Could Grape Seed Extract Be an Alternative Treatment in the Management of Hot Flashes?—Reply

In Reply Dr Altundag notes that a randomized, placebo-controlled trial by Terauchi et al showed improvement in menopausal symptoms, including hot flashes, in women taking grape seed proanthocyanidin extract. Similar proanthocyanidin-rich pine bark extracts have also been shown to alleviate menopausal symptoms. Of note, these studies did not specifically include breast cancer survivors, or patients with hormone therapy–associated hot flashes. Proanthocyanidin compounds possess aromatase inhibitor activity both in vitro and in vivo, and exert antiestrogenic activity in vitro in the presence of estradiol. Their mechanism of action of ameliorating hot flashes is unclear given this antiestrogenic biochemical activity, although they may not affect actual estrogen levels. They have also been shown to bind to the estrogen receptor-α with weak agonist activity.

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