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By the time women reach their late forties or early fifties, their ovaries begin producing less and less of the reproductive hormones estrogen and progesterone, resulting in the uncomfortable symptoms commonly known as menopause. During menopause, a woman will usually experience many symptoms which will greatly interfere with her quality of life - hot flashes, night sweats, vaginal dryness, mood swings, lack of concentration or irritability, and interrupted sleep. Once her menstrual cycle has completely ended, other bodily changes occur, such as thinning of the bones, often resulting in osteoporosis, and less pliant blood vessels, placing her at risk of heart disease.
Many women turn to estrogen replacement therapy as a means of finding relief from the burden of menopausal symptoms because of its high efficacy and other beneficial properties. Estrogen replacement has been shown to significantly reduce the frequency of hot flashes, and patients receiving this treatment reported improved sleep quality and sense of well being. It has also been found to decrease sleep latency and increase REM sleep, thereby reducing insomnia and subsequent fatigue (Ginsburg, 1994). Although estrogen replacement has produced drastic improvement in women's menopausal hindrances, some women are ineligible or uncomfortable with the idea of taking hormones and opt for a natural solution - ginseng.
Ginseng - the Natural Alternative
Ginseng, the root of the Araliaceous plant, has been used for several thousand years in the Orient as a tonic and restorative. Pharmacological investigations by Western pharmaceutical firms, encouraged by the growing interest in herbal remedies in the West, show that ginseng acts as an adaptogen, meaning it can bring abnormal physiology into balance by helping the body increase resistance against noxious or stressful physical, chemical, or biological influences (Chong & Oberholzer, 1988). Ginseng's potential capacity to increase nonspecific resistance to various stressors is the reason it has been used as an alternative treatment for menopausal symptoms.
It is important to remember that the effects of ginseng will vary different individuals depending on diet, lifestyle, exercise and other drugs. In other words, an individual's health and hormonal regulation will essentially determine the effects of ginseng (Bahrke & Morgan, 1994). It is possible for some individuals to respond to ginseng, while others will show no response at all.
Ginseng and Hot Flashes
Hot flashes are experienced by 60 - 85% of menopausal women and they may occur infrequently, or as frequently as 20 times a day (Ginsburg 1994).
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While there have not been any double-blind, placebo controlled studies performed on humans to determine the effects ginseng has on hot flashes women taking ginseng usually do report that the frequency and intensity of hot flashes may be diminished (Ginsburg 1994). There have, however, been investigations using animals on the effects of ginseng on body temperature and the release of adrenocorticotrophic hormone (ACTH). ACTH stimulates the release of fatty acids and the utilization of glucose, which are important for providing energy to deal with stressors.
It has been found that the release of ACTH occurs approximately 30 minutes after the onset of skin temperature elevation resulting from hot flashes. This release of ACTH is due to the peripheral cooling that occurs after the hot flash. When used on rats, ginseng saponin, the most active component of ginseng, was found to stimulate the secretion of ACTH (Chong & Oberholzer, 1988).
In a series of pharmacological studies, the neuroleptic properties of neutral ginseng saponins were investigated. One of the reported results showed that specific doses of neutral saponins in mice significantly lowered their body temperature (Bahrke & Morgan, 1994). In one study which measured the effects of ginseng root saponins on brain monoamines and serum corticosterone in heat stressed mice, it was found that ginseng root saponins lowered mice body temperature at room temperature and inhibited the rise of body temperature under heat environmental conditions (Yuan, Yuang, Shang, & Zhang, 1989).
The effect of ginseng on hot flashes is supported by anecdotal evidence and by rodent studies which suggest it effects temperature regulation and responses to stress. I would conclude, therefore, that it is plausable that ginseng is useful for preventing or reducing the frequency or severity of hot flashes. In the absence of controlled studies with humans, this is the strongest conclusion possible.
Ginseng and Sleep
Many women will experience interrupted sleep or even insomnia during menopause. This could possibly be attributed to hot flashes occurring at night, however some studies have found the hot flash to occur after awakening (Ginsburg 1994). Regardless of why it occurs, this disrupted sleep often results in a high instance of irritability, forgetfulness, difficulty in concentrating, and fatigue. Ginseng is believed to possess bipolar properties - it can instigate sleep and also help reduce fatigue. These contrasting effects are partially related to the dosage levels employed (Chong & Oberholzer, 1988). There have been a number of studies involving small animals such as mice, rats, and guinea pigs which show the effects of ginseng on sleep and fatigue.
Siberian ginseng (Eleutherococcus senticosus) was administered to mice on an acute or chronic basis and sleep latency and duration as a response to this herb were determined. Following the acute administration, Siberian ginseng produced a sedative effect which decreased sleep latency by 47% and increased sleep duration 45-228%. A similar effect was seen after the chronic administration with an increase in sleep duration of 125-202% (Medon, Ferguson, & Watson 1984). In another study, freely behaving rats were administered a continual one week intake of 15 mg/day of Panax ginseng extract. The results revealed a decrease in the amount of wakefulness and an increase in slow wave sleep (Rhee, Lee, Honda, & Inoue, 1990).
In a long term study, groups of mice were allowed to swim once every five days until exhaustion. After two months, results showed that the average swimming period of the mice given ginseng was double that of the other group. There was reported to be a consistent anti-fatigue activity in the mice following the administration of standardized extracts (Chong & Oberholzer, 1988).
Once again, there is a lack of controlled studies on humans to test the effects ginseng has on sleep, but the results of the tests on small animals clearly shows the bipolar properties ginseng has on on sleep. Consequently, I draw the conclusion that ginseng does help with both the insomnia and the nagging fatigue often experienced by females during menopause.
Ginseng and Its Hormonal Effects
There have been reported incidences showing that ginseng could possibly have many of the same properties as estrogen. Ginseng has been reported to produce an estrogen - like effect on the vaginal mucosa, resulting in the relief of the vaginal dryness which accompanies menopause (Bahrke &Morgan, 1994).
Several cases of actual vaginal bleeding after menstruation has already stopped have also been reported. In one case, a 72 year old patient taking one tablet containing 200 mg of ginseng daily experienced vaginal bleeding and a moderate estrogen effect. In another instance, postmenopausal bleeding occurred in a 44 year old woman who was applying a topical ginseng face cream (Bahrke & Morgan, 1994). Ginseng appears to have an estrogen - like effect on genital tissue which is not unexpected, since small quantities of estrone, estradiol, and estriol are present in ginseng root.
These observed instances clearly show that ginseng possesses many of the same properties as the hormone estrogen. Thus I conclude that Ginseng also wields action on the vagina much like estrogen. As a result, the shortening and thinning of the vaginal walls and the diminishing of vaginal lubrication which contribute to vaginal dryness and pain during intercourse will be greatly reduced through the use of ginseng.
Ginseng and Mood
Animal studies have given evidence that ginseng's ability to change the central neuroendocrine system results in enhanced mood following ginseng administration. In a study of the effect of ginseng versus placebo on mood, significant increases in subjective feelings of vitality, concentration, sleep, work output, and mood were noted in older females ages 40-60 years old (Bahrke & Morgan 1994).
Because this is a study on human responses to ginseng, the results are much more conclusive than those only pertaining to rodents. With the results from these studies of the effects of ginseng on human moods, the best conclusion is that taking ginseng does increase mood along with other beneficial results.
Adverse Effects of Ginseng
Although ginseng is thought to be relatively safe, there have been some adverse effects, such as hypertension, behavior stimulation, sleeplessness, diarrhea, mastalgia, occupational asthma, and skin eruption, reported in humans. In a study of various types of ginseng, including Panax ginseng and Eleutherococcus senticosus, in 133 individuals using a wide variety of commercial products over 2 years, ginseng had stimulant effects, but was also accompanied by a high incidence of sleeplessness, nervousness, hypertension, and euphoria (Bahrke & Morgan, 1994).
There is also ginseng abuse syndrome (GAS) which sometimes occurs after a long term usage of ginseng. GAS is characterized by hypertension together with nervousness, sleeplessness, skin eruptions, oedema, and morning diarrhea. The average daily dosage was 3 grams of root material for those experiencing this syndrome, however, the range was anywhere from 0 - 15 grams. High dosages of 15 grams or more per day resulted in feelings of depersonalization, confusion, and depression in some individuals (Bahrke & Morgan, 1994).
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