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Black Cohosh and Hot Flashes

  The popular herbal dietary supplement black cohosh, often used as an alternative to risky hormone therapy, failed to relieve hot flashes for women going through menopause, a study released on Monday found. The study, funded by the U.S. National Institutes of Health (NIH), tracked 351 women ages 45 to 55 for a year and found that black cohosh used by itself or together with other herbal supplements was no better than a placebo in relieving hot flashes. Women receiving menopausal hormone therapy experienced strong relief from hot flashes and night sweats, according to the study in the Annals of Internal Medicine. But research has linked hormone therapy to increased risk of heart attack, stroke and breast cancer. "I think the findings are disappointing because it would be nice to have a therapy besides hormone therapy that could be used for women, and we don't seem to have it in black cohosh," said Katherine Newton of the Group Health Center for Health Studies in Seattle and the University of Washington, who led the study. "We went into this study with a very open mind. So we weren't convinced that it worked and we weren't convinced that it didn't work," Newton added in a telephone interview. Black cohosh, a member of the buttercup family, is a perennial plant native to North America that was used in North American Indian medicine to treat various maladies including gynecological disorders, according to the NIH. The most common symptoms of menopause are hot flashes -- sudden sensations of intense heat with sweating and flushing -- and night sweats. Black cohosh has gained popularity among women as a remedy for these symptoms. FIVE THERAPIES Women in the study were given one of five therapies: black cohosh alone; a supplement combining black cohosh with nine other ingredients including alfalfa, licorice, oats, pomegranate and Siberian ginseng; the combined supplement plus diet counseling to increase soy consumption; hormone therapy (estrogen with or without progesterone), or a placebo. The women had experienced episodes of hot flashes or night sweats at least twice daily entering the study. Women taking black cohosh alone or with the other ingredients diminished their hot flashes by an insignificant half an episode per day compared to women taking a placebo, the study found. Women on hormone therapy cut their symptoms by about four episodes daily compared to the placebo group. Newton noted that menopause occurs as part of natural aging, and women should understand that symptoms like hot flashes eventually dissipate. "In the mean time, the kinds of things that women can do are: dress in layers, drink ice water if they're getting warm, avoid triggers such as alcohol or hot liquids in some women, or spicy foods, carry a fan and sleep in a cool room," Newton said. Mark Blumenthal, executive director of the American Botanical Council, a nonprofit group that provides information about herbal medicine and is in part funded by industry, faulted the design of the study and said the findings were at odds with existing evidence about black cohosh.

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