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Dissection of an Herbal Menopause Therapy

Black cohosh is used by women as an alternative to hot flashes and other menopausal symptoms.

But recent studies have raised doubts about the effectiveness of black cohosh in relieving symptoms.

Looking back, Native Americans are known to have used black cohosh to treat rheumatism, malaise, malaria, colds, constipation and nests. According to the National Institutes of Health website, it is also prescribed for lung and neurological conditions as well as labor pain, infertility and menstrual crises in the 19th century.

The number one brand of black cohosh supplement is Remifemin, manufactured by a German company, Schaper & Bruemmer.

Last year, Australia and some European countries needed all the supplementary labels to show warnings about liver toxicity. This is due to the reports of many cases of hepatitis in black cohosh users.

Authorities in those countries believe that the contributing factor to the problem is the fact that the treatment of menopause symptoms has not been intensively studied. This includes black cohosh. They say that only estrogen is widely studied and its uses and risks are clearly identified.

Another complicated issue is the regulation of black cohosh under food, not medicine, by the Food and Drug Administration, which is why there are so many black cohosh brands on the market, they are supplements.

The content of food supplements, unlike drugs, can be modified without changing the label. According to doctor Adriane Fugh-Berman, a professor in the complementary and alternative medicine program at Georgetown University School of Medicine, "Remifemin", which is sold on schedule today, is used to make liquids.

Internal Medicine Issues last month released the results of a yearly study of 351 women treated with a daily dose of 160 milligrams of black cohosh. According to the publication, trials have shown that black cohosh "is no more effective than sugar pills."

Dr. Tieraona Low Dog, director of education for the Integrative Medicine Program at the University of Arizona Health Sciences, doubts whether the scientists who created the latest study gave the right dose.

"The dose for black cohosh may be higher than that used in this experiment," Low Dog said. "Imagine if we were on a trial of ibuprofen administering 40 milligrams every six hours for arthritis pain, if it didn't work better than a placebo, one would conclude it was ineffective, but in fact, the dose was insufficient."

Another question about this study is the use of a different type of alcohol on black cohosh than that used in Remifemin. Fredi Kronenberg, a scientist from Columbia University and director of the Richard and Hindus Rosenthal Centers for Alternative and Alternative Medicine, notes that "no one knows if it can improve or hinder its effectiveness."

The makers of Remifemin, Schaper & Bruemmer, in their defense, asserted that it was "a safe and effective intervention to relieve the heat and other vasomotor symptoms associated with menopause."

Many women have sworn the efficacy of Remifemin and other black cohosh supplements. But the Low Dog notes that "those who think herbal medicine is ineffective, this study provides further confirmation." But for those who believe it, this study is an example of how researchers are not right, he said.


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