Menopause can be considered "reverse puberty." Rightfully so, as it can bring on a slew of new and unexpected reproductive health symptoms that send you through a physical, mental, and emotional whirlwind; according to one study, 85% of women experience hot flashes. This is just one of the uncomfortable symptoms that arise in this phase of life. Managing menopausal hot flashes, sleep disturbances, depression, and low libido with herbal medicine is an evidence-based way to mitigate the negative impact this phase of female reproductive health may have on your well-being.
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What is Menopause?
Part of normal female reproductive health includes menopause. Menopause is the conclusion of female menstruation for at least 12 consecutive months and marks the closing of a woman's fertile years. Menopause symptoms typically start in the perimenopausal phase and then exacerbate in menopause. Some of these symptoms include hot flashes, missed periods, emotional changes, sleep disturbances, and fluctuations in libido. Becoming knowledgeable about the shift in sex hormones that occurs as women mature can help you understand menopause.
The primary cause of this is the diminishment of ovarian follicles, which leads to a cascade of events, ultimately causing a decline of estradiol and inhibin. These two hormones are essential in controlling follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Without estrogen and inhibin, FSH and LH are left uninhibited and will increase. This process causes a decrease in the endometrial lining, which leads to menstruation, and the no longer cyclical peak of LH that leads to ovulation. While menopause is a normal process, there are natural remedies, such as herbal medicines, that can support your body through the transition.
The Role of Herbal Medicine in Menopause
Herbal medicine for menopause can provide both symptomatic relief and support organ systems as your body processes the changes. You may think of herbal medicine as an alternative treatment for menopausal symptoms. Still, it is a traditional form of medicine used for centuries to support reproductive health. There are many indigenous uses of herbal medicines. In terms of menopause, herbal medicine can be historically traced back to the people of Native America, Mexico, China, South America, the Mediterranean area, and India. Many of these plant medicines were used to mitigate symptoms like hot flashes, insomnia, night sweats, depression, stress, and anxiety.
In modern times, hormone replacement therapy (HRT) has become a popular intervention for menopausal women. While there is a time and place for HRT, some women may not have access to this resource, are not a candidate for this therapy, or, like many, are seeking alternative treatments for menopausal symptoms. Herbal medicines combined with or without lifestyle modifications can support these cases. Studies such as this one have shown that the use of Chinese herbal medicine can be just as effective as HRT in treating menopausal symptoms. Considering your health history while working with an integrative healthcare practitioner can assist you in figuring out which course of action can help you work through menopause most effectively.
Popular Herbs for Menopausal Symptoms
There are a handful of natural herbs for menopause that are supportive, safe, and effective. This includes Black Cohosh, Maca, Red Clover, and Humulus lupulus:
Black Cohosh
This North American native plant has traditionally been used in women's health and modern times. Black Cohosh, also known as Actaea racemosa, is commonly used for menopausal hot flashes and psychological effects that women may experience. This is most likely due to the impact this herbal extract's active ingredient has on the central nervous system. Literature states that the N-methylserotonin and triterpenoid isolates from the plant extract are potentially partial agonists to serotonin and GABA receptors. Interaction at these receptor sites can help modulate body temperature, sleep, and mood, thus reducing menopausal symptoms.
Red Clover
The Red Clover is a purplish-pink flowering herb native to Europe, Africa, and Asia and also goes by the Latin name Trifolium pretense. It's been utilized in cases of cardiovascular support to help reduce cholesterol, lower blood pressure, and improve vascular integrity, but it has also found a place in helping menopausal women. The active constituent most beneficial for menopause is the isoflavones in the herbal extract. Isoflavones are phytoestrogen, which means they can bind to estrogen receptors and induce estrogen-like responses. In the case of menopause, where estrogen levels drop, it makes sense that a phytoestrogen compound could be beneficial. As far as symptom relief goes, red clover can reduce the frequency of hot flashes women in menopause may experience.
Maca
This Andes mountain native plant has traditional properties that support menopause. While not many studies cover the effectiveness of this plant's medicinal benefits, it is often still utilized to support health conditions. Maca has been reported to have adaptogenic qualities, which help with overall balance when physiological changes occur in the body. Literature suggests that its effects are an increase in Estradiol (E2), which reduces excessive sweating, severity, and frequency of hot flashes, improves sleep, aids in depression or nervousness, increases sex drive, and reduces headaches.
Humulus Lupulus
Humulus Lupulus, or Hops, may sound familiar as it is a crucial ingredient in the beer brewing industry. It provides a “hoppy" taste, a component of its bitter profile. While the painful part has its uses, it's the polyphenol constituent, specifically Prenylflavonoids, of the cones of this plant that induce estrogenic effects. The 8-prenylnaringenin (8-PN) is the specific polyphenol that has been identified to provide equivalent efficacy to 17-beta-estradiol, a form of estrogen naturally produced by the ovaries. Positive findings regarding Hops have been reported in that it can not only alleviate fatigue, vaginal dryness, and sleep disturbances, but it can also do so without causing any drug interactions. Research out of Oregon State University investigated this area since Humulus lupulus has a long half-life of 20 hours, which can also be concerning in someone taking one or multiple medications. With this information in mind, the benefits of this herb are promising for women experiencing menopausal symptoms.
Scientific Evidence Supporting Herbal Treatments
While many of the herbs used in menopause have a place in traditional and historical uses, scientific evidence supports their service and claims. Regarding herbal medicine in general, the studies are not as abundant as in other medicine modalities. Specifically for menopause, the herbs mentioned earlier have the most sufficient clinical evidence. Black Cohosh (17), Red Clover (16), Maca (8), and Humulus Lupulus (1) have evidence-based research on menopausal herbal treatments. Addressing the deficiency in estrogen by providing either phytoestrogens or polyphenolic support, which mitigates symptoms of menopause, is the primary way these herbs assist in menopause. Safety can be of concern for any supplement, medication, or herbal remedy you consume. While many herbs have a stamp of GRAS (generally considered safe), safety studies should be done on these herbs. When natural products have an extended half-life, like Humulus Lupulus, verifying that they will not cause drug-herb interactions is essential. Another important point regarding safety is that you should always consult with your healthcare provider to ensure that you don't have any adverse effects based on your unique situation.
Integrating Herbal Medicine into Menopause Management
Herbal medicine is an effective and natural option if you are seeking complementary and integrative options for addressing menopause. While HRT and bio-identical hormone replacement are the most raved-about options for menopause support, integrative herbal medicine into your life may serve you well. Working with an herbalist, a naturopathic doctor, or an integrative healthcare professional trained in herbal indications, mechanism of action, and dosing can provide you with a plan of action to reduce your symptoms. There is also variety regarding the medium in which herbs can be consumed. They come in tinctures, capsules, and teas, which have a variety of benefits. This provides flexibility in dosage and options that suit your preference. When it comes to these particular herbs, here are standard doses for menopause and risk factors to be aware of:
Black Cohosh
Dose- 40-128 mg per day, divided into two administrations
Safety: Black Cohosh has been assessed for a maximum use of 6 months, in which side effects were minimally reported. The primary reported side effects of this herb are joint and muscle discomfort, swelling of breast tissue, painful breast, vaginal spotting or breakthrough bleeding, and infectious outbreaks. High-quality sourcing of herbal medicine is essential, as there may be a correlation between liver toxicity and low-quality Black Cohosh. Ruling out any liver dysfunction would be beneficial if you plan to use this herb. Always talk with your doctor before implementing any therapeutic intervention to get appropriate testing and clinical advice.
Red Clover
Dose- 40-80 mg daily
Safety: Red Clover is generally regarded as safe (GRAS) for up to one year of consumption. Mild reports of nausea, rashes, and headaches have been recorded. If you have breast cancer, consult with your provider before taking Red Clover, as it can negatively impact this condition. This herb can increase your risk of bleeding, so it should be cautioned in those on blood thinners.
Maca
Dose- 2 capsules twice a day of the MacaPause
Safety: Maca has only been evaluated for short-term use, up to 3 grams daily, with a maximum benefit of 4 months. There are no evidence-based adverse reports on this herb. Hormone-sensitive conditions, including endometriosis, uterine fibroids, ovarian cancer, uterine cancer, and breast cancer, should avoid Maca due to its estrogen-like properties.
Humulus Lupulus
Dose- 500 mg per day as a tablet
Safety: Humulus lupulus is a safe herb for short durations overall. It’s advised not to surpass 300mg daily and not to take longer than three consecutive months. Two low-risk side effects noted are sleepiness and dizziness. Due to this, do not take this herb when you are set to get anesthesia or other sedating medications. Much like Maca, “Hops” should not be taken by women with estrogen-sensitive conditions.
Lifestyle and Dietary Considerations
Optimizing your lifestyle and diet can support your transition into menopause and your body's response to this change. Eating a balanced diet rich in phytoestrogen, polyphenols, fatty acids, optimal protein, and fiber will help the hormones circulating in your body. Reducing inflammation through an anti-inflammatory diet can also relieve symptoms associated with menopause. In addition to your nutrition, lifestyle changes for menopause include reducing stress, regularly exercising, and investigating and optimizing your sleep can complement the effects of herbal medicines.
Consultation with Healthcare Professionals
Working with a healthcare provider who provides professional advice on herbal remedies is in your best interest. Consulting doctors for menopause treatment with a kin interest and background in herbal medicine can offer education, options, and a concrete plan to address your concerns. If you have a pre-existing condition or are taking other medications, consulting with your doctor assures you are making the safest choice for your overall health.
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Herbal Medicine For Menopause: Key Takeaways
Herbal medicine can be a natural and effective avenue to support this phase of your womanhood. Exploring all your options, from hormone replacement therapy to menopausal nutrition plans to an herbal medicine intervention, allows you to decide what avenue is best for you. Black Cohosh, Red Clover, Maca, and Humulus lupulus are four excellent choices if embracing herbal medicine for menopause is right for you.
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