Some women just aren't comfortable using HRT. The National Center for Complementary and Alternative Medicine has put together a list of alternative treatments and their researched effectiveness.
Botanicals
* Black cohosh (Actaea racemosa, Cimicifuga racemosa). This herb has received more scientific attention for its possible effects on menopausal symptoms than have other botanicals. Studies of its effectiveness in reducing hot flashes have had mixed results. A study funded by NCCAM and the National Institute on Aging found that black cohosh, whether used alone or with other botanicals, failed to relieve hot flashes and night sweats in postmenopausal women or those approaching menopause. Other research suggests that black cohosh does not act like estrogen, as once was thought. Black cohosh has had a good safety record over a number of years. Some concerns have been raised about whether it may cause liver problems, but an association has not been proven.
* Dong quai (Angelica sinensis). Only one randomized clinical study of dong quai has been done. The researchers did not find it to be useful in reducing hot flashes. Dong quai is known to interact with, and increase the activity in the body of, the blood-thinning medicine warfarin. This can lead to bleeding complications in women who take this medicine.
* Ginseng (Panax ginseng or Panax quinquefolius). The panel concluded that ginseng may help with some menopausal symptoms, such as mood symptoms and sleep disturbances, and with one's overall sense of well-being. However, it has not been found helpful for hot flashes.
* Kava (Piper methysticum). Kava may decrease anxiety, but there is no evidence that it decreases hot flashes. It is important to note that kava has been associated with liver disease. The FDA has issued a warning to patients and providers about kava because of its potential to damage the liver.
* Red clover (Trifolium pratense). The panel reported that five controlled studies found no consistent or conclusive evidence that red clover leaf extract reduces hot flashes. Clinical studies in women report few side effects, and no serious health problems have been discussed in the literature. However, there are some cautions. Some studies have raised concerns that red clover, which contains phytoestrogens, might have harmful effects on hormone-sensitive tissue (for example, in the breast and uterus). (See box below for more information on phytoestrogens.)
* Soy. The scientific literature includes both positive and negative results on soy extracts for hot flashes. When taken for short periods of time, soy extracts appear to have few if any serious side effects. However, long-term use of soy extracts has been associated with thickening of the lining of the uterus.
If you've tried any of these alternatives, what was your experience?