Let's Talk About Menopause.....

A woman is said to have completed natural menopause when she has not had a period for 12 consecutive months. For American women, this typically happens at around age 51 or 52. Menopause occurs immediately if the uterus or both ovaries are surgically removed, or if the ovaries are damaged in cancer treatment with radiation therapy or certain drugs.

COMMON SYMPTONS DURING MENOPAUSAL TRANSITION

Some symptoms that women experience are related to menopause and decreased activity of the ovaries. Others may be related to aging in general.

Scientific evidence of a link to menopause is strongest for the following symptoms:

*Hot flashes and night sweats (also called vasomotor symptoms, because they involve the expansion of the blood vessels)
*Sleep difficulties
*Vaginal dryness, which can lead to painful intercourse and other sexual problems.

It is not certain whether the following symptoms are due to menopause, other factors that can come with aging, or a combination of menopause and these factors:

*Problems in thinking or in remembering things
*Urinary incontinence
*Physical complaints, such as tiredness and stiff or painful joints
*Changes in mood, such as depression, anxiety, and/or irritability.

The expert panel assembled for the NIH State-of-the-Science conference noted that menopause is a normal part of women's aging and advised that menopause should not be "medicalized" (or viewed as a disease).

WHAT SCIENCE SAYS ABOUT HERBAL THERAPIES FOR MENOPAUSAL SYMPTOMS

The NIH State-of-the-Science conference panel discussed the evidence on several CAM therapies:

Six botanicals—black cohosh, dong quai root, ginseng, kava, red clover, and soy.

Very little well-designed research has been done on CAM therapies for menopausal symptoms. A small number of studies have been published, but they have had limitations (such as the way the research was done or treatment periods that may not have been long enough). As a result, the findings from these studies are not strong enough for scientists to draw any conclusions. Also, many studies of botanicals have not used a standardized product (i.e., one that is chemically consistent). The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring a number of studies on botanicals using products that are both well characterized (i.e., their ingredients have been carefully studied) and well standardized and on other CAM therapies that have shown possible promise for reducing menopausal symptoms.
Because CAM products used for menopausal symptoms can have side effects and can interact with other botanicals or supplements or with drugs, research in this area is addressing safety as well as efficacy. Some findings from this research are highlighted below.

Black cohosh (Actaea racemosa, Cimicifuga racemosa). This herb has received more scientific attention for its possible effects on menopausal symptoms than have other botanicals. Studies of its effectiveness in reducing hot flashes have had mixed results. A study funded by NCCAM and the National Institute on Aging found that black cohosh, whether used alone or with other botanicals, failed to relieve hot flashes and night sweats in postmenopausal women or those approaching menopause. Other research suggests that black cohosh does not act like estrogen, as once was thought. Black cohosh has had a good safety record over a number of years. Some concerns have been raised about whether it may cause liver problems, but an association has not been proven.

Dong quai (Angelica sinensis). Only one randomized clinical study of dong quai has been done. The researchers did not find it to be useful in reducing hot flashes. Dong quai is known to interact with, and increase the activity in the body of, the blood-thinning medicine warfarin. This can lead to bleeding complications in women who take this medicine.

Ginseng (Panax ginseng or Panax quinquefolius). The panel concluded that ginseng may help with some menopausal symptoms, such as mood symptoms and sleep disturbances, and with one's overall sense of well-being. However, it has not been found helpful for hot flashes