According to the 2000 census, about two million women turn 50 every year, and 51 is the average age of menopause. Many of these women experience menopausal symptoms of varying intensity. Unfortunately, alternatives to menopausal hormone therapy, including over-the-counter supplements and phytoestrogens, are are often assumed to be safe simply because they are herbal.
A recent study at the NIH cast a dim light on the use of herbal supplements for hot flashes. In large tial the government agency learned that
black cohosh, whether used alone or with other botanical supplements, did not relieve hot flashes in postmenopausal women or those approaching menopause. The same study found that women using menopausal hormone therapy did receive significant relief from their hot flashes and night sweats.
Three-hundred and fifty-one women, ages 45 to 55, took part in the HALT Study, conducted at the Seattle-based Group Health Center for Health Studies. Each participant was experiencing at least two hot flashes and/or night sweats daily at the start of the study. The women were approaching menopause, having missed at least one menstrual cycle in the preceding 12 months, or were postmenopausal, having had no menstrual cycle in at least 12 months. Researchers included women who were perimenopausal (or in the menopause transition) because most previous studies looked only at postmenopausal women, who tend to have fewer symptoms than women going through menopause.
Initially, the women were randomly assigned to receive one of five therapies:
Black cohosh
A multibotanical supplement, including black cohosh, alfalfa, boron, chaste tree, dong quai, false unicorn, licorice, oats, pomegranate and Siberian ginseng
A multibotanical supplement plus diet counseling to increase consumption of foods containing soy
Menopausal hormone therapy, consisting of estrogen with or without a progestin
A placebo, containing no drug or supplement
"While this study found that black cohosh alone or with other herbs did not reduce menopausal hot flashes," said NCCAM Acting Director Ruth L. Kirschstein, M.D., "it highlights the importance of studying herbs using well-designed research to find out what works and what does not. With this information women and their physicians can have a meaningful discussion of complementary and alternative medicine approaches to menopause."
The full report is titled "Treatment of Vasomotor Symptoms of Menopause with Black Cohosh, Multibotanicals, Soy, Hormone Therapy, or Placebo. A Randomized Trial." It is in the 19 December 2006 issue of Annals of Internal Medicine (volume 145, pages 869-879). The authors are K.M. Newton, S.D. Reed, A.Z. LaCroix, L.C. Grothaus, K. Ehrlich, and J. Guiltinan.
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