# Menopause - HRT or Remifemin (Black Cohosh)?



## robbiemac57

Hi, I'm a newby to this web site. I was diagnosed around 4-5 years ago with IBS-C after having a hysterectomy. My dietician has told me to cut out just about every foodstuff known to man because everything seems to cause irritation, but I am still unable to get it stable for more than a week at a time. I'm 51 and having noticed I was getting hot during the night over the last couple of months I have had now the blood test and been told I am menopausal (oh joy, oh rapture). Having experienced nasty side-effects from the pill and other hormone therapies in the past I am reluctant to go down the HRT road that leads to migraines etc. Someone has suggested Remifemin (black cohosh) and said she has been on it for years with no ill effects whatsoever. My web research tells me that there are two possible side effects; sever liver damage (minuscule risk), and 'gastric disturbance'. I'm willing to take the chance with the liver thing since it is a very small risk, but I am wondering if anyone has tried this stuff and experienced the 'gastric disturbance' and how severe this is? do I go with HRT and risk migraines or try Remifemin and risk aggravating my already disturbed gut? what is it they say about rocks and hard places??Any feedback on how to juggle these two delightful conditions would be appreciated!


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## overitnow

I can tell you that my wife uses a blend of black cohosh, soy extracts (for plant estrogen), and Dong Quai for 2-3 years without any side effects. She has found it very helpful. In the past 6 months she also increased her dosage of a flavonoid supplement that we both use--me for my cholesterol, GERD, and IBS-D and her for her GERD and to protect against dementia, which runs in her family--and all hot flashes have ceased completely since then.Mark


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## robbiemac57

Thanks for the response Mark. I have vaguely heard of the dong quai so I will check that out a bit more. I have always had problems with soy even before I got IBS. I don't know if an extract would cause the same problems as consuming the whole food does, I will have to investigate that aspect further. The hot flashes aren't too predominant at present, it's the sleep disturbance and lack of energy that get me down. I know if I sleep well my gut works better. No sleep means worse C and worse pain etc.It's so hard to know what to do to cause the least aggravation of the IBS. Especially when it may take a few weeks for a treatment to kick in, but meanwhile the side-effects run rampant! Trying to cope with working full-time with the IBS alone has been major, so I really didn't need to hormones to decide to pack it in as well!!! Of course the stress of trying to decide what to do isn't helping any! And as so many people on this site have said - people who don't have IBS don't understand.Thanks againRobyn


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## annie7

hi Robynyeah i'm going through menopause too--it's no fun is it plus it seems to be making my c worse.for a short while i was taking black cohosh but but then i did some research on it --mayo clinic, web md, nih--as well as other sources and decided it seemed too risky. you definitely don't want to take it if you already have hormone sensitive conditions like breast cancer, uterine cancer or endometriosis.this is from the nih office of dietary supplements: "black cohosh is estrogenic, long-term use may adversely affect uterine or breast tissue. No studies have been published on long-term safety in humans, particularly regarding abnormal stimulation of cells in the endometrium or breast. " the links to the mayo clinic, nih and web md info are in this post. sorry to be redundant if you've already read it. http://www.ibsgroup.org/forums/lofiversion...php/t95829.html


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## JudyO1106

Hi, I'm not sure if this info will help yo but a few years back my mother started menopause and someone told her about Black Cohosh. She takes it every day and she swears she hasn't had a hot flash since. I asked her about and side effects she's experienced and she said she had none. I guess like everything we put in our bodies, we all experience different things. Good luck.Judy


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## robbiemac57

Thanks for the feedback Judy and Annie. Still not sure which way to go; there are so many conflicting views aren't there??? going back to discuss further with my doc tomorrow. I really need something to help get the sleep pattern back on track so that I have more energy and to help settle the gut down again.


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## overitnow

Well, Robbie, this is where it always seems to get to. I remember being "warned" that no one knew what would happen if I started taking the flavonoids, but cancer was always at the back of these sincere concerns. I should have seen a doctor and gotten a script for Lipitor, that gingko is dangerous, this is a blood thinner and I would cut myself and bleed out, etc, etc. 10 years later and it has continued to be one of the best decisions I have ever made.It's a crapshoot, for sure.Mark


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## robbiemac57

Update!Well, I took a leap of faith and decided to try the black cohosh for a month and if it didn't work I would then try the HRT (reluctantly because of my past history of side effects with hormones). I am on black cohosh only at this stage (Femular brand name), no dong quai or other additives. Having been on it 6 days the night sweats are gone, the daytime hot flashes are almost gone, the sleep is much more restful, I have even had one night where i didn't have to get up and go to the loo! As for the effect on the IBS, the bowels are settling into a nice routine with almost normal type output. for the first time in nearly 2 years I am on a consistent very low dose of laxative. I have not had any 'digestive disturbance' which was the side effect I was afraid of. My energy levels are stating to increase, the emotions are stabilising and I am generally feeling almost 'normal'.They say it takes a month to feel the full benefits of this stuff, so if I feel this good after just 6 days I am hoping that by the end of a month I may be able wean myself right off the laxatives for the first time in 5 and half years.For the benefit of any other ladies who may be facing the same choices that I have been i will update again down the track when I've been on the black cohosh for longer.So far so good!!


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## MelanieLL

Well PLEASE let me know how it goes, and keep updating. I am facing the SAME issues. I have not had any success with hormones in the past, with lots of side effects. So I'm afraid to even try the black cohosh. I've had endometriosis, IBS-C, vestibular dysfunction, arthritis, and now you add menopausal stuff like hot flashes, moodiness, sleep disturbances. My poor family is walking on egg shells, when normally I am a very even keeled person. I don't like this roller coaster  If there is something I can do to help without causing more problems, I will try it. Thanks so much for your post!


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## Tiss

I just started using Hot Flash by Source Naturals. I bought it at the health food store. I am 52 and in the throws of menopause,, which started when I was about 45 or so. I have been on HRT for about 6 years now and have been trying to cut back my estrogen--my doctor wants me to get off it because of a family history of breast cancer and also fibrocycstic breast tissue. What a lot of NO FUN. I have been waking up all night with drenched hair, nightie, panties, legs and back dripping--just so totally uncomfortable. The worst part is how tired I feel during the day and this weird vague anxiety and depression. My doctor suggested I try black cohosh and the Hot Flash is the one I chose. It does have a few other things in it like licorice and dong quai. I swear, I have not had a hot flash in the 4 days I've been using this. I am on a very low dose of estrogen and next week I go to every other day and then go off totally. I hope this stuff keeps working.


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## overitnow

The one my wife used--she is now going without anything but the flavonoids to see if that is enough, which really seem to have boosted the effects--includes soy (plant) estrogen with the dong quai and black cohosh. She has not had any flashes in many months.Mark


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## Tiss

Has your wife gained any weight with the black cohosh? I read somewhere that it can cause that but I am only taking a small amount of the black cohosh so hopefully I won't gain weight.


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## overitnow

Weight has been a "problem" for her for as long as I have known her, which goes back over 30 years; but there was no particular gain ever associated with the herbs. Really, isn't sleeping through the night and not mopping yourself off in the middle of a conversation worth a few pounds?Mark


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## Tiss

Yep it is.. But then again, you are not a woman and unfortunately we all hate weight gain!! I love your attitude--you sound like such a sweet and caring husband. My hub's great but I would never find him on my IBS BB marking my progress!


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## robbiemac57

*Update!!*As I have never got on well with HRT I decided to try black cohosh (Femular by brand name rather than Remifemin). Within a week of commencing this my bowel habits started to become regular and predictable, also softer and more 'normal' looking. although I continued with the laxatives as I was not sure what would happen. After about 3-4 weeks I suddenly (overnight) developed a really strange type of diarrhoea (not the usual type you get with gastro). I also became nauseous and the bloating blew out of all proportion. There were also a few other symptoms. This went on for another 3 weeks and it was thought at the time that I may have had a systemic candida infection since I also developed vaginal thrush for no apparent reason (I normally only get this after antibiotics). I went on the candida diet but did not get any of the expected die-off symptoms, and the diarrhoea started to ease (I had lost 5kg by this time - a lot when I only weighed 50kg to start with). At this time the doc also did a stool test and told me I have blastocystis hominis which may have been the cause of the symptoms. I stopped taking everything but the Benefiber while I had the diarrhoea and once it started to ease I only went back on the black cohosh. To my surprise I was able to continue with no laxative assitance whatsoever. The motions became regular and normal. I did find though that after about 10 days I started to get diarrhoea symptoms back and so eased up on the black cohosh again. This cycle went on for a few more weeks and after discussing it with the microbiologist at QML the doc decided that the parasite was probably not responsible for the symptoms, but she didn't think the black cohosh was either. After a lot of internet research on the side effects I have found that it is highly likely that the black cohosh was the culprit, but as I could control it by varying the dose it wasn't a major concern. My main problem with this treatment came when red grapefruit came into season and I had one or two every day for a bit over a week. I found I started getting odd symptoms including dark coloured urine. When I did a bit of research into this I found the symptoms were the same as those attributed to grapefruit interaction with a number of prescription medications, except I didn't yet have jaundice. Being a herb there is little research available on the black cohosh, however it is known to affect the liver. The liver is also the issue with grapefruit/drug interaction. I put two and two together and gave up the black cohosh and the grapefruit but each time I tried either the symptoms started to come back.Rather than risk my liver further I have reluctantly switched to HRT (Sandrena oestrogen only gel) and have been on that for a few weeks, working through the migraine phase. I am pleased to say that the bowels have continued to be 'normal', like clockwork each morning, no tearing or bleeding, even coping with the extreme stress and emotional trauma this week of relationship meltdown. I also have no other symptoms of the IBS (as discernible from normal digestive ups and downs) and am gradually trying different foods back in the diet (even chocolate!!), so far with no nasty effects. I am still taking the Benefiber but am hoping that a bit further down the track I can cut that out as well. And I haven't put back on the weight I lost either.I was told when I had my hysterectomy that I may go through menopause early. Since the IBS set in not too far down the track after the hysterectomy I am now wondering if I haven't had IBS at all, just reducing oestrogen levels, and as the oestrogen levels depleted further with time, so the apparent IBS symptoms increased and would not settle down. I will never know for sure, but it seems more than likely to me that if only someone had thought to test my hormone levels 5 years ago I may never have had to go through all that I did.


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