Menopausal Symptoms - A Herbal Approach

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30 Nov 2007 THE menopause is a natural point in every woman’s life, a sign that the childbearing years are drawing to a close. But, however normal, this ‘change of life’ can cause some difficult physical and emotional symptoms.

Here we examine how and why the menopause can affect a woman’s life and the scientific evidence that a herbal approach to treatment could be effective.

During the menopause a woman’s ovaries stop producing eggs and levels of the hormones oestrogen and progesterone fall rapidly. Chemicals in the brain called dopamine and serotonin can also become disrupted. These changes can cause symptoms that last for an average of two years, although for some women they can continue for as long as six.

COMMON SYMPTOMS

• Headaches
• Hot flushes and night sweats
• Mood swings
• Fatigue
• Dizziness
• Anxiety
• Depression
• Bladder problems

• Poor libido
• Vaginal dryness
• Itchy skin
• Breast tenderness
• Wrinkling of the skin
• Heart palpitations
• Shortness of breath
• Insomnia

NATURAL TREATMENTS
There is now some good scientific evidence that some herbal treatments may work very well in relieving menopausal symptoms. Three herbs in particular have been used for many years and are backed by evidence from clinical trials. They are: Black Cohosh, Agnus Castus and Dong Quai.

Black Cohosh
This herb is native to North America and the most important trials to date show that it repeatedly reduced symptoms of the menopause (ref 1, 2). Other clinical studies show that it relieves symptoms including night sweats, irritability and hot flushes (ref 3). Many other studies show that this supplement can reduce menopausal symptoms effectively compared to many drugs (ref 4,5,6) .

It is thought that certain compounds that the herb contains allow it to help balance the brain chemicals dopamine and serotonin (ref 7,8) which are often disrupted in menopausal women. Imbalances of these chemicals are thought to cause hot flushes, irritability, mood swings and a lack of concentration.

Agnus Castus
Also known as Vitex or Chaste Tree this herb comes from the Mediterranean and has a peppery odour. The herb has been traditionally used for the early stages of the menopause. The best study into this herb to date (ref 9) suggests it can be effective in relieving symptoms associated with ‘the change’. Many clinical trials also show that it can help with the symptoms of PMS – such as hot flushes and irritability – and because these symptoms are identical to menopausal symptoms scientists take this as proof that Agnus Castus is effective for both conditions.

Agnus Castus has shown to be extremely helpful in re-establishing a normal hormone balance - it works on the pituitary gland and appears to have a balancing effect on the hormones. This makes it especially useful in the second half of the monthly cycle which is why it has shown to be such an important herb for treating PMS symptoms.

Dong Quai
This Chinese herb has been used for centuries in the East and is now increasingly popular in the West too. It appears to work far more effectively when combined with other herbs. A clinical trial in China revealed that when combined with several other herbs in a formula it was helpful for relieving hot flushes and other menopausal symptoms (ref 10). In another study patients with menstrual migraines were provided with 100mg of Dong Quai, 60mg of Soy Isoflavones and 50mg of Black Cohosh over 24 weeks. The results clearly showed that the average frequency of migraines fell (ref 11).

It is not yet clear how Dong Quai works, but herbalists have two main theories. The first is that the herb contains plant oestrogens that can help restore a woman’s hormone balance. The second theory is that the herb works thanks to the compounds called coumarins that it contains that can dilate blood vessels and may also be anti inflammatory. It is thought this may allow the herb to help reduce the severity of menstrual cramps.

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REFERENCES
1. Liske E. Black Cohosh: A review of the therapeutic effects in gynaecology. Adv Nat Ther 1998;15:45-53.
2. Mckenna DJ, Jones K, Humphery S, Hughes K. Black Cohosh: Efficacy, safety, and use in clinical and preclinical applications. Altern Ther 2001;7:93-100.
3. Blumenthal M. the ABC clinical Guide to Herbs. Austin: American Botanical Council, 2003. 4. Stoll W. Phytotherapy influences atrophic vaginal epithelium: Double-blind trial compaing cimicifuga and an estrogen preparation [in German]. Therapeutikon 1987;1:23-31.
5. Liske E, Hanggi W, Henneicke-von Zepelin HH, et al. Physiological investigation of a unigue extract of Black Cohosh (Cimicifugae racemossae rhizome): A 6-month clinical study demonstrates no systemic estrogenic effect. J Women’s Health Gend Based Med 2002;11:163-174.
6. Jacobson JS, Traxel AB, Evans J, et al. Randomised trial of Black Cohosh for treatment of hot flushes among women with a history of breast cancer. J Clinical Oncol 2001;19:2739-2745.
7. Borrelli F, Izzo AA, Ernst E. Pharmacological effects of Cimicifuga racemosa. Life Sci 2003;73:1215-1229.
8. Burdette JE, Liu J, Chen SN, et al. Black Cohosh acts as a mixed competitive ligand and partial agonist of the serotonin receptor. J Agric Food Chem 2003;51:56661-5670.
9. Attelmann H, Bends K, Hellenkemper H, et al. Agnolyt® in the treatment of gynecologicak complaints [in German]. Z Präklin Geriatr 1972;2:239.
10. Chang HM, But PPH, eds. Pharmacology and Applications of Chinese Materia Medica, vol.1. River Edge, NJ:World Scientific, 1986.
11. Burke BE, Olson RD, Cusack BJ. Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomed Pharmacother 2002;56:283-288.

MENOPAUSAL SYMPTOMS - A HERBAL APPROACH