So what to do about menopausal symptoms? It may surprise some women, but there are viable options in the vitamin aisle, but often times, it would be very difficult to compile the right blend of supplements to address this particular concern. Fortunately, there are a group of emerging companies in the personalized vitamin market that will complete a consumer assessment and drive a specific formula off inputs such as menopausal symptoms. The best assessment tools will get as granular as stage of menopause.
There are some prescription and natural remedies with decent evidence in their favor. First, we need to recognize that menopausal symptoms naturally resolve on their own in the vast majority of people. Most women’s symptoms abate within two to five years of onset. However, a small percentage, less than 10 percent, will continue to have hot flashes ten years into menopause and beyond.
If the symptoms are troublesome, some prescription options (other than hormones) can be considered, namely a variety of antidepressants. The key here is to recognize that they can be used in menopause beyond their use for depression. Some of the SSRIs and SNRIs (common classes of antianxiety/antidepressants) are very helpful in reducing hot flashes. We prefer SNRIs, as they tend to have fewer side effects (weight gain and loss of libido are more common with SSRIs). Venlafaxine and the other drugs in this class can be helpful in reducing hot flashes and some of the mood symptoms often associated with menopause.
Some herbal remedies are also commonly used for hot flashes. Perhaps the most popular is black cohosh. This root, from a plant native to North America, is touted as a natural reducer of hot flashes and vaginal dryness. While studies are mixed as to whether or not it is helpful, we have found that in practice it is hit or miss. That is, some women find it very helpful in reducing symptoms while others do not. As for any downsides, it is generally considered safe. However, rare reports of liver problems have been made. It is our belief that finding a pure reputable brand is essential as with all herbal and supplement products. Some authorities also caution using black cohosh if you have a history of breast cancer due to concerns that it may stimulate estrogen receptors. Data on this is lacking, but we do advise finding another solution in women with a family history of breast cancer. Vitamin E has been indicated as playing a role in reducing hot flashes. Some studies have combined it with black cohosh to show some modest relief, even at lower doses. It is our belief that low doses of vitamin E (under 100 IUs) are generally safe and possibly useful. Higher doses can increase risk of bleeding and have not been shown to be more effective.
Phytoestrogens (plant-derived xenoestrogens) have been shown to reduce some symptoms of menopause. Since many can be found in natural food sources (soy products abound), we suggest obtaining soy in moderation through these products (not to exceed two servings daily) and avoiding supplementation. Because soy and phytoestrogens can have an effect on estrogen receptors, caution should be used especially among those with a breast cancer history. Both primrose oil and flaxseed have been suggested for hot flashes. Little evidence supports their use. We believe you can do better with some of the other treatments mentioned.
Last but certainly not least talked about is DHEA. Many tout this supplement for its role in stopping aging or improving sex drive. If you think it sounds too good to be true, you are probably right. DHEA is a hormone made by the body in the adrenal gland, a small gland that rests on top of the kidney. It’s a building block used by your body to make other sex hormones like testosterone and estrogen. DHEA gradually declines with age after peaking in your twenties. While DHEA supplementation has been shown to improve bone density, its effect on hot flashes and other libido issues has not been proven. What does seem likely is an association between high DHEA levels and breast cancer. It is also known to cause hair loss. Therefore, we do not find its use warranted. Too bad; so sad: DHEA is not the fountain of youth. It sounds way better than it actually performs.
Menopause is a natural phase of life but is nonetheless a disruption of a woman’s previous hormonal balance that can cause many negative symptoms. However, most women can weather the storm and find a new and pleasant normal once hot flashes subside. There are many prescription and vitamin or supplement options for helping women through this period of flux. Hormone replacement is a complicated consideration, and each woman’s risks and benefits should be assessed individually. While menopause is a universal process, each woman’s experience with it is unique and should be treated as such. A personalized vitamin brand is a great starting point for bringing more precision into your daily vitamin routine.
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