More About The Herbal Treatment of Menopause
Herbal Products
Herbal products can help relieve many of the symptoms of menopause for some women. There are many different types of products and their ability to work, their quality and cost can vary greatly. What works for one woman, may not work for another woman. Because of this wide degree of variations, it is has been very difficult to set standard dosages and defined treatment programs. Also, for most of these products, there is only very limited facts and evidence of efficacy available.
Soy Products
Some soy products contain high amounts of isoflavones. Isoflavones, also known as plant estrogen, is a phytoestrogen. Plant estrogens act like a weak form of the hormone estrogen in the body.
Isoflavones are found in foods, such as flaxseed, legumes (peas, beans, peanuts), and whole grains (oats, wheat, corn). When soy is processed into a food, it can lose some of its estrogen-like benefits. Soy also can be taken in the form of supplements in capsules.
When taken regularly over a long period of time and in large amounts, soy products may help protect against osteoporosis. Soy products may also help to relieve some of the uncomfortable symptoms of menopause, such as hot flashes and vaginal dryness. It is believed by many, right or wrong, that because soy products have estrogen-like qualities, they may have some of the risks attributed to estrogen therapy. This has not been proven or disproven.
Black Cohosh
Black cohosh is a North American plant. It is often prescribed by herbalists for women to treat symptoms such as hot flashes, sleep disorders and depression.
Black cohosh apparently also has some estrogen-like properties and actions. There are mixed results on how well it works although many women report that it helps them to reduce menopausal symptoms. Side effects may include upset stomach and lowering of the woman’s blood pressure.
St. John's Wort
St. John's wort is an extract of the flower Hypericum perforatum. It has been used for hundreds of years to treat mild to moderate depression. Side effects may include dry mouth, dizziness, constipation, sensitivity to the sun, and increased rate of cataracts. St. John's wort may cause problems when it is used along with other antidepressant medications.
Wild Yam
Wild yam (and Mexican yam) is available in extracts, tablets, and creams. While there is little “scientific” proof that yams can relieve symptoms of menopause, many women swear by it. Although there is a estrogen-like substance found in some yams, it is believed that a woman would have to eat a large amount of raw yam to reach a level that would actually relieve symptoms. On the other hand, when used as a cream or compounded medication, many women do antidotally report symptom relief.
Dong Quai
Dong quai is the root of the plant Angelica sinesis. It is the most commonly prescribed Chinese herbal medicine for problems that affect the female reproductive system.
Dong quai is given to make menstrual cycles more regular. It is said to help with vaginal dryness and pain during sex. It is also used to reduce hot flashes. It works best when it is used with other estrogen-line herbal products. Dong quai may cause some women to have an increased sensitivity to sunlight, causing photo sensitive reactions or mild sun burns. It also may affect the time it takes for your blood to clot. Most studies have generally looked at the use of dong quai by itself. When used in Chinese medicine, it is usually prescribed along with other herbs. When used alone, it may not be as effective.
Products with Unknown or Questionable Efficacy
Evening Primrose
Evening primrose is a North American wildflower. Oil is expressed from the plant's seeds. This oil is used by some women to treat hot flashes. To date there is no “scientific” proof that it works. Antidotally, many women tell us that it has helped them.
Valerian Root
Valerian root comes from the garden plant heliotrope. It is used mostly to treat sleep problems. Studies do not show valerian root to be a useful treatment. It may cause muscle spasms or eye problems.
Ginseng
There are many types of ginseng: Siberian, Korean, American, white, and red. Ginseng often is promoted as an "adaptogen." This means it helps one cope with stress and it boosts immunity to diseases. For menopausal women, ginseng is said to increase a woman's desire to have sex, but to date there is no “scientific” proof that it does. Some studies have concluded that it does not reduce hot flashes.
Chasteberry
Chasteberry, or vitex, is the dried ripe fruit of the chaste tree. It is said to reduce sexual desires in men and increase sexual desires in women. Some think that it helps to reduce vaginal dryness and depression at menopause. There is not enough “scientific” proof to demonstrate that it works sufficiently to recommend it.
Special Concerns
The Dietary Supplement Health and Education Act of 1994 stated the following:
“Herbal products are not approved by the federal government before being sold to consumers. However, the Dietary Supplement Health and Education Act of 1994 made some rules about the labeling of these products that can help the consumer.
Herbal products cannot claim to diagnose, treat, cure, or prevent disease. These claims require approval by the FDA. A product can be labeled with statements that explain what effect they are supposed to have or what role they have in promoting well-being. For instance, a label cannot say "lowers cholesterol," but it can say "promotes heart health."
If there are federal guidelines for how much of a product to take per day, these must be included on the label. These guidelines exist for most vitamins. They rarely exist for herbs, for which effective doses have not been determined.
Keep in mind, the FDA has a different role with herbal products than with conventional medicines. For conventional drugs, the manufacturer has to prove to the FDA that the product is safe and effective when taken as directed before selling it to consumers. For herbal products, the FDA first has to prove that the product is dangerous when taken as directed, and then can recall an unsafe product.
A concern about herbal products is that they are not approved by the federal government. The herbal industry promotes its own standards for making herbal products. Some manufacturers have signed agreements to conform to these standards.”
Additional Concerns
Currently, there is no government body to oversee herbal products. As a result, they can vary widely. The content of the product itself can vary in terms of when and where it was grown or gathered, specific growing conditions and how it was finally produced.
Because of lack of quality control, the same product made by different companies may not have the same amount of the main active ingredients, even if the label says that it has the same amount. Even two bottles of the same product made by the same company, may be different. There is no guaranteed standard, quality control, or dosage regulation or rules currently used by herbal product growers, processor or manufacturers.
The U.S. Pharmacopeia (USP) has a program to help inform and protect consumers who use dietary supplements, including herbal products. In this program, the USP tries to make sure that products will meet the following strict standards:
- That they contain the amount and strength of ingredients stated on the label
- That it does not contain any contaminants
- That it has been made using approved U.S. Food and Drug Administration (FDA) standards for good manufacturing practices
If a product meets the USP standards, it is awarded a certification mark that can be found on the product label.
What Should You Do Before You Try Any Herbal Product?
Before you start taking herbal products for menopause symptoms, talk with your doctor. Herbs can interact with other drugs that you are taking already or that your doctor might prescribe in the future. Therefore, always tell you doctor if you are:
- Using any herbal products, vitamins, or home remedies
- Seeing any other health care providers
- Taking any prescription or nonprescription drugs
- Allergic to any plant products
Also of significant importance is that certain herbs may mask symptoms that your doctor might need to know in order to diagnose certain problem. Herbal medications may also cause problems if you take too much or if they interact with another medication you are taking. By talking with your doctor, you can rule out certain problems before you start treating symptoms. Your doctor will work with you to help you decide what is and is not safe for you.
Summary
- While using herbal products can help relieve symptoms of menopause, for some women, they can also have risks and dangers that should be considered prior to starting their use.
- You may find that herbal medication can work alone or even better in combinations with other herbal products. In order to be safe, it is always smart to consult a physician, herbalist or naturopath whois an expert in the use of herbal medications.
- While women may use herbs along with other forms of treatment, there can be dangers that should be considered prior to starting either. Once again a consultation with an expert can help to protect you and assist you in obtaining the very best results.
- For some women HRT or ERT alone may meet all of their needs. Your doctor should be able to help you decide which and what is best for you.
- If you are thinking about taking herbal products, it is a good idea to let your doctor know. Even products that seem safe, it is always possible that they can be harmful to you.
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