Red Ginseng and Menopause
Women’s Health
Abstract & Commentary
Red Ginseng and Menopause
By David Kiefer, MD
Synopsis: Seventy-two postmenopausal women were randomized to either a specific form of Panax ginseng or placebo daily for 12 weeks. The treatment group showed improvements in menopausal symptoms, lipid profiles, and carotid intima-media thickness.
Source: kim sy, et al. effects of red ginseng supplementation on menopausal symptoms and cardiovascular risk factors in postmenopausal women: A double-blind randomized controlled trial. Menopause 2012;19:461-466.
Postmenopausal women ages 45-60 were recruited from the general population in Seoul, Korea. Inclusion criteria included having menopausal symptoms, at least 12 months of amenorrhea, and no hormone therapy for at least 6 months, but women were excluded if they had uncontrolled hypertension, diabetes, cardiovascular disease, hypercholesterolemia, or a history of cancer. Seventy-two women were randomized to either red ginseng (1 g three times daily; n = 36) or identical placebo (n = 36) for 12 weeks. Although the red ginseng presumably was derived from the root, the plant part was not explicitly stated, nor was any extraction process undertaken beyond simply drying and powdering the plant for creation of the capsules for this study.
Baseline characteristics of the two study groups were statistically similar. Thirty-one of the women assigned to the red ginseng group completed the 12 weeks, compared to 32 of the placebo group, and all data were analyzed using an intention-to-treat approach. Ultrasound methodology (for carotid intima-media thickness [CIMT]), serum blood testing, and menopausal symptomatology measurement (using the Kupperman Index and Menopause Rating Scale) were described in detail. After 12 weeks, the Kupperman Index in the ginseng group went from 18.93 (standard deviation [SD] = 11.28) to 13.32 (SD = 10.15), a significant (P = 0.021) change, as well as being significantly different than the placebo group (P = 0.032). For the Menopause Rating Scale, a statistically significant improvement for the ginseng group also was observed over time and when compared to the placebo group. Furthermore, the hot flash score decreased over 12 weeks in the ginseng group (P = 0.032) to 3.51 (SD = 2.36), just barely significantly better than the 4.87 (SD = 2.94) in the placebo group (P = 0.046). Putting these results in perspective, the Kupperman Index score ranges from 0-51, whereas the Menopause Rating Scale ranges from 0-44.
In the lipid panels, the only statistically significant changes were observed in total cholesterol and low-density lipoprotein after 12 weeks of ginseng supplementation (a decrease from 138 to 108 mg/dL and 78 to 60 mg/dL, respectively). In the ginseng group, no differences were observed for high-density lipoprotein nor for triglycerides; in the placebo group, no changes over 12 weeks were observed for any of the four lipids. In addition, CIMT decreased over 12 weeks in the ginseng group, but not the placebo group; this difference was barely significant (P = 0.049) between the two groups. The serum C-reactive protein (CRP) was lower after 12 weeks compared to baseline in the ginseng group (P = 0.030), but this was not statistically different than the placebo group after 12 weeks. No significant differences in serum estradiol were noted in either group or between groups.
It is important to note that the funding for this research study was from the Korea Ginseng Corporation (www.kgcus.com), a manufacturer and distributor of Panax ginseng, and the provider of the product used in this research study.
Commentary
Panax ginseng (Family Araliaceae), also known by the common names of Asian or Korean ginseng, is arguably the most well-known adaptogen and the focus of many basic science and clinical trials, both in Asian and Western countries. Many of these studies were done on a particular extract, G115, which has now made it into the active pharmacopeia of clinicians around the world. But just as “ginseng” is so much more than “ginseng” (scientists recognize that there are many species of “ginseng,” some in the genus Panax and some not, and each with unique physiological effects), the article being reviewed here adds yet another layer of sophistication to our knowledge about this one ginseng species. No longer should we just think about a plant and its clinical uses, but the method of extraction may indeed be a key variable as much as its form (root, leaves, flower, etc).1 In this article, the reseachers studied red ginseng, a fermented form of Panax ginseng root, which changes the ginsenoside composition,1 and, per these authors, may lead to a more pronounced phytoestrogenic effect, hence its use in menopause. Regrettably, this particular clinical trial was financed by an exporter and manufacturer of red Korean ginseng, an unacceptable conflict of interest. Follow-up trials without this hitch would be very interesting.
Nonetheless, these are very interesting results adding to our knowledge of the clinical effects of Panax ginseng and other adaptogens. Only some of the published research is on this particular formulation of Panax ginseng (as opposed to non-fermented forms, including the oft-prescribed Ginsana [G115] patented extract), so it certainly broadens the clinical possibilities for this plant. Adaptogens are often thought of being antioxidant and anti-inflammatory, which could account for their far-reaching, multi-organ-system effects. Along these lines, this study showed improvements in the CIMT and serum CRP with the ginseng group. It is unclear how to interpret the clinical meaning of the lipid-lowering activity of ginseng in this trial, since there is no known benefit to lowering serum lipid values in normolipidemic people. It is interesting that they chose hypercholesterolemia as an exclusion of participation in this study. Again, the lipid effects in hyperlipidemic people would be an interesting follow-up study.
Reference
1. Karmazyn M, et al. Therapeutic potential of ginseng in the management of cardiovascular disorders. Drugs 2011;71:1989-2008.
Seventy-two postmenopausal women were randomized to either a specific form of Panax ginseng or placebo daily for 12 weeks. The treatment group showed improvements in menopausal symptoms, lipid profiles, and carotid intima-media thickness.Subscribe Now for Access
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