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4 May 2006
Red Clover Ineffective For Hot Flashes 
A meta-study carried out on previous trials of non-hormonal therapies for menopausal hot flashes has found antidepressants to be most effective, while there was no evidence to support the efficacy of red clover extracts. Carried out by researchers from the Oregon Health and Science University and Providence Health System, the study found supportive evidence for the effectiveness of both SSRI and SNRI antidepressants. Both selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenergic reuptake inhibitors (SNRIs) (eg. paroxetine, venlafaxine, fluoxetine and citalopram) were found to reduce the frequency and severity of menopausal hot flashes. But the trials do not support the effectiveness of red clover isoflavone extracts and present mixed results for soy isoflavone extracts. "Despite increasing interest in therapies for menopausal hot flashes that avoid use of estrogen, the efficacy and safety of other options currently are not well supported. The SSRIs or SNRIs, clonidine, and gabapentin provide some evidence of efficacy. However, effects are less than those for estrogen therapy. Adverse effects and cost may prohibit use for many women. Although these therapies may be most useful for highly symptomatic women who cannot take estrogen, they are not optimal choices for most women," the researchers said. Hot flashes are a common symptom related to menopause and are experienced by more than 50 percent of menopausal women. They can persist for several years after menopause and for some women can interfere with activities to such a degree that treatment is sought. Estrogen has been used as a hormone supplement in the past but recent studies reporting adverse effects such as cardiovascular events and breast cancer have raised important concerns about its use.
Commenting on the study, Jeffrey A. Tice and Deborah Grady, from the University of California, said that women with hot flashes should understand that most symptoms resolve over time with no treatment. "Those women with mild symptoms may find adequate relief by wearing layered clothing and keeping the home and bedroom cool. For women with more bothersome symptoms, clinicians should understand the advantages and disadvantages of both hormone therapy and non-hormonal alternatives. Non-hormonal alternatives are less effective than estrogen, generally have more symptomatic adverse effects, and long-term adverse effects are not as well documented. A better understanding of the pathophysiology of hot flashes will likely be necessary for the development of non-hormonal therapies that equal or surpass the efficacy of hormones," they concluded. Source: Journal of the American Medical Association
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