Peri- and post-menopausal women have various options for the management of hot flashes, including hormone replacement therapy, SSRIs, and gabapentin. It looks as if hypnosis may also be helpful. In a recent study, researchers randomly assigned postmenopausal women to hypnotherapy or "structured attention," which was used as a control intervention.
Over the past decade, the clinical literature has published many studies documenting the psychosocial and health benefits of various mind-body interventions. Mindfulness-based interventions have been shown to reduce stress, to improve coping skills, and to promote feelings of well-being. Mindfulness-Based Cognitive Therapy (MBCT) is a new psychotherapeutic treatment which has been shown to reduce depressive symptoms and to reduce the risk of depressive relapse.
We have recently written about the link between vitamin D and depression. While several studies have indicated that low vitamin D levels may be associated with depression, we lack randomized, controlled trials assessing the benefits of vitamin D supplements for the treatment (or prevention) of depression. A recent report from the Women's Health Initiative Calcium and Vitamin D Trial included 36,282 women (50 to 80 years of age) who were randomized to receive 400 IU vitamin D (with 1000 mg calcium) or to placebo.
Recent reports suggest that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms. Other studies indicate that in folate deficient patients, antidepressants may be less effective or may take longer to take effect. In addition, some clinical trials have shown that folate may have a therapeutic effect on depression, either when taken alone or in combination with an antidepressant.
Soy-based products have long been touted as a treatment for menopausal symptoms. However, many of the clinical studies measuring the effectiveness of dietary sources of soy isoflavones (e.g., soy beverages, soy powder) for the treatment of menopausal vasomotor symptoms (i.e., hot flushes, night sweats) have been negative. Less is known about the effects of soy on cognition. A large clinical trial suggests that soy may not have any positive effects on cognition in postmenopausal women.
Most women undergoing infertility treatment experience increased anxiety. In a randomized clinical trial, researchers explored the effectiveness of acupuncture in diminishing anxiety in a group of women undergoing IVF. 43 patients undergoing IVF received either active acupuncture (n=22) or sham treatment (n=21). Women with a history of psychiatric illness and those using antidepressants and/or anxiolytic drugs were excluded from the study. Anxiety levels were assessed before and after treatment using the Hamilton Anxiety Rating Scale (HAS).
While phytoestrogens have gained attention as possible alternatives to hormone therapy for the treatment of menopausal symptoms, placebo-controlled studies have yielded mixed results. Pomegranate seed oil is a very rich source of phytoestrogens. In this prospective randomized, placebo-controlled, double-blinded trial, 81 postmenopausal women received two daily doses of either 30 mg pomegranate seed oil (PGS) or placebo. The frequency of hot flashes decreased by 38.7% (P < 0.001) after 12 weeks of treatment with pomegranate seed oil and by 25.6% in the placebo group (P < 0.01). However, the difference between the two groups was not statistically significant (P = 0.17). The authors suggest that it may take a longer period of observation to demonstrate a difference between pomegranate seed oil and placebo.
In increasing numbers, women who are candidates for hormonal replacement therapy are requesting “bioidentical” rather than synthetic hormones. Although there is a tendency to think of bioidentical hormones as “all-natural”, they, like synthetic hormones, are manufactured in the laboratory. In contrast to synthetic hormones, they are chemically identical to the hormones produced by the human body; synthetic hormones are structurally different yet are designed to have similar biological effects as naturally produced hormones.
Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. In a previous post, we discussed the use of different types of medications to treat insomnia during pregnancy. While these drugs are highly effective, many women with sleep problems inquire about the use of "natural" agents, such as melatonin, during pregnancy.
