Q. Here I am – 20 years older – and back to the same problems which caused me to start taking hormonoe replacement therapy (HRT) in the first place. After consulting with my nurse/doctor in October, I phased off my regimen of Premarin and Provera (for at least 17 years I had been taking it during the week, not on weekends because of my fibroids).
She advised me to increase my B complex to 100, increase my total intake of folic acid, calcium to 1500, and vitamin E. I did all that, and after about 2 months realized that I was depressed (I thought it was just Christmas – I usually get depressed around then).
Figured out it was more than that, so started taking St. John’s Wort, which seems to be working. But I am also having what I’ve been referring to as mini-hot flashes, mostly at night but also frequently during the day, and general sleep problems.
I heard a comment on your radio show about primrose oil possibly working for night sweats. Do you have any information about that? And I just read your information on black cohosh. Is there any problem with taking that? I noticed you recommend not taking it for a long period of time.
I plan to go back to my medical person, but am not anticipating much help with this kind of treatment. This is becoming a very common problem – I feel like medical science has let women down once again and returned to the time when I was going through menopause in the first place with no information as to what to do.
I am really not interested in starting with any of the other prescription medicine (Fosamax, etc).
A. You are so right that women have been treated rather shabbily when it comes to menopause. For decades doctors thought HRT in the form of Premarin and Provera or Prempro would be the ideal solution. When problems were revealed (cardiovascular complications, cancer, etc), millions of women were left out to dry (actually, left out to drip).
Alternative approaches are not always the panacea many had hoped for. Studies have produced mixed results for black cohosh. A brand new investigation (not randomized, double-blind or placebo controlled) in the journal Phytomedicine (June, 2013) did demonstrate symptomatic benefit with black cohosh (Cimicifuga racemosa or CR for short):
“This observational study demonstrated that treatment with CR in unselected patients with climacteric complaints under the conditions of daily practice resulted in a significant improvement of menopausal symptoms assessed by the total KMI score and its sub-item scores with an effect size similar to that in a previous randomized, controlled clinical trial.”
A review of the scientific literature by the Cochrane Collaboration (an independent and highly regarded group of experts who analyze research data) concluded in 2012:
“There is currently insufficient evidence to support the use of black cohosh for menopausal symptoms. However, there is adequate justification for conducting further studies in this area. The uncertain quality of identified trials highlights the need for improved reporting of study methods, particularly with regards to allocation concealment and the handling of incomplete outcome data. The effect of black cohosh on other important outcomes, such as health-related quality of life, sexuality, bone health, night sweats and cost-effectiveness also warrants further investigation.”
To learn more about the benefits and risks of hormone replacement therapy (and bioidentical hormones), black cohosh, Pycnogenol, progesterone, red clover, St. John’s Wort, Vitamin E, and other non-hormonal approaches to relieving sympptoms, we suggest Graedons’ Guide to Menopause. This 8-page pamplet can be downloaded from our website for $2 or your can get a printed version for $3. Our Guide to St. John’s Wort is free.
Share your own strategies for dealing with hot flashes, night sweats and other symtoms such as vaginal dryness below.