Women's Health Articles

While hot flashes and other changes imposed by menopause may not be of your choosing, it doesn?t mean that you?re at their mercy. Equipped with the right knowledge, you can manage your hot flashes and regain control of your life.

Required reading before using any plant extract
Plants and plant extracts are the oldest form of treatment for the symptoms of menopause. This ?science? goes back at least 3,000 years. But it?s only recently that we?ve considered some of the problems with the use of plants for the treatment of human disease.

The variable of extractions
Black Cohosh and other plant extracts require chemical preparation, which basically means that the active ingredients must be extracted from the plant. Water is the most common solvent used for extraction but it is not the only one.

For example, you could make your morning coffee with 100% alcohol instead of water and if you did you would get a very different blend of coffee. I?m not recommending that you make coffee with alcohol and I do not have the slightest idea what the result would be. But that?s exactly the point. We don?t know what the results would be if we used a different extraction procedure.

The FDA makes sure that drugs sold in the U.S. have precise ingredients. But medicinal plants are considered food additives (not drugs) and are not regulated by the FDA. Consequently a manufacturer is free to use whatever kind of extraction procedure it wants in the preparation of a natural plant product. As a result there are wide variations in extraction procedures and, therefore, wide variations in the resulting products.

The variable of concentration
The second variable to consider is that the concentration of a chemical can vary considerably depending upon the conditions under which the plant was grown.

Usually we don?t know what conditions were present when a plant was growing. All we know is that the conditions vary; therefore the concentration of ingredients also varies. Manufacturers who plan on staying in business may take extreme measures to keep the conditions constant. But the point is they don?t have to and there are those who are willing to take short cuts to enhance the bottom line.

The variable of lack of FDA controls
The third thing to keep in mind when using a plant extract like black cohosh is that the FDA has spoiled us. We assume that what the label says is what?s in the bottle. But the bottle we bought from the health food store or from an Internet site is not controlled by anyone. Just because it says ?black cohosh? on the label doesn?t mean there is very much black cohosh in the bottle.

The variability of active ingredients in Black Cohosh
Black Cohosh, an herb sold as a dietary supplement, contains a complex mixture of triterpene glycosides listed on the product?s label as a percent. To give you some idea of how much variation there can be from one manufacturer to the next, look at Table 1.

Retail Product Amount of Active Ingredient
Nature?s Way Brand, 40mg tablets 0.25
GNC Brand, 50mg capsules 0.048
Sundown Natural Whole Herb, 540mg capsules 0.33

Nature?s Resource Brand, 500mg capsules 0.33

Nature?s Valley Brand, 40mg tablets 0.073

Table 1. Five commercially available preparations showing the concentration of the active ingredient in Black Cohosh. Notice that there is almost a tenfold difference between the highest (Sundown and Nature?s Resource) and the lowest (GNC). The two highest products were not extracts but whole root in capsule form.

Recommended by the American College of Obstetricians and Gynecologists Black cohosh is recommended by the American College of Obstetricians and Gynecologists as a non-estrogen treatment for hot flashes. They recommend its use for 6 months or less.

Recommended doses and formulations of Black Cohosh
Remifemin, distributed in the US by GlaxoSmithKline of Germany, is to date the only standardized extract available. The recommended dosage is 20?40 mg twice daily. If you do try it, do not give up too quickly because studies have shown it can take a month or two to get the full benefit.

Don't forget your regular check-ups, pap smears and breast exams.

"Hot Flashes 21 Non-Hormonal Strategies to Put Out the Fire" describes 20 other safe and effective strategies. www.stophotflash.com