GMS Health Technol Assess. 2012;8:Doc03. doi: 10.3205/hta000101. Epub 2012 May 07.
Alternative methods for the treatment of post-menopausal troubles.
GMS health technology assessment
Pamela Aidelsburger, Svenja Schauer, Kristin Grabein, Jürgen Wasem
PMID: 22690252
PMCID: PMC3356850 DOI: 10.3205/hta000101
Abstract
BACKGROUND: Menopause is described as the transition from the reproductive phase of a women to the non reproductive. Changes in hormone levels might lead to complaints and health consequences especially during peri- and postmenopause. Hormone therapy has a potential damaging health risk profile and is recommended for temporal limited therapy for acute vasomotor symptoms only.
OBJECTIVE: The present HTA-report aims to assess the effectiveness and the cost-effectiveness of alternative treatment methods for women with postmenopausal symptoms in Germany regarding patient relevant endpoints (reduction of symptoms and frequency of adverse events and improvement of quality of life).
METHODS: A systematic literature search was carried out in 33 relevant databases in September 2010. Citations were selected according to pre-defined criteria and were extracted and evaluated.
RESULTS: In the systematic research 22 studies are identified for the effectiveness evaluation, 22 primary studies and one review. High doses of isolated genistein reduce the frequency/intensity of hot flashes while low doses of genistein show no significant effect. Intake of isoflavone extract such as genistein, daidzein, glycitein in various combinations does not have an effect on improvement of cognitive function or vaginal dryness. The effect of black cohosh and hop extract for menopausal complaints cannot be determined since results are heterogenous. The combination of isoflavone, black cohosh, monk's pepper, valerian and vitamin E has a positive effect on menopause symptoms. Ginkgo biloba shows no significant effect on menopause symptoms and cognitive improvement beside mental flexibility. Acupuncture has a significant influence on hot flashes especially in severe cases.
DISCUSSION/CONCLUSION: No final statement can be drawn regarding the effectiveness of alternative treatment methods due to qualitative shortcomings of included studies and a general limited availability of studies in this field. Furthermore, the generalization of the present HTA is limited due to the inclusion of only postmenopausal women.
Keywords: EBM; HTA; HTA report; HTA-report; Health Technology Assessment; RCT; TA; acupuncture; alternative treatment method; change of life; climacteric disorders; climacteric/*; complementary therapies/*; complementary therapies/*adverse effects; complementary therapies/*economics; complementary therapies/*standards; complemtary medicine; cost effectiveness; cost-effectiveness; cure; diagnosis; effectiveness; efficacy; evidence-based medicine; female; hormone level; hormone preparation; hormone replacement therapy; hormones; hormonotherapy; hot flashes; humans; influence; life quality; medical treatment; menopause; method of treatment; peer review; phytotherapy; plant extracts; postmenopausal woman; postmenopause/*; quality of life; randomised controlled study; randomised controlled trial; randomized controlled study; randomized controlled trial; randomized controlled trials as topic; relaxation technique; relaxation therapy; review; review literature; review literature as topic; symptom; systematic review; technology assessment; technology assessment, biomedical; therapeutics; therapy; treatment; treatment method; treatment outcome; vasomotor symptom; women's health
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