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Hot Flashes Not Helped by Cohosh and Clover

Red Clover

The latest news flash on hot flashes is that two herbal remedies that many women have used to help relieve this menopausal-related symptom are not effective when compared with hormone therapy and placebo. An important distinction to make here is that black cohosh and red clover did help decrease the average number of hot flashes, but not significantly better than placebo.

Many cultures, including Native American, have long used both black cohosh and red clover for treatment of menstrual and menopausal symptoms, including cramps, bloating, and hot flashes. That tradition was passed along to newer generations and societies, and many women turned to these herbs based largely on positive anecdotal reports rather than scientific research.

The two latest studies by investigators at the University of Illinois at Chicago and Northwestern University compared use of black cohosh and red clover against the standard of care for hot flashes, namely hormone therapy, and placebo. In the first study, 89 women who had moderate to severe hot flashes and episodes of night sweats (at least 35 episodes weekly) were enrolled and randomized to one of four groups: black cohosh, red clover, hormone therapy, or placebo. The women were instructed to record daily the number and intensity of hot flashes.

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The results of this first study showed that the average number of hot flashes decreased as follows: black cohosh, 34 percent; red clover, 57 percent; placebo, 63 percent; and hormone therapy, 94 percent. The researchers noted that both black cohosh and red clover were safe and did not cause any side effects.

In the second study, 66 women who had participated in the first one were tested to determine what effect black cohosh and red clover may have on cognitive abilities, including verbal memory. This was the first study ever to evaluate the cognitive effects of black cohosh. Neither herb had any impact on memory, while the hormone therapy caused a slight negative effect on memory.

Women who are suffering with hot flashes may want to consider the results of yet another study, published in 2007, in which an herbal combination reduced hot flashes by 73 percent. The ingredients in the formula were red clover, black cohosh, dong quai, milk thistle, chaste-tree berry, and American ginseng. The 50 women in the double-blind, placebo-controlled trial took either the herbal formula or placebo twice daily for three months. Those who took the formula reported a 73 percent reduction in hot flashes and a 69 percent reduction in night sweats. Hot flashes disappeared completely in 47 percent of the treated women and in only 19 percent of those who took placebo.

For women who do not want to take hormone therapy for hot flashes and other symptoms of menopause, red clover and black cohosh may be a safe alternative. Whether the addition of other herbs to a treatment plan may be more beneficial remains to be seen. Until more scientific research is done, reports of success in fighting hot flashes with herbs may remain anecdotal.

Geller SE et al. Menopause 2009 Jul 15 (Epub ahead of print)
Maki PM et al. Menopause 2009 Jul 31 (Epub ahead of print)
Rotem C, Kaplan B. Gynecol Endocrinol 2007 Feb; 23(2): 117-22.