Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Black cohosh (Remifemin) is a commonly used herbal
supplement that is believed to reduce hot flashes. However, small German studies that tested
black cohosh only followed women over a short time period. The German agency that regulates herbs does not recommend using black cohosh for longer than
six months. Side effects can include
vomiting, dizziness, visual problems, slow heartbeat, and excessive sweating. Black cohosh is not regulated by the U.S. Food and Drug Administration, so women must be careful about the safety and purity of this supplement.
Plant estrogens (phytoestrogens) such as soy protein are a popular remedy for hot flashes, although data on their effectiveness are limited. Phytoestrogens are natural plant estrogens (isoflavones), which are thought to have effects similar to estrogen therapy. The safety of soy in women who have a history of breast cancer has not been established, although clinical studies indicate soy is no more effective for treating symptoms than a placebo. Soy comes from soybeans and is also called miso or tempeh. The best food sources are raw or roasted soybeans, soy flour, soy milk, and tofu. Soy sauce and soy oil do not contain isoflavones.
Herbals: Inconclusive and conflicting studies indicate that other herbals, such as dong quai, red clover (Promensil),
yam cream, Chinese medicinal herbs, and evening primrose oil, should be avoided or taken with care under the supervision of a health care
professional to avoid unwanted and dangerous side effects and interactions.
CAM: According to the National Center for Complementary and Alternative Medicine, other nonprescription techniques may relieve the symptoms of menopause. These techniques include meditation, acupuncture, hypnosis, biofeedback, deep
breathing exercises, and paced respiration (a technique of slow breathing
using the stomach muscles).
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 2/13/2013