Natural therapists will often refer to the collection of symptoms a woman experiences as the menopausal syndrome. Herbal therapies may be used to manage hot flushes, mood changes such as anxious thoughts and depressed feelings, sleep disturbance, fatigue and low energy. The best way to use herbal remedies for the treatment of symptoms at menopause is under the guidance and advice of a qualified naturopath.

Hot Flushes

A naturopath / herbalist manages hot flushes depending on the  trigger and chooses herbs to address the trigger (Table 2). A hot flush may be associated with, or triggered by: 

• Anxiety and stress
• Aggravated by fatigue and overwork
• Predominantly worse at night and associated with night sweats
• Sweating

Often 'oestrogen-like herbs' will form the core of the herbal prescription and other herbs are then added to formulate a specific prescription for the individual (Table 2). In many cases, hot flushes and night sweats may be more severe initially in women with early menopause and it may not be possible to get complete relief of symptoms with natural therapies. It may be appropriate to consider combination therapy, for example hormone therapy (HT) for hot flushes, and herbs for moods.

Dong Quai, evening primrose oil and wild yam creams were found to be ineffective in the management of hot flushes in single clinical trials. A recent meta-analysis of isoflavone  supplements (including red clover and soy) reported a small to modest statistically significant reduction in the number of menopausal hot flushes. However, an earlier systematic review  found no difference between placebo and isoflavones for the relief on menopausal symptoms.

Natural therapies potentially having a less direct hormonal action, and may be considered for those women with contraindications to oestrogen therapy (e.g. breast cancer). These include:

• Homeopathy
• Aromatherapy
• Traditional Chinese Medicine (studies report conflicting results as to the effect on breast cancer) and Acupuncture
• Kinesiology
• Remedial and relaxation massage

Vaginal Dryness

Black cohosh, Cimicifuga racemosa, taken orally, is prescribed to improve vaginal dryness. Some herbalists make a vaginal pessary / herbal cream containing a fluid extract of black cohosh (often specially prepared to reduce the alcohol content) with other healing oils such as calendula oil, evening primrose oil and olive oil. A soy-based vaginal gel, made from 10% concentrated soy isoflavones, is also available over the counter at pharmacies.

A study demonstrated that 25g (or 2 heaped dessertspoons) of ground linseeds daily improved vaginal dryness in perimenopausal women). It is best to use freshly ground linseeds (grind the amount of linseeds in a food processor or electric coffee grinder that would be consumed within two weeks and store in fridge) which can be added onto cereal or into smoothies.

Content updated June 25, 2007