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Studies: Popular herbal remedies ineffective for hot flashes

Black cohosh and red clover are ineffective at reducing menopausal hot flashes. Nor do those popular herbal therapies have any effect on memory.

Those are the findings from two small but randomized and double-blinded studies published last week in the journal Menopause.

Hormone therapy (HT) (an estrogen plus progesterone combination) did reduce the incidence of hot flashes. No surprise there.

HT was also found to have a slight negative effect on memory. No real surprise there, either. For although early studies suggested that HT might improve memory, later, better-designed studies have found some negative (albeit modest) effects of HT, particularly the combination form, on verbal memory.

But I thought the most interesting finding from this study was the placebo’s effect on hot flashes. During the 12 months of the study, the women who took a placebo reported a 63 percent reduction in the number of hot flashes they experienced weekly. That reduction was greater than for black cohosh (34 percent) and for red clover (57 percent).

HT resulted in the greatest reduction in hot flashes (94 percent), but, of course, it is no longer recommended for that purpose because of its strong association with an increased risk of stroke, heart disease and breast cancer.

The placebo finding was “higher than expected,” according to the authors of one of these studies. A few years ago, other researchers found that taking a placebo reduced hot flashes by about 50 percent.

What this suggests, of course, is that highly touted (and aggressively marketed) “natural” supplements for hot flashes are likely to be a waste of money.

What this also suggests is that time — and, I might add, a sense of humor — may be a menopausal woman’s best friend.


NB: This research was partially funded by a National Institutes of Health grant. The lead author in the memory study has received grant support from the Soy Health Research Board and Wyeth Pharmaceuticals, maker of the HT drugs Premarin and Prempro. Menopause journal is published by the North American Menopause Society, a nonprofit organization funded largely by a long list of pharmaceutical companies, including the leading manufacturers of HT drugs.

Comments (6)

  1. Submitted by Sheila Ehrich on 08/11/2009 - 11:42 am.

    Ms. Perry, I have to assume you haven’t suffered through night after night of night sweats 2 or 3 times a night that left you so drenched you had to change the bedding, nor through a work day where you wished you could change your clothes at least 2 or 3 times during the day.

    A sense of humor just doesn’t cut it. When I went off HRT, black cohash was the only thing that got me through the next 3 years. So please recognize that there is a range of symptoms and humor is not a solution for the extremes

  2. Submitted by David Skarjune on 08/11/2009 - 02:04 pm.

    Funny, how different people can interpret study results in different ways, as the LA Times reported on this:

    “Botanicals were safe,” said Stacie Geller, a professor of gynecology and obstetrics at the University of Illinois at Chicago. “Which is good, because many women will continue to use them,” Geller added.

    Note that Geller highlighted “good,” not “ineffective.”

    Though you might not discern this from the article, the goal of study was not to compare herbal versus hormonal therapies, as the study abstract cites:

    “Objective: The aim of this study was to examine interactions between hot flushes, estrogen plus progestogen therapy (EPT), and coronary heart disease (CHD) events in postmenopausal women with CHD.”

    This article has a nice spin to de-emphasize the actual goal and results of the study.

    Finally, if Perry wants to gripe about “highly touted (and aggressively marketed)” medical remedies, the she might want to consider estimates that the U.S. pharmaceutical industry spends almost twice as much on promotion as it does on research and development.

    “Ask your doctor about ______”
    Then ask how much they received in consulting fees from the pharmaceutical industry last year.

  3. Submitted by Susan Perry on 08/11/2009 - 09:23 pm.

    Sheila:

    I do not mean to belittle any woman’s experiences of hot flashes. Some women do have very severe hot flashes–just as some women have very severe menstrual cramps or long and difficult labors or severe depression after childbirth. Every woman is different, and every woman’s experiences with her own hormonal ups and downs are absolutely valid.

    That said, I still think a sense of humor helps. It’s not a cure for anything, but it helps.

    Thanks for the comment and for reading MinnPost.

  4. Submitted by Susan Perry on 08/11/2009 - 09:58 pm.

    David:

    I’m not sure what study you’re referring to, as the objectives in the two studies in the Menopause journal are not what you cite. In both studies that I wrote about the women were randomized to four groups: HT, black cohosh, red clover, and placebo. The HT group was included as a positive control.

    The Geller quote from the LA Times blogger is very close, oddly, to one that’s in a press release, with the word “important” changed to “good.” In both quotes, though, Geller (an author on both studies)is pointing out that the studies found the botanicals to be safe (other research had raised questions on this point)–a finding she finds important (or “good”) because women are likely to continue using them even though this study found the botanicals to be ineffective. In the study itself, Geller writes quite clearly that “compared with placebo, black cohosh and red clover did not reduce the number of vasomotor symptoms.”

    If something is less effective than a placebo, I’d say it’s ineffective.

    I certainly agree with you regarding the aggressiveness of the pharmaceutical industry in promoting HT. I wrote–and warned–about it 20 years ago in a book I co-authored on menopause.

    Thanks for the comment and for reading MinnPost.

  5. Submitted by David Skarjune on 08/13/2009 - 10:25 am.

    Susan,

    Thanks for clarifying. However, I simply cited the study abstract from your article link to Menopause Journal. Since this journal does not offer free public access, we have to rely upon journalists to filter the information. That’s one issue, you and the medical community get access–taxpayers who help fund the studies don’t. I apologize for suggesting ‘spin,’ when the problem is more about privileged access to information.

    Still, using the placebo effect to dismiss herbal therapies is hardly relevant; studies have shown that it is not truly blind since most medical practitioners can distinguish between the groups, particularly when side effects are involved. More important, herbal therapies use different diagnosis and treatment strategies than western medicine. Especially with Traditional Chinese Medicine, diagnosis has as much to do with the particular person as it does with their symptoms and disease.

    As Sheila points out, their is a range of both conditions people experience and remedies that do work for them. The fact that they are not cure-alls is interesting, but does not negate their effectiveness or safety. On the other hand, the side effects of drugs that the industry promotes as cure-alls are a serious problem, not to mention the high cost of the drugs.

    Dr. Andrew Weil had a great interview with Wolf Blitzer on the Larry King show on CNN last night discussing how alternative therapies can both lower health costs and improve outcomes. That’s NOT “a waste of money” as you say, that’s a legacy of health wisdom that western medicine dismisses in order to promoter their own profits.

  6. Submitted by Cynthia Van Pelt on 08/25/2009 - 09:56 am.

    We should all keep a sense of humor and exercise regularily – no matter what phase of life we are in. But, hey, I want some of those placebos! What was in them; they seem to work!!!

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