Beware of so-called ‘natural’ alternatives

THEY are touted assafe rand ‘ more natural ’ alternativesto conventional H RT .Yet menopausespecialist shavewarned women affected by theo estrog el supplycrisis not tore sort to buying so- calledcompound bioi den tic alHRT,whic hiss old by privateclinics .

Made from hormones extractedfrom plants , the products aremarketed with claims they causefewer side effects than themedicines dished out by NHSdoctors–because the activecompounds they containcloselymatch the body’ s own . But while ,in some cases , they containsimilaringredients to standardtreatments , they areun licensedbecause there is no evidence thatthey are safe or effective .

Ha it ham Ha mod a , chairman ofthe British Menopause Society ,said :‘ Women should stay awayfrom these products . We haveH RT products made from naturalsource son the NHS , but these a remade to strict manufacturingcriteria which regulates thing slike dosage and purity.

‘These compound bio identicalproducts are not the same –they’ re often madeu pins mallpharmacies and not subject to thesame controls , so you don’ t reallyknow what you’ re getting .’

GP and women’ s healthexpertDr Philip pa K aye added thatH RT offered on the NHS hasbeen specificallydesigned to beexactly the same as the chemicalstructure of oestrogen andprogesterone found in the body.

Women should also becautiousif consideringtaking alternativesupplements and herbalremedies ,Dr Ha mod a continued.

Several , including black cohos hand St John’ swo rt , andphytoestrog en supplements madefrom soy or red clover , arereputed to help ease symptoms .But Dr Ha mod a said scientificevidence is limited and that somehave side effects and caninterfere with other medication.

There is some evidence thatphyt oestrogens , for example ,which stimulate the body’ soestrogen receptors , can easesymptoms in the short term . Butlonger-term data isn’t clear andsupplements shouldnot be takenby women with breast cancer asthe rise in oestrogen may causetumours tog row or return.

St John’s wortis another he rbalsupplement often recommended

to easesymptoms of depression–

and is said to relieve hot flushes. NICE concluded it may have a beneficial effect.

‘But again, you need to be a bit cautious,’ said Dr Hamoda, ‘as it’s a liver enzyme inducer, which means if you’re taking other drugs, such as cancer drugs, they may not work as efficiently.’

Black cohosh, a member of the buttercup family, is ‘probably the most researched supplement’ for menopause, he added. One trial found the herb relieved symptoms more effectively than a placebo, and was as effective as HRT at controlling hot flushes.

But it can cause stomach upsets and rashes, and Dr Hamoda said: ‘Although there is some evidence of effect, it’s the same logic that applies to all of these supplements – and others such as flaxseed, sage and evening primrose oil – that there’s not enough of it to draw meaningful conclusions.

‘With herbal remedies, the other problem is the quality, purity and ingredients vary, so there are questions about what dose might be helpful. But the evidence suggests none of them make a huge difference anyway, and they’re of limited benefit.’

Women struggling to access their usual HRT should look on the British Menopause Society’s website for equivalent alternative preparations, he added. It also contains details of alternative remedies, their reputed benefits and a summary of the scientific evidence behind them. l thebms.org.uk