It is recognized as a potential source of unsaturated fatty acids. Moreover, EPO may decrease the severity of menopausal hot flashes. EPO is obtained from the seeds of Oenothera biennis, a biennial plant. ![]() EPO is a rich source of gamolenic acid (a precursor of prostaglandin E), popularly believed to suppress menopausal flushing. Comprehensive studies have reported the efficacy of CR in the reduction of hot flashes and controlling of vasomotor symptoms with mild side effects and good tolerability and safety. Furthermore, dopaminergic, serotonergic, and progestogenic effects are proposed. The pharmacological effects of black cohosh may be described as selective estrogen receptor modulator augmented by central nervous effects. Racemosa rhizome contains triterpene glycosides, ectoine, 27deoxyactein, cimicifugoside, cytisine, N-methyl cytisine, phenolic acids, flavonoids, volatile oils, tannins and a resinoid material called cimicifugin, which contain 25%–50% of the rhizome substances and other pharmacologically active components. These therapies include herbal remedies such as Cimicifuga racemosa ( CR) or black cohosh and evening primrose oil (EPO) ( Oenothera biennis L.). Complementary and alternative medicines (CAM) including herb-based therapies are commonly used for treatments of menopausal symptoms. Besides the safety concerns with HRT, about 18% of postmenopausal women do not benefit from HRT in terms of hot flash reduction and about 29% discontinue HRT within 5 months usually due to recurrent menses. Many women are turning to herbal medicines and refrain from using HRT because of fear of side effect of hormone therapy. Progressive interest in non-hormonal therapies for relief of climacteric symptoms has increased since the publication of adverse effects of estrogen replacement therapy. Recent clinical studies have demonstrated higher risks for long-term HRT use, particularly for combined estrogen-progestogen therapy started in the late postmenopausal period. However, HRT has been associated with an increased risk of breast cancer and negative cardiovascular consequences. Hormone replacement therapy (HRT) is a form of widely used treatment for menopause associated symptoms. Estrogen withdrawal appears to trigger hot flashes although the precise neuroendocrine mechanisms have yet to be elucidated. Hot flashes can have deleterious effects on a woman's work, recreation, sleep, and general quality of life. Hot flashes frequency is variable, and they may occur several times daily. Palpitations and anxiety are not uncommon. ![]() Hot flashes are described as a rapid feeling of exaggerated internal warmth that begins in the chest and rises to the neck and face along with sweating, flushing, and chills. The health consequences of menopause are associated with vasomotor symptoms such as hot flashes, psychic and somatic disorders, depressed mood, sleeping disorders, physical and emotional distress, skeletal and cardiovascular effects, and urogenital complaints. ![]() Menopause is clinically diagnosed when a previously menstruating woman is amenorrheic for at least 12 months and usually occurs at the age between 45 and 54 years when the ovarian function begins to decrease.
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