***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The purpose of this study is to investigate relationship of menopausal hot flash and calcitonin gene-related peptide ( CGRP ) . Furthermore , this study evaluated the effect of the Japanese herbal ( kampo ) medicine Keishi-bukuryo-gan from the aspect of CGRP regulation . METHODS Plasma CGRP and vasoactive intestinal peptide ( VIP ) levels were measured during hot flash and CGRP reactivity was studied by cold load test in subjects with/without hot flashes . The effect of Keishi-bukuryo-gan was assessed in comparison with plasma CGRP level . RESULTS Only plasma CGRP but not VIP significantly elevated at the occurrence of hot flash ( P=0.002 ) . Stress by cold load significantly enhanced the over-secretion of CGRP in subjects with flash compared with those without flash ( P=0.003 ) 3 min after the load . Keishi-bukuryo-gan decreased plasma CGRP level in subjects with hot flash . CONCLUSIONS CGRP but not VIP was mainly related to the occurrence of hot flash . Keishi-bukuryo-gan , Japanese herbal medicine , improves hot flash possibly affecting plasma CGRP level OBJECTIVE To explore the phytoestrogenic effects of ten kinds of Chinese medicine including flos carthami , radix cyathulae , radix salviae miltiorrhizae , fructus ligustri lucidi , fructus lycii , radix clycyrrhizae , herba cistanches , herba epimedii , fructus psoraleae and semen cuscutae . METHOD 240 female Kunming mice weighting 9 - 12 g were r and omly divided into two main groups A and B. A group was divided into 12 small groups : 1 solvent control group , 1 diethylstilbestrol control group and 10 Chinese medicine groups . B group was also divided into 12 small groups : 1 solvent control group , 1 diethylstilbestrol control group and 10 Chinese medicine antagonistic groups . Mice in ten antagonistic groups were administered both Chinese medicine and diethylstilbestrol everyday . After administered(op ) for 4 days , blood was collected and serum was separated . The effect of the pharmacological serum on proliferation rate of MCF-7 ( ER+ ) was analyzed by MTT-assay . RESULT In A group , proliferation rates of MCF-7 cells treated with serum from eight Chinese medicine groups including flos carthami , radix cyathulae , radix salviae miltiorrhizae , fructus lycii , herba cistanches , herba epimedii , fructus psoraleae and semen cuscutae were coued markedly increase respectively . While serum from fructus ligustri lucidi group could markedly decrease the proliferation rate of MCF-7 cells . In B group , the increased proliferation rate of MCF-7 cells caused by diethylstilbestrol was significantly reduced in seven Chinese medicine antagonistic groups including flos carthami , radix cyathulae , radix salviae miltiorrhizae , radix clycyrrhizae , herba epimedii , fructus psoraleae and semen cuscutae . While the increased proliferation rate could be markedly enhanced in herba cistanches group . CONCLUSION Six kinds of Chinese medicine such as flos carthami , radix cyathulae , radix salviae miltiorrhizae , herba epimedii , fructus psoraleae and semen cuscutae show both estrogenic effects ( when administered indepently ) and antiestrogenic effects ( when administered together with diethylstilbestrol ) . Such bidirectional effects depends on the internal estrogen level This study evaluates 23 ( 9 Chinese and 14 non-Chinese ) r and omized controlled trials for efficacy and side effects of Chinese herbal medicine on  menopausal symptoms .  Menopause was diagnosed according to western medicine criteria in all studies while seven Chinese studies and one non-Chinese study further stratified the participants using traditional Chinese medical diagnosis “ Zheng differentiation . ” Efficacy was reported by all 9 Chinese and 9/14 non-Chinese papers . Side effects and adverse events were generally mild and infrequent . Only ten severe adverse events were reported , two with possible association with the therapy . CHM did not increase the endometrial thickness , a common side effect of hormone therapy . None of the studies investigated long-term side effects . Critical analysis revealed that ( 1 ) high- quality studies on efficacy of Chinese herbal medicine for menopausal syndrome are rare and have the drawback of lacking traditional Chinese medicine diagnosis ( Zheng-differentiation ) . ( 2 ) Chinese herbal medicine may be effective for at least some menopausal symptoms while side effects are likely less than hormone therapy . ( 3 ) All these findings need to be confirmed in further well- design ed comprehensive studies meeting the st and ard of evidence -based medicine and including Zheng-differentiation of traditional Chinese medicine Objective : The aim of this study was to assess the efficacy of TU-025 , keishibukuryogan , a Japanese prescription herbal medicine used for hot flash management , in American women . Methods : This r and omized , double-blind , placebo-controlled , phase II trial enrolled 178 postmenopausal women aged 45 to 58 years with a Mayo hot flash score greater than 28 per week who met other inclusion criteria . After a 1-week placebo run-in period , participants were r and omly assigned placebo , or 7.5 g/day , or 12.5 g/day groups , for 12 weeks . Primary and secondary outcomes were measured using the Mayo Clinic Hot Flash Diary , the Greene Climacteric Index , and the Pittsburgh Sleep Quality Index . Results : At 3 months , hot flash scores , climacteric symptoms , and sleep quality improved by 34 % in the placebo group , 40 % in the 7.5 g/day group , and 38 % in the 12.5 g/day group . ( P < 0.001 ) . However , the differences in changes between groups were not statistically significant ( P = 0.990 ) . Diarrhea unexpectedly developed in 20 % of participants receiving active medication . Conclusions : For American women , unlike the clinical experience for Japanese women , TU-025 did not significantly reduce the frequency and severity of hot flash symptoms , improve climacteric symptoms , or benefit sleep quality . This study identified several potentially significant method ological factors to be considered in future scientific assessment s of traditional Asian medicines Objective The aim of this study is to investigate the effectiveness and safety of a Chinese herbal formula , Er-Xian decoction ( EXD ) , in the treatment of menopausal symptoms among Hong Kong perimenopausal women . Methods A r and omized , double-blind , controlled trial was conducted for 12 weeks among 108 Hong Kong perimenopausal women who reported Menopause Rating Scale ( MRS ) total scores of 28 or higher . Posttreatment follow-up was performed 3 months after the intervention . The primary outcome measure was the frequency and severity of hot flushes . The secondary outcome measures included the MRS , the Menopause-Specific Quality of Life question naire , and serum hormone levels . Results Among 108 participants , 101 participants finished the study . EXD significantly reduced the mean ( SD ) frequency of hot flushes from 5.8 ( 5.0 ) to 2.2 ( 3.0 ) in the treatment group and from 5.0 ( 3.8 ) to 2.4 ( 2.5 ) in the placebo group ( P = 0.04 ) . The mean ( SD ) hot flush score was also reduced from 19.6 ( 6.6 ) to 4.9 ( 7.8 ) in the treatment group and from 16.6 ( 5.4 ) to 7.0 ( 6.4 ) in the placebo group ( P = 0.02 ) . The superiority of EXD to placebo was also observed with greater improvement in the total scores for the MRS ( P = 0.03 ) and the Menopause-Specific Quality of Life question naire ( P < 0.01 ) . There were no differences in serum hormone levels between the EXD group and the placebo group . There were no serious adverse events , and the safety indices of whole blood counts , renal function , and liver function were within the normal range before and after treatment . Conclusions The Chinese herbal formula EXD is superior to placebo in reducing the frequency and severity of hot flushes and in improving menopausal symptoms in Hong Kong perimenopausal women . It is well tolerated , with no serious adverse events noted during the study period Objective : The study aims to evaluate the effectiveness and safety of Chinese herbal medicine granules Danzhi Qing’e formula ( DZQE ) , Erzhi formula ( EZ ) , and their combination ( Combined formula ) in the treatment of menopausal symptoms at different stages of menopause . Methods : Women between the ages of 40 to 60 years , who met menopausal symptoms diagnostic criteria and experienced hot flushes at least 14 times/week in the last 4 weeks , were recruited to participate in a stratified r and omized , double-blind , placebo-controlled  clinical trial ( n = 389 ) . They received a treatment period of 8 weeks and were followed up for 4 weeks . Participants were categorized into two subgroups : 197 in the perimenopausal subgroup ( menstrual disorder to 1 y after amenorrhea ) and 192 in the early postmenopausal subgroup ( 1 - 5 y after amenorrhea ) . Participants were r and omly assigned to placebo or one of the three herbal formula treatments . The primary outcome instrument was the Menopause-Specific Quality of Life ( MENQOL ) question naire . Results : When analyzing the two subgroups together , DZQE markedly decreased the MENQOL total score at the end of 12th week with statistical significance ( P = 0.02 ) and improved vasomotor symptoms after 8 weeks treatment and 4 weeks follow-up ( P < 0.05 ) . What is more , the combined formula also greatly improved the participants ’ vasomotor symptoms compared with placebo after the 4 weeks follow-up . No statistically meaningful difference was observed in any other outcomes among the groups . The results of subgroup analysis showed that DZQE and Combined formula were more effective than placebo in improving MENQOL total score for perimenopausal women at the end of week 12 . For typical menopausal symptoms such as hot flushes and night sweats , DZQE displayed more favorable effects on early postmenopausal participants . Compared to placebo , the DZQE both showed statistically significant differences after 8 weeks treatment and 4 weeks follow-up . Although at the end of 12th week , DZQE also had better effects than placebo in the perimenopausal subgroup on vasomotor symptoms . Participants in the EZ group did not show a significant difference of any domains in MENQOL compared with participants in the placebo group . Conclusions : The DZQE formula improves the quality of life for menopausal women , especially for those with vasomotor symptoms during the whole menopausal period . The DZQE and EZ combination formula is effective only on perimenopausal symptoms Objective : This study examined whether use of complementary and alternative ( CAM ) therapies during the menopause transition varied by ethnicity . Design : The Study of Women 's Health Across the Nation is a prospect i ve cohort study following a group of 3,302 women from five racial/ethnic groups at seven clinical sites nationwide . Using longitudinal data encompassing 6 years of follow-up , we examined trends in use of five categories of CAM ( nutritional , physical , psychological , herbal , and folk ) by menopause status and ethnicity . To account for potential secular trends in CAM use or availability , we also evaluated the trends in CAM use over calendar time . Results : Approximately 80 % of all participants had used some form of CAM at some time during the 6-year study period . White and Japanese women had the highest rates of use ( 60 % ) , followed by Chinese ( 46 % ) , African American ( 40 % ) , and Hispanic ( 20 % ) women . Overall use of CAM therapy  remained relatively stable over the study period . In general ,  CAM  use did not seem to be strongly associated with change in menopause transition status . Use of CAM  among white women did not change with transition status . Among Chinese and African American participants , we observed an increase in  CAM use as women transitioned to perimenopause and a decrease in use of CAM  with transition to postmenopause . Among Hispanic and Japanese women , we observed a decrease in use of CAM  in early perimenopause , followed by an increase as women entered late perimenopause and a decrease as they progressed to postmenopause . Patterns of use for the five individual types of CAM varied . White women had relatively stable use of all  CAM therapies  through the transition . Japanese women decreased use of nutritional and psychological remedies and increased use of physical remedies as they transitioned into late perimenopause . Among African American women , use of psychological remedies increased as they progressed through menopause . Conclusions : Although CAM use did vary in some ethnic groups in relation to advancing menopause status , there was no evidence of influence of calendar time on CAM use . Patterns of CAM use during menopause are likely to be driven by personal experience , menopausal health , and access to therapies . Women 's personal preferences should be taken into consideration by healthcare providers for medical decision making during menopause and throughout the aging process Objective The aim of this study was to evaluate the feasibility of a clinical trial investigating the effects of acupuncture ( AP ) and Chinese herbal medicine ( CHM ) on hot flushes and quality of life in postmenopausal women . Methods Forty postmenopausal women reporting at least 20 hot flushes per week were enrolled in a r and omized controlled 
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However , no statistically significant changes to hormone levels were detected .
Most commonly seen adverse events were mild gastrointestinal tract reactions .
Conclusions This review indicated that CHM formulae were safe to be applied in MHF females and able to improve MHF-related symptom scores as well as the peripheral blood flow .