p.4
Complementary Therapies for Menopausal Symptoms
What is black cohosh used for?
To alleviate menopausal symptoms.
p.4
Risks and Benefits of Alternative Treatments
What was the conclusion of the systematic review regarding phytoestrogen treatments for menopausal symptoms?
There was no evidence that phytoestrogen treatments helped to relieve menopausal symptoms.
p.4
Dietary Supplements and Vitamins
What is evening primrose oil rich in?
Gamma-linolenic and linolenic acid.
p.1
Lifestyle Measures for Menopausal Symptoms
What effect does low-intensity exercise like yoga have on menopausal symptoms?
It may reduce vasomotor symptoms and improve psychological wellbeing.
p.2
Pharmacological Alternatives to HRT
What did early trials of oral clonidine reveal about its effectiveness?
They showed no evidence for hot flush reduction.
p.6
Stellate Ganglion Blockade for Hot Flushes
What is stellate ganglion blockade and its purpose?
A technique involving local anesthetic injection to treat hot flushes and sweating, especially when HRT is contraindicated.
p.4
Future Research Directions in Menopause Management
What are the EU studies examining the role of phytoestrogens in health?
PHYTOS, ISOHEART, and PHYTOPREVENT.
p.6
Risks and Benefits of Alternative Treatments
What was the outcome of sham-controlled trials regarding acupuncture for menopausal hot flushes?
The authors failed to show beneficial effects of acupuncture over placebo.
p.6
Complementary Therapies for Menopausal Symptoms
What were the findings of the randomized trial involving reflexology for menopausal symptoms?
Both reflexology and nonspecific foot massage groups showed symptom reduction, but no significant difference between them.
p.5
Risks and Benefits of Alternative Treatments
What interactions have been reported with Dong quai?
Interactions with warfarin, increasing the risk of bleeding and photosensitisation.
p.1
Pharmacological Alternatives to HRT
What are progestogens used for in menopausal symptom management?
As an alternative to combined HRT for women with contraindications to estrogen.
p.3
Pharmacological Alternatives to HRT
What is the biochemical impossibility related to wild yam extract?
Steroids in yams cannot be converted to progesterone in the human body.
p.3
Pharmacological Alternatives to HRT
What was the outcome of short-term treatment with topical wild yam extract?
It appears to have little effect on menopausal symptoms.
p.6
Concerns about Hormone Replacement Therapy (HRT)
What should clinicians consider when discussing menopause treatment options?
The range of options available, their advantages and disadvantages, and the patient's specific risk factors.
p.6
Complementary Therapies for Menopausal Symptoms
What is the primary aim of reflexology?
To relieve stress or treat health conditions through pressure application to specific points.
p.2
Pharmacological Alternatives to HRT
What is clonidine and its role in treating vasomotor symptoms?
Clonidine is a centrally active alpha-2 agonist that has been used as an alternative treatment, but evidence for its efficacy is limited.
p.7
Risks and Benefits of Alternative Treatments
What is the concern regarding high-dose progestogens?
They carry a thromboembolic risk.
p.7
Future Research Directions in Menopause Management
What is needed to confirm the efficacy and long-term safety of alternative treatments?
Well-designed, prospective, randomised controlled trials.
p.5
Complementary Therapies for Menopausal Symptoms
What is known about Agnus Castus (chasteberry) in relation to menopausal symptoms?
Limited data exist, but a combination herbal product including it reduced vasomotor symptoms in a randomized controlled trial.
p.1
Lifestyle Measures for Menopausal Symptoms
What lifestyle changes can help reduce the severity of vasomotor symptoms?
Avoidance or reduction of alcohol and caffeine intake.
p.2
Pharmacological Alternatives to HRT
Which SNRI has shown the most convincing data for treating vasomotor symptoms?
Venlafaxine at a dosage of 37.5 mg twice daily.
p.5
Risks and Benefits of Alternative Treatments
What is the status of Kava kava in the UK?
It has been banned due to reports of liver damage.
p.4
Pharmacological Alternatives to HRT
What is the effect of the soy-derived preparation DT56a on hot flushes?
It has been shown to have an effect on hot flush reduction.
p.7
Pharmacological Alternatives to HRT
What should clinicians avoid using as first-line therapy in women with estrogen/progesterone-dependent tumors?
Phytoestrogens and progestogens/progesterone.
p.7
Risks and Benefits of Alternative Treatments
What is a concern regarding paroxetine in breast cancer treatment?
It may reduce tamoxifen’s effectiveness by inhibiting its bioactivation by CYP2D6.
p.7
Risks and Benefits of Alternative Treatments
Why should phytoestrogens be used cautiously in breast cancer patients?
Their safety is unknown and should be confined to specialist centres and clinical trials.
p.5
Complementary Therapies for Menopausal Symptoms
What is the efficacy of Dong quai for treating menopausal symptoms?
It has not been found to be superior to placebo in a randomized trial, but may be effective when combined with other herbs.
p.7
Risks and Benefits of Alternative Treatments
What is the efficacy comparison between alternative preparations and traditional HRT?
Alternatives provide 50-60% symptom reduction compared to 80-90% with traditional HRT.
p.3
Complementary Therapies for Menopausal Symptoms
What effect does DHEA have on hot flushes according to preliminary studies?
An uncontrolled pilot study showed a modest reduction in hot flushes with DHEA.
p.2
Pharmacological Alternatives to HRT
What class of drugs is commonly used for alleviating menopause symptoms as an alternative to HRT?
Selective serotonin and noradrenaline reuptake inhibitors (SSRIs and SNRIs).
p.5
Complementary Therapies for Menopausal Symptoms
What have studies shown about ginseng's efficacy for vasomotor symptoms?
It has not been found to be superior to placebo.
p.3
Complementary Therapies for Menopausal Symptoms
What do women perceive about complementary therapies compared to traditional hormone therapies?
They perceive them to be safer and more natural alternatives.
p.3
Risks and Benefits of Alternative Treatments
What is a major concern regarding herbal medicines?
They can cause unwanted effects and have potentially dangerous interactions with other medicines.
p.2
Complementary Therapies for Menopausal Symptoms
What is dehydroepiandrosterone (DHEA) and its initial use?
DHEA was initially used in the USA as a food supplement for its supposed anti-aging effects in postmenopausal women.
p.4
Risks and Benefits of Alternative Treatments
What concerns exist regarding phytoestrogens and hormone-sensitive tissues?
Safety concerns due to estrogenic actions and interactions with selective estrogen receptor modulators.
p.4
Risks and Benefits of Alternative Treatments
What is a concern regarding the long-term safety of black cohosh?
Potential liver toxicity.
p.1
Concerns about Hormone Replacement Therapy (HRT)
What is a primary concern regarding traditional hormone replacement therapy (HRT)?
The purported risks to the breasts and cardiovascular system.
p.1
Concerns about Hormone Replacement Therapy (HRT)
What has fueled interest in alternatives to HRT?
Concerns about the risks associated with traditional HRT.
p.2
Risks and Benefits of Alternative Treatments
What has the Women’s Health Initiative study indicated about progestogens?
It has raised concerns about the safety of progestogens due to an increased risk of breast cancer when combined with estrogen.
p.6
Dietary Supplements and Vitamins
What vitamins and minerals are mentioned as being present in supplements for postmenopausal women?
Vitamins E and C, and minerals like selenium.
p.7
Future Research Directions in Menopause Management
What is the current status of herbal preparations in the UK?
They must be registered with the Medicines and Healthcare products Regulatory Authority.
p.5
Complementary Therapies for Menopausal Symptoms
What was the outcome of the trial on Danggui Buxue Tang?
Benefit over placebo was found only for mild hot flushes.
p.6
Pharmacological Alternatives to HRT
How did gabapentin compare to vitamin E in treating hot flushes?
Gabapentin appeared to be more effective, with a favorable effect on sleep quality, while vitamin E had only a marginal effect.
p.7
Future Research Directions in Menopause Management
What new technique is showing promise for refractory symptoms?
Stellate ganglion blockade.
p.6
Homeopathy and Alternative Treatments
What is the current understanding of homeopathy's effectiveness for menopausal symptoms?
The mechanisms are unclear, and while some data is encouraging, more research is needed.
p.3
Pharmacological Alternatives to HRT
What is the recommendation regarding natural progesterone cream?
It is not recommended for progestogenic opposition due to inconsistent data.
p.2
Risks and Benefits of Alternative Treatments
What are some common side effects associated with SSRIs and SNRIs?
High incidence of nausea, reduced libido, and sexual response.
p.5
Risks and Benefits of Alternative Treatments
What interactions are associated with St John’s wort?
It decreases blood concentrations of several medications and may cause breakthrough bleeding with oral contraceptives.
p.5
Risks and Benefits of Alternative Treatments
What is the evidence for the effectiveness of other herbs like Ginkgo biloba and valerian root on menopausal symptoms?
There is no good evidence that they have any effect on menopausal symptoms.
p.5
Complementary Therapies for Menopausal Symptoms
What is the current understanding of acupuncture's effectiveness for menopausal symptoms?
The evidence is conflicting, with difficulties in trial design, particularly with blinding to 'sham' acupuncture.
p.7
Pharmacological Alternatives to HRT
What is a potential best choice for therapy in women with estrogen/progesterone-dependent tumors?
An SNRI (Serotonin-Norepinephrine Reuptake Inhibitor).
p.2
Risks and Benefits of Alternative Treatments
Why might progestogens be inappropriate for women with an increased risk of breast cancer?
Because they can increase the risk of breast cancer, especially in women with progesterone-receptor-positive tumors.
p.6
Risks and Benefits of Alternative Treatments
What is the current evidence regarding magnet therapies for hot flushes?
There is no known mechanism of action or evidence of benefit for magnet therapies.
p.2
Risks and Benefits of Alternative Treatments
What is a potential risk associated with doses of progestogens used for vasomotor symptom control?
Increased risk of venous thromboembolism.
p.1
Nonpharmacological Alternatives for Vaginal Dryness
What is the primary function of lubricants for vaginal dryness?
To relieve vaginal dryness during intercourse.
p.6
Dietary Supplements and Vitamins
What was the result of the trial investigating vitamin E for hot flushes in women with breast cancer?
A small statistically significant reduction in hot flush frequency was observed, but it may not be clinically significant.
p.1
Pharmacological Alternatives to HRT
What benefit has been shown for megestrol acetate in randomized studies?
A benefit over placebo for intractable vasomotor symptoms.
p.5
Risks and Benefits of Alternative Treatments
What caution should be taken when interpreting data on ginseng?
Caution is essential due to the use of the common name for multiple chemically different species.
p.5
Complementary Therapies for Menopausal Symptoms
What is the effect of St John’s wort on menopausal symptoms?
Its efficacy for vasomotor symptoms remains to be proved, but it has shown efficacy in mild to moderate depression.
p.2
Pharmacological Alternatives to HRT
What has research shown about gabapentin in relation to hot flushes?
Gabapentin has shown efficacy for hot flush reduction compared to placebo.
p.3
Dietary Supplements and Vitamins
What are phytoestrogens and where are they commonly found?
Phytoestrogens are plant substances with estrogen-like effects, found in soybeans, chickpeas, and red clover.
p.2
Risks and Benefits of Alternative Treatments
What are some adverse effects of gabapentin?
Drowsiness, dizziness, and fatigue.
p.3
Dietary Supplements and Vitamins
What are the major lignans associated with phytoestrogens?
Enterolactone and enterodiol.
