Non-hormonal options to MHT

Supplements such as plant oestrogens (phytoestrogens) occur naturally in certain foods. The main types of phytoestrogens are isoflavones, lignans and coumestans. Isoflavones are found in soybeans, lentils, chickpeas and other legumes. Lignans are found in flaxseed, whole grains and some fruits and vegetables. The high-dose phytoestrogen supplements are not recommended following breast cancer treatment.

Vitamin E, at a dose of 800 IU per day, can reduce hot flushes on average by one per day in some women.

Calcium and Vitamin D should be discussed around the time of menopause. Calcium requirements (1300mg per day) are preferentially achieved through dietary means, supplements may be needed if this is not possible. Vitamin D is acquired through limited sun exposure. Supplements may be required in certain circumstances.

Studies have shown that black cohosh can reduce hot flushes; however, it has not been proven in women who have had breast cancer.

Scientific evidence is limited and inconclusive on the effectiveness of red clover, kava, dong quai, evening primrose oil and wild yam (natural progesterone cream). Wild yam cream must not be used as an equivalent for progesterone in MHT.

Bioidentical compounded hormone therapy means the hormones in the product are chemically identical to those your body produces. Bioidentical compounded hormone therapy cannot be recommended because its safety has not been clinically proven.

Supplements can have side effects just like prescribed medications and there is not enough evidence to establish if they are safe and effective. Some can be dangerous and can interact with other medications, which can be risky. It is advised to speak to your GP or gynaecologist before taking these.