Hypnosis not yoga helps beat misery of the menopause

TRENDY therapies such as yoga and acupuncture do not help women beat the misery of menopause, experts say.

Herbal supplements are also unlikely to do much good – but hypnosis might combat some of the symptoms.

New guidelines on how to ease embarrassing and energy- sapping hot flushes warn that many of the remedies tried by millions simply do not work.

For other therapies, there is not enough evidence to say whether they do help, so women would be better fast-tracking to treatments with proven benefit, the US experts say.

And despite the widely held belief that alcohol and spicy food can trigger hot flushes, there is no data to support this, they add.

Hot flushes – the most common and most distressing symptom of the menopause – can disturb sleep, drain energy and cause embarrassment.

A single flush can last from a few seconds to an hour. Hormone-replacement therapy is the main treatment, but is not suitable for all and many who could take it are put off by fears that it may trigger breast cancer.

Those who do start on it can suffer unpleasant side-effects, from headaches to heartburn, leading many women to search for alternatives.

However, with options ranging from Chinese herbal supplements and dietary advice to powerful antidepressants and acupuncture, it is hard for them to know where to start.

Hypnosis is one of the few treatments backed by solid evidence that it works, the North American Menopause Society (NAMS) advises.

‘From 50 to 80 per cent of women approaching menopause try non- hormonal therapies for hot flushes. Many don’t really work and sticking with them can just prolong the misery,’ it says. ‘With little guidance on what does work, many women just experiment with products or suffer.’

NAMS asked a panel of experts to review medical literature on the topic. They found solid evidence of the effectiveness of hypnosis and cognitive behavioural therapy – including counselling, sleep advice and relaxa-

‘General well-being

is essential’

tion techniques. In one study, women who had hypnosis five times a week had a dramatic reduction in the number and severity of hot flushes.

The guidelines also recommend some prescription drugs, including the anti-depressant Seroxat and the epilepsy drug gabapentin. However, herbal supplements, including popular black cohosh tablets, evening primrose oil and ginseng, are unlikely to work, NAMS says. Exercise, yoga, acupuncture and chiropractic also lack evidence that they give relief.

Dr Janet Carpenter, who led the panel, said: ‘Many women try one thing after another and it is months before they stumble on something that truly works. This information will be critical in maximising the selection of the most effective therapies.’

Charles Kingsland, of the Hewitt Fertility Centre at Liverpool Women’s Hospital, said HRT was the most effective treatment, although the placebo effect – the mere belief that something will work – means other options appear helpful to start with.

‘What you have to be careful of are the things that may be harmful, not only to your health but to your pocket,’ he said. ‘In the menopause, general well-being is essential. Exercise the body and mind.

‘So many women in my menopause clinic have such low self- esteem, sometimes I think that’s often the worst thing. That’s where all the psychotherapy stuff comes in.’