It's important to approach any alternative treatment option with open eyes and healthy skepticism. Botanical extracts, herbal supplements, and nutraceutical compounds aren't inspected or approved by the FDA, so they haven't passed the rigorous testing process of prescription medications, and they haven't undergone a scientifically controlled process of long-term, in-depth study. Read Chapter 12, “Alternatives to MHT,” for a full discussion of this issue, and be aware that you can't just stroll down the aisle of your local health food store and choose a safe, effective, natural cure for any of your hormonal symptoms based on the claims of the label.

The Search for Herbal Treatments

Doctors and scientists around the world continue to evaluate the effectiveness of some of the most popular alternative treatments for the symptoms of menopause because many women use them. While a great deal remains to be learned about the safety, effectiveness, and long-term value of these treatment options, some of the alternative treatments most commonly used for the relief of hot flashes include:

• Soy products. Soy products, including whole soy foods, soy protein capsules, and isoflavone extracts, offer some relief from mild hot flashes, according to the results of some studies. Soy proteins are available in soy milk, tofu, tempeh, and roasted soy nuts. Because researchers haven't determined how phytoestrogens in soy interact with cancerous cells, however, these products aren't recommended for women seeking nonhormonal relief from menopause symptoms due to a history of cancer. Studies typically show that while women do experience lessening of hot flashes when they increase soy intake, it is not significantly more than the relief they experience when taking placebo.

• Vitamin E. Some women have reported that taking vitamin E offered them relief from hot flashes. In studies where participants took a regulated daily dose of 800 international units of vitamin E, the women did experience some minor relief (on the order of one less hot flash per day), and the vitamin caused no negative side effects. Right now, no study supports the idea that you can achieve significant relief from hot flashes by taking vitamin E, but studies continue in this area.

Is Black Cohosh the Answer?

Black cohosh is a plant in the buttercup family whose root is used in the treatment of menopausal symptoms. It is popular in Europe as a treatment for premenstrual syndrome and a number of menopausal symptoms. Though some products containing extracts of black cohosh carry labels that claim they can reduce hot flashes by as much as 25 percent, many medical experts feel that data to verify the herb's effectiveness is lacking. Studies have shown mixed results, but a rigorous double-blind study done in 2006 reported that black cohosh had no more effect on hot flashes than placebo, even when combined with other herbal therapies. Although many women report some improvement with the use of this herb, studies still do not support its use for hot flashes.

When considering whether to try this herbal treatment, remember that it does have a number of negative side effects, including nausea and dizziness. When using black cohosh for the treatment of perimenopause or menopause symptoms, you should limit the total treatment time to no more than six months.