Over The Counter Products - Treating Menopausal Symptoms: Menopause
Content provided by the Faculty of the Harvard Medical School
Over-the-counter products
There are many over-the-counter products to choose from, including herbals and natural estrogens. Most of these products have not been well studied for effectiveness. If you choose to use over-the-counter products, it's important to know that they are not FDA-regulated. These products fall in the category known as dietary supplements; they have not undergone the scrutiny of clinical trials and are not regulated for purity of content or effectiveness. Some products may have helpful effects; others are harmless but ineffective or expensive. A few can cause serious health problems.
Plant-derived hormones (phytohormones)
These products, synthesized from wild yams or other plants, are sometimes called "natural hormones." Although they may be derived from a natural source, plant-derived hormones aren't necessarily the same as the hormones made by the human body. People may also use the term "natural hormones" to refer to products containing hormones that are identical to those produced by the body, but the more accurate term for those is bioidentical hormones (see below).
| What are bioidentical hormones? Bioidentical hormones, sometimes called "natural" hormones, are hormones that are identical to those produced by your ovaries. For estrogen, the bioidentical hormones are 17 beta-estradiol, estrone, and estriol. For progestogen, it's progesterone. Several FDA-approved products contain estradiol and progesterone. Because women respond so individually to hormone therapy, the set dosages in manufactured products may not be right for all women. With a physician's prescription, special compounding pharmacies will mix your tailor-made doses of estradiol, estriol, or micronized progesterone. Keep in mind that quality assurance may not be as high for compounded products as those manufactured by a large pharmaceutical company and approved by the FDA. Also, research has not proved their superiority. Some doctors who prescribe these products test a woman's hormone levels periodically, but this is of uncertain value because no one knows exactly what hormone level to aim for. Many women consider compounded products appealing partly because of numerous testimonials in the lay press, in spite of the lack of scientific data supporting this approach. |
Natural progesterone
Skin creams that contain extracts of Mexican wild yams have been widely promoted for natural menopause relief for years. Progesterone or progesterone-like compounds are advertised as the active ingredient. The amounts of these substances in the creams vary widely from prescription level to none at all. What's more, the amount absorbed by skin varies, so you can't be sure how much you're getting. A low dose may not be harmful, but it may not be effective, either. Too low a dose could actually be harmful if you're relying on it to protect you from uterine cancer while taking estrogen replacement therapy. For these reasons, the North American Menopause Society does not recommend the use of nonprescription progesterone cream.
DHEA
Dehydroepiandrosterone, or DHEA, sold over the counter as a dietary supplement, also is synthesized from wild yams. In the body, the hormone DHEA is an androgen (male) hormone produced by the adrenal gland. Data on DHEA's benefits and risks are limited. Claims that DHEA supplements boost energy and mood, increase libido, aid weight loss, and delay aging have not been studied sufficiently to be confirmed or refuted. Findings on DHEA and cardiovascular disease are inconsistent. Some practitioners of complementary and alternative medicine recommend that postmenopausal women with fatigue and reduced sex drive take DHEA. But even low doses can cause such adverse reactions as facial hair growth and acne. Higher doses may cause depression, jaundice, and an increased risk of liver cancer. Long-term effects are unknown.
| Last updated: | August 13, 2007 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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