Most physicians are not comfortable treating a disease or managing symptoms such as hot flashes without clear data to support a given intervention. Yet more and more articles are appearing in major journals supporting what previously was considered “alternative” therapies. Physicians for some reason are more comfortable trying an “alternative” use of a prescription drug- such as a selective serotonin reuptake inhibitor(SSRI’s) for hot flashes- than an herb or nutrient like soy or black cohosh. There is relatively similar evidence for the effectiveness of SSRIs and soy isoflavones for reduction of hot flashes (60% reduction in hot flashes for both treatments).
Medical schools need to broaden then curriculum to where they teach physician therapies other than pharmaceuticals. I think only then will they feel more confident in thinking outside the “drug box” and can give their patients better options.