Menopause is a natural phase of life in which annoying symptoms such as hot flashes, sweating, vaginal dryness, foggy thoughts and mood swings can occur as oestrogen levels fall. If you are able and willing to take prescribed hormone replacement therapy (HRT), this will solve the problem for as long as you take it. When it eventually comes time to stop taking HRT, however, menopause symptoms often return although they are usually less troublesome. Numerous supplements can help women who have to stop HRT, or who prefer not to start it in the first place. Of these, the most effective are: isoflavones (ideally taken together with probiotics), Black cohosh, Sage leaf, St John’s Wort, Royal Jelly, Sea buckthorn oil, Evening primrose oil and Maca root powder.
Soy isoflavones for menopause
Soy isoflavone supplements are an easy way to increase your intake of plant hormones if you don’t want to make drastic changes to your way of eating.
The results from 19 randomised, placebo-controlled clinical trials show that taking soy isoflavone supplements for at least 12 weeks, can reduce menopausal symptoms by 45%.
Another large analysis of data from 62 trials, involving 6653 women, confirms that taking plant hormones, such as soy isoflavones, can improve menopausal symptoms with the daily frequency of hot flushes reducing by 1.3 flushes, their severity reducing by 21% and vaginal dryness improving by 31%.
Significant improvements are usually noted within 6 weeks, with maximum effects continuing over the following months. It can take at least 48 weeks to achieve 80% of their maximum effects, so don’t give up on soy isoflavones too soon.
Increasing evidence also suggests that soy isoflavones improve cognitive function (the ability to think straight), have beneficial effects on bone mineral density, and may have protective effects against breast, ovarian and intestinal cancers. If you have a personal or family history of these conditions, however, follow your doctor’s advice on whether or not to take isoflavone supplements, as opinions vary.
Probiotic supplements for menopause
Isoflavones and lignans are mostly eaten in an inactive form and the active components are released by bacterial digestion in the gut. Different women metabolise plant oestrogens in different ways, depending on the balance of bacteria within their intestines. Those who possess good amounts of probiotic bacteria are able to metabolise one of the isoflavones found in soy (daidzein) to a more powerful oestrogen called equol. Equol producers therefore obtain more benefits from soy isoflavones than non-equol producers so eat live bio yogurt and/or take a probiotic supplement to increase your equol production. Supplements with a higher genistein content are also more effective against menopause symptoms.
Taking a probiotic supplement together with your isoflavone will help to optimise their benefits. Another option is to take an oligosaccharide supplement to help the beneficial probiotic bacteria in your bowel to flourish.
Black cohosh for menopause
Black cohosh – also known as squaw root – has lovely white flowers but it is the knobbly root that is used medicinally to treat menopausal symptoms.
Black cohosh roots are a traditional herbal medicine to relieve hot flushes, night sweats, vaginal dryness, mood swings, anxiety and restlessness. Although Black cohosh contains a number of oestrogen-like plant hormones, such as formononetin, its main action is believed to result from a direct action on the hypothalamus and pituitary gland in the brain to lower levels of LH (luteinising hormone).
Black cohosh also helps to improve sleep quality by reducing night waking and has an effect on blood vessel dilation to reduce hot flushes and sweating.
Data from 7 trials involving over 1000 perimenopausal women, showed that Black cohosh reduced hot flushes and night sweats by 26% more than placebo. This is an impressive result given that the placebo itself reduced the severity or frequency of hot flushes by 25% to 30% after 4 weeks treatment.
When Black cohosh was used together with St John’s wort, the combined improvement was 33% greater than that seen with placebo.It may be taken together with soy isoflavones if you wish.
Some reports have linked Black cohosh with liver toxicity, but when these were investigated it was found that other factors such as a high alcohol intake, or the use of paracetamol or other drugs known to affect the liver, was involved. Reassuringly, there was no evidence of liver toxicity or changes in liver function in 5 studies, involving 1,117 women, who used Black cohosh for 3 to 6 months.
Sage leaf for menopause
Sage is a well-known Mediterranean herb whose name, Salvia, comes from the Latin salvere which means ‘to be saved’. Sage leaves – especially those from the red purple-tinged varieties – contain a number of essential oils such as borneol and camphor, and the polyphenol, rosmarinic acid, which has beneficial effects in reducing excessive perspiration.
Sage leaf extracts can relieve menopausal hot flushes and are especially helpful for night sweats. A study involving 69 women who were experiencing at least five flushes a day found that sage leaf extracts reduced the frequency of mild hot flushes by 46%, moderate flushes by 62%, severe flushes by 79% and stopped very severe flushes altogether. Overall, the intensity of hot flashes fell by half within 4 weeks and reduced by 64% within 8 weeks.
Sage leaf is also used to improve memory and alertness, and to promote feelings of calm and contentedness.
Maca powder for menopause
Maca powder, produced from the hardy root of an Andean plant, is referred to as Peruvian ginseng. Maca root powder contains unique sterols and alkaloids (eg macaridine, lipidiline) and macamides which have beneficial effects on hormone regulation and can improve sex drive as well as reducing menopause symptoms.
Maca does not contain plant oestrogens, and is believed to work through an effect on the hypothalamus and pituitary gland in the brain, to normalise hormone balance.
Maca can be used in place of prescribed hormone replacement therapy, or to help wean women off hormone replacement therapy after they have been taking it for some time, to reduce the chance of rebound worsening of hot flushes and night sweats.
A small study involving 14 women with low sex drive after the menopause found that, when they took 3.5g Maca powder for 6 weeks, they reported significant improvements in anxiety, depression and sex drive compared with when they took inactive placebo.
Royal jelly for menopause
Royal jelly is a rich, creamy substance fed to bee larvae to promote the growth of those destined to become queens. Royal jelly is a concentrated source of proteins, vitamins, sterols and growth factors, as well as three unique fatty acids which have an oestrogen-like action. These can interact with human oestrogen receptors to stimulate increased production of new bone in bone cell cultures.
Royal jelly is traditionally used to relieve menopausal hot flushes and night sweats. Royal jelly can also improve symptoms due to thinning of vaginal tissues, which can lead to soreness and painful sex, as well as urinary discomfort and frequency.
When 90 women attending a gynaecology clinic were diagnosed with postmenopausal vaginal thinning, a third were treated with Royal jelly vaginal cream (15% strength), a third with vaginal oestrogen cream, and a third with a non-hormonal lubricant.
After three months, those who used the vaginal Royal jelly cream experienced significantly greater improvement than those using either the vaginal oestrogen cream or the lubricant.
As well as improved quality of life, examination showed greater clinical improvements in the quality of the vaginal lining cells than in those receiving the prescribed oestrogen cream. The researchers concluded that treatment with vaginal Royal jelly cream was significantly more effective than standard medical treatments (conjugated oestrogen cream, or lubricants) in improving quality of life, sexual and urinary problems in postmenopausal women.
To preserve the active ingredients, Royal Jelly is either blended with honey, or freeze-dried and powdered for use in capsules.
Sea buckthorn oil for menopause
Sea buckthorn fruit oil is one of the few rich sources of omega-7 fatty acids in the form of palmitoleic acid, a monounsaturated fat that improves the quality of natural secretions to alleviate dryness of mucous membranes. It is used to overcome dry eyes, dry skin and vaginal dryness.
A three-month study involving 116 postmenopausal women with troublesome symptoms of vaginal dryness, itching or burning, compared the effects of sea buckthorn oil capsules, at a dose of 3 grams per day, against placebo.
Significant improvements in symptoms occurred in the women taking sea buckthorn oil, who were also three times more likely to show significant improvements in the appearance of vaginal lining cells, as assessed by a gynaecologist, than those taking placebo.
St John’s wort for menopause
St John’s Wort is sometimes referred to as nature’s ‘sunshine’ herb for its beneficial effects in lifting a low mood. St John’s Wort has vibrant yellow petals which, when held up to the light, reveal numerous pinpoint red glands that contain a fluorescent red dye. This dye contains numerous substances with a natural, antidepressant action, including hypericin and hyperforin.
St John’s wort is believed to work by helping to prolong the action of a wide range of neurotransmitters in the brain, including serotonin, noradrenaline, dopamine, GABA and L-glutamate.
St John’s Wort helps to lift a low mood that can occur around the time of menopause. Data from 27 studies, involving over 3,120 people with depression found that St John’s wort extracts were as effective as prescribed antidepressant drugs (SSRIs) with no differences between treatment in clinical response, remission, and reduction in depression scores. Treatment with St John’s wort produced significantly fewer side effects, however, and the researchers concluded that St John’s wort extract was a safer treatment for mild-to-moderate depression.
St John’s wort also helps to overcome low sex drive and physical exhaustion in menopausal women. In one study, 60% of menopausal women with low libido became interested in sex again, and even initiated sex with their partner. Eighty-two per cent also experienced reduced irritability, anxiety, low mood, hot flushes, sweating and disturbed sleep. They also reported increased self-esteem, as well as a marked increase in self-confidence and self-respect.
NB Before taking herbal supplements, check with a pharmacist if you are taking other herbal or prescribed medications to rule out any interactions.
Vitamins and minerals for menopause
Most vitamins and minerals are involved in the production of sex hormones, or the way that cells to respond to them properly. Lack of vitamins and minerals can worsen menopausal symptoms and, in the long-term can increase your risk of future health problems, including brittle bones. Vitamin and mineral deficiencies can also contribute to low sex drive.
Calcium supplements help to improve bone mineral density and can reduce the risk of bone fractures.
Vitamin D is needed for calcium absorption and is also involved in immunity, cardiovascular, brain and joint health.
Folic acid, vitamin B6 and vitamin B12 help to maintain a healthy heart and circulation and may reduce the risk of developing dementia. B vitamins are also involved in energy production and overcoming fatigue.
Magnesium is needed for over 300 metabolic enzymes to work properly, and is involved in hormone balance, muscle contraction, nerve conduction and blood vessel dilation. It helps to improve sleep, constipation and may reduce restless leg syndrome which is common at this time of life.
Zinc is needed for hormone production and responses and deficiency can worsen menopausal symptoms.
Several multivitamin blends are designed for women experiencing menopause, and often contain additional beneficial ingredients such as soy isoflavones.
Evening primrose oil for menopause
Whatever else you take, I recommend that you also use evening primrose oil supplements. These supply essential fatty acids that are involved in making sex hormones, reducing inflammation and improving calcium metabolism so that it is better deposited in bones.
As a bonus, evening primrose oil improves skin quality, reduces skin dryness and itching, and making a noticeable difference to skin smoothness and lustre. It may even reduce the appearance of skin wrinkles.
In a trial involving women in their forties, those taking 3g evening primrose oil experienced a twenty per cent improvement in skin moisture, smoothness, elasticity and firmness within three months. Evening primrose oil was also found to significantly reduce the frequency, severity and duration of menopausal hot flashes compared with inactive placebo.
|My book, Menopause Diet: Eat To Beat Hot Flashes is available on Amazon.co.uk and Amazon.com.|
Which supplements have you found most helpful for menopause-related symptoms? Please share your experiences below.