Objective: 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.
Design: 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.
Results: 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.
Conclusions: 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.
Little is known about patterns of use for herbs, dietary supplements, phytoestrogen supplementation, and other complementary and alternative medicine (CAM) therapies for conditions related to menopause. In addition, it is unknown whether women who use CAM therapies for relief of menopausal symptoms do so in conjunction with or instead of conventional therapy. The popularity of CAM among women 1,2 and the plethora of adertising of CAM therapies aimed at postmenopausal women point out the need to examine populationbased data on CAM patterns of use by this group. Furthermore, the release of the results from the Women's Health Initiative randomized, controlled trial on the risks and benefits of estrogen plus progestin in healthy postmenopausal women 3 has intensified the search for alternatives to this hormone replacement regimen. 4
The Conventional, Complementary and Alternative Menopausal Practices Survey (CAMPS) provides unique prevalence data on the use of conventional and CAM therapies for symptoms or conditions related to menopause. CAMPS, a collaborative product of the Exogenous Hormones Subcommittee of the Federal Interagency Working Group on Women's Health and the Environment, was organized by the Office on Women's Health (OWH) within the Department of Health and Human Services (DHHS). The subcommittee included representatives from DHHS, the Department of Defense, and the Department of Veterans Affairs. The National Institute of Health representatives were from the Office on Research on Women's Health, the National Institute for Child Health and Human Development, the National Heart, Lung, and Blood Institute, and the Office of Alternative Medicine, currently named the National Center for Complementary and Alternative Medicine. Other DHHS agencies represented on the subcommittee were the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration, the Food and Drug Administration, and the Agency for Health Care Policy and Research, currently named the Agency for Healthcare Research and Quality.
To characterize practices that women used to treat menopausal symptoms, we used CAMPS data to examine the prevalence of conventional and CAM therapy use by demographic characteristics and by menopausal symptoms among women 45 years of age or older. We also examined associations between the number and severity of menopausal symptoms and the use of CAM remedies during and after menopause.