Do you feel fear or worry regarding the onset of menopause, either for yourself or someone you love? Antidepressants and hormone treatments may be the popular prescriptions, but before you take medications with serious risks, learn about the incredible results of black cohosh for those pesky, sweaty, hot flashy nights

Even in the modern day, there are abundant myths and mysteries surrounding menopause, the period in a woman’s life that occurs 12 months after her last menstrual cycle.^[1] Perimenopause, the transition period before menopause, is marked by hormonal changes leading to the cessation of menses.^[2]

Both phases, hereafter collectively referred to as menopause, are characterized by physical and psycho-social changes that lend to the stories surrounding women’s behaviors, thoughts, and feelings during this time of transition.

Menopause can range from a few months to several years in duration and is spurred by decreased estrogenproduction in the ovaries. These hormonal shifts can have associated and, at times, unpleasant side-effects, which may be managed through holistic or pharmacological interventions, or a combination of the two modalities.

Historically, some have prescribed to the belief that “the change” brings about an unwelcome and inevitable reality, both for women and the men in their lives. Is it any wonder that the “fix” has become to prescribe mood-altering drugs, or to attempt to “put back” the hormones that the passage of time is depleting? In truth, this natural cessation of fertility need not be synonymous with a distressing or unpleasant experience.

Antidepressants are widely prescribed for menopause symptoms ranging from depression and low libido, to anxiety and social isolation. Instead of directly addressing the emotional aspects of aging, empty-nesting, and our physiological need for strong social bonds, modern medical dogma is to simply prescribe a “magic pill” in hopes that these uncomfortable feelings will disappear.

Beyond the emotional and psychological impacts, vasomotor symptoms are commonly experienced during perimenopause up to full menopause. Changes in body temperature such as flushing and night sweats are frequently reported, and the condition known as “hot flashes” can onset. According to a 2008 study,^[3] nearly 80% of peri- and postmenopausal women reported experiencing some or all of these symptoms.

Medicating Menopause: A Risky Prescription

A popular treatment administered to menopausal women in the U.S. is ERT, or estrogen replacement therapy. While it may seem natural to replace fading endogenous hormones with an exogenous supply,  warning bell has been sounded regarding potentially harmful side effects.^[4] ERT has been linked to cancer, cardiovascular disease and stroke, among other concerning outcomes.^[5]

Another prescribed treatment for vasomotor symptoms is gabapentin, known by the brand name Neurontin, an anti-seizure drug used to treat nerve pain and conditions such as restless leg syndrome. Also prescribed for anxiety, gabapentin has a high potential for addiction and misuse,^[6] and can have undesirable side effects such as slurred speech, blurred vision and impaired motor function.^[7] Even worse, Neurontin has been linked to cases of suicidal ideation^[8] and respiratory failure,^[9] among other serious side effects.^[10]

Another option frequently prescribed are the broad spectrum of mood-altering and antidepressant drugs. Selective serotonin reuptake inhibitors, SSRIs, and serotonin-norepinephrine reuptake inhibitors, SNRIs are often the first course of treatment when a menopausal patient complains of depression, lethargy, or hormonal issues.

According to the U.S. Centers for Disease Control and Prevention, women are 2.5 times more likely to be prescribed an antidepressant than men.^[11] Nearly 23% of woman ages 40 to 59 are taking antidepressant medication in the U.S., more than any other age-sex group.^[12]

Validated by Science: Natural Options for Hormonal Balance

While natural options for managing menopause may not be routinely prescribed by allopathic physicians, science has validated that black cohosh is a viable treatment for several discomforting symptoms of this life-changing transition.

This double-blind placebo-controlled study, found that black cohosh (scientific name: Cimicifuga Racemosa) was “equipotent” to mixed-estrogen drugs for relief from vasomotor symptoms, and for improving markers of bone metabolism, a factor related to osteoporosis.

What’s not equal when comparing most plant medicines to pharmaceuticals are potential adverse effects. Premarin®, a popular mixed-estrogen drug, has a warning label that cites increased risks of heart attack, cancer, blood clotsand stroke,^[13] while studies involving a 12-month course of treatment with black cohosh root (the part of the plant used in herbal formulations) show it was administered with no known adverse effects.^[14]

Another impressive study pitting black cohosh against a popular prescription involves Prozac® for treatment of postmenopausal symptoms. The 2007 study, published in Advances in Therapy, compared questionnaires from 120 healthy women with menopausal symptoms who rated such factors as quality of life, depression scores, and frequency and severity of vasomotor symptoms like flushing and night sweats.^[15]

Women in this study were randomly assigned to 1 of 2 groups, with one group receiving fluoxetine (generic form of Prozac®) and the other group receiving black cohosh. The women were surveyed before, during and after the study, for a period of six months. They kept daily diaries recording the number and intensity of hot flashes and night sweats, as well as completing several standardized questionnaires.

Results of this study showed that black cohosh reduced overall scores for hot flushes and night sweats better than Prozac®. At the end of the sixth month of treatment, black cohosh reduced the hot flush score by 85%, compared with a 62% result for fluoxetine.

By the study’s end, 40 women taking the prescription drug had discontinued the study, while only 20 women in the black cohosh group discontinued, potentially speaking to benefits gained from long-term use of herbs, the reverse of which is true for many pharmaceutical drugs, which are contraindicated for longer periods of use.

Managing Change Gracefully

Placebo effect dictates that the beliefs we hold about our health and treatment options have significant impact on our experiences. Be aware of any negative beliefs you might hold about menopause; despite popular opinions and superstitions,^[1] there is no mandate that this phase of life must be a difficult one.

With improved psycho-social awareness of the stressors women experience mid-life, and better understanding of naturally effective treatment options, we can begin to view menopause as a celebration of life rather than the death of fertility. It’s the dawning of a new cycle, a time ripe for giving of your experience and wisdom. Protect your vitality with naturally effective plant medicine and enjoy all the seasons of your life.

To learn more about black cohosh and other natural treatment options for menopause, explore the 79 abstracts and 38 natural substances that are compiled on GreenMedInfo’s Research Database.

References

[1] Menopause and Hormone Replacement February 25, 2015 https://www.ncbi.nlm.nih.gov/books/NBK279050/

[2] The North American Menopause Society, Menopause 101 https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal

[3] Frequency and severity of vasomotor symptoms among peri- and postmenopausal women in the United States. Williams RE, Kalilani L, DiBenedetti DB, Zhou X, Granger AL, Fehnel SE, Levine KB, Jordan J, Clark RV. Climacteric. 2008 Feb; 11(1):32-43. https://www.ncbi.nlm.nih.gov/pubmed/18202963/

[4] Project Aware https://www.project-aware.org/Managing/Hrt/benefits-risks.shtml

[5] Am J Obstet Gynecol. 1995 Sep;173(3 Pt 2):982-9. https://www.ncbi.nlm.nih.gov/pubmed/7573295

[6] J Exp Pharmacol. 2017; 9: 13-21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308580/

[7] Toxnet, Gabapentin https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+7364

[8] Pregabalin-induced self-harm behavior. Tandon VR, Mahajan V, Gillani ZH, Mahajan A. Indian J Pharmacol. 2013 Nov-Dec; 45(6):638-9. https://www.ncbi.nlm.nih.gov/pubmed/24347781/

[9] Recurrent hypoventilation and respiratory failure during gabapentin therapy. Batoon SB, Vela AT, Dave D, Wahid Z, Conetta R, Iakovou C, Banzuela M. J Am Geriatr Soc. 2001 Apr; 49(4):498. https://www.ncbi.nlm.nih.gov/pubmed/11347805/

[10] Pfizer, Neurontin https://www.pfizermedicalinformation.com/en-us/neurontin/adverse-reactions

[11] U.S. CDC, NCHS Data Brief No. 76, October 2011 https://www.cdc.gov/nchs/products/databriefs/db76.htm

[12] U.S. CDC, NCHS Data Brief No. 76, October 2011 https://www.cdc.gov/nchs/products/databriefs/db76.htm

[13] Pfizer, Premarin https://www.pfizermedicalinformation.com/en-us/patient/premarin

[14] National Center for Complementary and Integrative Health, Black Cohosh https://nccih.nih.gov/health/blackcohosh/ataglance.htm

[15] Adv Ther. 2007 Mar-Apr;24(2):448-61.https://www.ncbi.nlm.nih.gov/pubmed/17565936