When I was in medical school way back in the 1950’s, a popular drinking song at every party was “Lydia Pinkham’s Vegetable Compound.” I still remember every word of the song. It is about a woman who made a lot of money selling a tonic containing black cohosh (along with a lot of alcohol) to treat the pain and hot flushes that women suffered at the time of the menopause. The song is still sung at parties at just about every medical school, and Lydia Pinkham’s remedy is still advertised and sold to treat menopausal symptoms and other female complaints.

Lydia Pinkham’s black cohosh tonic was one of the top selling patent medicines back in 1875, almost 150 years ago, and today many women still buy black cohosh to treat hot flushes of menopause, even though it has been largely discredited by the medical community.  One double-blind study showed that it is no more effective for controlling menopausal hot flushes than a placebo sugar pill (Menopause, 2009 Nov-Dec;16(6):1156-660). A review of 16 placebo-controlled studies also showed no evidence that black cohosh relieves hot flushes of menopause (The Cochrane Library, September 2012), and another review of six studies failed to show benefit (Pharmacological Research, July 2008;58(1):8-14). Estrogen replacement significantly reduces the number of hot flashes, but most doctors no longer recommend it because of increased risk for breast cancer and uterine cancer.

A Pioneering Businesswoman
Lydia Estes was born in 1819 in the small town of Lynn, Massachusetts. In 1843, she married a wealthy shoe manufacturer, Isaac Pinkham, and when their shoe business went bankrupt in 1875, Lydia began to market her herbal tonic. She founded the first widely successful business run by a woman in the United States. She advertised to women, selling her medicine for “all those painful Complaints and Weaknesses so common to our best female population.”

She was a brilliant advertiser. She placed a picture of her own matronly face on her patent medicine, and became associated with her product line in a way that would not be matched until 80 years later when Col. Harlan Sanders used his face to advertise Kentucky Fried Chicken. She published articles and answered letters in ladies’ magazines, handed out free pamphlets and wrote newspaper columns, always including recommendations to take “Lydia Pinkham’s Vegetable Compound”. Every advertisement and article she wrote included her portrait and she became one of the best known women in the world. The chorus of the Lydia Pinkham song says, “On each bottle, there’s a picture of her face”.

Lydia Pinkham never saw the full effect of her medicinal empire. She died in 1883, after being in business for only eight years, but her Vegetable Compound made the family fortune, grossing $300,000 annually at the time of her death and peaking in 1925 at $3.8 million. At the height of Prohibition in the 1920s, Lydia Pinkham’s Vegetable Compound was very popular with men also. They could get around prohibition because the compound contained 18 percent alcohol which, the ads claimed, acted as “a solvent and preservative”.

Better than Available Medical Treatments
In 1876, the year the Vegetable Compound was patented, physicians were killing their female patients by removing healthy ovaries as a treatment for menstrual cramps. Removing healthy ovaries causes premature aging and horrible osteoporosis with its resultant broken bones. Unfortunately for the women who went to these male doctors for such treatment, almost 40 percent of them died because of unsanitary conditions in surgery and lack of antibiotics to treat the inevitable infections. At that time, Lydia Pinkham’s Vegetable Compound certainly was far less destructive than the treatment offered by many doctors.

Today Remifemin, a multi-million dollar herbal product containing black cohosh, claims to control menopausal depression and hot flushes.  The review of scientific studies 129 years after the death of Lydia Pinkham shows that black cohosh is not an effective preventative or treatment for the hot flushes of menopause. However, it causes no known harm, and placebos can be very powerful.

Medical students still sing of Lydia Pinkham today, and you can sing along with these lyrics, to the tune similar to “I Wish I Was an Oscar Meyer Weiner”:

We sing, we sing, we sing of Lydia Pinkham,
She is the savior of our race.
She gave to us her Vegetable Compound,
And on each bottle there’s a picture of her face.

Lydia died and went up to heaven,
All the church bells they did ri – hing – hing
She took with her, her Medicinal Compound,
Hark! The herald angels sing!

So-oh drink a drink a drink, to Lydia Pinkham,
She is the savior of the human race,
She invented a medicinal compound,
Whose effects that God can only replace.”

Mrs. Jones she had no children,
And she loved them very dear.
So she took three bottles of Pinkham’s
Now she has twins every year.

Lottie Smyth ne’er had a lover,
Blotchy pimples caused her plight;
But she took nine bottles of Pinkham’s
Sweethearts swarm about her each night.

Oh Mrs. Murphy (Oh Mrs. Murphy)
Was perturbed because she couldn’t seem to pee
Till she took some of Lydia’s compound
And now they have to cart her urine out to sea!

Lydia Estes Pinkham
February 9, 1819 – May 17, 1883