A survey on the use of alternative drugs during pregnancy

Ethnobotany of traditional cosmetics among the Oromo women in Madda Walabu District, Bale Zone, Southeastern Ethiopia

Traditional cosmetics play a significant role in the cultural practices and personal hygiene of many ethnic groups worldwide. The Oromo, an indigenous community in Ethiopia, has a rich history of utilizing local plants for cosmetic purposes. However, the use of plants as traditional cosmetics has only been poorly investigated as more emphasis was given to traditional medicines. The study thus aimed to identify and document plant species, and parts used in traditional cosmetics and associated knowledge, and practices among Oromo women in the Madda Walabu district, Southeastern Ethiopia. A total of 150 Oromo women were interviewed to gather ethnobotanical information including the plant species used for cosmetics, their preparation methods, and their applications. Ethnobotanical indices were computed to determine the most important species used by the women. A total of 48 plant species belonging to 31 families used as sources of traditional cosmetics were recorded. Most of these plants were trees. Leaves were the most commonly used plant part in traditional cosmetics, and maceration and decoction were the most common preparation methods applied to prepare traditional cosmetics. Topical application of traditional cosmetics was the most common, while oral infusions were rarely reported type of administration. All categories had high informant consensus factor (ICF) values, ranging from 0.80 to 0.98. The highest ICF value was found for skin treatment, followed by the hair, and face mask. Overall, Commiphora habessinica, Gnidia stenophylla, Kalanchoe lanceolata, Mimusops kummel, Sesamothamnus rivae, Terminalia brownii, T. laxiflora, Acacia drepanolobium, A. mellifera, and Aloe citrina were the most frequently cited and culturally important plants by Oromo women for traditional cosmetics in the area. The study highlights the importance of local plant resources for maintaining cultural practices and personal hygiene. However, the cultural heritage associated with traditional cosmetics is facing threats from various factors. Therefore, a continuous effort to document and disseminate knowledge about traditional cosmetics practices to ensure their preservation and transmission and awakening younger generations about the importance of traditional cosmetics and their role in cultural heritage is crucial.

Developmental neurotoxicity evaluation of three Chinese herbal medicines in zebrafish larvae by means of two behavioral assays: Touch-evoked response and light/dark transition

Chinese herbal medicine (CHM) is used among pregnant women. However, the question of its safety during pregnancy remains unclear. The use of these products relies on history of use data but there are specific toxicities like developmental neurotoxicity that are clearly understudied. Here we use the zebfrafish embryo developmental toxicity assay (ZEDTA) in combination with two behavioral assays: touch-evoked response and Light/Dark (L/D) transition assay to evaluate the neuro/developmental toxicity of three herbal products commonly used in CHM [Chinese name (abbreviation; part of the plant and Scientific name]: tian ma (TM; tuber form Gastrodia elata Blume), lei gong teng (LGT; root and rhizome of Tripterygium wilfordii Hook.f) and cha ye (green tea, leaves from Camellia sinensis (L.) Kuntze). In case significant alterations were detected, single components with potential exposure during pregnancy were identified in the literature and further tested. TM had no neurodevelopmental toxic potential in zebrafish embryos, while LGT and its main compounds triptolide and celastrol induced significant alterations in behavior. Developmental exposure to EGCG, the main catechin of green tea, also produced significant alterations in zebrafish embryos behavior after developmental exposure. A combination of ZEDTA with L/D Transition assay is proposed as a useful combination of alternative methods for DNT assessment of CHM products together with other New Approach Methodologies (NAMs).

Use of Medicinal Plants during Pregnancy, Childbirth and Postpartum in Southern Morocco

Southern Morocco, particularly the Guelmim-Oued Noun region, is rich in a wide diversity of plant species. Pregnant women in this region use medicinal plants during pregnancy and childbirth for various purposes; however, the use of these plants has never been documented. The objectives of this study are threefold: to estimate the prevalence of medicinal plant uses by pregnant women in the province of Guelmim, Morocco, to describe the traditional practices of self-medication and to determine the associated factors. This is a multicenter cross-sectional study with descriptive and analytical approaches. Data were collected using an interview questionnaire, which was administered to pregnant women at health care centers and hospitals in the province of Guelmim. A total of 560 women participated in this study. The prevalence of medicinal plant use was 66.96%. Artemisia herba-alba Asso, Thymus maroccanus Ball., Trigonella foenum-graecum L., Aloysia citriodora Palau, Lepidium sativum L. and Cuminum cyminum L. were the plants with the highest UV. Pain, the induction and facilitation of childbirth, flu syndrome and anemia were the most listed reasons for use. The use of medicinal plants was significantly associated with the level of education (chi-square = 15.651; p = 0.004), and pregnancy monitoring (chi-square = 5.283; p = 0.028). In the province of Guelmim, the prevalence of the use of medicinal plants by women during pregnancy and childbirth is high. Further research is necessary in order to explore potential associated risks and complications.

Use of complementary and alternative medicine in pregnancy: a cross-sectional survey on Iraqi women

BACKGROUND

Due to the lack of strong evidence on safety and efficacy of complementary and alternative medicine (CAM) approaches, the use of CAM in women during pregnancy could be hazardous for mother and fetus. Meanwhile, little is known regarding the patterns, the reasons and the factors affecting use of CAM among pregnant women in Iraq.

METHODS

A cross sectional survey design was used to carry out face-to-face interviews with 335 consecutive pregnant women. The questionnaire comprised of three sections: socio-demographic characteristics, pregnancy-related aspects and the patterns and attitudes towards use of CAM. Determinants of CAM use were assessed through the logistic regression analysis.

RESULTS

Three hundred thirty-five pregnant women completed the questionnaire. 56.7 % reported using at least one form of CAM modalities. In total, 24 different types of CAM were used; with herbal medicine (53.7 %) and multivitamins (36.3 %) the most commonly used modalities. From the logistic regression analysis, the variables positively associated with CAM use were: rural residence (odds ratio (OR) 2.0, p < 0.01), no occupation (OR 2.7, p < 0.05), high income (OR 2.0, p < 0.05), perceived healthy status (OR 2.6, p < 0.05) and ever use of contraception (OR 2.0, p < 0.01). Only 0.5 % of CAM users disclosed their CAM use to physicians.

CONCLUSIONS

The proportion of CAM users among pregnant women is relatively high and it is important to learn what types of CAM they use. However, disclosure of CAM use was extraordinarily low. Given the low rate of disclosure, it should be ensured that physicians establish good level of communication with pregnant women and have adequate knowledge of CAM.

"Natural" relief of pregnancy-related symptoms and neonatal outcomes: above all do no harm

ETHNOPHARMACOLOGICAL RELEVANCE

In the South of Italy the use of herbal remedies to alleviate pregnancy-related symptoms is very common.

OBJECTIVES

To investigate the proportion, prevalence of use, attitude and knowledge base in a sample of Italian pregnant women in the South of Italy. To explore the possible influence and risks of herbal consumption on pregnancy and neonatal outcomes.

METHODS

A retrospective observational study was conducted during the study period November 2010-September 2013. Six hundred and thirty expectant mothers were interviewed within three days after childbirth in a public Hospital in the South of Italy.

RESULTS

Due to a lack of data, a total of six hundred interviews were considered. Four hundred and eighty six women (81%) reported to have constantly used at least one herbal product throughout the pregnancy period. The study enrolled mostly women between 31 and 40 years of age, with a middle-high level of education, married and employed. The most commonly used herbal products, taken by oral route and for the entire period of pregnancy, were chamomile, fennel, propolis, cranberry, lemon balm, ginger, valerian and mallow. The most relevant source of information for the majority of participants was the doctor (95%), and most of the women (72%) informed their doctors about their use of herbal remedies.

CONCLUSIONS

The regular chamomile consumption resulted in a higher risk of pre-term delivery, lower birth weight and lower length of the newborn. Also a regular use of fennel resulted in a shorter gestational age. Finally, ginger intake resulted in a shorter gestational age and in a smaller circumference of the newborn's skull.

Herbal medicine use in pregnancy: results of a multinational study

BACKGROUND

The use of complementary and alternative medicines (CAM) is growing in the general population. Herbal medicines are used in all countries of the world and are included in the top CAM therapies used.

METHODS

A multinational study on how women treat disease and pregnancy-related health ailments was conducted between October 2011 and February 2012 in Europe, North and South America and Australia. In this study, the primary aim was to determine the prevalence of herbal medicine use in pregnancy and factors related to such use across participating countries and regions. The secondary aim was to investigate who recommended the use of herbal medication in pregnancy.

RESULTS

There were 9,459 women from 23 countries participating in the study. Of these, 28.9% reported the use of herbal medicines in pregnancy. Most herbal medicines were used for pregnancy-related health ailments such as cold and nausea. Ginger, cranberry, valerian and raspberry were the most commonly used herbs in pregnancy. The highest reported rate of herbal use medicines was in Russia (69%). Women from Eastern Europe (51.8%) and Australia (43.8%) were twice as likely to use an herbal medicine versus other regions. Women using herbal medicines were characteristically having their first child, non-smokers, using folic acid and consuming some alcohol in pregnancy. Also, women who were currently students and women with an education other than a high school degree were more likely to use herbal medicines than other women. Although 1 out of 5 women stated that a physician had recommended the herbal use, most women used herbal medicine in pregnancy on their own initiative.

CONCLUSIONS

In this multinational study herbal medicine use in pregnancy was high although there were distinct differences in the herbs and users of herbal medicines across regions. Most commonly the women self-medicated with herbal medicine to treat pregnancy-related health ailments. More knowledge regarding the efficacy and safety of herbal medicines in pregnancy is warranted.

Community pharmacists' views and experiences of counter-prescribing in pregnancy

Objective

To ascertain the sources of community pharmacists' knowledge base for counter-prescribing in pregnancy, whether sufficient additional information was readily accessible and, if not, to discover pharmacists' areas of concern.

Method

A structured telephone interview of community pharmacists by a single researcher using a pre-piloted questionnaire to obtain both quantitative and qualitative data. Questions covered previous education about counter-prescribing in pregnancy, reference sources used, and satisfaction with available reference sources. Respondents were also asked to cite examples where they would or would not recommend a medicine in pregnancy.

Setting

A random sample of 50 community pharmacies in Scotland.

Key findings

From the high response rate (43 pharmacists, 86 per cent) the topic was demonstrably important to community pharmacists, most of whom perceived their knowledge base for counter-prescribing in pregnancy to be experience-gained. Thirty-four pharmacists (79 per cent) agreed there was a need for more information to be available. Ten pharmacists (23 per cent) highlighted complementary therapies as an area where they found available information inadequate. Examples of requests from pregnant women and the action taken by the pharmacist are reported.

Conclusion

There is a need for an accurate, current and comprehensive data source for counter-prescribing in pregnancy. The field of complementary medicines and therapies is of particular concern to many community pharmacists. More research is required into GP referrals.

Use, Attitudes and Knowledge of Complementary and Alternative Drugs (CADs) Among Pregnant Women: a Preliminary Survey in Tuscany

To explore pregnant women's use, attitudes, knowledge and beliefs of complementary and alternative drugs (CADs) defined as products manufactured from herbs or with a natural origin. A preliminary survey was conducted among 172 pregnant women in their third trimester of pregnancy, consecutively recruited in two obstetrical settings; 15 women were randomly selected to compute a test-to-retest analysis. Response rate was 87.2%. Test-to-retest analysis showed a questionnaire's reproducibility exceeding a K-value of 0.7 for all items. Mean age was 32.4 ± 0.4 years; most women were nulliparae (62.7%). The majority of subjects (68%) declared to have used one or more CADs during their lifetime; 48% of pregnant women reported taking at least one CAD previously and during the current pregnancy. Women's habitual use of CADs meant they were at higher risk of taking CADs also during pregnancy (adjusted odds ratio = 10.8; 95% confidence interval: 4.7-25.0). Moreover, 59.1% of the subjects were unable to correctly identify the type of CADs they were using. The majority of women resorted to gynecologists as the primary information source for CADs during pregnancy, while they mainly referred to herbalists when not pregnant. Habitual use of CADs seems to be a strong predictor for their ingestion also during pregnancy; in addition most subjects were unable to correctly identify the products they were taking. In the light of the scanty data concerning the safety of CADs during pregnancy, these preliminary results confirm the need to investigate thoroughly the situation of pregnant women and CADs consumption.

The use during pregnancy of prescription, over-the-counter, and alternative medications among Hispanic women

BACKGROUND

Despite lack of scientific evidence about the safety of complementary and alternative medicines, the reported use of such remedies during pregnancies has increased. This study was undertaken to investigate the use of herbs, vitamins, and over-the-counter and prescription medications among pregnant Hispanic women and reasons for use, and to assess physician-patient level of communication about women's use.

METHODS

A total of 485 Hispanic women were surveyed by means of a self-administered questionnaire immediately postpartum in a public hospital in Houston, Texas. The primary outcome was use of alternative therapies during the prenatal period.

RESULTS

During their pregnancies, 19 percent of the participants took herbs and 47 percent took vitamin supplements, other than prenatal vitamins. The most common reason for using herbs and vitamins was to improve the woman's general health and energy level (59%); a few women (12%) had used them for specific pregnancy-related problems. Overall, 77 percent took prenatal vitamins and 21 percent supplemented with folic acid. The rates of use of over-the-counter and prescription medications were 23 and 29 percent, respectively. The use of prescription medication was two-and-a-half times higher among women with history of medical problems (adjusted OR = 2.59, 95% CI = 1.59-4.25, p = 0.0001). No other factor studied was independently associated with supplement or medication use. One in five women (20%) believed that herbs and vitamins were safer to use than prescription medication or were better at treating medical problems than prescription medicine, and one-third had not disclosed information about supplement use to their physicians.

CONCLUSIONS

Use of herbal remedies does not appear to be a replacement for conventional medicine among most pregnant Hispanic women. Patient education about the risks of alternative therapies may lead to a reduction in intake of alternative medicines and greater disclosure to medical practitioners among this ethnic group.

Attitude and use of herbal medicines among pregnant women in Nigeria

Background

The use of herbal medicines among pregnant women in Nigeria has not been widely studied.

Methods

Opinion of 595 pregnant women in three geopolitical zones in Nigeria on the use of herbal medicines, safety on usage, knowledge of potential effects of herbal remedies on the fetus and potential benefits or harms that may be derived from combining herbal remedies with conventional therapies were obtained using a structured questionnaire between September 2007 and March 2008. Descriptive statistics and Fisher's exact tests were used at 95% confidence level to evaluate the data obtained. Level of significance was set at p < 0.05.

Results

More than two-third of respondents [67.5%] had used herbal medicines in crude forms or as pharmaceutical prepackaged dosage forms, with 74.3% preferring self-prepared formulations. Almost 30% who were using herbal medicine at the time of the study believed that the use of herbal medicines during pregnancy is safe. Respondents' reasons for taking herbal medications were varied and included reasons such as herbs having better efficacy than conventional medicines [22.4%], herbs being natural, are safer to use during pregnancy than conventional medicines [21.1%], low efficacy of conventional medicines [19.7%], easier access to herbal medicines [11.2%], traditional and cultural belief in herbal medicines to cure many illnesses [12.5%], and comparatively low cost of herbal medicines [5.9%].

Over half the respondents, 56.6% did not support combining herbal medicines with conventional drugs to forestall drug-herb interaction. About 33.4% respondents believed herbal medicines possess no adverse effects while 181 [30.4%] were of the opinion that adverse/side effects of some herbal medicines could be dangerous. Marital status, geopolitical zones, and educational qualification of respondents had statistically significant effects on respondents views on side effects of herbal medicines [p < 0.05)] while only geopolitical zones and educational qualifications seemed to have influence on respondents' opinion on the harmful effects of herbal medicines to the fetus [p < 0.05].

Conclusion

The study emphasized the wide spread use of herbal medicines by pregnant women in Nigeria highlighting an urgent need for health care practitioners and other health care givers to be aware of this practice and make efforts in obtaining information about herb use during ante-natal care. This will help forestall possible interaction between herbal and conventional medicines.

The relationship between social factors and attitudes toward conventional and CAM practitioners

CONTEXT

The research results on the relationship between social factors and attitudes toward complementary and alternative medicines (CAMs) and conventional practitioners are equivocal. Some researchers theorize a relationship between social factors and attitudes toward providers, with CAM being more attractive to socially and economically marginalized groups.

OBJECTIVES

To evaluate the relationships between selected sociodemographic factors and attitudes toward CAMs in the general US population.

DESIGN

A subset of data from a 1997-1998 nationally representative survey was examined using descriptive and univariate analyses.

RESULTS

Five outcomes exploring preference for CAM or conventional medical practitioners are considered. Age was positively related to favoring one's conventional medical doctor. Subjects who reported using CAM for wellness/prevention reported significantly less confidence in their conventional doctors than individuals who did not report using CAM for wellness/prevention. Those with low income were also significantly less confident in their medical doctors and less satisfied with their conventional medical practitioners than those with higher incomes.

CONCLUSIONS

While more prospective work is needed, this analysis suggests that social factors may be related to practitioner preference. Finding out why these relationships exist is important for the effectiveness of health care.

Herbal medicine use during pregnancy in a group of Australian women

Background

There are limited data on the extent of women's use of herbal medicines during pregnancy, despite the fact that knowledge of the potential benefits or harms of many of these products is sparse, particularly with respect to their use in pregnancy. We aimed to measure the prevalence of herbal medicine use in a group of pregnant women attending a public tertiary maternity hospital in Melbourne, Australia. Secondary aims were to explore why women took the herbal medicine, where they received advice, what form the supplements took and if they perceived the supplements to be helpful.

Methods

Consecutive pregnant women were approached in the antenatal clinic and the birth centre at around 36–38 weeks gestation. A questionnaire was developed and self-administered in English, as well as being translated into the four most common languages of women attending the hospital: Cantonese, Vietnamese, Turkish and Arabic. Back translation into English was undertaken by different professional translators to verify accuracy of both words and concepts. Data collected included demographic information, model of pregnancy care and herbal supplement use. Descriptive statistics were used initially, with stratified and regression analysis to compare sub-groups.

Results

Of 705 eligible women, 588 (83%) agreed to participate. Of these, 88 (15%) completed the questionnaire in a language other than English. Thirty-six percent of women took at least one herbal supplement during the current pregnancy. The most common supplements taken were raspberry leaf (14%), ginger (12%) and chamomile (11%). Women were more likely to take herbal supplements if they were older, tertiary educated, English speaking, non-smokers and primiparous.

Conclusion

Use of herbal supplements in pregnancy is likely to be relatively high and it is important to ascertain what supplements (if any) women are taking. Pregnancy care providers should be aware of the common herbal supplements used by women, and of the evidence regarding potential benefits or harm.

Sociodemographic determinants of the utilization of specific types of complementary and alternative medicine: an analysis based on a nationally representative survey sample

OBJECTIVES

To evaluate the relationships between selected sociodemographic factors and the use of particular types of complementary and alternative medicine (CAM) in the general U.S. population. CAMs make up a heterogeneous group of practices. Although it is well established that sociodemographic factors impact the use of conventional medicine, it is unclear which, if any, influence the use of particular types of CAM.

DESIGN

Data from a 1997-1998 nationally representative survey (n = 2055) was examined using descriptive and univariate analyses.

RESULTS

The impact of particular sociodemographic factors was found to vary by type of CAM considered. Whites used more CAM than non-Whites except in the case of prayer. Users of CAM tended to be better educated than nonusers with the exception of prayer, self-prayer, and use of a lay midwife. Women used more CAM than men, especially weight-change diet.

CONCLUSIONS

As with conventional medicine use, the patterns of CAM use vary by individual type of therapy considered. Analytically, grouping many heterogeneous practices into the CAM category hides important differences in use patterns.

Impact of socio-demographic factors, knowledge and attitude on the use of herbal drugs in pregnancy

BACKGROUND

Herbal drugs are often promoted as 'natural' and 'safe'. These claims may especially attract pregnant women who are often concerned about their unborn child's well-being. Few studies have assessed the use of herbal drugs in pregnancy and the factors related to this use.

OBJECTIVE

To investigate the impact of socio-demographic factors, knowledge and attitude on the use of herbal drugs in pregnancy.

METHODS

A total of 400 postpartum women at Ulleval University Hospital in Oslo, Norway were interviewed within 3 days after giving birth by using a structured questionnaire in the period from February to June 2001.

RESULTS

In all, 36% of the women reported herbal use during their pregnancy. Both women who had used herbal drugs in pregnancy and those not, had a positive attitude toward the use of herbal drugs in pregnancy. Echinacea was the most well known herb among both groups of women. The factors associated with the use of herbal drugs in pregnancy were: prior use of herbs, high knowledge about herbal drugs and age between 26 and 35 years. There was a non-significant higher frequency of herbal drugs use in pregnancy among women with a higher education level.

CONCLUSION

The widespread use and positive attitude toward herbal drugs in pregnancy indicates an increased need for documentation about both the efficacy and safety of herbal drugs in pregnancy. Women between 26 and 35 years with a prior history of herbal drug use and high knowledge about herbs, are more prone to using herbal drugs in pregnancy.

Use of alternative drugs in Finland

OBJECTIVES

The purpose of this study was to assess the use of alternative drugs among the adult population in Finland, especially to find out how the health status, health behaviour and use of licensed drugs and health care services are related to the use of alternative drugs.

DESIGN

A telephone interview was conducted in March 1992 with a response rate of 85%.

SUBJECTS

A random, representative sample of 2134 Finns aged between 15 and 74 years.

RESULTS

A total of 39% of the respondents had used one or more types of alternative drugs during the last year. Most common was the use of health food products. Women used all types of alternative drugs more often than men. The use of alternative drugs was more common among educated and urban respondents. Perceived health or existence of a long-standing illness was not related to alternative drugs use whereas reporting of psychosomatic symptoms was. Non-smoking was positively related to the use of alternative drugs and also active exercise among men. The use of non-prescription drugs, official and unofficial health services were positively related to alternative drugs use.

CONCLUSIONS

The use of alternative drugs is popular and it may increase in the future. The use of alternative drugs can be considered a form of medicalization. More information on products used and people using alternative drugs is needed.

Prescription, over-the-counter, and herbal medicine use in a rural, obstetric population

OBJECTIVE

The purpose of this study was to identify the medications that are consumed by a rural obstetric population during pregnancy.

STUDY DESIGN

Over a period of 26 months, pregnant women were interviewed about medication use. Interviews on subsequent visits provided a longitudinal study of medication usage and discontinuation. Trend differences were analyzed according to the number of medications, the trimester of use, and insurance status.

RESULTS

Five hundred seventy-eight participants had 2086 interviews. The compilation of the interviews showed that 95.8% of the participants took prescription medications, 92.6% of the participants self-medicated with over-the-counter medications, and 45.2% of the participants used herbal medications. Over time, consumption of over-the-counter medications exceeded prescription medication use. Fifteen percent of the pregnant women took ibuprofen at some point during the pregnancy (5.7% in the third trimester). Eight percent of the women were noncompliant and 20% incompletely compliant with prenatal vitamin and mineral formulations.

CONCLUSION

Medication use was substantial in this population. Medications (eg, ibuprofen) that are contraindicated in pregnancy were used at unexpectedly high rates. Of the three medication classes, over-the-counter medications were used most frequently.

Quality, efficacy and safety of complementary medicines: fashions, facts and the future. Part I. Regulation and quality

This is the first of two papers which review issues concerning complementary medicines. The first reviews the extent of use of complementary medicines, and issues related to the regulation and pharmaceutical quality of these products; the second considers evidence for the efficacy of several well-known complementary medicines, and discusses complementary-medicines pharmacovigilance. The term complementary medicines describes a range of pharmaceutical-type preparations, including herbal medicines, homoeopathic remedies, essential oils and dietary supplements, which mainly sit outside conventional medicine. The use of complementary medicines is a popular healthcare approach in the UK, and there are signs that the use of such products is continuing to increase. Patients and the public use complementary medicines for health maintenance, for the treatment or prevention of minor ailments, and also for serious, chronic illnesses. The pervasive use of complementary medicines raises several concerns. Many of these arise because most complementary medicines are not licensed as medicines, and therefore evidence of quality, efficacy and safety is not required before marketing. The regulatory framework for herbal medicines and dietary supplements is currently under review. A new system for registration of traditional herbal medicines will ensure that marketed products meet standards for quality and safety. At present, the pharmaceutical quality of many complementary medicines is a cause for concern.

Alternative drug use for the climacteric in Finland

OBJECTIVES

To investigate the use of alternative drugs for the climacteric in Finland, which products are used, and who are the women using them.

METHODS

The study was based on a population-based survey conducted in 1989 among 2000 Finnish women aged 45-64 (response rate 86%).

RESULTS

11% of the women reported the use of alternative drugs for the climacteric. Food supplements and bee products were the most common types of alternative drugs used. Some of them may have allergic or other side effects. Users differ little from other women judging by health habits and the utilization of health care services. The best predictors for alternative drug use were urban residence, more than 9 years of general education, and among 50 54-year olds, the use of prescription or OTC drugs for menopause. Over half of the users of alternative drugs had also used hormone therapy.

CONCLUSIONS

Women using alternative drugs during and after the climacteric represent a large group. More information is needed about the clinical effects of alternative drugs, and the characteristics of alternative drug users.