Cardiovascular and Metabolic Effects of Alternative Therapies in Menopause: A Comprehensive Review

INTRODUCTION Menopause is associated with significant hormonal changes that increase cardiovascular and metabolic risks, including dyslipidemia, insulin resistance, and hypertension. Hormone replacement therapy (HRT) has traditionally been used to mitigate these risks; however, concerns regarding adverse effects have led to a growing interest in alternative therapies such as phytoestrogens, dietary modifications, exercise, and mind-body interventions. These approaches aim to provide symptom relief and cardiometabolic benefits without the potential risks associated with hormonal treatments. OBJETIVE To evaluate the cardiovascular and metabolic impacts of alternative therapies in menopausal women, providing an evidence-based perspective on their effectiveness and safety. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Menopause” AND “Phytoestrogens” OR “Cardiovascular risk” OR “Metabolic syndrome” OR “Hormone replacement alternatives” in the last years. RESULTS AND DISCUSSION Studies suggest that phytoestrogens, particularly isoflavones and lignans, may improve lipid profiles and endothelial function, while plant-based diets and Mediterranean-style eating patterns have been linked to better metabolic outcomes. Regular physical activity has shown a significant impact on reducing central adiposity and improving insulin sensitivity. Additionally, acupuncture and mind-body practices, such as yoga and meditation, have demonstrated promising results in regulating autonomic function and reducing stress-related metabolic disturbances. Despite these benefits, heterogeneity in study methodologies and individual variability remain challenges in establishing standardized treatment guidelines.   CONCLUSION Alternative therapies represent a promising avenue for improving cardiovascular and metabolic health in menopausal women. While they offer potential benefits, further high-quality research is required to determine optimal interventions, dosages, and long-term effects. A multidisciplinary approach that integrates lifestyle modifications and individualized treatment plans is essential to optimizing health outcomes and ensuring evidence-based recommendations for menopausal care.