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Natural Menopause Relief

The most popular herbal remedy worldwide for menopause relief from hot flashes, night sweats, mood swings and irritability is Black cohosh, a plant once used by Native Americans to treat rattlesnake bites.

Pharmacies, vitamin shops and herbalists in the United States have sold a variety of black cohosh supplements for years. Now pharmaceutical giant GlaxoSmithKline wants some of the action.

In March 2001, the company began mass-marketing RemiFemin, a black cohosh concoction used in Europe for more than 40 years. GlaxoSmithKline bought the U.S. distribution rights from Schaper and Brummer, the German company that developed RemiFemin and still manages international sales.

Unlike many herbal remedies, RemiFemin actually has considerable high-quality science supporting its safety and effectiveness. One widely cited study, among at least 20 on RemiFemin, is a double-blind German trial which followed 80 women for 12 weeks and compared the benefits of RemiFemin, a hormone replacement therapy and a placebo. (Double-blind means that neither the researchers nor the patients know who's taking what.)

The RemiFemin group saw their hot flashes reduced from five to less than one per day, on average, compared with a decline from five to about four in the other groups. Other studies also showed positive effects. No serious side effects were reported, other than the occasional upset stomach. But: Here comes the "but."

As with other herbals, the U.S. Food and Drug Administration has little authority to regulate black cohosh or the claims made for it. Some doctors say the herb may not be safe for all women, particularly those with breast cancer, and long-term use (more than six months) has not been evaluated. Prices vary greatly, from about $3 for a month's supply for generic black cohosh to $25 for RemiFemin.

One thing in RemiFemin's favor, though, is the 40 years of testing supporting it. "RemiFemin has been studied and shown to be effective," says Varro E. Tyler, professor emeritus of pharmacognosy and natural drug products at Purdue University. "We know about RemiFemin. We don't know much about the other black cohosh products."

Other black cohosh supplements could work as well as RemiFemin, Tyler said, but then again, they might be harmful. The way an herbal supplement is formulated affects its performance. Your doctor won't know how a particular black cohosh product is made because the formulation is a trade secret, an annoying characteristic of the herbal marketplace.

Most supplements use dried, powdered black cohosh root. RemiFemin uses both the root and the rhizome, the underground stem system that grows horizontally to form new shoots. Some supplements pack more than 500 milligrams of black cohosh into each pill, and this, Tyler said, is "far too much." The dose recommended by German studies is 40 to 80 milligrams of extract per day. RemiFemin contains 20 milligrams of black cohosh extract per pill and is to be taken twice daily.

One-A-Day Menopause, a competing product similar in price and dosage to RemiFemin, adds a little calcium and vitamin E. Ricola Herbal Health Women's Formula is less than half the price and four times the dose. Both of these products, however, use only the root of black cohosh.

Menopause can last from two to 10 years. RemiFemin is recommended for six months at a time, basically because no study has looked at long-term use. Michele Klingen smith, the RemiFemin brand manager at GlaxoSmithKline, said menopausal woman "can come off and go back on" if symptoms return after six months.

A year-long study on black cohosh is just underway at Columbia University's College of Physicians and Surgeons. The study, lead researcher Fredi Kronenberg says, will examine the herb's effectiveness in preventing heart disease and bone loss, as well as menopausal symptoms.

Don't expect instant results from any black cohosh supplement. The herb doesn't kick in until after a couple weeks of usage; the full effects of RemiFemin may take up to 12 weeks to manifest. One more caution: Black cohosh is different from blue cohosh, another "female" herbal. Blue cohosh can be poisonous, even in small amounts.

And of course, you still should watch out for snakes: The science supporting black cohosh for rattlesnake bites is pretty skimpy.




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