Help in a Flash: Natural Support for Common Menopausal Symptoms


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.

Hops

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.

Passion Flower

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.

Black Cohosh

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.

Motherwort

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.

Vitex

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.

Cranberry

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.

Love

AJR-Sig

 

 

 

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Bonnie Kavanagh, R.N/Herbalist

I am wondering what you recommend for women who have a big family history of breast cancer? My mother had estrogen receptive breast cancer in her late thirties. Would it be advisable for me to use herbs that have estrogenic properties such as hops and red clover? Thank you.

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    aviva

    Hi Bonnie, Nope, those herbs are not recommended for wonderful ladies like you with a personal or family history of breast cancer ... better safe than sorry so please avoid them. There's a great product called Breast Health that a number of my patients with breast CA family history take... Has DIM and other great estrogen detox support. Best wishes!

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Summer McCreless

Thank you! I have been asked for herbal help for menopausal symptoms several times in the last few weeks. This is very timely!

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Janet

Thank you for this list of herbs for menopause. I am trying to switch from bio-identical hormones to more natural supplements and I wish more research would be funded to address non-pharmaceutical means to treat menopausal symptoms (dream on, right!). I do have to speak up, though, on the WHI study. It bothers me to see this quoted as Truth (in many different places) when it was actually a very limited study (they only used PremPro in the HRT, which is completely unnatural in the human body; they had issues with a large drop-out rate and with the selection of the study participants, a majority of whom were somewhat overweight former smokers with an average age of 63; it did not address the length of time before a woman began HRT, and many other issues ). They concluded from this study that ALL hormones are harmful for ALL women, when in truth they don't have the evidence to say this. Off my soapbox now! Regardless, I am switching over to more natural methods.

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Jacquelyn Howard

This is perfect and easily guided! As it has been a very topsy turvy last 4 years for myself, I have used almost all of these and have found great success! I wanted to mention an infusion of Nettles as another key herbal ally that has helped me balance my increase in protein needs, the insomnia at night and an overall nourishment. Blessings!

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Cedar Cat

Aviva - You have a big platform to teach women about health and herbal medicine. Seeing you spread 2 of the 3 most common myths menopausal women believe that keep them struggling with hot flashes, low libido and sleepless nights is disappointing.. Here's the truth about unfermented soy products. Yes, high in phytoestrogens, but also very high in powerful anti-nutrients (like all beans). However, most beans can be soaked in water to remove the anti-nutrients but not soy. It must be fermented. Unfermented soy consumption disrupts the hormone and endocrine system, increases cancer risk, heart attack risk and many other problems. Moreover, soy has long-path estrogens that contribute to estrogen-receptive breast cancers. Red Clover blossom infusion has more phytoestrogens than soy, without the anti-nutrients. It has short-path estrogens that will fill the estrogen-receptive breast cancer genes and repair them. (Lentils also have these properties, as well as freshly ground flax seeds.) In addition, Black Cohosh has now been proven to have NO effect on hot flashes or other menopausal symptoms beyond the placebo effect. It is an endangered, deep woods perennial plant. It is NOT useful for menopausal symptoms. Please preserve her. Finally, as you must know, taking herbs in pill form is, at best, useless, and at worst, harmful. Without digestive cues like taste and smell, the body cannot make the necessary enzymes to digest the "pill". The body treats it like an invader, invoking an immune response. www.AncientMother Wisdom.com

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    aviva

    Dear Cedar, I appreciate your comments, however, not all of your information is accurate and some is recognizable rhetoric. As a woman who thinks for herself and has used herbs and natural foods for over 30 years personally and in clinical practice, and does my own EXTENSIVE research, I know that soy can be beneficial, black cohosh is helpful for some women (and can be cultivated quite well so does not need to be from any endangered sources) and while I prefer herbs in tea, infusion, and tincture, form, the body can make use of herbs in many forms - even in pills and capsules when they are of good quality. Contrary to what one herbalist in particular says, taking them in this form does not automatically make them ineffective, and the body does not invoke an immune response from them! I hope you will keep reading, stay informed, share your opinions, and also be open to a wide variety of knowledge and information. Warmly, Aviva

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Stacy

I was hoping that you would address memory symptoms in the article. This is the one issue that I have been struggling with and I would be interested in hearing what you recommend.

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    aviva

    more to come!

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Paula

I am really happy that you are an herbalist and a M.D. I used Women's Support form Banyan Herbs prior to going through menopause and my periods were never so regular - like clockwork - and my emotional state was also helped. Then there was one month when I had 2 periods. After that I felt I was finally ready to stop having periods - and I did. Never another one.

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Anne

I have had many teachers recommend maca as helpful for hot flashes - do you find it to be so, and if so, how do you dose it? Thanks!

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    aviva

    Yes! Absolutely can be useful.

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Joanna

I had a complete hysterectomy at 40, and have been on Estriodol for 7 years (1 ml). My doctor says I should take until I'm 50 and then let menopause happen. What will the differences be for an unnatural menopause, and is it necessary to wait 3 more years? Thanks for any advice.

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    aviva

    Hi Joanna, You doc is probably just thinking about protecting your bones with the few extra years on estrogen. This is a reasonable approach. But you don't have to wait the extra few years if you are concerned about the hormones. Many herbs can help with menopause symptoms, as can supplements. Susun Weed, Christiane Northrup, and Amanda McQuade Crawford all have great books on menopause.

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MADELENE

HI AVIVA I'M PERIMENOPAUSAL AND SUFFERING FROM ANXIETY. MY DOCTOR PUT ME ON THE LOW DOSE CONTRACEPTIVE PILLS. I'M TAKING STRESSTABS WITH ZINC ALONG WITH MAGNESIUM(250MG), THEY HELP ME WITH SLEEP BUT I'M STILL STRUGGLING WITH ANXIETY. IS IT SAFE TO TAKE PASSION FLOWER WITH MY PILLS AND MY SUPPLEMENTS? THANK YOU SO MUCH

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Kathryn

Hi aviva, thank you for this illuminating post. I just turned 40, am breastfeeding my toddler, and started experiencing terrible hot flashes. I assume when we are done nursing, the hot flashes will end for a while (I hope). Are all these herbs safe for breastfeeding? I use most of them for other issues, but not black cohosh. Is it safe? Thank you!

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    aviva

    Yes, black cohosh is safe for use during BF'ing -- as are the other articles in the blog, with the exception of hops which is estrogenic so I'd avoid.... Aviva

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Laurita

I tried to sign up for your e-mail For some reason your site will not let me put my email address with all lower case letters even when I adjust the the cap and lower case button....any suggestions?

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    Megan Liebmann

    Hi Laurita, It should all be fixed now! Thanks for joining and please let us know if it doesn't work for you. Warm wishes, Megan- Aviva's executive assistant

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melina

hi i have a history of er+ breast cancer. 3 years ago i suffered from breast cancer. now i am good . but i am taking Tamoxifen. i must avoid of estrogen and phytoestrogens because i am ER+ and PR+. because of chemotherapy i experience early menopause. i have hot flushes. and i noticed that passiflower reduces my hot flashes noticeably . is it safe for me? i am so worry if Passiflora has estrogenic effect . i want to take it but i'm afraied of its possible side effects . is passiflora safe for women with a history of breast cancer ER+??? thank you.

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    Aviva Romm

    Hi Melina, To my knowledge, it does not have any estrogenic effect. Hops, another herb used for sleep and hot flashes does - so avoid combination products. The limited amount of chrysin, a chemical compound thought to be helpful in low testosterone, in the plant, is not thought to be absorbed well at all, and some use the herb for elevated estrogen in a protective way. But of course, run this by your prescribing oncologist. https://examine.com/supplements/chrysin/ Very best health wishes to you!

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