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Women in New Zealand who rely on hormone replacement therapy to manage the symptoms of menopause are facing supply issues and shortages of oestradiol patches that may continue for some time into 2025. Many women are exploring alternative ways to manage their menopausal symptoms when they aren’t able to source HRT patches. Overseas, the natural active ingredient black cohosh (Actaea racemose/Cimicifuga racemose) is regarded as a proven natural remedy worldwide, with over 60 years of medical research. The German product Remifemin is used by millions of women globally with contraindications to HRT or who simply prefer not to take hormones.
Pharmac has announced that the ongoing shortage or oestradiol patches in New Zealand may continue into 2025.
Pharmac and the supplier have been sourcing alternative brands of patches to try to keep up with demand – but, unfortunately, supply gaps will persist.
For the most up to date supply information, we recommend visiting the Pharmac Oestradiol (Estradot) patches: Supply issue page.
There are non-hormonal treatment options available for menopausal symptoms. On of the most used natural supplements is black cohosh (Actaea racemose/Cimicifuga racemose). It is a North American medicinal plant that is often used as a gynecological remedy. People commonly use black cohosh for menopausal symptoms, premenstrual syndrome (PMS) and painful menstruation (dysmenorrhea).
Black cohosh is the active ingredient in the popular German women’s health supplement Remifemin. It was first used in an allopathic herbal medicinal product (HMP) in 1956 and has been studied extensively since. In Germany HMPs are authorized medicines that have strict regulatory control requiring proof of efficacy, safety, and quality.
Remifemin has been used extensively in Germany and the rest of the world since its approval in 1956 – often recommended to women who aren’t able to use HRT, want to refrain from HRT, or do not have access to HRT.
The use of black cohosh for menopause symptoms is well-studied with findings supporting it’s efficacy.
For example in a 2018 study on hot flashes, a group of 80 postmenopausal women were given 40 mg of black cohosh twice a day for 8 weeks. The women reported significantly fewer hot flashes than before they started the supplement, the flashes they did experience were less severe too.1
The most compelling research on black cohosh for the treatment of menopausal symptoms is focused on the unique black cohosh extract found in Remifemin. This extract is called isopropanolic Cimicifuga racemosa extract (iCR).
A 2020 review and meta-analysis on iCR found that all studies with iCR consistently demonstrated it’s efficacy for natural climacteric (menopausal) symptoms. With iCR exhibiting significant superiority versus placebo and an efficacy comparable to low-dose transdermal estradiol.2
Researchers found that only registered CR medicinal products were able to prove their efficacy, with isopropanolic CR extract (iCR) providing the best evidence. After looking at a multitude of clinical studies involving more than 11,00 patients, there was consistently positive data regarding efficacy and safety of iCR in the treatment of menopausal symptoms.3
The menopausal symptoms that were often best improved with iCR were vasomotor symptoms.4 These could include hot flushes, sweating, and sleep disorders. The therapeutic benefit was most significant in patients that were early in the climacteric phase.
If you cannot access HRT patches due to supply issues, alternative treatment options like Remifemin may be worth considering. Many women treat their menopausal symptoms with products containing the active ingredient black cohosh. Remifemin is the world’s No.1 selling pharmacy menopause brand, and it is used by millions of women in 77 countries worldwide.
Remefemin is considered safe for most people who are not pregnant or breastfeeding. Black cohosh has in very rare cases been associated with liver failure and should be avoided if you have liver disease. Talk to your pharmacist or doctor to see if this option may be suitable/safe for you.
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