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Women and Menopause: Herbal Remedies and Alternative Treatments

Ann Witt, M.D., and Natalie Staats Reiss, Ph.D., edited by Benjamin McDonald, MD

Herbs are primarily used for minimizing hot flashes in menopausal women. Studies on herbal medicine are limited and the production of herbs is not regulated in the United States. Therefore, it is important to obtain herbs from a reputable supplier to decrease the risk of other products being mixed with the intended herb. Furthermore, some herbal products, while "natural", can still interact with traditional medicines, affecting the blood levels of other drugs. It is important to tell your physician about any herbs or supplements you are consuming so that drug-drug and drug-disease interactions can be minimized.

herbsBlack Cohosh: The stems and roots of the black cohosh plant are commonly used to make teas (infusions), capsules/pills, or liquid extracts (tinctures). Black cohosh has effects on the body that are similar to estrogen. Common side effects of this herb include abdominal pain, nausea, headache, dizziness, and trembling.

Because of effects created by this herb that are similar to estrogen, there remains concern about the potential of increasing a women's risk of breast cancer, particularly if she has a family history of this disease. Black cohosh also interacts with iron therapy.

There are no large studies investigating the long-term use of black cohosh for menopause symptoms. One small study showed a decrease in hot flashes of up to 80%, but because of limited data this herb should not be used as a treatment for longer than six months, or without consulting your physician.

Dong Quai is another herb women use to treat hot flashes. Dong quai is a member of the the celery family, and is native to China, Japan, and Korea. This root of this herb is used as the medicine, and it comes in tablet, liquid extract, and raw root forms. In China, this herb is given in combination with other herbal preparations.

The benefits and potential negatives of taking dong quai are not well-studied. Side effects of this herb include sensitivity to the sun and thinning of the blood. Women who take warfarin (a prescription medication used to thin the blood ), or who are nursing or pregnant should avoid taking this herb.

Evening Primrose: Evening primrose is a plant native to North America that has yellow flowers which bloom in the evening. Evening primrose oil, extracted from the seeds of the plant, contains gamma-linolenic acid (GLA), an essential fatty acid. Essential fatty acids are required by the body for growth and development, and must be obtained from the diet. The small numbers of studies performed on evening primrose do not suggest that this herb helps with hot flashes or other symptoms of menopause.

Red Clover: This herb belongs to the family of plants called legumes. Red clover contains phytoestrogens, which are similar in composition to estrogen. As with some of the other herbs, there is not much scientific information on the effects of red clover on menopause symptoms. In addition, the few studies performed give conflicting information. Several studies have shown that this herb does not decrease women's hot flashes, but at least one small study showed that taking 40mg of red clover per day decreased symptoms.

One potential side effect of red clover is thinning of the blood. In addition, because this herb contains estrogen-like compounds, there is a potential for increasing the risk of uterine or breast cancers. Women who are pregnant, breastfeeding, taking warfarin (or other blood thinning medications), or who are at high risk for uterine or breast cancer should avoid taking this herb.

Other Alternative Treatments:

In addition to herbal therapy, women try acupuncture, chiropractic therapy, and massage. There have not been many studies to support their benefit though individual women may certainly find positive effects from these therapies. For more information on Complementary and Alternative Mental Health Approaches, please see that topic center.