Here is a quick two-part article on the best bets for women dealing with the frustrating effects of menopause. Here I hone in on the main natural aid: black cohosh.
In 2000, results from two large studies showed that taking estrogen and medroxyprogesterone could actually increase the risk of heart attacks, strokes, and breast cancer. (Medroxyprogesterone is a drug that protects the uterus and may reduce a woman’s risk of cancer.) Then came the news that hormone replacement therapy was linked to the risks of urinary incontinence and dementia.
Ever since all this news broke, there has been intense focus on finding alternative therapies. Here, I want to give you an up-to-date, unbiased review of what all the scientific literature says. Do dietary supplements actually reduce menopausal symptoms? Let’s go case-by-case starting with the big hitter.
Black cohosh is native to North America. It is the most-studied supplement for treating menopausal symptoms. As early as 1940, it has been widely used in Germany. Here are the best studies conducted so far in chronological order:
1988: Over six months, 48 to 140 milligrams (mg) of black cohosh a day significantly reduced menopausal symptoms in a manner comparable to hormone treatments. The women in the study had had hysterectomies.
2002: Over six months, 39 and 127 mg a day reduced menopausal symptoms in 70% of women studied. There were no changes in hormone levels.
2003: Over three months, 40 mg a day significantly reduced symptoms in a manner comparable to conjugated estrogen in postmenopausal women.
2005: Over three months, 40 mg a day significantly reduced symptoms, especially in early postmenopausal women.
2005: Over three months, black cohosh significantly reduced hot flushes, sweating, insomnia, and anxiety.
2005: Over three months, 40 mg a day reduced hot flushes and other symptoms by the one-month mark. It also reduced anxiety and depression without affecting hormone levels.
2005: Over three months, black cohosh was not found to be superior to placebo.
2006: Over a year, 40 mg a day significantly reduced hot flushes and did not cause endometrial thickness.
2007: Over six months, black cohosh reduced hot flushes and night sweats by 85%, compared to 62% by the drug fluroxetine.
Most of the studies used a special commercial extract, “Remifemin, Phytopharmaica/Enzymatic Therapy,” and showed positive effects. Studies with negative results usually used non-commercial extracts. In 2001, the American College of Obstetrics and Gynecology guidelines recommended black cohosh for up to six months in the treatment of hot flushes, sleep and mood disturbance. Four years later, a review concluded that the herb showed great promise for relief of menopausal symptoms, and could be considered perfectly safe for use for at least six months.