Management of perimenopause: focus on alternative therapies.

A variety of herbs and other "natural alternative medicines" are marketed directly to consumers and sold over-the-counter as treatments for perimenopausal symptoms. Far from being innocuous placebos, many of these substances have real physiologic effects, including potential adverse effects and drug interactions. Yet they are largely untested and, by law, totally unregulated. This article reviews a few of the untested substances your patients may be taking, along with established treatments.