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American Medical Association Family Medical Guide - American Medical Association [76]

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it if you have an inflammatory intestinal disorder (see page 764) such as Crohn’s disease or ulcerative colitis or if you have an intestinal obstruction. Do not take aloe during pregnancy because it can trigger contractions of the uterus. Children younger than age 12 should not consume aloe because of its laxative effect.


Black Cohosh

Also known as black snakeroot or bugbane, black cohosh is a traditional Native American remedy for snakebites and gynecologic disorders. Derived from a plant from the buttercup family, black cohosh is used as a dietary supplement to treat hot flashes and other symptoms of menopause, such as mood swings, insomnia, and vaginal dryness. It also is taken for the relief of premenstrual syndrome (PMS; see page 850).

Alternative Therapies for Menopause

Deciding whether to use alternative therapies after menopause is a decision that many women face as they get older. Hormone therapy (see page 853) with estrogen is very effective in relieving symptoms of menopause—such as hot flashes and vaginal dryness—but some forms of hormone therapy carry small but known health risks, especially with long-term use. Many women are considering alternatives to hormone therapy in hopes of alleviating their symptoms and possibly reducing the risks of heart disease and osteoporosis.

Options that postmenopausal women have explored include natural or plant estrogens, acupuncture, and herbal supplements such as black cohosh, red clover, hops, dong quai, and ginseng. Of the herbal supplements, black cohosh seems to be the most effective in reducing symptoms of menopause, but not enough evidence exists to determine whether any of these therapies are safe over the long term. Limited studies have shown that plant estrogens—such as those present in soy products, wild yams, and flaxseed—may benefit some women who have hot flashes. With so many women seeking effective alternatives to estrogen, researchers are studying many of these plant substances to understand their effects on women’s health. The best course is to talk to your doctor about your personal risks and the possible benefits and risks of using hormone therapy or alternative therapies to reduce your menopausal symptoms.


Several scientific studies have shown that black cohosh improves menopausal symptoms. However, most of these studies have been short-term, and little is known about the long-term effects of the supplement. For this reason, you should not take black cohosh for more than 6 months, and must not take it if you are pregnant or breastfeeding. Side effects can include stomach discomfort, headaches, and possible weight gain.


Cayenne

Also called capsicum, capsaicin, or red hot pepper, cayenne is an antioxidant that when eaten stimulates blood flow and metabolic rate and strengthens the heartbeat. It may also reduce blood cholesterol and triglyceride levels. Cayenne tastes hot, but it actually lowers body temperature by stimulating the cooling center of the hypothalamus in the brain. When applied to the skin, cayenne first stimulates and then blocks pain receptors. It is used as an active ingredient in creams and lotions to decrease pain associated with conditions such as arthritis (see page 996), fibromyalgia (see page 985), and shingles (see page 936). Although eating foods seasoned with hot pepper (such as cayenne) does not cause ulcers, people who have ulcers sometimes have discomfort after eating spicy foods.


Chamomile

When taken internally, usually in the form of tea, chamomile is a digestive aid and mild sedative. It contains a compound called coumarin, which relieves muscle spasms, including spasms of the intestine. Allergic reactions to chamomile are common, especially in people who are allergic to rag-weed. Externally, chamomile extract is used in cosmetics to treat inflammation of the skin and mucous membranes. But avoid using chamomile around the eyes because it can cause irritation.

Vitamin Megadoses

Taking large doses of some vitamins—especially antioxidants (nutrients that destroy cell-damaging substances called free radicals)

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