Ginseng
Place in Therapy
Based on the primary evidence and other literature that is currently published, ginseng (panax, American, and Siberian) should not be recommended as a single product for the treatment of vasomotor menopausal symptoms. It was thought to have some weak phytoestrogenic effects, which was demonstrated in vitro, and indirectly in some animal studies, however this did not pan out to clinical benefit for vasomotor symptoms in menopausal women[2,3,4,5]. One well-designed double-blinded RCT did not show benefit, and multiple review articles articulate that ginseng does not confer benefits on vasomotor menopausal symptoms[4,5]. It is fairly well-tolerated, with the number one side effect being insomnia[5,6]. It is possible unsafe in pregnancy, since a constituent of ginseng has been shown to be teratogenic[1]. Ginseng may potentiate the hypoglycemic effects of antidiabetic medication including oral antihypoglycemics and insulin[5,6]. It may have moderate immunosuppressant activity, and so is not recommended in immunocompromised individuals[5,6]. There is a low/moderate risk of potentiation of antiplatelet/anticoagulation effects[5]. Overall, Ginseng is fairly well tolerated[5,6]. Possible side effects include most commonly: insomnia, headache and gastrointestinal disturbances[5,6].
References:
1Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8
2Lee YJ, Jin YR, Lim WC, et al. Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells. Arch Pharm Res 2003;26:58-63.
3Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
4Wiklund IK, Mattsson LA, Lindgren R, et al. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Int J Clin Pharmacol Res 1999;19:89-99.
5Ginseng, Panax Monograph. Natural Medicines Comprehensive Database. Accessed from http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=&s=ND&pt=100&id=1000&ds=&name=Ginseng++(GINSENG%2c+PANAX)&searchid=39959036. Accessed February 16, 2013
6Coon JT, Ernst E. Panax Ginseng: a systematic review of adverse effects and drug interactions. Drug Saf. 2002;25(5):323-44
7Tode T et al. Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes. Int J Gynaecol Obstet. 1999 Dec;67(3):169-74
8Search Licensed Natural Health Products. Health Canada. Accessed from http://webprod3.hc-sc.gc.ca/lnhpd-bdpsnh/index-eng.jsp Accessed on February 16, 2013.
References:
1Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8
2Lee YJ, Jin YR, Lim WC, et al. Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells. Arch Pharm Res 2003;26:58-63.
3Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
4Wiklund IK, Mattsson LA, Lindgren R, et al. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Int J Clin Pharmacol Res 1999;19:89-99.
5Ginseng, Panax Monograph. Natural Medicines Comprehensive Database. Accessed from http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=&s=ND&pt=100&id=1000&ds=&name=Ginseng++(GINSENG%2c+PANAX)&searchid=39959036. Accessed February 16, 2013
6Coon JT, Ernst E. Panax Ginseng: a systematic review of adverse effects and drug interactions. Drug Saf. 2002;25(5):323-44
7Tode T et al. Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes. Int J Gynaecol Obstet. 1999 Dec;67(3):169-74
8Search Licensed Natural Health Products. Health Canada. Accessed from http://webprod3.hc-sc.gc.ca/lnhpd-bdpsnh/index-eng.jsp Accessed on February 16, 2013.