Black cohosh doesn't help with hot flashes...or does it?

I took Black Cohosh for a year without any result until my new doctor said not to take it because it could hurt more than help you. I stopped taking it and foot discomfort and tingling stopped within two weeks. I certainly have much more respect for this doctor.

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I'm a naturopathic physician and am interested in your question. However, just because someone might report that it has an effect does not mean that it did. This issue gets to the heart of a placebo-controlled study. In fact, 3 out of every 10 women who have tried black cohosh should be able to write a positive comment on this blog. But does it mean that the herb did anything?

As women are running away from hormone therapy for menopausal symptoms in droves, the search for other options is heating up.

I'm sure that most other naturopaths and alternative healers were as excited as I was a couple of years ago. I felt like the announcement that various types of cancers could be increased with the standard estrogen-progestin prescriptions was a great opportunity for natural medicine. "Finally!", I thought, "People are going to really see what natural medicine can do..."

Unfortunately, there is no "big gun" therapy that can have the same effect on hot flashes as hormone replacement therapy, as the recent study on black cohosh suggests. I have to admit that I haven't read the actual study, but it is hard to ignore a year-long study with 351 participants. It even had a seperate arm of the study that included women on a multi-herb preparation that included black cohosh along with other herbs.

Maybe the dose was low, but to work barely more than placebo doesn't say much for the intervention. And in fact, this is another example of the Type 2 error that dominates the natural side of "best guess medicine." We often lump a number of treatments into our bag without knowing what their true efficacies are. We say that this is ok because the treatments aren't as expensive or dangerous as many drug or surgery options.

And we also say that the type 2 error is ok because the research hasn't caught up to the treatment yet. For years, we've said that as the research is done, our treatments will be validated. Well, it's time to take an honest look at some of this medicine and wonder if finding a green alternative to a drug is really the best plan.

It's time to step away from the medical, car mechanic model of the human body. The vast majority of natural medicine is just as reductionist as conventional medicine- no matter what kind of herbal skirt you dress it up with.
www.drtraviselliott.com

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Having had my ovaries removed 8 years ago along with treatment for cervical cancer, I can definitely say that black cohosh is the wonder drug for me. I tried all the HRT's and had very bad times with all them. A PA suggested I try black cohosh and I have been hot flash free, mood swing free and loving life every since. How can they say it does no good when in reality it may work for some people and not others, the same as ANY other drug or herb on the market.

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