Menopause: Herbs Can Help

By Staff
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Black cohosh root herb used in natural alternative herbal medicine over old wood background. Used to treat menopausal and pre menstrual symptoms in women. Actaea racemosa.

Black cohosh, vitex, dong quai, and other herbs to help ease menopausal symptoms.

Black cohosh root (Actaea racemosa) a herb used in natural herbal medicine  to treat menopausal and pre-menstrual symptoms in women. Recently, a large hormone replacement therapy (HRT) study was abruptly halted because researchers found that women who took estrogen and progestin for more than four years had a higher risk of developing breast cancer and cardiovascular problems. This has causes may women to rethink their strategies for dealing with the physical changes that occur during menopause. Personally, the study has invoked in me a renewed gratitude for the herbal menopause formula that I take every morning, because it has made this physical transition for me virtually symptom-free.

There are currently an estimated 40 million women in the United States experiencing menopause, a natural part of a woman’s life and a significant milestone marking the end of the reproductive stage. Historically, the average age of menopause has been around fifty years old. Because life expediencies have lengthened, the modern woman can expect to live a substantial portion of her life after menopause. This makes finding natural ways to mitigate potential symptoms all the more important.

An array of symptoms can accompany this natural change in a woman’s body. The symptoms may include hot flashes, decreased elasticity in the skin, vaginal dryness and irritation, loss of muscle tone, insomnia, and thinning hair. It is estimated that more than half the women in the United States experience hot flashes during menopause, with 10 percent to 20 percent reporting “extreme” discomfort. Estrogen replacement therapy prevents hot flashes initially but usually only delays their occurrence. Additionally, some women also experience irritability, depression, lethargy, fatigue, and memory problems. Increased joint and muscle pain often add to the discomfort. There is further concern about the heart and bones after menopause, which causes some women to consider HRT for protection.

The good news is that with the diminishing supply of estrogen, some estrogen-related problems, such as uterine fibroids, fibroid breast cysts, and endometriosis, start to disappear. Painful cramps, menstrual headaches, and other symptoms of menstruation also eventually dissipate as menstruation ceases.

Fortunately, there are positive, natural steps such as exercise, diet, and herbs that women can take to help ease menopausal symptoms. You can try experimenting with available alternatives to find what works best for you.

Herbal Help

Herbs also offer women an effective way to avoid many menopausal woes. Some of the more popular ones include black cohosh (Cinicifuga racemose), dong quai (Angelica sinensis), vitex (Vitex agnun-castus), and Asian ginseng (Panax ginseng). A reduction in hot flashes serves as a good indicator of these herbs’ hormonal activity, and evidence is mounting that they confer a variety of protective effects on the body.

Brian Weissbuch, a license acupuncturist with more than 40 years of experience, says that at least 80 percent of his menopausal patients find that herbs can help relieve their symptoms. About half find that some symptoms, such as vaginal dryness, improve almost immediately. He recommends starting an herbal regime when menopause symptoms first appear. Weissbuch customizes his formulas to an individual’s constitutional needs but usually starts with black cohosh and red raspberry (Rubus idaeus).

Black cohosh preparations are commonly prescribed by European doctors and are sold in drugstores there to reduce hot flashes and relieve depression and insomnia. There have been so few reported side effects that the German equivalent of the U.S. Food and Drug Administration considers black cohosh to have no contraindications. Native American women favored the herb for a variety of women’s health problems. Studies have found it as helpful in reducing stress-related menopausal problems as the sedative Valium. Suggested dose: 10 to 60 drops of tincture two to three times daily; 1 cup of tea twice daily; 1 tablet of powdered extract twice daily.

Vitex berries are included in most herbal menopause formulas to stop hot flashes, dizziness, vaginal dryness, and depression. According to David Hoffmann, a British-trained herbalist and the author of several herb books including An Elders’ Herbal, vitex preparations are the most common herbal menopause treatment in England, Wales, and Scotland. The herb is thought to regulate progesterone through its effect on the hypothalamus and pituitary. Suggested dose: 1 dropperful of the tincture daily before breakfast.

Dong quai has a reputation in Asia that’s probably second only to ginseng.  According to Traditional Chinese Medicine, it is the most effective herb to help prevent anemia and bring extra blood and nutrients to the female organs. Studies from China tell of its effectiveness for treating menopausal symptoms, especially hot flashes and vaginal dryness. Dong quai is safe for has a few cautions. Because it encourages menstrual bleeding, it is often inappropriate for women with fibroids or endometriosis or those who bleed heavily. Suggested dosage: 1 cup of tea or 1 to 3 droppersful of tincture two times daily.

Asian ginseng is a hormone-toning herb used traditionally to support sexual hormone production in women older than forth and to increase blood circulation. It is also reputed to improve sexual vigor, increase vitality, help the body better to withstand stress, and lead to increased energy. Suggested dosage: Drink 1 cup of tea, or 1 to 3 droppersful of tincture, or 1 to 2 capsules of standardized extract two to three times daily.

Adrenal-Support Herbs

It is also important to keep the adrenal glands in a healthy state, because by the time a woman reaches menopause, she relies on her adrenals for a backup supply of estrogen. Strong adrenal glands encourage a more balanced menopause. Herbs that help support adrenals in their job of building estrogen include Siberian ginseng (Eleutherococcus senticosus), American ginseng (Panax quinquefolius), and the Chinese herbs rehmannia (Rehmannia glutinosa) and ligustrum (Ligustrum lucidum). You can find these herbs in tea, tablet, and tincture form in most herb and natural food stores.

Stress-relieving Herbs

If menopause also involves stress, try some relaxing herbs, such as valerian (Valeriana officinalis), passionflower (Passiflora incarnate), skullcap (Scutellaria lateriflora), and hops (Humulus lupulus). To make a pleasant-tasting, relaxing formula, make a blend of the herbs below.

Hormonal changes, aging, lack of sleep, problems with memory, and other physical complaints can also lead to depression. For this condition, women can try St. Johns’ wort (Hypercum perforatum), which unlike many antidepressant drugs does not impair attention, concentration, or reaction time. Clinical trials have shown it to be as effective as antidepressant drugs for milk to moderate depression, with much fewer side effects.

Supplement Checklist

Calcium and magnesium support bone building and help maintain healthy bones. Take 1,000 to 1,500 mg calcium daily and 500 to 750 mg of magnesium daily. Magnesium may facilitate muscle relaxation, thereby helping with insomnia. For this purpose, take 500 mg of magnesium combined with the same amount of calcium at bedtime.

Boron  also helps with the maintenance of healthy bones and helps prevent osteoporosis. Take two to five mg daily.

Vitamin E has been shown to reduce menopausal symptoms, as well as benefit the cardiovascular system. Take 400 to 800 IU daily.

Essential Fatty Acids and a Healthy Diet

You can even eat your way to good menopausal health. Foods that may be particularly helpful during this time are ones that include linolenic acid–the essential fatty acid found in flaxseed oil and evening primrose oil–and the omega-3 fatty acids that occur in salmon, trout, and mackerel. These oils help promote and maintain the health of skin, hair, and vaginal tissues. Flaxseeds also contain lignans, which have both anticancer and estrogen-like properties. The best way to use flaxseed is to grind it fresh, and take one to two teaspoons per day.

Plant compounds (known as phytoestrogens) that mimic estrogen in the body can benefit women before, during, and after menopause. Soybeans and soy products are probably the best-known sources of phytoestrogens, but others include yellow lentils, black beans, adzuki beans, and kidney beans.

Although it is not known for certain whether it is a cultural or dietary phenomenon, it is clear that Japanese women report significantly fewer menopausal symptoms that North American women. The average Japanese woman gets around 200 mg of isoflavones (a type of phytoestrogen) in her diet per day, and the average American woman gets only about 15 mg.

If you’d like to try to get more isoflavones in your diet, tempeh (a cultured soybean cake sold in health-food stores) in an excellent choice, because it is high in isoflavones and the body absorbs it easily. Another food that is extremely rich in isofavones is edamame, the green soybean that you can find as an appetizer in many Japanese restaurants. Edamame is becoming widely available in the frozen-foods section of grocery and health-food stores. Other good isofalvone sources include soymilk and tofu.

Exercise to Reduce Hot Flashes

Some research has shown that women who exercise regularly have been able to eliminate or lessen hot flashes. In a Swedish study, seventy0nine postmenopausal women were compared to those who chose exercise instead of HRT. The women who spent as much as three and a half hours per week exercising reported no hot flashes. More moderate exercisers had fewer and milder hot flashes.

Aromatherapy Options

Some women find that during menopause, essential oils used in massage oils or in fragrant baths can be helpful. Choices include clary sage, sage, anise, peppermint, and lemon. Sage may be particularly effective, as it has a long history of use for lessening excessive sweating and can also help alleviate hot flashes.

The essential oils of rose geranium, neroli (orange blossom), and lavender also have reputations as hormonal balancers. They were used historically to slow the skin’s aging, and modern aromatherapists use them to treat menopause.

To help relieve vaginal dryness, you can make a fragrant oil (using Kathi Keville’s recipe below) and apply it to the vaginal area as needed.

Beth Baugh has been the managing editor of multiple books on botanical medicine and has been involved in the herb industry for almost 40 years. Along with Christopher Hobbs, she started an herb company called Native Herb.


“Treatment of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society”, Menopause, 2004, 11(1), 11-33.

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