CHINESE HERBS--AN ALTERNATIVE TREATMENT FOR HOT FLASHES

DESCRIPTION (adapted from applicant's abstract): Hot flashes (HFs) are the predominant complaint of menopausal women in the United States, with a prevalence of 58-93% during the first two years postmenopause. They can impact on daily functioning, particularly when they disrupt sleep, leading to fatigue during the day. Hot flashes can continue for many years postmenopausally, posing a problem of considerable magnitude for millions of women. Estrogen therapy is the most effective treatment available in Western medicine. Yet estrogen, with or without progestin, is contraindicated for some women, particularly those with breast or reproductive system cancers. Other women cannot tolerate the side effects associated with hormone therapy (HT) or are concerned whether HT might increase the risk for breast cancer. Given few medical choices, many women look for other ways to ease their passage through menopause. They experiment with "alternative" remedies. Despite this ongoing experimentation by women, and much anecdotal information about herbs, there has been no systematic examination of herbal remedies for HFs. Chinese herbs have been used for thousands of years for menopausal problems, including HFs. Some of the component herbs are known to be estrogenic in activity, but it is not known whether this might be their mechanism of action. If it is, an important concern would be whether these exogenous sources of estrogen might pose problems for those very women who take herbs because they cannot take HT. The objective of the proposed research is to examine the effect of two Chinese herbal preparations on the frequency and intensity of HFs in postmenopausal women using a double-blind, placebo-controlled crossover study design. All women will record the HFs. A subset of women will have the HFs recorded physiologically before and after the treatment phases of the study. It is proposed to measure serum estradiol, estrone, before and after active and placebo phases, and other indices of estrogenicity including the vaginal maturation index, and serum lipid levels.