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Integrative Medicine Approaches for Menopause
Jyoti Patel1, Rajita G Patil, Denise M Millstine
1Section of Integrative Medicine, Division of General Internal Medicine, Department of Medicine, Mayo Clinic Arizona, Scottsdale, and the Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, Arizona; and the Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Abstract:
Women transitioning through menopause are often affected by vasomotor symptoms (VMS), bone loss, metabolic dysfunction, and increased cardiovascular risk. Although menopausal hormone therapy remains the most effective treatment for menopause, nonhormonal strategies are essential for women with contraindications, personal preference, or a history of hormone-sensitive cancers. This narrative review evaluates evidence-based integrative approaches to menopause care, including lifestyle interventions, mind-body therapies, nutritional strategies, botanicals, and complementary modalities. Cognitive behavioral therapy and clinical hypnosis have been shown to significantly reduce vasomotor symptom distress and are recommended as nonhormonal options. Although mindfulness-based interventions may improve sleep and quality of life (QOL), they are not recommended for the relief of VMS. Regular physical activity and dietary optimization are foundational for bone health and improving metabolic risk factors. Acupuncture may provide subjective improvements in overall symptom burden and QOL for some individuals. Despite the common use of phytoestrogens and various botanical therapies, high-quality evidence supporting their efficacy for VMS remains inconsistent. Consequently, these modalities are not advised for routine symptom management, particularly given their lack of standardization and potential safety concerns. Integrative approaches should be incorporated as part of an individualized, patient-centered care plan. Further research is needed to clarify effectiveness, safety, and optimal integration of these treatment approaches into clinical practice.
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