What Herbal Therapies Are Safe and Beneficial for Menopausal Symptoms?

November 10, 2016

Question

I recently visited my gynecologist to discuss my menopause symptoms. My doctor told me there were herbal therapies that could help my symptoms. My question is what herbal therapies are safe and beneficial for menopausal symptoms?

Answer

Many women are concerned about the proven risks from menopause hormone therapy and want to learn more about alternative approaches that can help their menopause symptoms. Here are the primary supplements that are used for menopause symptoms:

  • Black Cohosh is said to be effective at helping relieve hot flashes and night sweats. It is available in the U.S. as a dietary supplement called Remifemin. The National Center for Complementary and Integrative Health (NCCIH) states that there is limited knowledge and inconsistent study results about black cohosh’s effects.1 There’s also a lack of high-quality research testing black cohosh’s safety in women who are pregnant, nursing, or have had hormone-related conditions like breast cancer. NCCIH reports that there have been cases of liver damage in people who have used commercial black cohosh products. There’s not enough research to determine black cohosh’s effectiveness in treating menopausal symptoms, and women should be aware that the supplement could cause more harm than good.
  • Another popular herb to address menopausal symptoms is John’s Wort. St. John’s Wort is thought to contain chemicals that behave like anti-depressants and is used to improve mood swings, depression, and insomnia. Studies on the herb’s effectiveness are mixed, however, and NCCIH studies indicate that St. John’s Wort can have dangerous interactions with other medications.2 These interactions can result in weakening the effects of some cancer medications, heart medications, blood thinners, antidepressants, birth control pills, and HIV drugs. Side effects include sensitivity to sunlight, gastrointestinal symptoms, headache, sexual dysfunction, anxiety, and dry mouth.2
  • Red clover is used to help in alleviating night sweats and hot flashes, but studies have not shown consistent evidence of its effectiveness. NCCIH reports that most research shows red clover supplements do not prevent hot flashes.3 One study reports that short-term use of red clover by postmenopausal women may have small health benefits on bone mass density, cognitive abilities, and plasma lipid concentrations due to the presence of estrogen-like compounds called isoflavones.4 However, isoflavones’ estrogen-like nature also may increase the risk of endometrial and breast cancers, which are sensitive to estrogen. There’s a need for more research on this topic. Women who are pregnant, breastfeeding or have hormone-sensitive cancers, such as estrogen-receptor-positive breast cancer, should not use this supplement.

The NWHN notes that herbal supplements cannot be assumed to be safe for short- or long-term use just because they are “natural.” Also, supplement manufacturers are not required to obtain approval from the U.S. Food and Drug Administration (FDA), so be cautious when considering these products. It is important to be as informed as possible about any product you use for health reasons. Discuss with your healthcare provider about possible ways to reduce menopausal symptoms and be sure to inform her if you’re using an herbal supplement. For more information, see the feature article, and check out NWHN’s Consumer Health Information on herbs and phytoestrogens.

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References

1. National Center for Complementary and Integrative Health (NCCIH), Black Cohosh, Bethesda, MD: NCCIH, 2016. Retrieved March 28, 2017 from: https://nccih.nih.gov/health/blackcohosh/ataglance.htm#hed4

2. National Center for Complementary and Integrative Health (NCCIH), St. John’s Wort, Bethesda, MD: NCCIH, 2016. Retrieved March 28, 2017 from: https://nccih.nih.gov/health/stjohnswort/ataglance.htm

3. National Center for Complementary and Integrative Health, Red Clover, Bethesda, MD: NCCIH, 2016. Retrieved March 28, 2017 from: https://nccih.nih.gov/health/redclover/ataglance.htm

4. Gellar SE, Studee L, “Soy and red clover for mid-life and aging,” Climacteric 2006; 4(9): 245-263.