CHICAGO (AP) -- Red clover supplements marketed as a way to relieve menopausal symptoms work no better than dummy pills at easing hot flashes, a study found -- disappointing news for women seeking alternatives to hormone treatment.
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July 9, 2003
By James Winshall, M.D.
Harvard Medical School
How does this article relate to me?
This story raises two important issues. The first concerns the specific benefits of red clover extracts: Should doctors recommend red clover extracts for women suffering from menopausal hot flashes? Based on the study, the answer should probably be no. While the drug is generally safe, it appears no more effective than a dummy pill at reducing hot flashes. (Both the women in the study who took a dummy pill and those who took red clover found that their hot flashes improved over time — an interesting insight into the "placebo effect.") Women who still want to take red clover extracts probably aren't being harmed, but they probably aren't being helped either.
The second, wider-ranging issue concerns the benefits of herbal supplements in general. While it's unfair to condemn the entire herbal medicine and supplement industry based solely on this report, many recent studies of herbal treatments have raised serious doubts and concerns. Among the findings:
- Remifemin (black cohosh) doesn't appear to reduce hot flashes.
- Gingko does not appear to help with memory loss.
- Ephedra, a common weight loss supplement, may cause a wide range of serious side effects.
- St. John's wort, used for depression, may interfere with the metabolism of certain drugs such as cancer chemotherapy.
- Certain "natural" remedies actually contain dangerous amounts of prescription drugs such as Viagra or blood thinners.
These latest study results are important precisely because they help us to separate the myth from the facts. While it's disappointing that red clover doesn't appear to live up to its claims, it's only by learning this that we can feel confident when a different study finds an herbal remedy that really does work.
What changes do I need to make?
Women suffering from menopausal hot flashes continue to have limited treatment options. The best treatment, estrogen-based hormone replacement therapy, has significant side effects including an increased risk of breast cancer, heart attacks and blood clots. Some doctors continue to recommend estrogen for short-term treatment of menopause symptoms, but many women are understandably nervous about using this drug for even short periods.
As noted above, the herbal remedies red clover and black cohosh appear safe, but not terribly effective. Soy supplements have also been recommended, although the natural estrogen-like compounds found in soy are similar to those found in red clover.
The latest drugs that appear to help with hot flashes are antidepressants including Paxil and Effexor. No one is certain why these drugs work, but studies have shown them to be better than dummy pills (but probably not nearly as effective as estrogen). Since these drugs do have some important side effects, you should speak with your health-care provider about the pros and cons of an antidepressant drug before trying one.
What about taking herbal supplements in general? The major rule continues to be "Let the buyer beware." Many people feel more comfortable taking a natural product than something synthesized in a laboratory, but it's important to fully understand what any drug offers in terms of risks and benefits. Is it better to take an ineffective herbal supplement than a prescription medication that works? Ultimately this is a personal decision, but an educated and open-minded consumer is in the best position to make a good decision.
What can I expect in the future?
High quality medical studies have been performed for only a handful of the hundreds of herbal remedies and supplements that are on the market. Hopefully, we will see many more studies like this one; and hopefully, some of them will turn up some encouraging rather than disappointing results. Menopausal hot flashes are just one medical problem for which we have only limited and unsatisfying treatment options. Fortunately, the National Institutes of Health is gearing up to study a much broader range of complementary and alternative therapies, and we should begin to get more result soon.
Related Areas:
Hot Flashes
Complementary And Alternative Medicine
Index Of Herbal Medicines And Supplements
