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Seeing red

In the past year we’ve grown accustomed to hearing reports about the dangers of combined hormone replacement therapy (HRT). So when a new study was released last week that reported on the “failure” of red clover extract in preventing hot flashes, I’m afraid that many women may have simply filed this news in their ever-growing folder of HRT disappointments.

But this study deserves a second look for two reasons: 1) because red clover is worlds safer than combined HRT pharmaceuticals, and 2) because the results are open to interpretation.

In other words: If you’re a menopausal woman looking for relief from hot flashes, don’t pass on the red clover extract just yet. It might be exactly what you’ve been looking for.

How you look at it

Red clover is a botanical that we’ve written about many times in both HSI Members Alerts and e-Alerts. For centuries, healers in Europe and Asia have used red clover to treat chest congestion, gout, psoriasis, eczema, and to generally purge toxins from the body. And of course, red clover has also been shown to relieve hot flashes in menopausal women.

Last week the Journal of the American Medical Association published the results of a recent study that tested two red clover extract formulations called Promensil and Rimostil. Each dose of Promensil contained 82 mg of isoflavones (the bioactive plant chemicals that have estrogenic activity), and each dose of Rimostil contained 57 mg. Both of these products are manufactured by Novogen, the company that funded the study.

Researchers divided 252 menopausal women into three groups to receive daily doses of Promensil, Rimostil, or a placebo. To qualify for the study, all of the women (aged 45 to 60) reported having a minimum of 35 hot flashes every week. Compiling data from personal diaries kept by each woman for 12 weeks, the researchers found that all of the subjects enjoyed a significant reduction of hot flashes: a 41 percent reduction for the Promensil group, 34 percent for the Rimostil group, and 36 percent for the placebo group.

So is this glass half full or half empty? The answer to that depends on whether you’re looking at it through the critical eye of a clinical researcher, or the critical need of a woman suffering from hot flashes.


Showdown in Chicago


Coming up statistically even with a placebo is not exactly impressive. Nevertheless, one overriding fact remains: something gave relief to the subjects in this study. And because of what we already know about past studies of red clover, we shouldn’t assume the success of the Promensil and Rimostil groups can be easily written off as a placebo effect.

In the e-Alert “Rolling in Clover” (10/24/02), I told you about a smaller but similar study conducted in Amsterdam, in which menopausal women receiving a red clover extract reported their frequency of hot flashes reduced by 44 percent (remarkably close to the percentage experienced by the Promensil group in the Novogen study). Women in the placebo group, however, showed little or no change in the frequency of their hot flashes.

If you’re wondering how there could be such a large discrepancy between the placebo groups in the Amsterdam study and the Novogen study, the answer would almost certainly be revealed if we knew the actual content of the placebos. But all placebos are not created equal, which is a topic that I’ll tell you more about in next Monday’s e-Alert.

To paraphrase the comment that you’ll find at the end of nearly every published study: “Further research is necessary to determine the efficacyetc.” And that’s obviously the case with red clover, as well as with other natural methods that address the symptoms of menopause. But one of the unforeseen results of the failures of so many pharmaceutical HRT studies is that these natural remedies are now getting more attention from the research community.

The University of Illinois at Chicago is currently recruiting subjects for a large, one-year study of the effectiveness of red clover and black cohosh in relieving menopausal symptoms. One of the groups in this study will also receive Prempro (the HRT that combines estrogen and progestin). It’s somewhat surprising that Prempro is being used, because this is the HRT that was shown to elevate the risk of breast cancer, shutting down the Women’s Health Initiative (WHI) study last summer. And a more recent study released this past May revealed that the risk of Alzheimer’s disease is also increased with Prempro usage.

In any case, it will be a Showdown in Chicag the two botanical contenders going head-to-head with the dangerous mainstream pharmaceutical. I’m sure that when the study is completed the results will be widely reported, and you can be sure that I’ll keep you posted.


Other options
In the meantime, any woman coping with hot flashes probably looks at the results of the Novogen study and wonders: Will it work for me?

To answer that question, I’d like to say “It couldn’t hurt.” But the fact is that red clover usage comes with a couple of warnings.

Studies have shown that red clover extracts may thin the blood, so it’s not recommended for patients taking anticoagulant medications. And because estrogenic activity is stimulated by isoflavones, those with hormone sensitive diseases (such as thyroid dysfunction) should also use red clover extracts with caution.

If red clover isn’t right for you, however, there are other ways to address hot flashes without pharmaceuticals. In the e-Alert “Turning Down The Heat” (12/17/02), I shared several e-mails from HSI members who wrote to tell about the natural methods that had worked for them, such as: indium, natural progesterone yam cream, and large doses of vitamins C and E.

And in the e-Alert “Jumpin’ Pax Flash” 6/9/03) I told you about a special report titled “Look and Feel Your Best,” written by HSI Panelist Linda Page, N.D., Ph.D. In this report Dr. Page shows women how to make their way through menopause naturally, without using hormone replacement therapy. Learn more about how Dr. Page’s techniques can make the difference between just surviving menopause, and emerging from it happier and healthier at http://www.agora-inc.com/reports/610SHORM/W610D712/home.cfm.

To Your Good Health,

Jenny Thompson
Health Sciences Institute

Sources:
“Phytoestrogen Supplements for the Treatment of Hot Flashes: The Isoflavone Clover Extract (ICE) Study” Journal of the American Medical Association, Vol. 290, Pgs. 207-214, 7/9/03, jama.ama-assn.org
“2 Supplements Offer Questionable Relief From Menopause” Amanda Gardner, HealthDay, 7/8/03, healthscoutnews.com
“Study: Clover Effect on Menopause Benign” Lindsey Tanner, Associated Press, 7/9/03, newsday.com
“Herbal Research Spurred on by HRT Risk” NutraIngredients.com, 7/11/03, nutraingredients.com

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