Appendix 1: Sample quotes illustrating themes associated with using complementary and alternative medicine for symptoms related to menopause. Italics have been used to note explanatory comments and questions by the researchers. Bold face has been used to clarify important sentences in a long quote.

Theme / Quote / Description of the participant
“Natural” / “(Herbs) seem okay to me because they’re natural. It’s not a chemical. And I… look back and I say, ‘Well, these ladies I know are in their 70’s and they never took none of that stuff.’ It wasn’t even around-- patches and all that stuff. And what about before them? The old Latina women, they just did whatever it was they had to do.” / -Administrative assistant
-Age 49
-Latina
-Using traditional Mexican herbs
“(CAM) kind of goes with the martial arts and my spiritual and naturalistic thing. I lived in Oregon for a while. It's sort of the path of my friends and my particular circle. It's more appealing to me since it’s natural, seems less harsh on my body.” / -Educator
-Age 54
-Caucasian
-Using herbal tincture, meditation
Menopause as a Life Stage / “It’s like menopause did do something in terms of telling me my life span, that I’m going to get older, and things are happening. ‘Cause it’s like I get these hot flashes and it’s like it kind of remind me.” / -Nurse
-Age 52
-Asian American
-Using tai chi, herbs, meditation, acupressure,
“Certainly the menopause is an incentive to continue an exercise program… I try to do more stretching and yoga stuff now…. Oh, I’ve got the orange juice with the calcium in it. I was happy to hear that yams are good for you, whatever it is in yams. And tofu or something… Okay, I’ll eat more of these, I like them.” / -Researcher
-Age 53
-Caucasian
-Yoga, increasing dietary soy
Non-medical Sources of Information / “Anecdotal information seems to be what we’ve got to go on 90 percent of the time... Like my sister-in-law was having real problems with hot flashes and I... sent a box of Estroven* to her and she started taking it. And now she’s… referred a couple of her friends to it. So it’s just like, okay, I’m not saying your experience will be the same as mine, but this was my experience…It feels like often in medicine the anecdotal evidence or the anecdotal stories, or the people’s personal experience is pushed aside. Is ignored.” / -Writer
-Age 47
-Caucasian
-Using herbal blend, increased dietary soy
“As I was taking it (St. John’s Wort for menopause-related mood symptoms), there was some controversy that was coming up with mainstream society saying well, there really isn't any proof that St. John's Wort really works. And here we were for centuries… using yerbas (herbs), right? And now we're saying oh, no, I'm sorry but there's not enough proven research, right? … It can be a mind trip. Because if you're listening to both camps and you're taking it at the same time I really wondered about its effectiveness and was I tripping myself out? And I just decided to keep the TV turned off and that I was not going to read any articles pro or against St. John's. So that way I could hear my body. I can't hear my body if I'm sitting here going well, people think I'm crazy because I'm taking St. John's Wort.” / -School teacher
-Age 48
-Latina
-Using meditation, numerous herbs
Patterned Response to Concerning Symptoms / “I have a menopause file that I made a few years ago. I put menopause articles and stuff….And when I started getting the hot flashes of course I looked in there to kind of get an idea of what is going on and some of the things you can do….I like when they give alternative ways to deal with it… I’ve never been one to want to take pills….”
Interviewer: “And so you said in the past you have pursued alternative therapies?”
“Yeah… I will read or try to find something and do something….For example, I was having a problem with my eye was swelling up… the doctor … gave me a prescription for an antibiotic. And then I started doing some research…. I looked on the website… ‘Ask Dr. Wyle?’ …He would do the calendula ointment to soothe the area. And that he would try a compress of cool tea bags. So that’s what I did.” / -City planner
-Age 52
-Caucasian
-Using nutritional supplements, yoga
“My doctor told me, ‘Oh, you’re going through menopause.’… and gave me a lot of literature on going more natural, as well as hormone replacements… And I did try the black cohosh and I increased exercise. …I believe in herbs. All that kind of stuff. I thought I’d give it a try… That seemed like that would fit best for my personality and life… I had taken St. John’s Wort and Valerian to sleep sometimes. And I also at one point took kava kava derivatives, too.” / -Public Health Employee
-Age 46
-Caucasian
-Used black cohash and later discontinued, currently using HT

*Estroven is a trademarked product sold widely at drug stores that includes: soy isoflavones, black cohosh, calcium, boron, vitamins E, B-6, B-12, and folic acid..