The transition to menopause – when a person permanently stops having menstrual periods – can bring symptoms like hot flashes, night sweats, irregular periods and anxiety. Women may want to find assistance with these symptoms.

Dennis Sands, MD, is an OSF HealthCare gynecologist and chief medical officer at OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois. He cautions you to be wary of over-the-counter medication that claims to help with all menopause symptoms.

“In general, a lot of the at-home remedies are marketed very well. They are touted as cure-alls or things that will work for the most common complaints, like hot flashes,” Dr. Sands says. “What we’ve found is most of them don’t work.”

Dr. Sands adds that these medicines are marketed as dietary supplements, not pharmaceuticals. So, there’s more wiggle room to make claims about their benefits. Dr. Sands says he’s seen menopause medicine labels at the pharmacy that tout vitamin, soy or phytoestrogen ingredients. Equelle is a common brand name. Dr. Sands says these medicines can have a minor effect on menopause symptoms in healthy people, but they are not cure-alls or effective for all people. In particular, he says irregular bleeding usually requires a treatment plan laid out by a health care provider and an evaluation to rule out something more serious.

That’s where your gynecologist comes in, with Dr. Sands reminding that treatment is different for everyone. The first advice you’ll likely hear: keep up with your health.

“We’ve noticed that people who are healthy overall, exercise well, sleep well and are in good relationships generally do pretty well in the menopausal transition,” Dr. Sands says. “The more stress people are under, the more they’re not as healthy as they could be, the more their sleep is disturbed. It seems a lot of those people tend to have a more difficult transition.”

Estrogen patches and progesterone creams can also help, especially in younger women. A provider may also see if other medications you’re taking are making your menopause symptoms worse.

“If you’re struggling, see your provider and review all the options,” Dr. Sands suggests. “There are some great options that are effective and safe. Generally, they’re only used for a short time to get people through the transition.”

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Manufacturers say the items will help consumers relieve anxiety, decrease stress, become relaxed and even fight addiction. However, there’s major concern about the negative side effects these products can have. They can be bought as drinks, like the Feel Free Classic, or in pill form with powder from the kava plant inside.

The California Department of Public Health says kava’s active ingredient, kavalactones, contain sedative and psychoactive (mind-altering) properties.

Erica Dawkins, a clinical dietitian with OSF HealthCare, dives into the additional health concerns that have been widely reported to have a connection to kava.

"We're seeing nausea and vomiting, dizziness, gastrointestinal distress. Some people are having trouble with their vision," Dawkins says. "Because of all these kavalactones, or active ingredients, some of them tend to damage the liver. Because we're seeing some extra liver damage going on, if you're also taking other medicines, supplements, or drinking alcohol, which can also damage the liver, we're seeing an exacerbated effect of that, too." 

In 2002, the U.S. Food & Drug Administration (FDA) issued a consumer advisory about dietary supplements containing kava, saying they might be associated with severe liver injury and hepatoxicity (hepatitis, cirrhosis, liver failure).

Nearly two decades later, the FDA released a memorandum concluding that there’s enough data to suggest that using kava for “recreational” or “relaxation” purposes “is not safe for human consumption.” It lists kava as an unapproved food additive when used as an ingredient in conventional foods.

In addition to the concerning reports released by the FDA, the U.S. Drug Enforcement Agency (DEA) reports that chronic use in large quantities may cause “dry scaly skin or yellow skin discoloration.” This is known as kava dermopathy, as well as causing tremors or other abnormal body movement.

"The safety of these supplements aren't as closely regulated by the FDA,” Dawkins says. "So, I would be very careful and talk to a physician about any alternatives before going down that route."

Kava is native to the South Pacific and is a member of the pepper family, the National Center for Complementary and Integrative Health, a section of the National Institutes of Health (NIH), reports.

Traditionally, kava would be used in ceremonial, social and medical situations. Dawkins says how it’s being produced today offers an added layer of danger.

"Boiled down again, no pun intended, to the way it's being made and manufactured. Back in the traditional sense, a lot of times the root was dried or grounded and then extracted with pure water. Nowadays it’s extracted with alcohol or acetone (colorless, solvent liquid)," Dawkins says. "When it's extracted with those things, you can get a larger amount and an amount that's much more potent and effective than if it were done in the traditional sense."

Dawkins says to speak with your medical provider about speaking with a therapist or counselor. There are other medications out there which can respond more safely and effectively to the issues you're facing, instead of an unregulated product.

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Andrew Zasada, MD, can’t help but chuckle when asked about the “latest and greatest” body cleansing fads.

But the internal medicine physician at OSF HealthCare says these whims can turn into anything but a laughing matter.

“When you put stuff that’s not really regulated in your body, you don’t know what’s going in,” Dr. Zasada says. “And if you mix in your regular medicine, too, you’re not doing yourself a favor.”

Dr. Zasada is reminding you to talk to your primary care provider before starting any significant treatment. Don’t believe everything you read online or on a label.

Diatomaceous earth as a cleanse

Dr. Zasada says diatomaceous earth has several legitimate uses in industry. But it’s also seen in powder form as a dietary supplement.

The product comes from ground-up and processed skeletons of algae. It contains silica, one of the main components of sand. There are two types of diatomaceous earth: edible, which contains 2% to 4% silica, and industrial with 60% or more silica.

Dr. Zasada says ingesting silica in small amounts – for example, mixing it in water – is harmless because it does not absorb into your body. But you should never inhale it.

“It causes irritation of the lungs which can be permanent and cause scarring. It can cause you to be short of breath. It’s called silicosis,” Dr. Zasada explains. “It’s similar to what coal miners get when they inhale coal dust. People die from silicosis every year.”

Dr. Zasada says some people claim diatomaceous earth cleanses your digestive tract and improves cholesterol. But he says scientific evidence for and against these claims is “scant at best.”

“There have been a few studies that showed that it lowers cholesterol. But at the same time, we don’t know what else that patient may have eaten because it was a poorly designed study,” Dr. Zasada says. “Was the silica responsible? Was it dietary? We simply don’t know.”

Dewormers and other cleanses

Dr. Zasada says dewormers do what the name suggests – remove intestinal parasites from your insides. He says they serve a purpose in livestock but not humans.

“Some people believe we all carry some type of parasite, and we need to deworm ourselves,” Dr. Zasada says with a sigh.

“If you really think you have an intestinal parasite, see your doctor. The test is simple. If you do, in fact, have a parasite, it can be eliminated.”

Dr. Zasada adds that there’s no evidence that our bodies are loaded with toxins that must be removed. He says that removal happens naturally through our liver, kidneys and bowel movements.

“We’ve been around as a species for hundreds of thousands of years without colon cleanses, and we’ve done pretty well,” he quips.

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