Menopause Clinical Trial
This randomized, controlled trial will evaluate the efficacy and safety of three alternative approaches utilizing phytoestrogens to treat hot flashes and night sweats in peri- and post-menopausal women. The treatments were chosen because of the scientific evidence supporting a possible benefit, the availability of products with adequate quality control, and their frequency of use in naturopathic medicine. RECRUITMENT FOR THIS STUDY SHOULD END BY AUGUST 1, 2003.
Over 17 million U.S. women are in the peri- and post-menopausal age range (45 - 55), and by
the year 2015 nearly half of U.S. women will be post-menopausal. Of these, 25-33% will
experience moderate to severe menopausal symptoms, and all will be faced with decisions
related to maintaining their health through mid-life and beyond. Hormone Replacement Therapy
(HRT) is the standard pharmacologic intervention for menopausal symptoms against which other
therapies are measured. Concerns about breast cancer and thromboembolism risk, the need for
safe alternatives for symptom relief among women in whom HRT is contraindicated, and the
resistance to HRT due to its side effects fuel the search for alternatives.
The primary aim of this randomized, controlled trial is to compare the effects of three
alternative treatments utilizing phytoestrogens, HRT, and placebo on the frequency and
intensity of vasomotor symptoms measured by the Wiklund Menopause Symptom Checklist and
daily vasomotor symptom diaries. The alternative treatments chosen for the study are a
single herbal formula of black cohosh, a multibotanical formula containing black cohosh,
alfalfa, boron, chasteberry, dong quai, false unicorn, licorice, oats, pomegranate, and
Siberian ginseng, and soy diet counseling in addition to the multibotanical formula.
The findings of the Women's Health Initiative study published in July 2002 gave the medical
and research communities new information about the long-term risk of HRT use. In response to
these findings, the study design allows women to be randomized either to the 5-arm trial
that includes HRT, or to be randomized only to 4 of the 5 arms: one of the three herbal
groups or placebo, without the chance of being assigned to HRT.
Secondary aims are to compare the effects of three alternative treatments, HRT, and placebo
on:
1. vaginal cytology (vaginal maturation index)
2. serum lipids (total cholesterol, HDL and LDL cholesterol, triglycerides)
3. bone mineral density (hip and spine dual energy x-ray absorptiometry scan)
4. glucose metabolism (insulin, fasting blood glucose)
5. clotting factors (fibrinogen, PAI-1).
Approximately 400 peri- and post-menopausal women will be recruited and randomized to one of
5 or one of 4 treatment arms for one year. Primary and secondary outcomes will be measured
at baseline, 3, 6, and 12 months. Changes in outcomes will be compared between the groups
taking alternative treatments and those in the HRT and placebo groups.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Masking: Double-Blind, Primary Purpose: Treatment
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