In my grandma’s day “the change” was a hushed topic – along with nearly every other aspect of women’s health! My grandma could never say the word “period” – she called it my “whoositz” or sometimes my “whatsitz.”
Now women are openly talking about menopause. Since the publication of the Women's Health Initiative Trial we know that hormone replacement therapy (HRT), previously the mainstay of treatment for menopausally-related symptoms, can increase the risk of heart disease, strokes, and even dementia. As a result many of us are looking for natural strategies to maintain health and minimize discomforts.
Botanical (herbal) medicines, simple nutritional approaches, and a positive attitude can provide mild, effective alternatives to hormones and other drugs with much less concern for their safety. Herbs have been long used by herbalists and naturopathic physicians in the US and Europe. In countries such as France, Germany, and the United Kingdom they are considered part of standard medical care. Integrative doctors in the US are increasingly recommending their use because of studies showing safety and effectiveness.
Menopause can be a time in life to celebrate – a time of new freedom and power! (If you came to menopause early as a result of surgical intervention such as total hysterectomy or other medical reasons, I am sure you aren’t jumping up and down about it. The good news is that the suggestions discussed below can be helpful to you, too). But symptoms can get in the way of feeling the love!
- About 75% of American women will experience hot flashes; 15% will have severe hot flashes. They can lead to embarrassment, physical discomfort, and can interfere with sleep when they occur overnight.
- Memory difficulties may occur as a function of hormonal changes, and are worsened by lack of sleep and emotional stress. For many women, this is the most disconcerting symptom.
- Insomnia is a common problem, and lack of sleep aggravates stress, memory loss, depression, and physical discomfort.
- Heart palpitations are a common disturbing symptom in otherwise healthy perimenopausal women, though cardiac and thyroid problems should be ruled out.
- Hormonal changes, aging, personal concerns, loss of sleep, inadequate nutrition, problems with memory, and other physical complaints can fuel feelings of frustration and depression, and new concerns about health and aging can lead to anxiety.
- Vaginal dryness is uncomfortable, increases susceptibility to vaginal and urinary tract infections, and have a negative impact on sexual experience with both physical and psycho-emotional ramifications.
Women also encounter new concerns about their heart and bones after menopause. These will be addressed in separate articles.
The goal of this article is to give you an overview of several effective, safe herbs, along with a few nutritional tips, to help ease your symptoms and help you comfortably enjoy what can be a potentially transformative time in your life.
Hold the Presses: Food is Our First Medicine
Nutrition can prevent or decrease symptoms and problems of menopause. Here are my top suggestions:
- Eat plenty of fiber from vegetables and flax seeds daily
- Eat good quality fats (olive oil, walnut oil, coconut oil, butter) at each meal and take essential fatty acids daily, especially evening primrose and fish oil
- Keep your blood sugar balanced with ample protein at each meal, eat every few hours, and minimize sugar and empty calories
- Eat legumes regularly (yes, consider including soy – see my blog on women and soy) for their “phytoestrogens”
Six Favorite Herbs for Menopause
I have used herbs reliably in clinical practice for over 30 years and turn to them again and again to help my patients’ relieve their symptoms and thus improve their quality of life. Many of the herbs below are backed by solid research, and all have strong historical evidence, with decades of contemporary use by practitioners skilled in the use of herbs.
While there are many more herbs for supporting you during your menopausal years than are described below, these six are some of my favorite herbal gal pals – the ones I turn to over and over for help with my patients’ symptoms.
For dosage, use as directed on the package, or as directed below when dosing is provided. I prefer to use high quality herbal lines as found in large national health food retailers and smaller local specialty herb shops. Herb Pharm and Gaia Herbs are two of my favorite herbal companies and sell these herbs singly, and some in combinations specifically for menopausal symptoms. Mountain Rose is a company that sells single herbal tinctures on-line.
One of the key ingredients in beer, hops decreases hot flashes and promotes sleep. Better sleep means better mood, better memory, and more balanced blood sugar. Since this herb is too bitter for tea, I use the tincture (alcohol extract), 1-2 mL (about 40-80 drops) before bed for night sweats. It can make you sleepy, so avoid using before driving. Hops has mildly estrogenic effects so this herb is not recommended if you have risk factors for estrogen receptor positive breast cancer.
One of the best herbs to promote sleep and ease anxiety, I use passionflower for my patients struggling with insomnia by giving a few doses of 1-3 mL repeated every hour for 2-3 hours before bed, and every 3-6 hours during the day for mild to moderate anxiety. While quite safe, I recommend caution when combining with antidepressant or psychiatric medications.
One of the most popular herbs in Europe for the relief of menopausal symptoms, black cohosh is most effective for the relief of hot flashes. It can be used in capsules or tincture form. While there were a few reports of liver toxicity in the medical literature several years ago, further studies have not borne out any concerns and used as recommended it is considered safe. Commercially available preparations of black cohosh usually contain 1 mg of the active ingredients in each 20 mg dose of extract. Take as directed on the individual product.
One of my favorite herbs for emotional irritability related to hormonal changes, motherwort, whose botanical name means “lion hearted” relieves anxiety and is useful when there are benign heart palpitations. Dose is 2 mL of extract several times daily as needed, or capsules taken as recommended on the package.
One of the most popular medicines in Europe for regulating the menstrual cycle, vitex (chaste berry), can be used in the perimenopause if periods are irregular, and also relieves emotional symptoms. Use as directed on the product package.
While increased urinary tract infections in menopause generally need to be treated by improving associated vaginal dryness or decreased tone and fullness of the genitourinary tissues, cranberry makes an excellent addition for its ability to help prevent infections. I use a product that contains cranberry d-mannose in my practice.
Mind Over Symptoms
While the changes you are going through physically may cause you varying degrees of discomfort from mild to severe, it is important to remember that this can be the beginning of a welcomed new phase of life for women. And here’s the amazing news: embracing menopause as natural and as something to honor can decrease the number, frequency, and severity of symptoms! Embracing “the change” with a positive attitude can increase the transformative power – and ease – of your experience.
Wishing you the force of nature, strength, and ease.