hypericum and Hot-Flashes

To compare by meta-analysis the efficacy and adverse events of Hypericum perforatum L. (St. John's Wort), or its combinations, and placebo for menopausal women.. A systematic review and meta-analysis were carried out by searching in Pubmed, Cochrane Library, Embase and the Web of Science database.. Extracts of Hypericum perforatum L. and its combination with herbs were significantly superior to placebo (standard mean difference = -1.08; 95% confidence interval -1.38 to -0.77); extracts of Hypericum perforatum L. proved to be more effective than placebo in the treatment of menopause. Adverse events occurred in 53 (17.4%) patients on Hypericum perforatum L. preparations and 45 (15.4%) patients on placebo (relative risk = 1.16; 95% confidence interval 0.81-1.66).. Extracts of Hypericum perforatum L. have possibly fewer side-effects than placebo for the treatment of menopausal women.

Topics: Adult; Confidence Intervals; Depression; Female; Hot Flashes; Humans; Hypericum; Menopause; Middle Aged; Phytotherapy; Plant Extracts; Randomized Controlled Trials as Topic; Treatment Outcome

The systematic review examines whether Cimicifuga racemosa (CR), Hypericum perforatum (HP), Agnus castus, vitamins and minerals, either as monotherapy or in combination, have an evidence-based impact on vasomotor, genital and psychological climacteric complaints. DATA SOURCES AND METHODS OF STUDY SELECTION: We searched in the databases EMBASE, OVID and PubMed using the keywords "vasomotor symptoms, hot flashes, vaginal atrophy, psychological problems, endometrium, sleep, concentration, cognition in combination with vitamins, multivitamins, minerals, multiminerals, black cohosh, Cimicifuga, Agnus castus, chasteberry, chaste tree, monk's pepper and menopause" for randomized controlled trials (RCT). Relevant studies were reviewed by four independent reviewers qualitatively.. Most of the studies with a comparison of CR vs. placebo do not show an evidence-based significant effect of CR on climacteric symptoms. The combination of CR and HP shows an improvement of climacteric complaints in comparison to placebo. In some RCTs, there was no significant difference between CR and hormone-replacement therapy. The combination of HP and Agnus castus showed no significant difference in the treatment of climacteric complaints.. CR monotherapy as well as HP and Agnus castus showed no better effect than placebo. The combination of CR with HP demonstrated a positive effect on climacteric complaints.

Topics: Cimicifuga; Climacteric; Hot Flashes; Humans; Hypericum; Menopause; Phytotherapy; Plant Extracts; Vitex

Review on complementary and alternative therapies for climacteric symptoms.. Search for publications about complementary or alternative treatments for climacteric symptoms based on Cochrane Library and Medline (1966-2006) including the references from the identified clinical trials and reviews.. Cimicifuga may influence climacteric symptoms, especially hot flushes. Results for phytoestrogens, hop and Salvia seem promising but are less convincing. St. John's wort is an option for the treatment of moderate depressive symptoms. Phytoestrogens seem to have some potential for the prevention of osteoporosis and cardiovascular diseases. Results for the influence of lifestyle on hot flushes are conflicting, but interventions have demonstrated their use for the prevention of osteoporosis and cardiovascular diseases.. Lifestyle modifications, Cimicifuga and phytoestrogens may relieve climacteric symptoms. Phytoestrogens and Cimicifuga should not be given to breast cancer survivors.

Topics: Acupuncture; Adult; Aged; Aromatherapy; Breast Neoplasms; Cardiovascular Diseases; Case-Control Studies; Cimicifuga; Climacteric; Cohort Studies; Complementary Therapies; Contraindications; Depression; Diet; Dioscorea; Exercise; Female; Homeopathy; Hot Flashes; Humans; Humulus; Hydrotherapy; Hypericum; Life Style; Longitudinal Studies; MEDLINE; Middle Aged; Osteoporosis; Phytoestrogens; Phytotherapy; Plant Extracts; Postmenopause; Prospective Studies; Randomized Controlled Trials as Topic; Relaxation Therapy; Salvia; Stress, Physiological; Surveys and Questionnaires; Survivors; Trifolium

To critically evaluate and synthesize intervention research related to hot flashes in the context of cancer and to identify implications and future directions for policy, research, and practice.. Published, peer-reviewed articles and textbooks; editorials; and computerized databases.. Although a variety of pharmacologic and nonpharmacologic treatments are available, they may not be appropriate or effective for all individuals.. The large and diverse evidence base and current national attention on hot flash treatment highlight the importance of the symptom to healthcare professionals, including oncology nurses.. Using existing research to understand, assess, and manage hot flashes in the context of cancer can prevent patient discomfort and improve the delivery of evidence-based care.

Topics: Antidepressive Agents; Antineoplastic Agents; Belladonna Alkaloids; Cimicifuga; Combined Modality Therapy; Complementary Therapies; Drug Combinations; Drug Interactions; Ergotamines; Female; Glycine max; Hot Flashes; Humans; Hypericum; Male; Methysergide; Neoplasms; Neurotransmitter Agents; Phenobarbital; Progestins; Selective Serotonin Reuptake Inhibitors; Treatment Outcome; Vitamin E

Hypericum perforatum (St John's wort) is an herbal plant that has antidepressant activity and contains ingredients such as flavonols derivatives, bioflavonoids, proanthocyanidins, xanthones, phloroglucinol, and naphthodianthrones. This study was aimed to test the effect of Hypericum perforatum on hot flashes, menopausal symptoms, and depression in postmenopausal women.. This randomized controlled study was conducted on 80 postmenopausal women aged 45-60 in Izeh, Iran.. Two groups received 270-330 μg of H. perforatum (n = 40) or placebo (n = 40) tablets three times a day for two months.. Data were collected using a socio-demographic questionnaire, the modified Kupperman index before the intervention and 2, 4, 6 and 8 weeks after intervention. The Hamilton Depression Rating Scale was used to gather data before the intervention and in the 8. Seventy women completed the study and five women from each group withdrew the study. The frequency and intensity of hot flashes and the score of Kupperman scale significantly decreased in the H. perforatum group compared to the control group (p < 0.001). In addition, the intensity of depression significantly decreased in the H. perforatum group compared to the control group. At the end of the study, 80% of women in the intervention group did not have depression compared to only 5.7% in the control group (p < 0.001).. Treatment with Hypericum perforatum is an efficient way of reducing hot flashes, menopausal symptoms, and depression in postmenopausal women.

Topics: Antidepressive Agents; Depression; Depressive Disorder; Double-Blind Method; Female; Hot Flashes; Humans; Hypericum; Iran; Middle Aged; Phytotherapy; Plant Extracts; Postmenopause

Because of a decline in estradiol levels, premenopausal, perimenopausal, and postmenopausal women experience symptoms related to vasomotor instability. Certain plants have been found to have molecular components that are identical in structure and function to human hormones. We conducted this study to compare the efficacy of St John's wort with that of placebo in women with hot flashes.. A total of 100 women participated in a clinical trial conducted in an academic medical center in Shiraz-Iran. Women were treated with St John's wort extract or placebo for 8 weeks. Climacteric complaints were evaluated by using the Blatt-Kupperman Index at two follow-up visits. Statistical analysis was carried out by using descriptive statistics and multivariate analysis.. The mean age of the participants was 50.4 years. Both groups responded to the interventions, and the within-group differences in frequency, duration, and severity of hot flashes were statistically significant (P < 0.05). The difference in duration of hot flashes between groups was not significant on the 4th week of intervention (P = 0.27); however, it was statistically significant between the two groups on the 8th week of treatment (P < 0.001). The fall-off in frequency of hot flashes on the 4th and 8th weeks of intervention was more evident in women receiving St John's wort, and the differences between groups were statistically significant (P = 0.005 and P < 0.001, respectively). Furthermore, comparing both study groups, we showed that the decrease in the severity of flashes in women who received St John's wort was more evident on the 4th and 8th weeks (P = 0.004 and P < 0.001, respectively).. St John's wort can be used as an effective treatment for the vasomotor symptoms of perimenopausal or postmenopausal women.

Topics: Administration, Oral; Double-Blind Method; Female; Follow-Up Studies; Hot Flashes; Humans; Hypericum; Iran; Middle Aged; Multivariate Analysis; Perimenopause; Phytotherapy; Plant Extracts; Postmenopause; Premenopause; Severity of Illness Index; Treatment Outcome

Assumptions underlying placebo controlled trials include that the placebo effect impacts on all study arms equally, and that treatment effects are additional to the placebo effect. However, these assumptions have recently been challenged, and different mechanisms may potentially be operating in the placebo and treatment arms. The objective of the current study was to explore the nature of placebo versus pharmacological effects by comparing predictors of the placebo response with predictors of the treatment response in a randomised, placebo-controlled trial of a phytotherapeutic combination for the treatment of menopausal symptoms. A substantial placebo response was observed but no significant difference in efficacy between the two arms.. A post hoc analysis was conducted on data from 93 participants who completed this previously published study. Variables at baseline were investigated as potential predictors of the response on any of the endpoints of flushing, overall menopausal symptoms and depression. Focused tests were conducted using hierarchical linear regression analyses. Based on these findings, analyses were conducted for both groups separately. These findings are discussed in relation to existing literature on placebo effects.. Distinct differences in predictors were observed between the placebo and active groups. A significant difference was found for study entry anxiety, and Greene Climacteric Scale (GCS) scores, on all three endpoints. Attitude to menopause was found to differ significantly between the two groups for GCS scores. Examination of the individual arms found anxiety at study entry to predict placebo response on all three outcome measures individually. In contrast, low anxiety was significantly associated with improvement in the active treatment group. None of the variables found to predict the placebo response was relevant to the treatment arm.. This study was a post hoc analysis of predictors of the placebo versus treatment response. Whilst this study does not explore neurobiological mechanisms, these observations are consistent with the hypotheses that 'drug' effects and placebo effects are not necessarily additive, and that mutually exclusive mechanisms may be operating in the two arms. The need for more research in the area of mechanisms and mediators of placebo versus active responses is supported.. International Clinical Trials Registry ISRCTN98972974.

Topics: Adult; Antidepressive Agents; Anxiety; Depression; Double-Blind Method; Female; Hot Flashes; Humans; Hypericum; Menopause; Middle Aged; Phytotherapy; Placebo Effect; Placebos; Plant Extracts; Randomized Controlled Trials as Topic; Treatment Outcome; Vitex

This study was conducted to investigate the efficacy of black cohosh (Cimicifuga racemosa) and St. John's wort (Hypericum perforatum) in women with climacteric symptoms, and to assess their effects on vaginal atrophy, hormone levels, and lipid profiles.. In this double-blind randomized, placebo-controlled, multicenter study, 89 peri- or postmenopausal women experiencing climacteric symptoms were treated with St. John's wort and black cohosh extract (Gynoplus), Jin-Yang Pharm., Seoul, Korea) or a matched placebo for 12 weeks. Climacteric complaints were evaluated by the Kupperman Index (KI) initially and at 4 and 12 weeks following treatment. Vaginal maturation indices, serum estradiol, FSH, LH, total cholesterol, HDL- cholesterol, LDL-cholesterol, and triglyceride levels were measured before and after treatment. From the initial 89 participants, 77 completed the trial (42 in the Gynoplus group, 35 in the placebo group).. Baseline characteristics were not significantly different between the two groups. Mean KI scores and hot flushes after 4 and 12 weeks were significantly lower in the Gynoplus group. Differences in superficial cell proportion were not statistically significant. HDL levels decreased in the control group from 60.20 +/- 16.37 to 56.63 +/- 12.67, and increased in the Gynoplus group from 58.32 +/- 11.64 to 59.74 +/- 10.54; this was statistically significant (p=0.04).. Black cohosh and St. John's wort combination was found to be effective in alleviating climacteric symptoms and might provide benefits to lipid metabolism.

Topics: Cimicifuga; Double-Blind Method; Estrogens; Female; Hot Flashes; Humans; Hypericum; Middle Aged; Perimenopause; Phytotherapy; Placebos; Plant Extracts

Topics: Adenomyosis; Carcinoma, Endometrioid; Cimicifuga; Endometrial Neoplasms; Female; Hot Flashes; Humans; Hypericum; Middle Aged; Phytotherapy; Plant Extracts

Topics: Back Pain; Chiropractic; Chondroitin; Cimicifuga; Complementary Therapies; Dietary Supplements; Echinacea; Fibromyalgia; Glucosamine; Glycine max; Herbal Medicine; Hormone Replacement Therapy; Hot Flashes; Humans; Hypericum; Massage; Melatonin; Menopause; Neck Pain; Osteoarthritis; Plant Extracts; Plant Structures