Quick Guide to Alternative Therapies to HRT

Contributed by Dr.Jane Johnston.

AGNUS CASTUS
Monk's Pepper or Chasteberry
Has a regulating effect on hormones -especially useful in the peri-menopause.

BLACK COHOSH
Good for hot flushes and general menopausal symptoms. Reputed to have a better effect on mood and emotions than some of the other alternatives.Caution with salicylate sensitivity. Case report of autoimmune hepatitis.

DONG QUAI
Caution with clotting as coumarin derived.

EVENING PRIMROSE OIL - recently withdrawn from prescription.
Of benefit for mastalgia and helpful for PMS mood swings and irritability.
Do not be swayed by the recent change of indication-the grade of the product has a lot to do with the potency of the drug.

GINKGO BILOBA
Has anti-coagulation effect so caution. Case reports of Sub Arachnoid Haemorrhage. Has beneficial effects on cerebral blood flow and memory - can offset Alzheimers disease.

HIGH DOSE VITAMIN E
One of the few supplements which has been scientifically shown to be of benefit, especially for the cardiovascular system.
Shown to be of moderate benefit for vasomotor symptoms.

RED CLOVER
Many trials show benefits for vasomotor symptoms.
Useful as an alternative to HRT, particularly in the perimenopause and for the transition from HRT to nothing.
Caution in Breast cancer patients but similar to a daily dietary intake of the same phytoestrogen content.

SAGE
Caution with hypertension as can raise BP and do not give with TAMOXIFEN.
Not advisable for diabetics and epileptics due to the volatile oils that it is held in.

ST JOHNS WORT
Generally a good alternative if there is mild to moderate depression and anxiety.
Watch out for drug interactions, especially with drugs which require levels to be monitored: DIGOXIN, THEOPHYLLINE, WARFARIN, ANTIEPILEPTICS, IMMUNOSUPRESSANTS, CYCLOSPORIN and HIV DRUGS.
THE PILL could theoretically have reduced efficacy.
Be cautious with antihypertensive therapy.
Photosensitivity has been reported.