For most women, menopause is known chiefly through its side effects. Up to 85 percent of Western women experience menopausal symptoms, including hot flashes, night sweats, disturbed sleep, fatigue, and related psychological changes, such as depression and anxiety (Burd et al 2001; Mahady et al 2002; Philp 2003; Soares et al 2003). Physical changes include urinary tract atrophy, vaginal atrophy and dryness with discomfort during sexual intercourse (Burger 2001; Coope 1996; Griffith 2004). These uncomfortable symptoms can last up to five years, with an average duration of two to three years (Samsioe 1995). Other symptoms include the following:
- Strength, energy, muscle, and bone loss (Notelovitz 2002; Proctor et al 1998)
- Cognitive changes, such as decreased memory, lack of concentration, and decreased learning capacity (Bhavnani 2003; Duffy et al 2003; File et al 2001; Lephart et al 2002)
- Elevated cholesterol levels due to alterations in cholesterol metabolism, as well as hardening of the arteries (atherosclerosis) and increased blood pressure (Philosophe et al 1991). Estrogen deprivation is a contributing factor to cardiovascular disease, the leading cause of death of women (Brochier et al 1998). It has been hypothesized that elevated cholesterol may be connected to falling hormone levels because the body tries to compensate for lost hormones by increasing the supply of precursor cholesterol (Dzugan et al 2002).
Native American Indians have used black cohosh as a traditional medicine for many years, and Koreans have used it to treat pain and inflammation (Huntley 2004; Kim et al 2004; McKenna et al 2001). Today, it is used primarily for the treatment of menopausal symptoms, such as hot flashes, and menopausal depression and anxiety (Kennelly et al 2002). Black cohosh has also been used to treat younger women who have surgically induced hormonal deficits due to hysterectomy or ovariectomy and for menstrual disorders (McKenna et al 2001). It is effective for reducing hot flashes, night sweats, fatigue, and insomnia (Kronenberg et al 2002; Philp 2003; Pockaj et al 2004).
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