title: Herbal remedies for menopausal symptoms: are we cautious enough?
abstract: OBJECTIVE
  To evaluate adverse effects of herbal remedies consumed by menopausal women for control of the climacteric syndrome.
  
  
  METHODS
  We examined the long term safety and herb-drug interactions of commonly used herbal therapy such as soy, black cohosh, dong quai, ginseng and vitamin E.
  
  
  RESULTS
  Even carefully designed studies on herbal treatments for vasomotor menopausal symptoms never addressed specifically safety issues. Sporadic reports show dangerous adverse effects of these herbal preparations as well as hazardous interactions between botanic compounds and conventional medications.
  
  
  CONCLUSIONS
  The unrestricted sale of plant products constitutes a new situation for physicians with little training in phytotherapy. The qualitative and quantitative diversity of the commercially available preparations, the absence of precise prescribing guidelines, and the risk of self-prescribed medication justify the introduction of 'phyto-vigilance'. Physicians should warn their patients about the lack of evidence regarding safety and possible interactions of herbal remedies with concurrent medications.
authors.affiliation: Division of Obstetrics and Gynaecology, Hadassah Hebrew University Hospital, Jerusalem, Israel. kochman@hadassah.org.il
authors.forename: Ronit
authors.initials: R
authors.lastname: Haimov-Kochman
authors.forename: Amnon
authors.initials: A
authors.lastname: Brzezinski
authors.forename: Drorith
authors.initials: D
authors.lastname: Hochner-Celnikier
mesh_terms: D002979:Climacteric; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D048789:Phytoestrogens / Q000627:therapeutic use; D008517:Phytotherapy / Q000009:adverse effects; D028321:Plant Preparations / Q000009:adverse effects / Q000627:therapeutic use*; D012449:Safety; D014810:Vitamin E / Q000627:therapeutic use
chemical_list: D048789:Phytoestrogens; D028321:Plant Preparations; D014810:Vitamin E