Eradicating Hot Flashes- Herbs, Spices, and Wishful Thinking
Estroven™, Estrovera™, Amberen™, Black Cohosh, Chinese Herbs, Dong Quai, Evening Primrose, Maca, and Wild Yam
It is estimated that up to 75% of postmenopausal women use complementary and alternative therapies to manage hot flashes, based on recommendations they get from a co-worker, their manicurist, a menopause influencer, or an ad that pops up on Facebook. It’s creepy how Facebook knows you’re having hot flashes and inundates you with remedies. Usually at 2 AM. Pollen extract, maca, Estroven™…the options are as endless, as are the ads. And the testimonials are so convincing that even I sometimes believe them.
This is hardly a new phenomenon. Back in the 1880s, Lydia Pinkham’s Vegetable Compound was the popular cure-all for virtually every gynecologic ailment, including menopause-related problems.
You’ve got to love Lydia Pinkham. Not only was she a supporter of women’s rights and publicly and vehemently anti-slavery, but she also really wanted to help other women. She was particularly interested in menstrual and menopausal ailments that women would be too embarrassed to report to their doctors. So, she mixed up an herbal concoction and started selling it out of her basement. And no surprise, Lydia Pinkham’s Vegetable Compound, which claimed to be “A Positive cure for all those painful complaints and weaknesses so common to our best female population and is particularly adapted to the change of life,” was wildly successful.
No doubt, its 18% alcohol content had something to do with its popularity. Even very proper ladies could remain legitimately inebriated as they dealt with difficult menstrual and menopausal symptoms.
Another key ingredient of Mrs. Pinkham’s remedy? None other than black cohosh, an extract of dried roots derived from a plant used by native North American Indians, and still, a widely used botanical therapy for the treatment of hot flashes.
Fast forward to today. There is no end to herbs and nutraceuticals that are promoted as giving relief from flashes. Unfortunately, very few scientific, well-designed studies on popular products to reduce hot flashes have been published.
Additionally, the placebo effect is significant. If a trusted source advises taking soy, Chinese herbs, or blue M&M’s, at least 30% of women will experience fewer flashes.
The placebo effect is real—it just doesn’t last. For about 12 weeks, pretty much any product you believe in will reduce the severity and number of hot flashes and help you sleep, which would be great…if flashes lasted only 12 weeks.
A multibillion-dollar industry has evolved to promote “natural” products to women who are suffering and seeking safe, effective options. Although some women distrust the pharmaceutical industry, which is obligated to test and report all negative findings, the general population appears to have little problem placing its trust in information and promotional ads placed by companies or celebrities that have no established efficacy or safety standards.
There are only two criteria that are appropriate when deciding to use a product: Is it safe? And does it work?
Too often, no one really knows. These products are neither foods nor drugs, so approval from the Food and Drug Administration is not necessary, and manufacturers are not held responsible for their safety or efficacy. On every website, scroll past all of the enthusiastic testimonials, and you will find a disclaimer that the FDA has evaluated none of their claims and that the “product is not intended to diagnose, treat, or prevent any disease”.
Fueled by aggressive, creative marketing and supported by the placebo effect, along with the fact that, by nature, perimenopausal hot flashes come and go, companies can convincingly market their products with testimonials and “secret proprietary ingredients” that are often the equivalent of oregano.
Today, I’m going to cover the research and scientific studies that have been done on a few of the most commonly used over-the-counter products that claim to ease hot flashes and other menopause symptoms.
For each product, I assign a category based on published scientific studies.
Category 1: Effective- products that in placebo-controlled trials have been scientifically shown to reduce hot flashes beyond the placebo effect
Category 2: Not Effective and/or Dangerous Products that in placebo-controlled trials have scientifically been shown NOT to reduce hot flashes, and/or are harmful.
Category 3: Who Knows? Studies are conflicting or inadequate; however, there is no evidence to suggest that the product is dangerous. More studies would be nice.
Category 4: Who knows? Possibly Dangerous Studies are conflicting, inadequate or non-existent. This is the scary category, because not only is efficacy questionable, but even more important, there is no way to know it is safe. And just because something is natural, it does not mean it is safe. Arsenic comes to mind.
