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Complementary and herbal therapies for menopausal symptoms

Complementary therapies are a range of approaches to care aimed at enhancing quality of life and improving wellbeing. They may be used alongside conventional treatments.

You may also hear people talk about ‘alternative therapies’. These are therapies that are taken instead of conventional approaches to treatment.

Herbal or complementary remedies should only be prescribed by a naturopath who is trained in their use. Most 'complementary', 'natural' or 'alternative' therapies have not been fully tested for their effectiveness or safety in treating menopausal symptoms.

It’s important for women to talk to a doctor before taking any complementary or 'natural' therapies as they may interact with other cancer therapies. Some herbal therapies may contain oestrogen-like compounds. This can be a concern for women who have had a diagnosis of breast cancer.

Some examples of complementary therapies used to manage menopausal symptoms are given below.

Black cohosh

Most studies show that black cohosh (eg Remifemin) is not effective in treating hot flushes. Black cohosh can also have side effects, including gastro-intestinal upsets and skin rash. There are also concerns about its safety after reports of liver damage.

Phyto-oestrogens and soy

Phyto-estrogens (eg soy products and isoflavones) are not effective in treating hot flushes in menopausal women who have not had breast cancer. They have not been tested following breast cancer but phyto-oestrogens and soy are unlikely to be effective. Their safety after breast cancer is not known.


Early studies on the effectiveness of acupuncture in treating hot flushes look promising. If you have had breast cancer with surgery or radiotherapy to the axilla (armpit), you should avoid having acupuncture on the affected arm and ensure sterile needles are used to help prevent lymphoedema.

Vitamin E

Vitamin E given at a high dose (800 IU per day) may be mildly effective in some women in reducing hot flushes. Vitamin E is thought to be safe after breast cancer.

Other complementary and over-the-counter remedies for menopausal symptoms

A wide range of 'over-the-counter' medications or herbal remedies are available for the management of menopausal symptoms. There is very little evidence about the effectiveness or safety of over-the-counter menopausal remedies in women who have not had breast cancer and very little is known about their effects in women who have had breast cancer.

Examples include:

  • Dong Quai
  • evening primrose
  • ginseng
  • red clover
  • Chinese herbs.

Women who are considering any of these therapies should discuss them with their doctor first.