Herbal Remedies for Menopausal Symptoms

There are many "herbal" products for sale that claim to help menopausal symptoms. These products are not regulated through the same government system as drugs, so there is little research to back up their claims. In addition, most have to be taken routinely, are not covered by insurance, and can become costly over time. Any herbal remedies for menopause should be thoroughly discussed with your health care provider. You should tell your provider if you are taking any other medications, since some of the herbal products can have harmful interactions with other drugs.

However, there are some products that seem to help some women. Soy and soy products have been used for the alleviation of menopausal symptoms due to their high concentration of phytoestrogens. Phytoestrogens are plant-derived compounds that possess estrogenic activity, and therefore could have some of the same effects as hormone therapy, but their long-term safety has not been adequately studied. There is limited, and sometimes conflicting, research on the safety and effectiveness of many other popular herbal products that claim to help menopause, including ginseng, black cohosh, dong quai, and evening primrose.

Recently, the American College of Obstetricians (ACOG) issued the following guidelines on the most popular "alternative" medicines for menopause:

1. Soy and Isoflavones (plant estrogens found in beans, particularly soybeans) - High isoflavone intake (about 50 grams of soy protein per day) may be helpful in the short term (2 years or less) in relieving hot flashes and night sweats. Taken over the long term, it also may have beneficial effects on cholesterol and bones. While safe in dietary amounts, the consumption of extraordinary amounts of soy and isoflavone supplements may interact with estrogen and may be harmful to women with a history of estrogen-dependent breast cancer and possibly to other women as well.

2. St. John's wort - May be helpful in the short-term (2 years or less) to treat mild to moderate depression in women (when given in doses of less than 1.2 milligrams a day.) A recent study showed it is not effective in treating severe depression. It also can increase skin sensitivity to the sun and may interfere with prescription antidepressants.

3. Black cohosh - May be helpful in the short term (6 months or less) to treat hot flashes and night sweats. It seems to be extremely safe, although studies have been small and brief, none longer than six months.

4. Chasteberry (also known as monk's pepper, Indian spice, sage tree hemp, and tree wild pepper) - This may inhibit prolactin, a natural hormone that acts on the breast. It is touted for breast pain and premenstrual syndrome. There are very few studies in menopausal women. A study of women with premenstrual syndrome found they reported improvements in mood, anger, headache, breast fullness, but not bloating and other symptoms.

5. Evening primrose - This plant produces seeds rich in gamma-linolenic acid, which some experts believe is the nutritionally perfect fatty acid for humans. Although evening primrose capsules are taken for breast pain, bladder symptoms and menopausal symptoms, there is little or no evidence that they work. The one high quality study of effects on hot flashes found that evening primrose was no better than placebo.

6. Dong quai - A study aimed at reducing hot flashes found that dong quai was not better than placebo - although the 4.5-gram dose used in the study was lower than that typically given in Chinese medicine. The herb is potentially toxic. It contains compounds that can thin the blood, causing excessive bleeding, and make the skin more sensitive to sun, possibly increasing skin cancer risk.

7. Valerian root - This has traditionally been used as a tranquilizer and sleeping aid. But the U.S. Pharmacopoeia, which sets manufacturing standards for medicines, does not support its use, and there have been reports of heart problems and delirium attributed to sudden withdrawal from valerian.

8. Ginseng - Most of the many types of ginseng (including Siberian, Korean, and American, white and red), are promoted for relieving stress and boosting immunity. A study of menopausal women by the leading ginseng manufacturer found the product did not relieve hot flashes but did improve women's sense of well being. Analyses of ginseng products have found a troubling lack of quality control: some contained little or no ginseng, contained large amounts of caffeine, or were tainted by pesticides or lead.

9. Wild and Mexican yam - There are no published reports that show wild and Mexican yam cream is effective in helping menopausal symptoms. The hormones in wild and Mexican yam do not have any estrogenic or progestational properties, so they are not expected to help women with these symptoms.