Dietary supplements and other over-the-counter (OTC), nonprescription therapies for treating menopause symptoms should only be used with appropriate oversight from a healthcare professional. Few OTC therapies have the patient package insert that provides vital information on the safety and effectiveness of the drug, information that is required by the US Food and Drug Administration (FDA) for all prescription medications. Because the normal regulations for prescription or OTC drugs do not apply to dietary supplements, demonstrating safety is not required before a dietary supplement is put on the market. Although a number of manufacturers do employ rigorous quality-control measures, many products are not monitored for purity or levels of active ingredients. In Canada, the term natural health product is used in place of dietary supplement. The 2004, Canadian Natural Health Products Regulations ensure that these products are safe, are of high quality, and actually do what they claim that they do. Canadian regulations require that all natural health products have a product license before they can be sold, and they must be produced at a site that also has a license. Supplements in the United States are not regulated in this fashion, and the buyer should be aware of this lack of regulation. Products are typically not pulled from the market until after people have been harmed.
Dietary supplements or herbal therapies can interact with prescription drugs, resulting in either increased or decreased effects of the drug, the supplement or both. Until clinical trials provide scientific evidence of the effectiveness and safety of any given supplement, it is always best to speak to your clinician before using any dietary supplements in the United States and to inform your physician if you are already taking them.