Herbal Products - Treating Menopausal Symptoms: Menopause Managing The Change Of Life

Content provided by the Faculty of the Harvard Medical School

Herbal products

The following herbs are frequently included in products marketed for treatment of menopausal symptoms.

Black cohosh

One of the most common herbs found in over-the-counter menopause supplements, black cohosh appears to relieve hot flashes and improve mood in some women. This Native American herb is also sold as Remifemin. Black cohosh doesn't appear to have estrogenic effects, although some controversy persists about this. It does not cause vaginal bleeding the way combined hormone therapy does. Side effects include stomach upset, low blood pressure, or reduced effectiveness of estrogen therapy if the two are taken together. Several incidents of serious liver toxicity have been reported, possibly as a response to contamination or to the herb itself. No long-term studies have been done.

Black cohosh

Red clover

Also known as Trifolium pratense, red clover is a medicinal herb originally used by Native Americans to treat whooping cough, gout, and cancer. It's also taken as a cancer treatment in many other parts of the world, and it's found in herbal preparations for skin irritation. Red clover extract has been promoted for relief of menopausal symptoms, namely hot flashes and vaginal dryness. Proponents claim that its effectiveness comes from its estrogenic effects. But research results have been disappointing. Two studies published in the journal Menopause found red clover to be no better than a placebo for treating hot flashes or vaginal dryness. Red clover is on the FDA's GRAS (generally recognized as safe) list, but its long-term use has never been studied.

St. John's wort

For many years, St. John's wort has been used to treat mild to moderate depression. In studies, it has been shown to be more effective than placebo when used on a short-term basis — two months or less. A long-awaited study reported that St. John's wort is no more effective than placebo in treating major depression. Side effects include gastrointestinal problems and sun sensitivity. In addition, it can diminish or over-enhance the effects of prescription medications such as indinavir (Crixivan), warfarin (Coumadin), digoxin (Lanoxin), theophylline (Uniphyl, Theo-24, others), cyclosporine (Neoral, Sandimmune), and oral contraceptives.

St. John's wort

Ginkgo biloba

Studies have shown that ginkgo biloba may produce limited improvements in memory and social interactions in people with Alzheimer's disease. Some experts believe it may be useful for women with perimenopausal or postmenopausal memory problems, but there is no conclusive evidence to support such use. Ginkgo may cause stomach upset, headache, skin reactions, and prolonged bleeding. Caution is urged if it's used with anticoagulant medication. Ginkgo has been linked with bleeding in the brain when used with the anticoagulant drug warfarin. Experts also recommend that it not be used for two weeks before surgery because of the increased bleeding risk.

Gingko biloba

Valerian

Used as a sedative for centuries, valerian may help some women bothered by menopause-related sleep problems. It has been shown to decrease the time it takes to fall asleep and improve the quality of sleep. It may cause headaches, excitability, and heartbeat irregularities. Valerian should not be used with other sedatives, and its odor has been compared to that of old socks.

Kava

Studies have shown that kava is more effective than placebo in relieving anxiety, but the scientific strength of these studies has been called into question. Kava has been linked with liver failure and cirrhosis in reports from Germany, Switzerland, and the United States. It has been banned in several European countries and Canada but is still available in the United States. Additional side effects include gastrointestinal upset, headache, and agitation or sleepiness. It may enhance the effects of other central nervous system depressants and anticoagulants.

Ginseng

Despite its prominent place in traditional Chinese medicine, ginseng has not been found effective in treating hot flashes or any other symptoms associated with menopause. It comes with a list of side effects: insomnia, high blood pressure, prolonged bleeding time, and low blood sugar reactions if used with insulin.

Ginseng

Dong quai

Another common component of traditional Chinese medicine, dong quai has been used to treat a number of gynecological conditions. In one placebo-controlled study, it was not proved effective in relieving hot flashes or other menopausal symptoms, but critics of this study point out that Chinese herbs are not usually administered alone as in this study, and beneficial effects may result only from a combination of herbs as used by Chinese practitioners.

Last updated:	August 13, 2007