BACKGROUND: Interest in non-hormonal therapies for the treatment of menopausal 
symptoms has increased since the publication of adverse effects of estrogen 
replacement therapy.
OBJECTIVE: To provide information on the efficacy of non-hormonal therapies for 
menopausal vasomotor symptoms based on evidence from published randomised 
controlled studies.
METHODS: The Cochrane Database of Systematic Reviews (CDSR), MEDLINE, 
Alternative Therapies in Health and Medicine database (ATHMD) and Allied and 
Complementary Medicine database (AMED) were searched for randomised controlled 
trials in the English language reporting data on treatment of menopausal 
vasomotor symptoms. Trials including cancer breast patients were included.
RESULTS: Our search identified 58 randomised controlled trials of which 11 
involved the use of clonidine, six for SSRIs, four for gabapentin, seven for 
black cohosh, seven for red clover, 18 for phytoestrogens, two for ginseng, one 
for evening primrose, one for dong quai and one for vitamin E. Most trials had 
methodological deficiencies.
CONCLUSION: There is evidence that clonidine, paroxetine, venlafaxine, 
gabapentin and black cohosh may be beneficial in the treatment of menopausal 
vasomotor symptoms in some women. Current evidence does not support the use of 
fluoxetine, red clover, phytoestrogens, Ginseng, evening primrose, dong quai and 
vitamin E. The side effects profile of these therapies should be considered.