is not an option for them due to personal belief, health concerns, or prior history of hormone-positive cancers. In my clinic of integrative medicine in San Jose CA, I am usually able to address menopausal symptoms like hotflashes or insomnia using supplements instead of hormone therapy.
We always have a discussion about potential alternatives that may target menopausal symptoms, which include, but are not limited to, options such as black cohosh, St. John’s Wort, chasteberry, schisandra, DIM, evening primrose oil, sarsaparilla, and phytoestrogens like soy in limited dosing. But I am a firm believer in presenting all options to patients regarding their health concerns. So, even though I personally do not use HRT very often and prefer using supplements, that does not mean that HRT may not be the right choice for some women.
All herbal potential alternatives have pros and cons to them. So, the most important questions to ask yourself and your healthcare practitioner is:
- What are the main symptoms that are concerning you?
- What are the predominant treatment goals you have in mind?
- What are your biggest concerns about hormone therapy?
- Is there family history or personal history of hormone-based cancers?
- What is the duration of therapy you are aiming for? Long term or short term?
After clarifying these questions between you and your healthcare practitioner, you can then best decide on the most appropriate therapy to address your symptoms.
Many of the HRT alternative therapy options are much milder than HRT, therefore may not be as effective when used alone. Therefore, patients frequently have to use several supplements to allow for synergistic therapeutic effects.
Also, some of these supplements may have adverse effects that need to be monitored; such as monitoring liver function tests when using black cohosh and making sure that St. John’s Wort doesn’t affect drug metabolism of the patient’s other medications.
However, in my experience, these herbal options have worked well synergistically with 2-3 combinations at the same time for those women hoping to avoid hormone therapy exposure. So, it is definitely worth having a discussion with your practitioner about your alternative options to treating menopausal symptoms aside from HRT.
So, the main takeaway points are that there are definitely alternative options to HRT.
Just keep in mind that you may need more than one to achieve a desired therapeutic effect. Even though they are supplements, side effects may still occur, therefore, physician monitoring of therapy is always recommended.