Herb ineffective for menopause symptoms

The widely used herbal remedy black cohosh does nothing to eliminate hot flashes, night sweats and other symptoms of menopause, either alone or in combination with other herbs, federally sponsored researchers reported Monday.

Thousands of women use the supplement, but a controlled trial reported in the Annals of Internal Medicine showed it is no more effective than a placebo. Only estrogen produced a significant reduction in hot flashes.

“In the doses we used and the way we used it, it did not work,” said epidemiologist Katherine M. Newton of Group Health, a Seattle-based health system, who led the study. “The findings will certainly be a disappointment to women. It would have been nice to find something that is safe and effective.”

The study was sponsored by the National Institute on Aging and the National Center for Complementary and Alternative Medicine, both components of the National Institutes of Health.

Dr. Carol M. Mangione, of the University of California at Los Angeles’ School of Medicine, wrote in an editorial accompanying the study that physicians and women will have to look elsewhere for help, but unfortunately, there are few alternatives available.

An estimated 2 million American women turn 50 each year, and about 80 percent suffer at least some symptoms of menopause.

A 2002 federal study showed that women who underwent estrogen replacement therapy have an increased risk of breast cancer and heart disease. For many women, black cohosh has become the primary alternative to hormone therapy.

Newton and her colleagues studied 351 women from 45 to 55 years old. Half were in the midst of menopause and half were post-menopausal. They averaged about six symptoms per day.

The women were divided into five groups. One group received black cohosh. A second group received a multi-botanical of black cohosh and nine other herbs. The third received the multi-botanical and were encouraged to eat more soy foods. The fourth received estrogen with or without progestin. And the fifth received a placebo.

Women receiving either black cohosh or the multi-botanical had an average reduction of 0.5 symptom per day compared with those in the placebo group, a statistically insignificant finding.

Women receiving estrogen, in contrast, had a reduction of four symptoms per day. Those consuming soy had more symptoms for reasons that are not clear.

The good news, Newton said, is that over the course of a year, symptoms in the placebo group gradually were reduced by about 30 percent.

“The really strong message we need to get out is that menopause is a natural event – it is not an illness – and the symptoms are self-limiting,” said Newton, who is not affiliated with any supplement or hormone manufacturer.

If the symptoms are too powerful, women should take hormones in the lowest dose possible for the shortest time possible, she said.