Overview
The female menstrual cycle has far-reaching effects on the life of every woman, affecting nearly 30-40 years of life and impacting many aspects of daily life like energy levels, mood, sleep, food cravings, and health. The menstrual cycle is usually 25-30 days long and is cyclical, that is, it is repeated after every cycle until menopause. The menstrual cycle is divided into proliferative and secretory phases separated by an event called ‘ovulation’, which is the fertile part of the cycle. The menstrual cycle is orchestrated by a complex interplay of multiple hormones secreted by the pituitary and ovaries. The predominant of these hormones are the oestrogen and progesterone.Even mild changes in the levels of these secretions from endocrine glands have significant health effects.3
When the delicate balance of the complex interacting hormones is disturbed, it produces a lot of effects on the menstrual cycle. These hormones especially oestrogen has been found to have a potent effect on the functioning of the body’s immune system.1 Some studies show that women are vulnerable to abusing drugs when the levels of ostrogen are high.2
An imbalance in hormone levels in reproductive age-women can lead to polycystic ovarian syndrome which causes difficulty in conceiving. Around menopause, their levels fluctuate due to the progressive failure of ovaries to function as before.
Herbs to balance female hormones
Menopause is perceived to be a difficult time for most females owing to the distressing symptoms that falling hormone levels bring along. In addition to the periods getting irregular, a variety of other problems like mood swings, hot flushes, loss of sexual drive, and urine leaks. Hot flushes are when women experience episodes of flushing and sweating associated with the sensation of nausea, anxiety, and chills.People have tried many remedies for these troublesome complaints. Even though hormone therapy can bring relief to many symptoms of menopause, they increase the risk of breast cancer, heart attacks, and clotting in the lungs.4 Due to the side effects that hormone replacement brings, many people have explored natural and safe alternatives like medicinal plants to manage the symptoms of menopause.4
Several plants have been explored and it has been found that those containing ‘phytoestrogens ’ have been found to be effective in menopause. The phytoestrogens are plant components similar in structure and function to oestrogen. They include flavones, lignans, and coumestan.4 It has been seen that Asian women consume phytoestrogens regularly in their diet and experience a reduction of symptoms of menopause and incidence of breast and uterine cancers and an increase in bone mass when compared to other regions.4 It is worth remembering to research well into the herbs before consuming them, especially those that have complex interactions with other drugs that you may be taking regularly. They should only be taken under the guidance of a healthcare professional.
Saliva officinalis/Sage herb
The first in the list of medicinal plants is the sage herb. It acts on certain receptors in the brain and relieves sweating and hot flashes, and has a positive impact on the brain, especially memory and sleep. Sage can be consumed as capsules or in the form of tea or as aromatherapy for inhalation. As always, one should not exceed recommended dose (around 1500 mg)and use with caution with diabetes and blood pressure drugs.5
Mellisa officinalis
Also called the ‘lemon balm’, it is a lemon-scented herb of the mint family. Taken as a capsule, tea, or ointment, it is used to treat sleep problems of menopause and anxiety. It also has anti-oxidant and anti-microbial properties. It is safe to take in recommended doses.4
Valerian officinalis
The valerian root has been used since ancient times to treat insomnia. They act on certain receptors in the brain to increase the levels of a substance called GABA in the brain that brings calmness and sleep. Valerian root has also been found to benefit women suffering from hot flushes related to menopause.6 They are available in capsules in doses ranging from 300-600 mg.6
Black cohosh
Black cohosh is a member of the buttercup family and has been used by Native Americans for medicinal purposes. In a study by Mehrpoorya et al, a comparison was made between black cohosh and evening primrose oil for the treatment of menopausal symptoms. Although the improvement of menopausal symptoms was observed in both groups, the improvement was significantly superior in the group that consumed black cohosh when compared to evening primrose oil.7 The dosage of black cohosh has not been standarised and varies between 8 mg to 160 mg per day.8
Trigonella foenum
Proven effective for menopausal symptoms like hot flushes, trigonella is also very effective in reducing blood cholesterol effects and metabolic syndrome. Metabolic syndrome refers to a set of physical and blood parameters that together, herald the onset of chronic diseases like diabetes and high blood pressure.
Commonly called fenugreek, both the leaves and seeds of this plant are used widely in cooking, especially in Indian cuisine. It has a long history of being used for inducing labor, reducing menstrual cramps, increasing milk production, and treating hormonal disorders.
Nigella sativa
Also known as the black cumin or the black seed, it has been a part of traditional systems of medicine. Also called the ‘panacea’ or the universal healer, because of its wide-ranging health benefits, it is especially beneficial in the treatment of metabolic syndrome in post-menopausal women, improves blood sugar control and reduces risk factors for heart disease.9
Vitex agnus-castus
The fruit of Vitex agnus-castus, also called the chaste berry or the monk’s pepper. This berry is known for its benefits in easing pre-menstrual symptoms like irritability, depressed mood, and breast tenderness. This is brought about by a reduction in the levels of prolactin and rebalancing the levels of other hormones like oestrogen and progesterone. In several studies, women have experienced relief from menopausal symptoms, better mood, and sleep.10
Foeniculum vulgare
Popularly known as ‘fennel seeds’, the aromatic and flavourful herb has anti-inflammatory and anti-androgenic properties (reduces the levels of male hormones) and helps with hot flushes and vaginal thinning in menopausal age-group women.4
Evening primrose
Evening primrose oil is extracted from the seeds of this plant and is available in capsule form. It has anti-oxidant, anti-inflammatory effects and has been shown to reduce hot flushes associated with menopause.4
Ginkgo biloba
A native tree to China, the benefits of Ginkgo biloba extracts in brain functioning and memory of women who have attained menopause have been observed in many studies.12 However, a variety of side effects including allergies and seizures have been reported.
Medicago sativa
Also called ‘alfalfa’, it is part of the legume family and has been used to feed cattle for many years. Its benefits in menopausal symptoms have been demonstrated in several studies but there have also been reports of lowering blood potassium levels and digestive disturbances, hence we need to exercise caution.4
Hypericum perforatum
Known as the St. John’s wort, it has been shown to alleviate mild-moderate depression, anxiety, and mental problems related to menopause in clinical trials.4 St. John’s wort is available in the form of teas, liquids, and tablets. St.John’s wort is known to interact with other drugs. Hence it is taken under the guidance of a health professional only.
Panax ginseng
Commonly used in herbal medicine, Panax ginseng is one of the several types of ginseng. It has anti-inflammatory properties and is used to treat fatigue, and weakness and for improving concentration. In post-menopausal women, this has been shown to improve depression and mood disorders .4
Pimpinella anisum
Pimpinella anisum or the aniseed has been used in the food industry since ancient times. There have been reports of mitigating symptoms like hot flashes in menopause.4 In addition, anti-depressant properties have been demonstrated in research as well.11 No harmful side effects have been reported on using this within therapeutic doses.
Glycyrrhiza glabra
Also called the licorice, the oil obtained from this plant is used as a sweetener and flavouring agent and is mostly used in the confectionery industry. Licorice has anti-oxidant, anti-inflammatory, anti-cancer, and liver-protecting properties. Menopausal symptoms like hot flashes have been mitigated by the intake of licorice, however prolonged intake of licorice has been associated with high blood pressure, heart problems, and electrolyte disturbances .4
Conclusion
Herbal treatment is very popular and sought-after for the treatment of hormonal imbalances in women. They are available in various forms and can be taken easily in the form of teas or culinary ingredients. They are widely believed to be safer than taking hormones. However, it is worth remembering that they all come with side effects and interact in a complex way with other drugs. They have been found to be effective in several trials and are better taken under the guidance of professionals.
References:
- Nadkarni S, McArthur S. Oestrogen and immunomodulation: new mechanisms that impact on peripheral and central immunity. Current Opinion in Pharmacology [Internet]. 2013 Aug 1 [cited 2023 Feb 6];13(4):576–81. Available from: https://www.sciencedirect.com/science/article/pii/S1471489213000672.
- Anker JJ, Carroll ME. Females are more vulnerable to drug abuse than males: evidence from preclinical studies and the role of ovarian hormones. Curr Top Behav Neurosci. 2011;8:73–96.
- Brucker-Davis F, Thayer K, Colborn T. Significant effects of mild endogenous hormonal changes in humans: considerations for low-dose testing. Environmental Health Perspectives [Internet]. 2001 Mar [cited 2023 Feb 7];109(suppl 1):21–6. Available from: https://ehp.niehs.nih.gov/doi/10.1289/ehp.01109s121
- Kargozar R, Azizi H, Salari R. A review of effective herbal medicines in controlling menopausal symptoms. Electron Physician [Internet]. 2017 Nov 25 [cited 2023 Feb 7];9(11):5826–33. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783135/.
- Can sage help lower your cholesterol? [Internet]. Verywell Health. [cited 2023 Feb 7]. Available from: https://www.verywellhealth.com/add-flavor-and-lower-cholesterol-with-sage-4069887.
- Can valerian root help you sleep? [Internet]. Verywell Health. [cited 2023 Feb 7]. Available from: https://www.verywellhealth.com/what-you-need-to-know-about-valerian-88336
- Mehrpooya M, Rabiee S, Larki-Harchegani A, Fallahian AM, Moradi A, Ataei S, et al. A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes. J Educ Health Promot [Internet]. 2018 Mar 1 [cited 2023 Feb 7];7:36. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868221/.
- What is black cohosh? [Internet]. Verywell Health. [cited 2023 Feb 7]. Available from: https://www.verywellhealth.com/black-cohosh-88875.
- Trigonella foenum-graecum - an overview | sciencedirect topics [Internet]. [cited 2023 Feb 9]. Available from: https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/trigonella-foenum-graecum.
- Which benefits of chasteberry are backed by science? [Internet]. Healthline. 2019 [cited 2023 Feb 9]. Available from: https://www.healthline.com/nutrition/vitex.
- Kazemi F, Masoumi SZ, Shayan A, Oshvandi K. The effect of evening primrose oil capsule on hot flashes and night sweats in postmenopausal women: a single-blind randomized controlled trial. Journal of Menopausal Medicine [Internet]. 2021 Apr [cited 2023 Feb 9];27(1):8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102809/.
- Elsabagh S, Hartley DE, File SE. Limited cognitive benefits in Stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba. J Psychopharmacol. 2005 Mar;19(2):173–81.
- Shahamat Z, Abbasi-Maleki S, Mohammadi Motamed S. Evaluation of antidepressant-like effects of aqueous and ethanolic extracts of Pimpinella anisum fruit in mice. Avicenna J Phytomed [Internet]. 2016 [cited 2023 Feb 10];6(3):322–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4930539/