Plantas medicinais na menopausa. Artigo de revisão. ; Herbal medicines in menopause. Review article

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina ; Approximately 25 million women worldwide experience the menopause each year. The menopause is a physiological and multidimensional process that corresponds to one-third of a woman's life. As a result of the state of hypoestrogenism, systemic symptoms manifest that can significantly affect the quality of life of menopausal women. Although hormone therapy is globally accepted as the treatment of choice, it has absolute contraindications that make its prescription impossible, as well as adverse effects and potential risks associated. These reasons, combined with the increased demand for and use of medicinal plants, have contributed to a growing interest in the search for safe and effective non-pharmacological alternatives for the treatment of menopausal symptoms. The most widely used plants in this condition are Glycine max and Trifolium pratense, since they consist of phytoestrogens that have structural and functional similarities to estradiol, and Cimicifuga racemosa, as a non-estrogenic alternative. This review article aims to evaluate the efficacy and safety of phytoestrogens, derived from G. max and T. pratense, and of C. racemosa extract in the treatment of menopausal conditions. Therapeutic efficacy has been demonstrated in gynecological, bone, endocrine, cognitive, neurovegetative, mood and sleep quality in perimenopausal and postmenopausal women. Both phytoestrogens and C. racemosa extract are well tolerated, showing a similar frequency of adverse events compared to placebo. Women treated with phytoestrogens have significantly higher rates of gastrointestinal adverse effects. No clinically relevant effects on liver function or hepatotoxicity were observed even with higher doses (128 mg/day) of C. racemosa for 3 to 6 months. Furthermore, the data obtained are in consensus regarding safety in the endometrium and breast under treatment with these medicinal plants. The scientific evidence supports that G. max, T. pratense ...