Herbs For Perimenopause

Herbs for perimenopause and postmenopause symptoms are an integral part of the treatments received by most women today to control menopause symptoms.

 It has been estimated that about 50 to 75 percent of postmenopausal women use some form of alternative medicines to help with their symptoms.

I will present a general advice from a scientific perspective on these herbs and a brief listing of the commonly used herbs

A Doctor’s Perspective

Whenever a medication is prescribed, there is often some reliable scientific proof of its efficacy and its safety.

The major limitation we face as physicians in recommending herbal therapies is that the safety and efficacy of these herbs have not been established. Some have been studied but with mixed results while other studies are of poor quality to permit meaning conclusions.

The truth is, as physicians, we are not “at war with herbs” as some patients think. We are guided by the principles of science, recommended only what standard scientific studies have shown proof of their utility and safety.

My first advice therefore is that you strongly consider asking your doctor about any herbs you are considering taking. This is especially important if you are taking other medications.

Commonly Used Herbs

I have presented below the commonly used herbs for perimenopause and tried as hard as possible to mention the scientific evidence in simple language. I have included some selected medical references  at the end for those who might want to  further explore these resources.

Phytoestrogens

Phyto  means of plant origin. Phytoestrogens therefore mean estrogens originating from plants. These are natural compounds that are found in many plants, fruits, and vegetables.

There are  different types of phyotestrogens, including isoflavones found in soybeans, chickpeas, and lentils and lignans which are found in flaxseed, fruits and vegetables. Phytoestrogens have both estrogen activity and anti-estrogen activity.  Scientific studies thus far have  shown that  phytoestrogens  are not effective in relieving hot flashes.

 Some reports now suggest that phytoestrogens can promote breast cancer growth
and block the activity of tamoxifen though this remains a topic of debate.(See medical references below).

Black cohosh

This is one of the most commonly used herbal therapies for hot flashes. Though some small studies had suggested some efficacy, the best medical evidence to date suggest that , black cohosh alone or  with other herbs does not have any additional benefits.

There has been a concern about the effect of black cohosh in potentially inbreeding the risk of breast cancer and thus should be avoided with women with breast cancer or those who are at risk like those with a family history of breast cancer.

Evening primrose oil

This contains linolenic acid and has been used for many years by postmenopausal women in managing their hot flashes. However, the only major study done thus far failed to show any improvement in hot flashes in women taking the Evening primrose oil.

Ginseng, dong quai and kava kava have also been studied without any  proven benefit. Others like licorice and chasteberry  have not been well studied.

Conclusion

Medically, there is no evidence to strongly recommend any of these herbs for perimenopause  based on what is known at the moment. If you think you want to try any, please discuss with your doctor to ensure it  is safe for you.

References

Kronenberg F, Fugh-Berman A. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Ann Intern Med 2002; 137:805.

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