Menopause Discussion > Alternative Therapies

St John's Wort and Black Cohosh tablets (Holland & Barrett and Menomood)

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willowrannoch:
Hi

I had been taking the above tablet for probably almost a year - I found that it really helped with my mood fluctuations and night sweats, hardly any migraines and in general I felt like a million dollars compared to before.  I take no other medicine nor have any medical history to suggest that taking these would be a problem.  The only thing I seemed to get was going for a poo regularly, every morning after breakfast and it would be a bit loose - but for me that was a bonus as I often suffer constipation.

Anyhow, I was wondering about long term use and studied the leaflet in my current packet which is the Holland and Barrett stuff (as it's half the price of Menomood).  I could find nothing that suggested long term use was inappropriate but just to be on the safe side I emailed the company (NYBT Europe).  The advice I got back was that it is NOT recommended for long term use, that I should try it for 8 weeks on with a 2 week break and if after 3 months I hadn't noticed an improvement in my symptoms I should see a doctor.  I am horrified that there was nothing on the leaflet about this and I'm now worried that I may have done myself some harm.  I can't say for sure if there was anything on the Menomood leaflet as I didn't have any to hand.  I stopped taking it a few days ago and now have a stinking migraine.

I feel gutted that I shouldn't be taking these anymore.  I have a gyny appointment if a few weeks time to discuss other options and will ask about it then but in the meantime can anyone shed any light?


I've read everything I can on this forum

Dancinggirl:
Many people are under the illusion that herbal remedies are safe because they are deemed ‘natural'. Many of the most powerful drugs on prescription come from botanical sources. Most herbal or alternative remedies are still drugs and should be taken with caution and preferably under the guidance of a medical professional. 
HRT is now mostly bio identical, particularly the oestrogen, so basically a natural way to supplement the hormone balance.
I know Black Cohash can have an effect on the liver if taken for too long and St. John's wort should not be taken for too long without medical monitoring.
You are right, these remedies should come with clear guidelines.
I doubt you have done yourself harm though, so don't worry. It's good you have questioned what you have been using. DG x

willowrannoch:
Further update. This was the original reply I received from NYBT Europe:
Thanks for your enquiry regarding menopause mood relief tablets. The tablets are not intended for consistent long term use. As a general guide I would suggest an initial intake of 8 weeks on and 2 weeks off until symptoms improve . If you find after 3 months or so your symptoms have not improved please visit your GP for further advice.

I replied to the email asking why this information was not on their leaflets but got no reply.  I then also emailed Schwabe Pharma who have the licence to manufacture these tablets (Menomood is their brand which is exactly the same as the Holland and Barrett one).  Their response was entirely different and stated that there was no reason why Menomood cannot be taken long term - so conflicting advice.

I then emailed Holland and Barrett since they sold both but the email goes straight to NYBT Europe and got the following reply to my questions:
Are these products identical? Yes, they have the same active ingredients.
If so, why would I receive different guidelines on their long term use and which is correct?
The advice received from our nutrition team is “general advice”, in line with Schwabe pharma if you are benefitting from the product, there is no reason why you cannot take it long term.
If long term use is indeed not recommended then why is this not indicated on the information leaflet? It is not “not recommended”. That is why there is no reference to this on the leaflet. However, as good practice and general advice an initial intake of 8 weeks on and 2 weeks off until symptoms improve set safety boundaries for individuals that may need to consider medical intervention.
If they are different, then in what way? They are not different
Could you please explain what the Traditional Herbal Registration number is? A number that is provided by the regulatory authorities to licence a company to manufacture and sell the product.

This was from the same help desk as the original email so I replied again suggesting that they ensure their staff are better informed as it is not great when conflicting advice comes from the same company.  I got the following response:
As mentioned in my previous email, we offer tailored advice to customers in the nutrition team at Holland and Barrett. My colleague *** recommended eight weeks on and two weeks off as a guideline to measure symptoms and ensure ongoing suitability for the product, as it may not be necessary to continue the product long term if symptoms have improved. Whilst the product is safe for long term use, our personal advice would be using a method to assess requirements and continue use or discontinue accordingly.
I hope this has provided further clarification, please do not hesitate to reply if you require any further information.

Though I feel more comfortable that taking the product long term is ok, I'm annoyed about the conflicting advice and am considering making a complaint to the pharmaceutical ombudsman.  What do others make of how they have responded and what would you do?

Roseneath:
Hi Willlowrannoch. I sympathise. We are so desperate to find a solution that together with the internet it is very tempting to try ' natural remedies'. I took a product called Menopace which seemed to get good reviews when I was in early Peri. I thought it would do ' no harm' although it didn't seem to effect any of my symptoms. Wrong. I had a basic blood test an my liver enzymes where elevated. I got a telling off my the doctor when I showed him what I had been taking. He said he sees it all the time (but not to worry). I came off them and 2 weeks later the bloods were back to normal. 

AgathaC:
This is very interesting.
I too am committed to finding a “natural” solution to some of my perimenopause symptoms. But what does “natural” mean?
I take starflower oil (for sore boobs), magnesium (for anxiety) and agnus castus (for both). Also turmeric (can't remember why - all round wellness?).
I've also taken those Menopace tablets which I too assumed “couldn't do any harm”. Hmm. Lots of food for thought in what has been written above. Never occurred to me that there could be any negative effect which is a bit stupid of me really.

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