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Herbs to Manage Menopause. Maybe.

by Dr. Barb DePree

Humankind has relied on medicinal plants for thousands of years. From that perspective, treatments like estrogen therapy (ET) are a flash in the pan.

And with insecurity about prescription oral ET because of rumored links to breast cancer and heart disease, are we back to leaves and roots?

Well, that’s an option. Maybe.

Many people choose nontraditional therapies, such as acupuncture, massage therapy, and homeopathy, either exclusively or in addition to traditional medicine. Botanicals—herbs and other plants—is just another of those nontraditional approaches. In fact, botanicals are still used in about half of the prescription drugs we take, according to an article in WebMD.

If you’re interested in trying botanicals for menopausal symptoms, like hot flashes, night sweats, and mood swings, here are a few options.

But first, a few caveats:

  • Herbs are drugs, just like pharmaceuticals. Don’t think that because they’re “natural” that they’re somehow safer or more pure. I often remind women that marijuana and cocaine are botanicals, too, so “botanical” does not always equal “healthful.” Botanicals can interact with other drugs, and they can cause side effects. If you have any medical conditions or are taking other medicines, do your homework and check with your doctor before taking any botanical.
  • Botanicals aren’t regulated. Dosages might vary and so might the quality and the efficacy of the remedy, depending on the manufacturer. So be sure to check the dosage you’re taking and buy botanicals from a reputable source.
  • There isn’t much credible research on the efficacy and long-term safety of most botanicals, so a lot of information is conflicting or based on hearsay from less-than-credible sources. For solid, current information, check out the National Center for Complementary and Alternative Medicine (NCCAM) website, which is maintained by the US Department of Health and Human Service.
  • No drug or botanical remedy replaces good health habits, like weight control, exercise, and a well-rounded diet.

So here’s the lowdown on the top botanicals for relieving some menopausal symptoms.

Black cohosh

Native Americans have used this member of the buttercup family to treat “female troubles” for hundreds of years. More recently, Germany’s Commission E, which is similar to our FDA, approved black cohosh for relief of menopausal symptoms. Remifemin is the commercial (and standardized) version of black cohosh. It’s also the version of black cohosh that’s been used in several studies.  As with most botanicals, however, the research is contradictory. It’s used to relieve hot flashes, night sweats, vaginal dryness and “other symptoms.”


While not an herb, per se, soy is one of those few plant-based substances that can only do you good. As a source of isoflavone—an estrogenlike hormone—it might relieve menopausal symptoms, although the North American Menopause Society stops short of recommending it due to inconclusive evidence. However, soy is known to control cholesterol and to help prevent osteoporosis, besides having several other health benefits. In any of its many forms—tofu, soy milk, roasted soybeans—it’s safe and good for you.


Fruit of the chaste tree, which is native to central Asia and the Mediterranean, chasteberry has been used for menstrual and menopausal symptoms for millennia. While it might be more effective in treating menstrual problems, the jury is still out on how it works and how effective it is on menopausal issues. While it doesn’t have serious side effects, it might affect hormone levels. It might also suppress sexual desire (thus the basis of its quaint name), so if you’re experiencing that side effect of menopause, this isn’t the herb for you. It’s also knows as “monk’s pepper” for its libido-suppressing qualities.

Dong quai

Sometimes called the “female ginseng,” dong quai is another of those ancient remedies with conflicting and unproven results. Some sources unequivocally praise its ability to relieve hot flashes and night sweats; others that it has no benefit beyond placebo.

But everyone agrees that one side effect is increased sensitivity to sunlight, so be more vigilant about using sunblock if you take it.

Evening primrose

Evening primrose is a pretty North American plant with yellow flowers that blooms, as its name suggests, in the evening. Oil from its seeds is extracted to make the botanical remedy. It has few side effects, but it apparently isn’t very effective at treating menopausal symptoms. Maybe plant the seeds in your garden and enjoy the pretty flowers?


Not long ago, ginseng root was touted as an herbal tonic for everything from memory problems to erectile dysfunction to a general energy booster. It would be hard for any substance to live up to such hyperbolic claims, and ginseng doesn’t. “Research results to date do not support health claims associated with the herb,” states the NCCAM fact sheet.

As a magic bullet for menopause? Not so good.

It’s fairly innocuous, and might have some health benefits, but it isn’t the miracle cure it was cracked up to be.

St. John’s Wort

Another of those old-time remedies that has recently made a comeback as a sedative and treatment for mood disorders, such as anxiety and depression. While it may—or may not—be beneficial (a large NCCAM study found it no more effective than a placebo), it definitely has some powerful side effects.

St John’s Wort interacts negatively with a host of medications, including other antidepressants. It has a long list of side effects, including sensitivity to sunlight and sexual dysfunction. Yikes!

Have you tried any of these or other botanicals? How have they worked for you?


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