Associated Women's Health Specialists  
     
     

Herbal Products for Menopause

During menopause, a woman's body produces less estrogen. This can cause changes that occur slowly over time. Some women find these changes uncomfortable.

Treatment with hormone therapy (HT) may relieve some symptoms of menopause, but also poses some health risks. Women also may use herbal products. Some herbal products may be helpful in the short-term treatment of symptoms, whereas others are not. Still others may cause harm.

This pamphlet will explain:

  • Types of herbal medicine
  • Common herbs used for relief of symptoms
  • Some concerns about herbal products

    For some women, using herbs can help relieve symptoms of menopause.

    What Is Herbal Medicine?

    Healers have been using herbs as medicine for thousands of years. Many drugs we use today come from plants. Some drugs that are now manmade first came from plants. Herbal treatments also come from plants and can be given in many forms (see box).

    Some doctors may suggest herbal treatments in addition to conventional treatments or drugs prescribed. Herbal treatments also may be used by other professions:

    • Herbalists—People who treat illness with herbs
    • Homeopaths—People who treat conditions by giving small doses of a remedy that would produce symptoms of the condition in a healthy person.
    • Acupuncturists—People who use the Chinese method of placing needles at points on the body to treat disease and pain
    Some people think of herbal medicine as being more "natural." They may think natural means safer and better. But natural things can hurt you too. Just because something is natural does not mean it is good for you.

    Herbal products may interact with drugs prescribed by your doctor and cause problems. It also can be hard to know how safe a product is because herbs are not tested the same way as drugs are tested. Because of these factors, women who use herbal products for relief of menopause symptoms should consult their doctors.

    Forms of Herbal Treatment

    Bulk herbs: Raw or dried plants ground up in a powder used to make teas or tinctures. The powder also can be put into pill capsules or pressed into tablet form.

    Oils: Concentrates of chemicals from herbs, often used on the skin. Many can be harmful if taken by mouth.

    Tablets or capsules: Often used to provide a measured dose of an herb.

    Teas: Herbs mixed with hot water. The strength of the mixture depends on how long the herbs brew in the water.

    Tinctures: An herbal solution often added to water or placed in the mouth or under the tongue.

    Menopause

    Menopause is different for everyone. Some women do not notice much change in their bodies or moods. Others may find it hard to cope with their symptoms. Symptoms of menopause can include:

    • Hot flashes and flushes. Some women have a sudden feeling of heat that spreads over the body. This often lasts from 30 seconds to several minutes and can occur throughout the day and night.
    • Bone loss. As estrogen levels decrease, bones can lose their strength. This can lead to osteoporosis.
    • Vaginal changes. The lining of the vagina can become thin and dry. These changes can cause pain during intercourse. The vagina also may be more prone to infection, which can cause burning and itching.
    Women also may have mood swings or depression during menopause. These feelings may be related to life changes and other factors. They also may be linked to a lack of sleep caused by having hot flashes at night.

    Herbal Products

    Herbal products can help relieve some symptoms of menopause for some women. There are many different types of products that vary widely. Because of this wide variety, it is hard to set a standard dose. What works for some women may not work for others. For many of these products there are limited facts available.

    Soy Products

    Some soy products contain high amounts of isoflavone. Isoflavone is a phytoestrogen, also known as plant estrogen. Plant estrogens act like a weak form of the hormone estrogen in the body.

    Isoflavone is found in foods, such as flaxseed, legumes (peas, beans, peanuts), and whole grains (oats, wheat, corn). However, when soy is processed into a food product it can lose some of its benefits. Soy also can be taken in the form of supplements.

    If taken for a long time in large amounts, soy products may help protect against osteoporosis. They also may help relieve some symptoms of menopause, such as hot flashes and vaginal dryness. Because soy products may have some estrogen-like qualities they may have some risks.

    Black Cohosh

    Black cohosh is a North American plant. Some women use it to treat symptoms such as:

    • Hot flashes
    • Sleep disorders
    • Depression
    Black cohosh may act like estrogen. Although results of studies on how well it works are mixed, it may help reduce these symptoms. Side effects may include an upset stomach and low blood pressure.

    St. John's Wort

    St. John's wort is an extract of the flower Hypericum perforatum. It has been used for hundreds of years to treat mild to moderate depression. Side effects may include:

    • Dry mouth
    • Dizziness
    • Constipation
    • Sensitivity to the sun
    • Increased rate of cataracts
    St. John's wort may cause problems when it is used with other antidepressants.

    Wild Yam

    Wild yam (and Mexican yam) is available in extracts, tablets, and creams. There is no proof that yams can relieve symptoms of menopause. Although there is a hormone-like substance found in some yams, a woman would have to eat a large amount of raw yam to reach a level that would relieve symptoms.

    Dong Quai

    Dong quai is the root of the plant Angelica sinesis. It is the most commonly prescribed Chinese herbal medicine for problems that affect the female reproductive system.

    Dong quai is given to make menstrual cycles more regular. It is said to help with vaginal dryness and pain during sex. It also is said to reduce hot flashes. This is only if it is used with certain other herbs. Dong quai may cause some women to be sensitive to sunlight. It also may affect the time it takes for your blood to clot.

    Studies have only looked at the use of dong quai by itself. When used in Chinese medicine, it is prescribed with other herbs. When used alone, it does not seem to be effective.

    Evening Primrose

    Evening primrose is a North American wildflower. Oil is expressed from the plant's seeds. This oil is used by some women to treat hot flashes. There is no proof that it works.

    Valerian Root

    Valerian root comes from the garden plant heliotrope. It is used mostly to treat sleep problems. Studies do not show valerian root to be a useful treatment. It may cause muscle spasms or eye problems.

    Ginseng

    There are many types of ginseng: Siberian, Korean, American, white, and red. Ginseng often is promoted as an "adaptogen." This means it helps one cope with stress and it boosts immunity to diseases.

    For menopausal women, ginseng is said to increase a woman's desire to have sex, but there is no proof that it does. It also has not been shown to reduce hot flashes.

    Chasteberry

    Chasteberry, or vitex, is the dried ripe fruit of the chaste tree. It is said to reduce the desire in men to have sex, but increase it in women. Some think that it helps to reduce vaginal dryness and depression at menopause. There is not enough proof that it works to recommend it.

    Special Concerns

    A concern about herbal products is that they are not approved by the federal government (see box). The herbal industry promotes its own standards for making herbal products. Some manufacturers have signed agreements to conform to these standards.

    The Dietary Supplement Health and Education Act of 1994

    Herbal products are not approved by the federal government before being sold to consumers. However, the Dietary Supplement Health and Education Act of 1994 made some rules about the labeling of these products that can help the consumer.

    Herbal products cannot claim to diagnose, treat, cure, or prevent disease. These claims require approval by the FDA. A product can be labeled with statements that explain what effect they are supposed to have or what role they have in promoting well-being. For instance, a label cannot say "lowers cholesterol," but it can say "promotes heart health."

    If there are federal guidelines for how much of a product to take per day, these must be included on the label. These guidelines exist for most vitamins. They rarely exist for herbs, for which effective doses have not been determined.

    Keep in mind, the FDA has a different role with herbal products than with conventional medicines. For conventional drugs, the manufacturer has to prove to the FDA that the product is safe and effective when taken as directed before selling it to consumers. For herbal products, the FDA first has to prove that the product is dangerous when taken as directed, and then can recall an unsafe product.

    There is no government body to oversee herbal products. As a result, they can vary widely. The content of the product itself can vary in terms of:

    • When and where it was grown and gathered
    • Growing conditions
    • How it was produced
    The same product made by different companies may not have the same amount of the active ingredient, even if the label says it is the same. Even two bottles of the same product by the same company may be different. There is no guaranteed standard, quality control, or dosage.

    The U.S. Pharmacopeia (USP) has a program to help inform and protect consumers who use dietary supplements, including herbal products. In this program, the USP makes sure that a product meets the following strict standards:

    • It contains the amount and strength of ingredients stated on the label
    • It does not contain contaminants
    • It has been made using the U.S. Food and Drug Administration (FDA) standards for good manufacturing practices
    If a product meets the USP standards, it is awarded a certification mark that can be found on the product label.

    Before You Try Herbal Products

    Before you start taking herbal products for meno-pause symptoms, talk with your doctor. Herbs can interact with other drugs that you are taking already or that your doctor might prescribe.

    Questions from Your Doctor

    To learn more about an herbal product you may be using or thinking about using, your doctor may ask if you are:

    • Using any herbal products, vitamins, or home remedies
    • Seeing any other health care providers
    • Taking any prescription or nonprescription drugs
    • Allergic to any plant products
    Taking herbs can mask symptoms that your doctor needs to know about to diagnose a problem. They also can cause problems if you take too much or if they interact with another medication you are taking. By talking with your doctor, you can rule out certain problems before you start treating symptoms.

    Be sure to tell your doctor about all herbs and supplements you are taking. They all have an effect on your body. In order to be helpful, your doctor needs to know what you are taking. He or she also can help you decide what is safe.

    Finally...

    For some women, using herbs can help relieve symptoms of menopause. Some women may use herbs along with other forms of treatment. Others may find that HT alone meets their needs. Your doctor can help you decide what is best for you.

    If you are thinking about taking herbal products, it is a good idea to let your doctor know. Even products that seem safe can be harmful.

    Glossary

    Cataracts: Cloudy areas in the lens of the eye.

    Estrogen: A female hormone produced in the ovaries that stimulates the growth of the lining of the uterus.

    Hormone Therapy (HT): Treatment in which estrogen, and often progestin, is taken to help relieve some of the symptoms caused by the low levels of hormones produced by the body.

    Menopause: The process in a woman's life when ovaries stop functioning and menstruation stops.

    Osteoporosis: A condition in which the bones become so fragile that they break more easily.