Title: Complementary
1Complementary Alternative Approachesto
Menopause and Post-Menopausal Health
National Center for Complementary and Alternative
Medicine, NIH, HHS
NIH Scientific Workshop Menopausal Hormone
Therapy October 23-24, 2002
2Self-Reported Use of CAM SWAN Baseline Cohort
Embargoed until 10/28/02, 4pm AJPH
Percent
Hispanic
Chinese
Japanese
SWAN, 1995-1997 N3300
African Am
Caucasian
3Sources of Phytoestrogens
Black Cohosh
Red Clover
Soybeans
Hops
4Alternatives to Hormone Therapies The Evidence
- Small clinical trials - indicated that some CAM
products may relieve menopausal symptoms - Basic studies - identified agents, such as soy
isoflavones, that are estrogenic and other
products that may exert progestational or
anti-steroidogenic activities - Long-term studies - none conducted yet to
determine whether these products are effective or
safer than conventional hormone therapies
5Botanical Products in Medical Research
- Issues Affecting Choice of Products for Study
- Identifying appropriate parts, species, and
cultivars of plant - Optimizing growing and harvesting conditions
- Selecting whole extract or a specific fraction
- Establishing method of extraction,
product standardization, and purity - Defining formulation, dose, and length of
administration
6Womens Health An NCCAM Area of Emphasis
- Some current research projects
- Supporting Phase I - II clinical trials of black
cohosh and red clover - Studying how soy consumption influences
menopausal symptoms in Japanese women - Examining herbal-drug interactions
- Examining effects of isoflavones on bone density
and breast cancer - Assessing the interactions between soybean
phytochemicals and tamoxifen in breast cancer
7Future Research Objectives for Industry,
Government, and Academia
- Delineate more fully the quality of life
problems imposed by menopause - Prepare well-characterized and standardized
products for research studies - Define chemical constituents, mechanisms, and
pharmacology - Conduct dose-ranging studies
8Future Research Objectives for Industry,
Government, and Academia
- Clinical trials to determine efficacy for
menopausal symptoms and quality of life - Lab and clinical studies of the safety in women
with hormone-sensitive cancers - Large collaborative trials to study long-term
activity and safety in products proven to be
reliably effective