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Table 7. Alternative Therapies for Treatment of VMS
Agents Comments
Agents with inconsistent reports of benefit
Genistein, daidzein • Purified isoflavones
• ± Estrogenically active
• Breast safety not established
S-equol Metabolite of daidzein
Nonpurified isoflavones Breast safety not established
Flaxseed
Red clover Breast safety not established
High-dose extracted
or synthesized
phytoestrogen
Dietary soy Agreement about breast safety
Vitamin E 10% benefit in some studies
Reports with predominantly no benefit
Black cohosh • Some short-term trials report benefit, most report no
benefit
• Breast safety not established
• Reports of liver toxicity
Omega-3 fatty acids No benefit in MSFLASH trial
Acupuncture Not effective when compared to "sham acupuncture"
controls
Exercise Exercise with sweating may increase hot flashes
Other complementary
approaches
Ginseng, dong quai, wild yam, progesterone creams,
traditional Chinese herbs, reflexolog y, magnetic devices
Agents requiring further study
Stellate ganglion block Need further randomized controlled trials (RCTs) to
establish lack of complications
Guided relaxation Stress management, deep breathing, paced respiration,
guided imagery, mindfulness training
Hypnosis Recent studies suggest efficacy
Cognitive behavior
modification
Recent studies suggest efficacy with trained practitioners
