Everywhere you look nowadays you see alternative medicine, herbal supplements and remedies promising amazing results in curing and alleviating health problems. Many people choose these "natural" options rather than tried and true medical treatments and medicines. When it comes to menopause this is no exception. Menopause is a natural and important part of every woman's life. Most women experience this stage after age 40 and spend a third of their life in this phase. Although it might be a shared life experience for all women, it certainly may not be a welcome and pleasant one. Among the various products out there claiming to get rid of hot flashes and other symptoms of menopause there are the herbal teas and pills that contain the botanical black cohosh or red clover. According to the National Center of Complementary and Alternative Medicine (NCCAM) these commonly used botanicals have been used more recently to treat breast pain associated with menstrual cycles, hot flashes, night sweats, vaginal dryness and other symptoms that can occur during menopause.
There has not been much scientific basis that can back up these claims about these botanicals alleviating menopausal symptoms. However, two studies conducted by researchers at the University of Illinois at Chicago and Northwestern University have found that these two botanicals do not have an effect on hot flashes or on cognitive function in menopausal women. They conducted a four-arm, randomized, double-blind clinical trial where black cohosh and red clover were compared to the standard of care, which is hormone therapy, and to placebo for the treatment of hot flashes.
The researchers enrolled 89 women with moderate to severe hot flashes (who experienced at least 35 hot flashes and night sweats per week) were followed for 12 months. For the study, they kept diaries to record the number of hot flashes per day as well as the intensity. When the data was completed the researchers found that the average number of hot flashes per week decreased over time across all groups, black cohosh decreased 34 percent, red clover 57 percent, placebo 63 percent and hormone therapy 94 percent. When reading these results its curious to see that the placebo (which contains no active ingredients that help reduce menopausal effects) did better than the botanicals that claimed such results. "The important message is that all women improved, but there was a large placebo effect, and the botanicals did not work significantly better than placebo," said Stacie Geller, the G. William Arends Professor of Obstetrics and Gynecology at UIC and lead author of the study. "As expected, hormone therapy, considered the gold standard, significantly reduced hot flashes when compared with placebo," Geller said.
Despite these findings many women will still continue to use these botanicals as natural remedies. On the other hand, it is important to note both red clover and black cohosh have side effects and cautions according to the NCCAM. These warnings include such symptoms as abdominal pain, dark urine or jaundice. There have been several case reports of hepatitis (inflammation of the liver), as well as liver failure (although rare), in women who were taking black cohosh. The NCCAM says that red clover seems to be safe for most adults when used for short periods of time. No serious adverse effects have been reported. Yet because red clover contains estrogen-like compounds, there is a possibility that its long-term use would increase the risk of women developing cancer of the lining of the uterus. However, the NCCAM also notes "studies to date have been too brief (less than 6 months) to evaluate whether red clover has estrogen-like effects on the uterus." Conversely, to counter these warnings Geller and colleagues from the UIC/National Institutes of Health Center for Botanical Dietary Supplements Center reported no significant differences between botanical treatments and placebo for any of the safety parameters, including breast and endometrial safety, liver enzymes, complete blood count or lipid profiles. The study will appear online and will be published in an upcoming issue of Menopause, the journal of The North American Menopause Society.
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