Herbal supplements for menopause
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You may have heard of natural herbal supplements for menopausal support, but there is so much information out there!! Truly there are hundreds of natural alternatives to support symptoms at all stages of menopause, but the research on many of these supplements is either mixed or lacking. With the abundance of information available, we are here to help you determine which supplements are best for you. Herbal remedies have been around for thousands of years. Before medication, people turned to herbs for their health and even reproductive systems. Herbs have also been shown to help with decreasing menopausal symptoms such as hot flashes, sleep disturbances, and psychological changes. The herbal products below may be beneficial for most experiencing menopausal symptoms.
Black Cohosh
Black Cohosh is an herb native to North America. Many articles suggest that Black Cohosh is used for menopausal symptoms including hot flashes, fatigue, pain, and depression. One study showed that it improved hot flashes but did not have any effect on depression or anxiety. There is some evidence suggesting that black cohosh in combination with St. John’s wort improves menopausal symptoms and depression. Though, many studies have shown no significant evidence that black cohosh can alleviate menopausal symptoms and more studies are required (Johnson, 2019).
Things to consider with a black cohosh supplement:
Recommended dose ranges from 20 to 80 mg per day.
Please note: Cisplatin, Cytochrome P450 2D6 (CYP2D6) substrates, Hepatotoxic drugs, Estrogen and Atorvastatin moderately interact with Black Cohosh, therefore, if you are taking any of these medications please contact your healthcare provider before using supplementation
Dong Quai
Dong Quai has been used as an herb for the reproductive system by Traditional Chinese Medicine. Although Dong Quai has been known to relieve premenstrual symptoms, some have reported that it has reduced their menopausal symptoms as well. In some studies, Dong Quai has shown a decrease in frequency of hot flashes while others have shown no improvement at all. A clinical trial with 50 women reported improvements in hot flashes, night sweats and sleep quality when used with a combination of other herbs showing that Dong Quai alone may not help with reducing symptoms (Johnson, et.al., 2019).
Things to consider with a dong quai supplement:
Capsules 500 to 600 mg tablets or capsules up to 6 times daily.
Warfarin (blood thinners), hormonal replacements, and St John's wort moderately interact with Dong Quai, therefore, if you are taking any of these medications please contact your healthcare provider before using supplementation
Evening Primrose
Evening Primrose is a plant native to North America. It is used to reduce menopause symptoms though some studies show it is inconclusive. Evening Primrose contains omega 6 fatty acids, which our bodies cannot produce and need from the diet but in small amounts. One study showed that it has helped the frequency and severity of night sweats but did not have a high impact on hot flashes (Kazemi, et. al., 2021), while another showed improvement in the intensity of hot flashes (Farzaneh, et. al., 2013). There is also evidence that it helps with psychological symptoms such as depression and anxiety during menopause (Safdari, et. al., 2021).
Things to consider with a evening primrose supplement:
Dosage is typically between 500-1000 mg daily in capsule form
Anticoagulants and antiplatelet drugs, Cytochrome P450 3A4 (CYP3A4) substrates, Lovastatin, and Lopinavir and ritonavir (Kaletra) moderately interact with Evening Primrose, therefore, if you are taking any of these medications please contact your healthcare provider before using supplementation
Valerian root
Valerian is an herb that comes from a plant originating in Europe and Asia. It has been used to alleviate sleeping disorders, stress, and psychological issues, such as anxiety and depression. For this reason, it can help with menopausal symptoms. Some studies have also shown a reduction in hot flashes (Kenda, et.al, 2021). Valerian root is best taken up to 3 times per day with the last dose taken near bedtime.
Things to consider with a valerian supplement:
Tea: Pour 1 cup boiling water over 1 teaspoonful (2 to 3 g) of dried root, steep 5 to 10 minutes.
Alcohol, sedative medications (CNS depressants), Xanax, and Glucuronidated drugs moderately interact with Valerian, therefore, if you are taking any of these medications please contact your healthcare provider before using supplementation
Maca
Maca is a plant native to South America and is also referred to as Peruvian Ginseng. Maca was traditionally used for fertility, libido, respiratory disorders, rheumatoid disorders, and even anemia. More recently, it has sparked an interest in the effects of menopausal symptoms. Studies on maca and menopausal symptoms continue to interest researchers, although there has been no conclusive evidence thus far. The studies conducted have shown a decrease in menopausal symptoms including depression and hot flashes. Decreased blood pressure was also among the benefits reported during menopause (Meissner, et.al., 2006).
Things to consider with a maca supplement:
Powder, liquid, or capsule form
Typical dosage is 1.5-3.5 grams daily for up to 16 weeks
There are no known drug or medication interactions with maca, however, it is always best to speak with your healthcare provider before starting a new supplement
As noted above, some of these herbs are not recommended to be taken with other medications as they can have interactions and side effects. It is recommended to speak with your healthcare practitioner before taking alternative supplements and products, especially when you also take pharmaceutical medications. Herbs may also interact with other supplements, although these interactions have not been studied as well. We are happy to be a resource to review some of these natural options with you!
Interested in learning more about herbal supplements and menopause?
We’d love to work with you! Schedule a complimentary Meet + Greet session. We look forward to finding individualized solutions to fit your needs.
Published: October 7th, 2024
This blog post was written by dietetic intern Lucy Cholakian and edited by Amanda Sikkema, a dietitian at Katie Chapmon Nutrition. Amanda works with clients virtually and is accepting new clients.
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Farzaneh, F., Fatehi, S., Mohammad-Reza, S., Alizadeh, K. The Effect of Oral Evening Primrose Oil on Menopausal Hot Flashes: A Randomized Clinical Trial. Archives of Gynecology and Obstetrics 2013; 288(5):1075-9. DOI: 10.1007/s00404-013-2852-6
Johnson, A., Roberts, L., Elkins, G., Complimentary and Alternative Medicine for Menopause. Sage Journals 2019; DOI: https://doi.org/10.1177/2515690X19829380
Kazemi, F., Masoumi, S.Z., Shayan, A., Oshvandi, K. The Effect of Evening Primrose Oil Capsule on Hot Flashes and Night Sweats in Postmenopausal women: A Single0-Blind Randomized Controlled Trial. Journal of Menopausal Medicine 2021; 27(1): 8–14; DOI: 10.6118/jmm.20033
Kenda, M., Glavač, N.K., Nagy, M., Dolenc, M.S., on behalf of the OEMONOM. Herbal Products used in Menopause and for Gynecological Disorders. Molecules 2021; 26(24):7421. DOI: https://doi.org/10.3390/molecules26247421
Meissner, H.O, Reich-Bilinska, H., Mscisz, A., Kedzia, B. Therapeutic Effects of Pre-Gelatinized Maca (Lepidium Peruvianum Chacon) used as a Non-Hormonal Alternative to HRT in Perimenopausal Women - Clinical Pilot Study. International Journal of Biomedical Science 2006; 2(2): 143–159; PMCID: PMC3614596
Safdari, F., Dastenaei, B., Kheiri, S., Karimiankakolaki, Z., Effect of Evening Primrose Oil on Postmenopausal Psychological Symptoms: A Triple-Blind Randomized Clinical Trial. Journal of Menopausal Medicine 2021; 27(2):58-65; DOI: https://doi.org/10.6118/jmm.21010
