Perimenopause: Plants for Perimenopause

Soybeans and Soy products have been the subject of many controlled studies and are well-known for their ability to reduce hot flashes and relieve other perimenopausal discomforts. The isoflavones responsible for this effect are antioxidants and are believed to be effective anticancer agents. The best-known source of isoflavones are soy and soy products, but isoflavones are also found in significant quantities in many other legumes, including lima beans, black beans, and lentils. A diet rich in legumes is the surest way to obtain a good supply of the key isoflavones that mimic estrogen in the body. The most common recommendation for daily dietary intake of isoflavones is about 40 mg.

Many other plants also can be useful during perimenopause. James Duke, Ph.D., an Herbs for Health editorial adviser and the developer of an extensive database of plants’ chemical constituents, lists dozens of herbs that possess constituents with hormonal properties. Here is a brief summary of some of the herbs most ­widely used for hormone balancing and as ­female tonics. Most are available in supplement form or can be brewed together for a tea to drink once or twice a day. Herbalists Christopher Hobbs and Kathi Keville, in their book Women’s Herbs, Women’s Healing (Interweave Press, 1998), have created a recipe for a menopause tincture made from many of these same herbs; the tincture is diluted in water and taken three times a day. Additionally, many women’s herbal tea products containing the herbs described below are available in the marketplace and even the neighborhood grocery store nowadays.

For women who don’t have the inclination to eat many beans or soy products, red clover (Trifolium pratense) is an easy way to get isoflavones in dietary supplement form. Naturopathic physician Donald Brown, in a 1997 monograph on standardized red clover extract, reported that a 500-mg tablet containing 40 mg of isoflavones and given daily to eighty-six perimenopausal women decreased the incidence and severity of their hot flashes.

The fruit or fruit extract of the shrub vitex (Vitex agnus-castus, also called chaste tree) is pres­ent in virtually every herbal formula for meno­pause. Researchers have found that it stimulates the release of lutenizing hormone (LH) and inhibits the release of follicle-stimulating hormone (FSH), there­by increasing the level of progesterone relative to estrogen. This hormonal balancing act can be effective in relieving hot flashes, regulating the menstrual cycle, alleviating PMS symptoms, and is even used to improve ovulation by women trying to conceive during perimenopause. It shouldn’t be used during pregnancy, though, or while receiving HRT. A typical dose is up to three 650-mg capsules daily.

The root of black cohosh (Cimi­­cifuga racemosa) has long been prepared for use as a women’s tonic. An herb native to North Amer­­i­­ca, black cohosh is widely used in Germany for menopausal and perimenopausal symptoms such as hot flashes and PMS. An isoflavone in the root has been shown in studies to have estrogenic activity comparable to that of conventional estrogen replacement therapy. It is generally taken in tincture or extract form. It shouldn’t be used by anyone with heart disease. A typical dose is three 500- to 600-mg capsules daily of the whole herb. Black cohosh is considered an at-risk plant by some groups. For information on how to be a wise consumer, turn to page 47.

For thousands of years in China, the root of dong quai (Angelica sinensis) has been used for women’s health. The Chinese infuse the dried root in a tea, sometimes combining it with other herbs, and use it as a toner of the reproductive system and to protect the liver from toxins. Most research on the herb has been conducted in China and Japan and shows that dong quai extracts stimulate uterine contractions and can normalize irregular uterine contractions and improve blood flow to the uterus. It is more commonly available here in liquid extract form and is included in most Chinese formulas. A typical dose is up to six 500- to 600-mg capsules daily, or follow a manufacturer’s or practitioner’s recommendations.

Another staple of Chinese medicine is known as Asian ginseng (Panax­ ginseng). It can help with problems such as depression, hot flashes, fatigue, and a decreased sex drive, according to Hobbs and Keville in Women’s Herbs, Women’s Health. It has long been used for the reproductive system, is strongly antioxidant, and may help protect against cancer, according to some Chinese studies. Product forms include tinctures, capsules, teas, and other extracts, and a typical dose is up to four 500- to 600-mg capsules daily. (For more about Asian ginseng, see page 88 of this issue of Herbs for Health.)

Wild yam (Dio­scorea villosa) is part of Traditional Chinese Medicine too, but it is a source of confusion in the United States. Wild yam contains diosgenin, which can be converted in the laboratory to progesterone identical in chemical structure to that in the human body. But without the lab’s help, the body can’t synthesize it. So, while wild yam may be beneficial for menopausal complaints based on the Chinese experience, it isn’t the same as progesterone.

What plants offer
Not only are some herbs effective at relieving discomfort, but a growing body of evidence suggests that phytoestrogens –plants that contain estrogenlike compounds–can prevent or reduce the occurrence of these symptoms. Plant estrogens are not identical to estrogens manufactured in the human body, but are similar and mild enough to act as buffers. Many researchers believe that phytoestrogens can not only soften the impact of perimenopause and alleviate the short-term symptoms, but also support a woman’s body after menopause, helping her avoid heart disease and osteoporosis.

Natural estrogens synthesized from wild yam or soybeans are available by prescription from health-care practitioners in creams, tablets, and patches, but with a little care and attention, phytoestrogens can also be obtained through the diet and herbal supplements. Phytoestrogens are present in all plants and are found in significant quantities in soybeans, other legumes, and herbs such as vitex, black cohosh, dong quai, wild yam, and red clover. A precautionary note: Anyone switching from HRT to herbal treatments should do so gradually.

Little scientific research has been conducted on phyto­estrogens in comparison with HRT, but they are backed by a long history of use by herbalists for helping maintain hormonal balance, as well as anecdotal evidence and the experience of many patients under the care of physicians such as Hanley, Lee, and Cass. Recommended dosages have not been established for most phytoestrogens, but the right dose is the one that works on menopausal symptoms, which is sometimes fairly easy to gauge.

Some women may wish to undergo hormone testing to determine the balance–or imbalance–of their hormone levels before seeking any kind of treatment. However, testing can be more confusing than helpful because of the way in which hormone levels fluctuate during perimenopause, Hanley says. “If a woman is doing well and the things she’s doing are working, then a lab test may not add any information. We can read our bodies, and the more we listen, the more we learn.” She recommends that women who don’t feel comfortable with this approach find an herbalist or other health-care practitioner who’s knowledgeable about natural remedies.

Kathleen Halloran is former editor of The Herb Companion, Herbs for Health’s sister publication, and a freelance writer living in Colorado.

Click here for the original article, Perimenopause.

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