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3. What treatment does conventional medicine offer for menopausal symptoms?
For many decades, estrogen (available by prescription with or without another hormone called progestin) has been the main treatment in conventional medicine for menopausal symptoms. For a long time, this treatment was called hormone replacement therapy (HRT), but the preferred term now is menopausal hormone therapy (MHT). MHT has been the most effective therapy to date for women who have severe or long-lasting problems related to menopause. It is especially effective against hot flashes and night sweats.
MHT has some other beneficial effects as well. For example, it helps to protect against osteoporosis, an age-related disease in which the bones become brittle and can break more easily. The risk for osteoporosis goes up in both men and women as they age, but it is greater for women after menopause. Drug treatments other than MHT, however, are available for reducing the risk of osteoporosis in both men and women, and certain lifestyle changes also may help. Conventional medicine is medicine as practiced by holders of MD (medical doctor) or DO (doctor of osteopathy) degrees and by their allied health professionals such as nurses, physical therapists, and dietitians. CAM is a group of diverse medical and health care systems, practices, and products that are not currently considered to be part of conventional medicine. Complementary medicine is used along with conventional medicine. Alternative medicine is used instead of conventional medicine. Some conventional medicine practitioners also practice CAM.
4. Why are many people concerned about the effectiveness and safety of MHT?
MHT was widely prescribed until a few years ago. In 2002, findings from a large study called the Women's Health Initiative raised concerns about its safety and side effects. Researchers found increased risks for serious health problems (including heart disease, breast cancer, stroke, and blood clots) in women who had taken a combination of estrogen and progestin for several years. Women who were taking estrogen alone had an increased risk for stroke and blood clots.
MHT is being used more cautiously now. The U.S. Food and Drug Administration (FDA) recommends that it be used at the lowest dose for the shortest period of time possible. However, the specific risks and benefits of these low doses, and how long to use them, are not known. The NIH SoS conference panel noted that estrogen may not be an appropriate treatment for some menopausal complaints. This situation is one reason that many women and their health care providers have become interested in whether CAM treatments could be helpful for menopausal symptoms.
