Severity of menopausal symptoms and use of both conventional and complementary/alternative therapies

To describe the prevalence and correlates of using conventional therapies, complementary and alternative therapies, or a combination of both types of therapies for menopausal symptoms and to examine the association between severity of symptoms and type of therapy use.

Data on 2,602 women aged 45 years or older were gathered through a cross-sectional telephone survey conducted in Florida, Minnesota, and Tennessee during 1997 and 1998 using the Behavioral Risk Factor Surveillance System. Participants were asked a series of questions about their menopausal status, menopausal symptoms, healthcare provider selection in relation to menopause, and therapies used for menopausal symptoms.

Of the eight menopausal symptoms assessed, the highest prevalence estimates were reported for hot flashes (62.9%), night sweats (48.3%), and trouble sleeping (41.1%). The average number of symptoms (range 0-8) was 3.10 (SD +/- 2.25) and, for women reporting symptoms, the average symptom severity score (range 1-24) was 6.78 (SD +/-4.63). About 45% of the women had not consulted with a healthcare provider for treatment of menopausal symptoms or for medical conditions related to menopause even though only 16.3% did not report any of the symptoms included in the survey. Forty-six percent of the women used complementary/alternative therapy either alone or in combination with conventional therapies. Age-adjusted average symptom severity scores were significantly higher among women who had undergone a hysterectomy, with removal of the ovaries (7.73; 95% CI 7.33,8.12) or without (7.60; 95% CI 7.16,8.05), than among women who experienced a natural menopause (6.42; 95% CI 6.14,6.71). Average severity scores were significantly higher among women who used both conventional and complementary/alternative therapies in relation to menopause (8.61; 95% CI 8.26,8.96) than among women who used only conventional therapies (7.09; 95% CI 6.67,7.50). This statistically significant association persisted when adjusted for age, education, income, race/ethnicity, state of residence, and menopausal category.

In this sample, 46% of the women used complementary/alternative therapy either alone or in combination with conventional therapies, whereas a third of the women did not use any therapy in relation to menopause. Although causal inferences cannot be made, the menopausal symptom severity score was significantly higher among women who reported using a combination of conventional and complementary/alternative therapies than among women who used only conventional therapy, only complementary/alternative, or no therapy.