Eficácia de terapias fitoterápicas no manejo de sintomas associados ao climatério: uma revisão integrativa de ensaios clínicos randomizados

Abstract

The climacteric is the period in a woman's life that marks the transition from the reproductive to the non-reproductive period, comprising the perimenopause, menopause and postmenopause phases. One of the main symptoms is hot flushes, sometimes accompanied by anxiety, confusion, nausea and depression. It is also associated with other health conditions, such as high cardiovascular risk, due to the drop in oestrogen levels which negatively affects the lipid profile. From this point of view, the most effective evidence-based treatment for the uncomfortable symptoms of this period is hormone therapy (HT), which reduces bone loss and can have cardiometabolic benefits, involving the use of the hormones oestrogen and progesterone (and sometimes testosterone). Although hormone therapy is widely used and effective in managing these symptoms, its application is limited due to contraindications and potential health risks. In view of this, non-hormonal interventions, such as the use of herbal medicines, are also available for symptom relief. Although herbal medicines are considered to be a safe and affordable alternative for women seeking non-hormonal alternatives, there are still gaps in the literature regarding the consolidation of evidence on their long-term efficacy and safety for the treatment of conditions associated with menopause. This integrative review aimed to evaluate the effectiveness of herbal approaches in the management of symptoms associated with the climacteric. Based on this, a search strategy was devised, using two databases: PubMed and Lilacs, with a time frame of articles published in the last 10 years. A total of 677 studies were identified and, after analysis and application of the eligibility criteria, 11 were included in this review. The results indicate that various extracts and natural compounds, such as fenugreek, sage, saffron, resveratrol, isoflavones and Cornus extract, have shown significant benefits for perimenopausal and postmenopausal women, especially in reducing vasomotor symptoms and improving hormonal and metabolic parameters. However, the evidence varied with regard to efficacy, with some interventions showing more consistent results and others requiring further studies to confirm their therapeutic properties