The Benefits Of Medicinal Herbs For The Symptoms Of Menopause

What happens during the menopause?

Hormone levels naturally begin to decrease around the age of 45, with menopause typically occurring between the ages of 45 to 55. Levels of the key hormones oestrogen and progesterone fluctuate during the preceding years (perimenopause) until the ovaries stop releasing eggs and periods cease (menopause).

The menopause can occur at an earlier age due to the following causes:

• Surgery, such as the removal of ovaries (hysterectomy)
• Chemotherapy
• Idiopathic (unknown causes)
• Genetics

What is the perimenopause?

Once hormone levels have begun to drop a person assigned female at birth enters a stage of reproductive life known as perimenopause. Perimenopause (meaning ‘around menopause) is the time before periods stop completely. It can cause a wide range of physical and mental symptoms including hot flushes, irritability and sleeping issues. The perimenopause can last for up to a decade and persists until the menopause. Not everyone will experience perimenopausal symptoms, and those that do may range from having mild to severe symptoms. If you think your health may be affected by the perimenopause, a GP or menopause nurse will be able to give advice.

Perimenopause or menopause?

Having symptoms (see below) if you are around the average age will alert you to the onset of perimenopause this is when you may notice things beginning to change. If you are around the average age and are not experiencing symptoms then you would be said to be premenopausal.

Menopause is characterised by the absence of a menstrual period for 12 months. At this point, the ovaries have stopped producing reproductive cells.

Doctors can test for levels of follicle-stimulating hormone (FSH), consistent elevation of this hormone combined with the absence of a period for 12 months would confirm a diagnosis of menopause.

What are the signs and symptoms of perimenopause and menopause?

• Change in period patterns such as irregularity and eventually stopping
• Changes in mood such as low mood, mood swings and anxiety
• Problems with memory and concentration or brain fog
• Hot flushes, characterised by sudden sensations of heat in your upper body and face
• Sleep difficulties including night sweats
• Palpitations which are an increased awareness of your heartbeat
• Worsening headaches and migraines 
• Joint and muscular pain
• Changes in weight and body shape
• Dry and itchy skin
• Reduced sex drive
• Vaginal symptoms including itching, dryness and discomfort during sex
• Increase in urinary tract infections

What are effective treatments for menopausal and perimenopausal symptoms?

• Hormone replacement therapy (HRT)

This can be used to treat both perimenopausal and menopausal symptoms, replacing the natural hormones as their levels decrease. 

There are various types of HRT available based on different combinations of oestrogen and progesterone and various ways of accessing them including tablets, skin patches and vaginal creams. 

Oestrogen is available as estradiol, estrone and estriol. Progesterone can be synthetic e.g. dydrogesterone or a body-identical type that is chemically identical to natural progesterone.

• Risks and benefits of HRT

The benefits of taking HRT are the reduction in symptoms and the fact that it can prevent the bone disease osteoporosis.

Risks include a small increase in the chance of getting breast cancer with the combination hormone replacement, an increased risk of blood clots from the tablet version and a slight increase in the risk of cardiovascular diseases such as heart attacks and strokes.

• Lifestyle

Exercise helps with all symptoms and improves general well-being. Managing stress is important and taking practical steps to reduce symptom impact such as keeping cool at night will help. 

• Diet 

Reducing alcohol, caffeine and spicy foods can be beneficial as they can all trigger hot flushes.  Consuming soya bean products such as tofu and soya milk may be of benefit as soy contains plant oestrogen or phytoestrogen.

• Supplements

Bioidentical hormones are also from plant sources and are considered safer than standard HRT but research is lacking to support their efficacy

Other popular supplements to help with menopausal symptoms include Vitamin D, calcium and flaxseed.

Medicinal herbs for menopause

Phytoestrogens

Many plants contain a class of plant chemicals (phytochemicals) called phytoestrogens which are similar in their chemical structure to the HRT drug ‘Estradiol’.¹

Phytoestrogens act like human oestrogen and consist of four different types and are found in a variety of plant sources.

• Isoflavones: These are the most studied phytoestrogens and are found in soybeans, red clover and many other plants
• Stilbene: Found in grapes and peanuts
• Coumestan: Sources include alfalfa and split peas
• Lignan: Found in flaxseeds, whole grains and vegetables

Phytoestrogens work by binding to oestrogen receptors and can stimulate the production of oestrogen in the ovaries.¹

Gut health is very important as the microbiome aids with the absorption of phytoestrogens and their conversion into bioavailable compounds.¹

Benefits of phytoestrogens 

• Protection against cardiovascular disease: reducing cholesterol, improving heart function and reducing hypertension
• Regulation of blood sugar 
• Lower rates of chronic diseases
• Aids weight loss
• Decrease breast cancer risk 
• Aids brain health
• Improved ageing of the skin

5 medicinal herbs containing phytoestrogens

• Licorice - Glycyrrhiza glabra 
• Red Clover - Trifolium pratense
• Hops- Humulus lupulus 
• Black Cohosh- Cimicifuga racemosa
• Alfalfa- Medicago sativa

Herbs for common menopausal symptoms

Herbs for treating hot flushes

General use of phytoestrogens to increase oestrogen levels can reduce hot flushes, as these are a symptom of hormone deficiency. Any from the list above may help with hot flushes, avoid liquorice if you have high blood pressure (hypertension), and hops are not advised for those suffering from depression.

Salvia officinalis commonly known as Sage has long had a reputation for use as a treatment for hot flushes. A number of studies have looked at how it may work to reduce flushes and how well it does this. One trial involving participants taking a sage tablet found a significant decrease in the incidence and severity of flushes.² 

Other trials looked at how sage reduces hot flushes, one found the tincture to have some oestrogenic effect due to its flavonoid content.³ Another found sage to act on neuroreceptors that regulate temperature and also improve mood by increasing serotonin.⁴

Herbs for balancing mood 

Sage as discussed previously can improve mood symptoms by influencing serotonin levels. 

St John's Wort (Hypericum perforatum) is a well-researched antidepressant herb that has been found in trials to be as effective as conventional antidepressants. 

A herb that demonstrates anti-anxiety or anxiolytic benefits is Valerian (Valeriana officinalis). 

Both Valerian and St John’s Wort have demonstrated benefits for mood changes related to menopausal changes.⁵

Herbs for improving sleep 

Valerian, Lavender (Lavandula lavender) and Lemon Balm can improve sleep (Melissa officinalis), one trial found that participants taking these herbs had significant improvement in sleep patterns.⁶

Summary 

Perimenopause and menopause can have a significant impact on an individual’s life and the severity of symptoms may prompt a sufferer to seek medical intervention. A simple blood test along with a description of symptoms aids in the diagnosis of menopause and perimenopause. Hormone replacement therapy HRT is the standard treatment and offers flexibility in treatment options. HRT has some risks associated with its use. However, it is widely acknowledged that the benefits generally outweigh the potential harms.

For those seeking natural remedies for the symptoms of menopause, medicinal herbs combined with diet and lifestyle changes may be beneficial. This article discusses which herbs may benefit in general and suggestions for the most common symptoms. Consult a Medical Herbalist for thorough guidance.