Menopausal symptoms are common causes for women to seek treatment. The severity of symptoms vary from patient to patient and reduces the quality of life for many women. Most women reach menopause between the ages of 45 and 55, some not until 60 and some at an early age in their thirties or forties (Stoppler, 2008). Aim This study aimed to offer an alternative form of treatment for women that are experiencing the unpleasant symptoms that are experienced with menopause, since hormone replacement therapy, may have adverse effects in some women (Wang-Cheng, 2007). This double-blind placebo controlled study investigated the efficacy of a complementary formulation of Folliculinum D6 and Five-Flower Formula™, (Folliculinum D6, Rock Rose, Impatiens, Clematis, Star of Bethlehem, Cherry Plum ) in the treatment of menopausal symptoms in terms of participants’ perception of the treatment. iii This formula is currently available commercially as an unregistered product trading under the name of Femme Rosa. This formula was developed by Dr Maharaj, and is prepared by Natura®. The formula consists of Folliculinum D6 and Five-Flower Formula™. Methodology A total of 60 female participants who were going through natural menopause and currently experiencing menopausal symptoms took part in the study. They were randomly assigned according to the randomization sheet drawn up by the supervisor, 29 participants to the treatment group and 31 to the placebo group. The study was conducted over a period of six weeks and participants were required to attend two consultations at the Homoeopathic Day Clinic at the Durban University of Technology. Participants were recruited according to the inclusion criteria set out. During the first consultation the participants completed the Greene Climacteric Scale questionnaire and a concise case history was taken, thereafter each patient was handed two hot flush diaries to be completed one week before treatment and during the sixth week of treatment. Each participant was required to take one tablet every morning and evening for 6 weeks. Six weeks after the first consultation participants attended the second consultation and the Greene Climacteric Scale was completed for the final time and the hot flush diaries collected. iv Results The results of the first questionnaire and hot flush diary were used as a baseline for statistical analyses. As each group consisted of 29 and 31 subjects, non-parametric tests were used for data analysis. All statistical analyses were carried out using SPSS version 15.0. Conclusion An improvement was demonstrated in both treatment and placebo groups after treatment yet this improvement was not statistically significant. The only symptoms that improved in the treatment group were the hot flushes and psychological symptoms however, there were no significant differences between the treatment and placebo group. It was concluded that the complementary formulation of Folliculinum D6 and Five-Flower Formula™ was not statistically effective in the treatment of menopausal symptoms in terms of the participants’ perception of the treatment.

More than half of the women aged from 45-55 suffer from menopausal symptoms which can seriously affect the quality of life of the midlife women. The menopause transition has become a very active research area in healthy aging in the last several decades. In recent years, more and more women have turned to traditional Chinese medicine (TCM) to manage their menopausal symptoms. Among various Chinese medicine formulae, Er-Xian Decoction (EXD) is one of the most acceptable Chinese medicine formulae to relieve menopausal symptoms. Although EXD is popular in the management of menopausal symptoms, its effectiveness has not been evaluated by strictly designed clinical study. A systematic review was conducted to evaluate the current evidence to assess the efficacy and safety of EXD as a basic formula for menopausal symptoms. A total of 12 randomized controlled trials (RCTs) were included for further analysis. The results of these studies suggested that EXD was more effective than the control interventions, which included various HRT and other Chinese herbal medicine. Seven of the studies compared EXD with HRT and the meta-analysis seemed to suggest that EXD as a basic formula was superior to hormone replacement therapy. However, the included studies were insufficient in methodological quality and had a high probability of bias. A double-blind randomized controlled clinical trial was then conducted to assess the efficacy and safety of EXD for menopausal symptoms. Of 557 recruited women, 108 subjects were eligible to participate in the study and 101 subjects finished the study. Comparisons between placebo and EXD groups were conducted by using an analysis of covariance (ANCOVA) with baseline as covariate. EXD granules when compared with placebo significantly reduced the frequency and severity of hot flushes and night sweats. EXD compared with placebo significantly reduced the frequency of hot flushes (P=0.041) and the hot flush severity score (P=0.016). Superiority of EXD over placebo was also observed in greater improvement in total scores of MRS (P=0.028) and MENQOL questionnaires (P=0.021). There were no differences between EXD and placebo group in serum hormones and bone markers. There were no serious adverse events and the safety indices of whole blood counts, renal and liver functions were normal before and after the treatment. Both EXD and placebo were well tolerated. In summary, this Chinese herbal formula EXD was found to be superior to placebo in reducing hot flushes and improving menopausal symptoms in Hong Kong perimenopausal women. It was well tolerated, with no serious adverse events noted during the study period. / published_or_final_version / Chinese Medicine / Doctoral / Doctor of Philosophy

A grounded theory method was used to investigate the experiences of women who use naturopathic medicine, a system of alternative therapy, for health care during the menopausal transition. Transcripts of 16 in-depth interviews with women who received naturopathic health care during the menopausal transition were analyzed with respect to three research questions: (a) Why do women seek naturopathic health care during the menopausal transition? (b) Do women who use naturopathic treatment for menopausal health care share similar experiences of menopause? and ( c) Are women satisfied with the naturopathic treatment they receive for menopausal health care? Conditions leading to informants' use of naturopathy were represented by two categories: Practicing natural self-care, and Rejecting the conventional medical system Experiences of menopause were represented by three categories: It's not a singular event, Paying attention to changes in and around me, and Information helps. Informants' satisfaction with naturopathy for menopause-related health care was represented by four categories: Naturopathy is consistent with engaging in natural self-care practices, Naturopathy is effective in treating troubling menopausal signs, Naturopathy addresses individual and interrelated aspects of menopause, and Naturopathy provides moral and informational support. Continued analysis of the data revealed a core category, Exchanging infonnation, that provided a foundation for the theoretical model representing the experience of women who use naturopathic health care at menopause. The grounded theory developed in this study may be useful to health professionals by increasing understanding of the naturopathic health care option for menopausal women. Suggestions for further study include quantitative evaluation of components of the theory developed in this study, continued qualitative and quantitative investigation of aspects of information exchange between patients and their conventional and alternative practitioners, application of grounded theory methodology to studies of women's use of hormone replacement therapy, and application of grounded theory methodology to studies of patients' selection of alternative medicine for health matters other than menopause.

Findings released from recent pivotal clinical trials on hormone therapy (HT) benefits and risks have stimulated a growing trend towards lower doses and earlier discontinuation of HT for menopausal women. Yet, there is little knowledge regarding women's personal experiences with the resultant earlier and possibly abrupt withdrawal of HT. The purpose of this study was to explore postmenopausal women's vasomotor symptom experiences after discontinuing HT. The data for this study was collected from menopausal women who discontinued HT. The study questionnaire was created through an extensive review of the literature as well as an expert panel review. The questionnaire was also piloted with a small group of women prior to its use in this study. Data analysis consisted of descriptive analysis with means and standard deviations and/or frequency distributions with percentages for demographic data, health behaviors, factors influencing HT decisions, use of CAM and perceived efficacy. Chi-square analysis, Spearman Rho correlation, and logistic regression analysis were conducted for contextual factors and vasomotor symptom experiences. A McNemar test was performed to assess within group differences for vasomotor symptoms experiences pre and post HT. Questionnaires were received from 563 menopausal women throughout the United States. This study revealed that 80% of participants experienced vasomotor symptoms after discontinuing HT. The most common predictors which accounted for only 13% of variance in the occurrence of vasomotor symptoms were younger age, type of menopause and the occurrence of vasomotor symptoms prior to initiation of HT. Of the 563 women participating in the study, less than half reported the use of CAM to treat reemerging vasomotor symptoms. For the most part, less than half of the women felt their treatment choices were helpful in relieving their reemerging vasomotor symptoms Because a woman's experience of menopause can be highly individualized, an adaptation of Bronfenbrenner's ecological theory was used guide this exploratory study. The study findings supported the usefulness of the adaptation of Bronfenbrenner's ecological theory as a model through which to view the vasomotor experiences of menopausal women who have discontinued HT. / text