Herbs and menopausal symptoms

Monique Rainford,  HER HEALTH

Many patients ask me about the safety and/or benefits of certain supplements or herbal medications for menopausal symptoms. I have had to reveal that for many of these products, whether they are effective, information regarding their safety and efficacy is limited, and just because a product is said to be 'natural' does not make it safe.

Fortunately, over the years, several research institutions have realised the importance of these treatments and more time and money is being invested in obtaining the necessary information for the safer guidance of patients.

A number of herbal (botanicals) treatments have been suggested to treat menopausal symptoms, and I will discuss a few.

Black cohosh has been used for many years to treat menopause symptoms. Although some studies have been conflicting, many have shown that it can improve menopausal symptoms such as hot flushes and vaginal dryness. It has also decreased anxiety symptoms, fatigue and irritability and improved women's sleep, mood, sweating and sexual function. To date, no scientific study has shown any serious negative effects of this botanical.

Ginseng has been shown to improve symptoms of fatigue, depression, mood, insomnia and the sense of well-being. However, the type of ginseng used is important as many botanicals carry this name. The benefits are noted with Panax gingseng. Side effects of this botanical include headache, breast pain, diarrhoea or bleeding if it is used with stimulants.

Red clover is a source of phyto-oestrogens (plant-based compounds that have weak oestrogenic activity) and has been touted in the past as a treatment of menopausal symptoms. However, to date, this has not been proven by research studies.

Kava appears to be effective in reducing irritability and insomnia for menopausal women. Unfortunately, it can cause severe liver damage, although rarely.

Soy supplements have not consistently been shown to improve menopausal symptoms and current recommendations are that women who want to take these phyto-oestrogens should do so as part of their diet rather than through supplements.

St John's Wort appears to be effective in the treatment of mild to moderate depression while ginkgo may improve libido in menopausal women, but both may interact with certain medications.

I encourage women to continue to share with their doctors any herbal medications they may be taking. Although we may not always have the answers, we can seek to identify their safety, any harmful interactions with other medications and effectiveness.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.