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Alternative methods for the treatment of post-menopausal troubles [Alternative Methoden zur Behandlung postmenopausaler Beschwerden]

DOI: 10.3205/hta000101

Keywords: acupuncture , alternative treatment method , change of life , climacteric disorders , climacteric/* , complementary therapies/* , complementary therapies/*adverse effects , complementary therapies/*economics , complementary therapies/*standards , complemtary medicine , cost effectiveness , cost-effectiveness , cure , diagnosis , EBM , effectiveness , efficacy , evidence-based medicine , female , Health Technology Assessment , hormone level , hormone preparation , hormone replacement therapy , hormones , hor

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Abstract:

[english] Menopause is described as the transition from the reproductive phase of a women to the non reproductive. Changes in hormone levels might lead to complaints and health consequences especially during peri- and postmenopause. Hormone therapy has a potential damaging health risk profile and is recommended for temporal limited therapy for acute vasomotor symptoms only.The present HTA-report aims to assess the effectiveness and the cost-effectiveness of alternative treatment methods for women with postmenopausal symptoms in Germany regarding patient relevant endpoints (reduction of symptoms and frequency of adverse events and improvement of quality of life).A systematic literature search was carried out in 33 relevant databases in September 2010. Citations were selected according to pre-defined criteria and were extracted and evaluated.In the systematic research 22 studies are identified for the effectiveness evaluation, 22 primary studies and one review.High doses of isolated genistein reduce the frequency/intensity of hot flashes while low doses of genistein show no significant effect. Intake of isoflavone extract such as genistein, daidzein, glycitein in various combinations does not have an effect on improvement of cognitive function or vaginal dryness. The effect of black cohosh and hop extract for menopausal complaints cannot be determined since results are heterogenous. The combination of isoflavone, black cohosh, monk’s pepper, valerian and vitamin E has a positive effect on menopause symptoms. Ginkgo biloba shows no significant effect on menopause symptoms and cognitive improvement beside mental flexibility. Acupuncture has a significant influence on hot flashes especially in severe cases.No final statement can be drawn regarding the effectiveness of alter-ne treatment methods due to qualitative shortcomings of included studies and a general limited availability of studies in this field. Furthermore, the generalization of the present HTA is limited due to the inclusion of only postmenopausal women. [german] Als Wechseljahre wird der übergang von der reproduktiven Phase der Frau zur nicht-reproduktiven beschrieben. Insbesondere in der Peri- und Postmenopause k nnen Beschwerden aufgrund des sich ver nderten Hormonspiegels auftreten. Aktuell wird die Hormontherapie wegen der mit dieser verbundenen Risiken nur noch zur kurzfristigen Behandlung akuter vasomotorischer Symptome empfohlen. Von den betroffenen Frauen werden alternative und komplement re Heilmethoden eingesetzt.Im vorliegenden Health Technology Assessment (HTA) sollen die Effektivit t

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