Ginseng and Vaginal Bleeding

To the Editor.— Ginseng has been reported to produce a physiological estrogenlike effect on the vaginal mucosa, mastalgia with diffuse mammary nodularity in postmenopausal women, and, experimentally, stimulation of corticotropin secretion and altered RNA hepatic metabolism. After bilateral oophorectomy, Punnonen and Lukola1observed a notable vaginal effect in a patient ingesting an unstated amount of Rumanian ginseng only two weeks per month. A 72-year-old woman experienced vaginal bleeding and a moderate estrogen effect after ingesting one tablet daily of a Swiss-Austrian geriatric formula containing 200 mg of ginseng of an unspecified source (Geriatric Pharmaton, Bernardgass, Austria). Physicians should be alerted to a possible vaginal bleeding action of ginseng in postmenopausal women.