Could a complementary medicine help? A story about hot flushes Could a complementary medicine help? A story about hot flushes

I’ve always had an open attitude to health. I like to know what’s out there and to learn about different treatments, especially natural ones. I’m going through menopause at the moment and the hot flushes are a nuisance. A friend told me about a herbal medicine, black cohosh, and said that it worked well for her.

I decided to look into it. My hot flushes don’t last too long, but sometimes I get them at night and have trouble sleeping. I started browsing on the internet and found a website from the US that said black cohosh had been used by the native North Americans for a couple of hundred years for menopause. It said I could buy black cohosh from their website and get it delivered to Australia.

This set off alarm bells for me, because I like to know that any complementary medicines I buy have been through some sort of check. There can be too many unknowns if you buy something direct from overseas — sometimes they don’t even contain the ingredients they say they do. I was also worried that if the website was written by the people selling it, they might just put all the positive information and not the down sides.

So I checked the NCCAM (National Center for Complementary and Alternative Medicine) website, which is run by the US National Institutes of Health. It said the results of scientific studies on black cohosh were mixed — that is, some said it worked while others said it didn’t. I kept reading and then saw that black cohosh might be linked to liver damage. It was rare, but it made me feel less comfortable.

The more I thought about it, the more it felt like a risk that I didn't want to take. Some people have a really bad reaction to certain medicines, and how would I know if that would be me with black cohosh? I wasn’t sure about it, even if it did work for my friend.

If I’m going to take a medicine, I want it to be safe.

While I was on the NCCAM site, I thought I would see what it said about valerian — another friend uses it to help her sleep. The website said it may be helpful for insomnia, but there wasn’t a huge amount of research to confirm it. There didn’t seem to be anything about safety that worried me. So maybe that’s an option.

I talked to my GP about the hot flushes, and she said I could think about hormone replacement therapy (HRT) if they were really bad, because it was still the most effective proven treatment. She said HRT came with its own risks too, including a small increase in breast cancer risk and other problems that I would need to take into account.

How would you compare HRT to black cohosh? My GP agreed it was difficult. But she said we had to think about the quality of the information available. She pointed out that the risks of HRT were identified in huge studies involving thousands of women. Those kinds of studies haven’t been done for black cohosh, so it’s like comparing apples and oranges.

We know there is a risk with HRT but we also know the size of it. She said if 1000 women took HRT for 5 years, an extra four women (and maybe fewer with shorter treatment) would get breast cancer because of it compared to women who didn’t take it. But for black cohosh and other treatments, we simply don’t know. My GP stressed it was my choice and she suggested I take some time to think about the risks and benefits of both options. She gave me lots of information about exercise and diet and other ways to stay healthy during menopause, and a few tips like avoiding alcohol, hot drinks and spicy food, since they can bring on hot flushes.

I decided that if the hot flushes were unbearable, I might feel differently, but I think I’ll just try to keep cool without taking anything for now — except maybe some valerian tea at night.

This is a fictional account for educational purposes.