I know I wrote about menopause only three weeks ago (and received some joking complaints from a few male patients about covering irrelevant topics) but I donâ€™t write the medical literature; I just report it.
A great study was published this week in the Annals of Internal Medicine, and the summary for patients is free without a subscription. Itâ€™s brief and informative. The study enrolled menopausal women who were having at least two episodes of hot flashes per day and randomized them to five treatment groups, each of which received one of the following treatments: black cohosh (an herb frequently marketed for the treatment of menopausal symptoms), a multibotanical herbal product, a multibotanical herbal product and counseling to increase dietary soy intake, estrogen hormone therapy, or a placebo pill. The group receiving estrogen had fewer hot flashes and night sweats; the other four groups all had similar symptom frequency. Black cohosh, herbs, and soy did no better than placebo.
(By the way, a brewing controversy that I have not seen addressed is that the New England Journal of Medicine calls them “hot flushes”, while the Annals calls them “hot flashes”.)
An editorial in the same issue of Annals ends with some words of encouragement.
“The good news from [this study] has to do with the natural history of vasomotor symptoms. Women in the placebo group experienced an approximately 30% reduction in the severity and frequency of vasomotor symptoms during the 12-month follow-up period. â€¦ Therefore, if a woman is not severely bothered by her vasomotor symptoms, it is important to reassure her that she has a good chance of having fewer symptoms within 6 to 12 months. Indeed, she may not need treatment at all.”
So female patients should take heart â€“ your symptoms will likely be mild and temporary. And male patients should be patient until I write about prostate problems, or football.
I wish all of my patients and readers who are celebrating a very merry Christmas!