Herbal remedies are taken by 40% of women in menopause alongside - or instead of - hormonal replacement therapy) to ease hot flushes, sleeplessness and other symptoms. They are perceived as natural products without risk, says a report in the Drug and Therapeutics Bulletin. Editor Dr Ike Iheanacho said that herbal medicines have pharmacological actions, and so can cause unwanted side effects and have potentially dangerous interactions with other medicines, both herbal and conventional. He added that health care professionals should ask women routinely if they are taking any such products.

Among those used are wild yam extract, black cohosh, sage leaf, red clover, ginseng, and kava

kava which was banned in the UK after reports of liver damage.

The Royal College of Obstetricians and Gynacologists has warned that many herbal remedies and supplements have not been properly tested. It says alternative medicine preparations may reduce symptoms by 50-60%, which is 'considerably lower' than HRT, which results in 80-90% fewer symptoms.

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