MENOPAUSAL SUPPLEMENTS.

Black Cohosh 

Typical Brands: Nature's Resource Black Cohosh, Remifemin, Schiff Menopause Nutritional System.

Typical Claim: "Will help you maintain vibrant health during menopause, freeing you to enjoy life as you always have" (Remifemin).

Evidence: In the best study on black cohosh root, 30 women who took Remifemin for 12 weeks reported far fewer hot flashes and other symptoms than 20 similar women who were given a placebo.(1) But in the same study, 30 other women who were given estrogen reported no more relief than women who took a placebo.

"I wouldn't trust the results of a study like this," says Wake Forest's Gregory Burke, "since estrogen has been shown again and again to be effective for menopausal symptoms."

(1) Therapeuticon 1: 23, 1987.

Red Clover

Typical Brands: Nature's Way Red Clover, Promensil.

Typical Claim: "Helps women maintain physical and emotional well-being during midlife ... Just as Nature intended" (Promensil).

Evidence: In three small Australian studies, Promensil was no better than a placebo at relieving the symptoms of menopause.(1)

(1) Climacteric 2: 79, 85, 1999.

Soy Isoflavones 

Typical Brands: Estroven, Healthy Woman, Novasoy.

Typical Claim: "Helps relieve hot flashes" (Healthy Woman).

Evidence: Among 177 women who suffered more than four hot flashes a day, those who took Healthy Woman once a day for 12 weeks reported no fewer flashes, but a 28 percent reduction in the flashes' average severity, says David Upmalis, who conducted the not-yet-published research for Johnson & Johnson, which manufactures Healthy Woman. The women who took a placebo reported a 20 percent reduction. "It's a small difference," he concedes. The supplement had no effect on night sweats.

The only studies testing Novasoy against a placebo haven't been completed. (Novasoy is sold in bulk to supplement manufacturers, who add it to their products.)

Dong Quai 

Typical Brands: Health Products Warehouse Dong Quai, Rejuvex, Rite Aid Mature Women's Dietary Supplement.

Typical Claim: "Provides nutritional support for the discomfort of hot flashes and other symptoms of menopause caused by hormonal changes" (Health Products Warehouse).

Evidence: In the only good published study, researchers at the Kaiser Permanente Medical Center in Oakland, California, gave 35 women 4.5 grams of dong quai root and 36 similar women a placebo every day for six months.(1) The women taking dong quai had no fewer hot flashes or other menopausal symptoms. (Dong quai traditionally has been used in combination with at least four other herbs to treat menstrual disorders and menopausal discomfort.)

(1) Fertility Sterility 68: 981, 1997.