Alternative Therapies at Menopause

The most effective treatment for menopausal symptoms is menopausal hormone therapy, best indicated within the first 10 years after menopause. However, hormone therapy is contraindicated in some women and others do not wish to use hormonal treatment due to potential adverse effects or other personal preferences. Alternative and complementary therapies are widely used by women globally, using methods familiar to local cultures as well as emerging newer techniques. Methods which are recommended on the basis of available evidence include pharmacological options such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, gabapentin, fezolinetant and oxybutynin, cognitive behavioral therapy, clinical hypnosis, weight loss, and stellate ganglion blockade. Others which are not recommended due to insufficient evidence include cooling techniques, avoiding triggers, exercise including yoga, dietary modifications or supplements, mindfulness-based intervention, relaxation techniques including paced respiration, acupuncture, and pharmacological treatment such as clonidine and pregabalin. Awareness of the current recommendations, indications, risks and benefits of non-hormonal therapies for menopausal symptoms will enable healthcare workers to deliver optimal care for menopausal women.