The Links between Your Diet and Hormone Levels, and How Estrogen May Protect You Against Dementia

Story at-a-glance 

Your hormones have far-reaching effects in your body, and hormone deficiencies can therefore wreak total havoc on your health Continue reading

The Evidence For and Against Birth Induction

Abstract: Smith (2003) found unexplained stillbirth occurs once in 2000 births (0.5/1000) after 34 weeks among low risk second pregnancies, following a first vaginal birth in the absence of induction for postdates.  If induction for postdates could prevent stillbirth by expediting the deliver, one would expect to save 0.5/1000.   Four systematic reviews performing meta-analysis of the data regarding the effect of induction for postdates draw three different conclusions.  Cochrane (2012) concludes that inducing at 41 weeks can prevent 1 stillbirth/perinatal death for Continue reading

A Natural Remedy for Menopause – Black Cohosh

In 2000, results from two large studies showed that taking estrogen and medroxyprogesterone could actually increase the risk of heart attacks, strokes, and breast cancer. (Medroxyprogesterone is a drug that protects the uterus and may reduce a woman’s risk of cancer.) Then came the news that hormone replacement therapy was linked to the risks of urinary incontinence and dementia.

Ever since all this news broke, there has been intense focus on finding alternative therapies. Here, I want to give you an up-to-date, unbiased review of what all the scientific literature says. Do dietary supplements actually reduce menopausal symptoms? Let’s go case-by-case starting with the big hitter.

Black cohosh is native to North America. It is the most- studied supplement for treating menopausal symptoms. As early as 1940, it has been widely used in Germany. Here are the best studies conducted so far in chronological order:

1988: Over six months, 48 to 140 milligrams (mg) of black cohosh a day significantly reduced menopausal symptoms Continue reading

CAM Treatments for Hot Flashes

Herbal Treatments

Herbal medicine is based on the use of plants as remedies for a wide range of conditions. Herbal supplements (containing either one or several herbs or mixed with other ingredients) are available from health food stores, alternative healthcare professionals, pharmacies, herbalists and the Internet. As such, the range of potency, ingredients, quality and price can vary greatly.

In the US, there is very little regulation on alternative medications, making it difficult to be able to quantify through research that a particular herb or compound has a positive (or negative) treatment effect. The lack of standardization and regulation makes it difficult to determine just how much of an herb or supplement is contained in a product, or if there are additional unlisted ingredients. Another misconception is that any herb or supplement  Continue reading

What is Black Cohosh?

Latin names: Cimicifuga racemosa, Actea racemosa

 Black cohosh is a tall perennial plant in the buttercup family that grows in eastern and central areas of the United States. Black cohosh was used by Native Americans as a traditional folk remedy for womens’ health conditions, such as menstrual cramps and hot flashes, arthritis, muscle pain, sore throat, cough and indigestion. The juice of the plant was used as an insect repellent and was made into a salve and applied to snake bites.

 Today, black cohosh is used primarily as a nutritional supplement for hot flashes, mood swings, night sweats, vaginal dryness and other symptoms that can occur during menopause, as well as for menstrual cramps and bloating.

 The parts of the plant used medicinally are the fresh or dried roots and rhizomes (underground stems), which are available in health food stores, some drug stores and online in tea, capsule, tablet or liquid extract forms. The active compound is believed to be 26-deoxyactein.

 How Does Black Cohosh Work?

How black cohosh works isn’t understood. It was once thought to have estrogen-like activity, but there is growing evidence that it does not.

 Why Do People Use Black Cohosh?

•Menopausal Symptoms

 Black cohosh is one of the more popular herbal remedies for menopausal symptoms, such as hot flashes, night sweats, migraines, mood disturbances, heart palpitations and vaginal dryness. Initial research on black cohosh suggests that it may improve some menopausal symptoms for up to six months. In fact, in 2001, the American College of Obstetricians and Gynecologists stated that black cohosh may be helpful in the short-term (less than 6 months) for menopausal hot flashes.

 A recent, year-long study on black cohosh, however, didn’t find that it had any significant benefit in women with hot flashes or night sweats. Researchers from the National Institute on Aging and the National Center for Complementary and Alternative Medicine gave 351 peri-menopausal and post-menopausal women either black cohosh, black cohosh combined with other herbs, the black cohosh/herb blend plus a soy-enhanced diet, hormone replacement therapy or a placebo.

 Although this is the longest study to date, there were some serious limitations, such as the small number of women in each treatment group. The study authors acknowledge that changes may not have been detected.

 Side Effects and Safety Concerns

The safety of black cohosh in pregnant or breastfeeding women or children hasn’t been established. Black cohosh is sometimes used by nurse-midwives to induce labor, but it should never be used by a pregnant woman without supervision by a qualified healthcare provider because it could stimulate uterine contractions and result in miscarriage.

 People with hormone-sensitive conditions, such as cancer of the breast, prostate, ovaries or uterus, endometriosis or uterine fibroids, should avoid black cohosh until more is known about how it works and whether it has a hormonal effect.

 Side effects of black cohosh may include:

 •Indigestion

 •Headache 

•Nausea

 •Perspiration

 •Vomiting

 •Heaviness in the legs

 •Weight gain 

•Low blood pressure

Excessive doses of black cohosh may cause seizures, visual disturbances and slow or irregular heartbeat. There have been a number of cases of liver damage suspected to be associated with black cohosh use. In most of the cases, there were other medical problems present and other medications used that may have contributed to the liver damage. Also, the quality and purity of the black cohosh products used isn’t known. Some black cohosh products, for instance, have been found to contain a Chinese cimicifuga (Cimicifuga foetida) instead of black cohosh.

 Still, in August 2006, Health Canada advised consumers of the possible link between black cohosh and liver damage. In June 2007, the United States Pharmacopeia proposed that black cohosh product labels contain a cautionary statement. The American Botanical Council has countered that there is insufficient evidence to warrant the proposed caution.

 Black cohosh should not be confused with the herb blue cohosh (Caulophyllum thalictroides), white cohosh, bugbane, Cimicifuga foetida, sheng ma or white baneberry. These species have different effects, and blue cohosh and white cohosh, in particular, can be toxic. There is a case report of neurological complications in a post-term baby after labor induction with a herbal blend of black cohosh and blue cohosh.

 People with allergies to plants in the buttercup (Ranunculaceae) family should avoid black cohosh.

 Black cohosh contains small amounts of salicylic acid, so people with allergies to aspirin or salicylates should avoid black cohosh.

 People with a history of blood clots or stroke, seizures, liver disease and those who are taking medications for high blood pressure should not use black cohosh.

 Possible Drug Interactions

Because it may act like the hormone estrogen in the body, black cohosh could interfere with hormone replacement therapy or oral contraceptives.

 Black cohosh may interfere with the effectiveness of the chemotherapy drug cisplatin. 

Theoretically, black cohosh may interfere with the effectiveness of hormone replacement therapy or oral contraceptives.