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Middle-aged women have gotten an earful lately about what they shouldn't do to treat menopausal symptoms: boost their risk for heart disease, breast cancer and stroke by taking hormone replacement therapy unnecessarily. Now, finally, someone is saying what they should do.
But the advice of the North American Menopause Society, published in the January / February issue of its journal Menopause, may strike some as strange medicine.
The NAMS report suggests that women disturbed specifically by hot flashes follow these steps:
1. Try lifestyle changes, such as regular exercise and body- cooling tactics such as eating cold food.
2. Consider nonprescription remedies, such as soy, red clover, black cohosh and vitamin E.
3. Take prescription hormones, but only at the lowest effective dosage for the shortest possible time.
Step 2 is the zinger, given that the "remedies" cited, as the report itself notes, have not been proven effective or safe for long- term use. However, adds the report, "no serious side effects have been associated with short-term use. . . . "
Pamela Boggs, director of education and development for NAMS, defended the report as science-based and responsive to women's needs. She conceded that for many products, "the efficacy data is just not there, but . . . the perceived risks are minimal and they may work. . . . If they do work, wonderful."
Because supplement content can vary, the group's advice is sometimes brand-specific -- for example, the Remifemin brand of black cohosh.
To see the whole report, go to www.menopause.org/hotflashes.pdf.
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