Herbal options for hot flushes

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What advice should I give women seeking information on herbal remedies for menopausal hot flushes? Is there any evidence that rhubarb extract ERr 731 is more effective than black cohosh at controlling hot flushes? What are the contraindications for the use of such treatment?—ROSEMARY TROTTA, FNP, Wadsworth, Ill.

Clinical trials using standardized scales for measuring well-being, anxiety, and menopause symptoms indicate a slight advantage of rhubarb extract over black cohosh. Both supplements carry similar risks in terms of allergic potential and herb-drug and herb-herb interaction, with some cases of hepatotoxicity reported.—Sherril Sego, MSN, FNP (131-11)
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