Natural Menopause Treatments

Some women decide not to take HRT or ERT to relieve the symptoms of menopause, and turn to herbal remedies or to certain estrogen-like chemicals in plants (called phytoestrogens) for help. There are many over-the-counter and natural remedies to help women with menopausal symptoms, such as black cohosh, ginseng, dong quai, and evening primrose. There is limited, and sometimes conflicting, research on the safety and effectiveness of many of these popular herbal products that claim to help menopause. Discuss herbal remedies with your health care provider before taking them. You also should tell your provider if you are taking any other medications, since some of the herbal products can have harmful interactions with other drugs.

Recently, the American College of Obstetricians and Gynecologists (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) to relieve hot flashes and night sweats. Taken over the long term, it also may have good 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.

Symptoms of Menopause

  • Hot flashes
  • Sweating
  • Sleep problems
  • Depression
  • Mood swings
  • Vaginal dryness and irritation
  • Memory loss
  • Changes in sex drive and sexual response
  • Weight gain
  • Hair loss
  • "Spotting" and abnormal bleeding (may be normal, but report to doctor)

Preventing Osteoporosis

  • A diet that is rich in calcium and vitamin D
  • regular weight-bearing exercises
  • Avoid smoking
  • Limit alcohol intake
  • If you take certain medications
    (glucocorticoids, antiseizure drugs, sleeping drugs, cancer drugs, or drugs to treat endometriosis or an overactive thyroid)
  • talk to your doctor about what can be done to protect your bones

Important Notice

On July 9, 2002, the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) stopped early a major clinical trial of the risks and benefits of combined estrogen and progestin in healthy menopausal women. The trial was stopped due to an increased risk of invasive breast cancer.