NAPWA

Non-hormonal methods of treating menopausal problems include increasing consumption of soy products and using herbal preparations. There is no hard evidence proving the usefulness of these remedies, but in cultures where soy products are eaten in large quantities menopausal problems are reported to be less severe.

Many positive women report that nutrition can play a key role in reducing menopausal problems.

If you have had breast cancer or have a higher than average risk (assessed through family history) you should avoid high-dose supplements of soy products, where the active ingredients may be processed in such a way that they may fuel oestrogen-receptor positive breast cancer (it is thought that consuming soy food products as part of a normal diet does not constitute a risk). For more information on this see www.breastcancer.org and www.project-aware.org (these sites have good sections on menopause, but be aware that it does not consider HIV in menopause,1 so you should check any recommendations with your doctor).

Antidepressant medications in the SSRI class (selective serotonin re-uptake inhibitors, the class from which Prozac comes) used in doses lower than those to treat depression can be used to treat hot flushes. However, antidepressants can reduce your sex drive or ability to orgasm. In addition to soy products (phytoestrogens), there are a wide range of herbal preparations that are reputed to be helpful with symptoms and general enhancement of well-being. There is a lack of research in this area, but it makes sense to explore the possibilities keeping a few key things in mind:

• Herbs can interact with HIV drugs - check with your doctor (St John’s Wort and garlic, for example, have proven interactions);
• See a good herbal practitioner;
• Contact your local AIDS Council or PLWHAPerson (or People) Living with HIV/AIDS. group if you would like to see a complementary medicine practitioner, but you are unsure who to see or need financial assistance;
• Set a budget and don’t exceed it.

Herbal products include black cohosh (there is some research supporting this as a treatment for hot fl ushes and night sweats), dong qui, wild yam, evening primrose, ginseng, ginger, red clover and valerian for sleeping problems. The project aware website www.projectaware.org has a comprehensive list of menopausal symptoms and herbal remedies.

1. 1. Burgi A et al. 'Incidence and risk factors for the occurrence of non-AIDS-defining cancers among human immunodeficiency virus-infected individuals.' Cancer (online edition), 2005.

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