Perimenopausal women who took a Chinese herbal formula called EXD (Er-xian decoction) experienced a significant reduction in the number of menopausal hot flashes, researchers from the University of Hong Kong reported in Menopause.

(Perimenopausal means at or near the menopause)

Among the females in the trial, all of them menopausal and complaining of multiple episodes of hot flashes, a reduction in the frequency of daily hot flashes of 62% was observed, compared to a 52% reduction among those on a placebo.

The most effective treatment for symptoms associated with the menopause is HRT (hormone replacement therapy), the authors explained. However, because of the potential health risks linked to HRT, women seek out other therapies, Professor Yao Tong wrote.

EXD (Er-xian decoction) contains compounds extracted from the leaves, stems or roots of six different Chinese herbs. They are processed into granules and packed into tea sachets - the patient drinks them in a tea infusion.

The authors explained that previous studies had already linked EXD to a reduction in episodes and severity of hot flashes. However, they were "not high quality studies".

Professor Tong and team carried out a double-blind, controlled trial involving 108 perimenopausal women who reported MRS (Menopause Rating Scale) total scores of at least 28. The women drank an herbal formula or placebo twice a day for 12 weeks. They were followed up post-treatment three months later.

The primary outcome of the study was to see whether EXD reduced the frequency and severity of hot flashes. The secondary outcome measures included serum hormone levels, the MRS (Menopause Rating Scale), and the Menopause-Specific Quality of Life questionnaire.

For a period of two weeks before they started taking their twice daily teas, the women were asked to complete a daily diary where they logged their hot flashes.

The researchers reported the following findings:
  • 101 out of the 108 women completed the study

  • EXD reduced the mean (SD) frequency of hot flashes from 5.8 per day to 2.2 per day

  • In the placebo group, hot flashes frequency reduced from 5 per day to 2.5 per day

  • Three months after treatment was completed, those in the EXD group continued with 2.2 hot flashes per day, while those in the placebo group rose to 2.9 hot flashes per day

  • Hot flashes severity in the EXD group dropped from 3 to 1.6 (out of four)

  • Hot flashes severity in the placebo group fell from 3 to 2.3 (out of four)

  • There was a greater improvement in MRS scores among those in the EXD group as well as the Menopause-Specific Quality of Life questionnaire, compared to the women in the placebo group

  • Serum hormone levels were the same in both the EXD and placebo groups
The researchers said there were no serious adverse events in either group, and safety indices for renal function, liver function and whole blood counts were within normal range pre- and post-treatment.

In an Abstract in the journal, the authors concluded:

"The Chinese herbal formula EXD is superior to placebo in reducing the frequency and severity of hot flushes and in improving menopausal symptoms in Hong Kong perimenopausal women. It is well tolerated, with no serious adverse events noted during the study period."

In the USA, people say "hot flashes", in the UK, Ireland, Australasia and most of the Commonwealth, people say "hot flushes".

Alternative therapies have become increasingly popular among perimenopausal women who experience hot flashes. Researchers from Linkoping University and Linkoping University Hospital, both in Sweden, found that patients who underwent group therapy and learned to relax experienced a 50% drop in their menopausal problems.

Women who eat more soy-based foods are more likely to experience reductions in menopausal vasomotor symptoms, including hot flashes, a team from the Group Health Research Institute, University of Washington and the Fred Hutchinson Cancer Institute found.

Researchers from Baylor University's Mind-Body Medicine Research Laboratory found that hypnotic relaxation therapy reduced hot flashes by as much as 80%. It also improved quality of life and reduced symptoms of anxiety and depression.

Written by Christian Nordqvist