The value of complementary and alternative medicine in the treatment of climacteric symptoms: results of a survey among German gynecologists

OBJECTIVES: The present study aims to detect the attitude and experience towards complementary and alternative medicine (CAM) in the treatment of climacteric disorders among gynecologists in Germany.

STUDY DESIGN: A self-administered questionnaire, containing 15 questions, was sent to all gynecologists in private practice in Germany (n=9589).

MAIN OUTCOME MEASURES: Gynecologists were asked about their experience with several forms of CAM. They were asked to rate different procedures as "effective", "sometimes effective" or "unimportant".

RESULTS: The response rate was 33.7% (n=3227). We report on 2549 (26.6%) eligible questionnaires. Well-known therapies were black cohosh (Cimicifuga racemosa), chaste tree (Vitex agnus castus) and St. John's wort. More than 98% had had experiences with these therapies. Fewer experiences were stated with hormone-yoga (42.9%), acupuncture (29.1%) and homeopathy (21.6%). The most effective alternative therapy rated was an alteration of lifestyle with 54.4% (n=1325) stating it was effective and 35.7% (n=871) stating it was sometimes effective. Only 3.9% (n=96) prescribed no efficacy to a change of lifestyle. Other treatments rated as effective were St. John's wort (25.0%, n=606) and Black cohosh (21.1%, n=527). Agents regarded most ineffective were hormone-yoga (4.7%, n=109), acupuncture (10.3%, n=243) and homeopathy (10.6%, n=250). Female gynecologists were more likely to vote for a therapy to be effective compared to their male colleagues.

CONCLUSIONS: German gynecologists seem to have made positive experiences with CAM when observing their patients, in general. An alteration of lifestyle is seen as the most effective alternative therapy in menopause. Due to their widespread use, possible side effect of natural agents should be excluded.