Because of the HRT-cancer scare, women have turned to supplements as a safer way to reduce menopausal symptoms. One herb that has dominated the conversation is black cohosh—it’s one of the most recommended herbs for menopausal women and has been historically used to relieve hot flashes, night sweats, anxiety, and vaginal dryness.
Originally, researchers and healthcare practitioners believed that black cohosh contained chemical compounds that could mimic estrogen in the body. But several studies have disproved this theory. Research published in The Journal of Agriculture and Food Chemistry theorized an alternate reason for the herb’s efficacy: Black cohosh targets the serotonin receptors in the hypothalamus—the part of your brain that produces hormones to regulate body temperature—to offer relief from hot flashes. Serotonin also affects mood, which is why the herb helps to abate mood swings, says Susan Lark, MD, a women’s health specialist.
Offering another explanation, Marcus Laux, ND, author of Natural Woman, Natural Menopause (Harper, 1998), says that black cohosh affects the brain’s pituitary gland, lowering levels of hormones that are linked to menopause symptoms. “If the hormones are imbalanced, the pituitary gland will send out signals to create more hormones.” Black cohosh, he says, may “dampen down” the pituitary’s frantic hormone-boosting attempts.
It’s worth noting that not all black cohosh is created equal. As we first reported in 2006, Asian varieties of the herb were found to have no effect on symptoms, while Remifemin (a proprietary version of black cohosh) was found to produce significant relief, says a study in Obstetrics and Gynecology.
Another herb to consider is rhubarb—specifically the Siberian rhubarb root extract ERr 731—which, according to David Riley, MD, Natural Solutions’ medical editor, has been shown to have estrogenic effects in the body. Recent studies in Menopause and Alternative Therapies (Natural Solutions’ sister publication) found that the extract significantly reduced the occurrence of hot flashes in perimenopausal women. Siberian rhubarb root extract is marketed as Estrovera and available only through authorized healthcare practitioners.
What to do: If you take black cohosh, Sellman recommends 80 to 160 mg daily. For Remifemin, Laux suggests taking 20 mg twice a day. For rhubarb, Riley suggests taking one tablet (4 mg) daily, which can be increased to two tablets after three to six weeks. The key with any supplementation is patience, says Catherine Austin, LAc, a faculty member at the Pacific College of Oriental Medicine in San Diego. It can take six to 10 weeks for daily herb supplements, coupled with weekly acupuncture treatments, to have an effect, she says. The earlier you start an herb regimen—she recommends visiting your acupuncturist or herbalist as soon as your periods become irregular—the easier it is to treat symptoms.
Bioidentical hormones, which are made from plants that mimic human estrogen and progesterone (and are available as gels, patches, creams, or pills), are considered safer than synthetic hormone-replacement therapies. Yet Laux, who patented bioidentical hormones in 2002, says the mind-set today is “shifting toward the next medical revolution—that hormone intervention is unnecessary.” In most cases, women (unless they are not responding to other therapies) don’t even need bioidentical hormone replenishment, he says. This is because, as Sellman points out, taking hormones doesn’t heal at the root level or rejuvenate your body. “If underlying problems like adrenal fatigue are addressed, you may not have to take bioidentical hormones for long, if at all,” she says.
Yurth says another option is to simply take a soy supplement, which boosts estrogen. The same ingredient is used in bioidentical hormones, but because supplements aren’t as concentrated as prescription hormones, you’ll have to load up.
What to do: Lark says if you do opt for hormone therapy, stick with topical bioidentical hormone gels, which can be prescribed by your doctor or naturopath and custom made for you. Because topical gels allow hormones to be directly absorbed into the bloodstream rather than through the digestive tract, they usually have lower dosages of hormones than pills.
Find Relief With These Remedies
In her book Hormone Revolution (Portola Press, 2007), Susan Lark, MD, a women’s health specialist, recommends a daily cocktail of botanicals, vitamins, and minerals to decrease menopausal symptoms.
- Black cohosh (standardized) to relieve hot flashes (40 to 80 mg)
- Bioflavonoids like quercetin to reduce estrogen levels (1,000 to 2,000 mg)
- Calcium carbonate to ease mood swings, bloating, and cravings (1,200 to 1,500 mg)
- Ground flaxseed to promote progesterone production (4 to 6 tablespoons)
- Magnesium to reduce water retention (600 to 750 mg)
- Soy isoflavones to normalize estrogen levels (50 to 150 mg)
- Vitamin B6, taken with magnesium, to decrease PMS-related anxiety (50 to 100 mg)
- Vitamin C to lower estrogen and lessen menstrual bleeding (1,000 to 4,000 mg)
- Defining Menopause
- Perimenopause The two-to-eight year interval when the body begins its transition into menopause. It is characterized by rising and falling estrogen levels, with a gradual increase in irregular periods, mood swings, hot flashes, and vaginal dryness. The average age of onset is 40.
- Menopause Marked by one year without a menstrual period. The average age of onset is 51.
- Postmenopause The time after a woman has gone 12 months without a period. Symptoms caused by estrogen swings will tend to cease.
6 Supplements for Menopause
- EstroSoy Plus: Made with fermented soy and black cohosh. $20, 60 capsules;
- Estrovera: Made with a Siberian rhubarb root extract. $30, 30 capsules;
- Femi-Yin for Menopause Relief: A blend of traditional Chinese medicine herbs, including wild yam, which may boost progesterone. $26, 60 capsules;
- i-Cool for Menopause: Made with geniVida, a proprietary isoflavone (found in soy) believed to reduce hot flashes. Available in stores at the end of June. $20, 30 tablets;
- Menopret: Made with proprietary black cohosh (formerly called Klimadynon). $22, 30 tablets;
- Remifemin: The first standardized, proprietary black cohosh product. $20, 60 capsules;