Can Supplements Ease Menopause Symptoms?

An HT alternative?

Hot flashes, insomnia, mood swings, and the other symptoms of menopause can be unpleasant and difficult to manage. Hormone therapy (HT) can help in the short term, but long-term HT can increase a woman's risk of breast cancer, stroke, and heart attacks.

Instead, many women opt for dietary supplements. But do they work? Supplements are rarely tested thoroughly, and their manufacturers make health claims that aren't always backed up by science.

In the following article, we use the latest research to break down the most commonly used supplements for menopause.

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1. Black cohosh

What it is: The extract of the root of the black cohosh plant.

The evidence: Despite the plant's widespread use, a 2008 review concluded that there is insufficient evidence for black cohosh's effectiveness in treating menopausal symptoms. Another review published in 2010 found that unspecified black cohosh "preparations" decreased hot flash symptoms by 26 percent.

The bottom line: More evidence is needed to confirm the effects of black cohosh, both positive and negative. It has been linked to liver damage and other side effects, so as with all supplements, don't take it without consulting a physician.

• Dong quai

What it is: An herb, also known as Chinese angelica, that is said to mimic estrogen in the body.

The evidence: The use of dong quai for menopause symptoms has not been studied extensively, and the results have largely been negative. A controlled trial conducted in 1997 found that dong quai was no better than placebo in treating symptoms such as hot flashes; more recently, a 2008 study in Hong Kong found no significant difference from a placebo in the treatment of menopausal symptoms.

The bottom line: Claims that dong quai acts like estrogen in the body are not supported by research.

• Evening primrose oil

What it is: Oil extracted from the seeds of a yellow-flowered plant. An omega-6 essential fatty acid (gamma-linolenic acid) is the active ingredient.

The evidence: According to a 2009 review in American Family Physician, only one placebo-controlled trial of evening primrose oil in menopausal women has been conducted. In the study, the women took eight capsules of the oil daily for six months, but the capsules were no better than placebo at treating menopausal flushing.

The bottom line: Evidence to support the use of evening primrose oil for menopause is still lacking.

• Gingko

What it is: The extract of the leaves of the ginkgo plant (also known as the maidenhair tree).

The evidence: Ginkgo has traditionally been used to improve memory, concentration, and mood, all of which can dip during menopause. However, two 2009 studies showed that ginkgo had no effect on cognitive function. As for mood, a 2007 review found no evidence of ginkgo's effectiveness for that purpose in postmenopausal women.

The bottom line: Despite the popularity of ginkgo, little efficacy has been demonstrated for memory or mood enhancement.

• Ginseng

What it is: An Asian herb that has been used in traditional medicine for centuries.

The evidence: A 1999 study found that 200 milligrams of ginseng a day boosted mood and general well-being in women undergoing menopause, while another study, conducted earlier this year, concluded that Korean red ginseng was successful in improving sexual arousal in menopausal women.

Research suggests, however, that ginseng can contribute to heart problems in some women.

The bottom line: Ginseng has shown potential for treating menopausal symptoms, but it carries some potentially serious side effects.

• Hops

What it is: The flower clusters of the Humulus lupulus plant.

The evidence: Only one controlled trial has been conducted on the potential effects of 8-PN, an estrogenic compound found in hops, and it concluded that the compound "exerted favorable effects" on hot flashes and other menopausal symptoms. Other research suggests that another hops derivative, xanthohumol, may have anti-inflammatory properties.

The bottom line: The research on hops and menopause is very limited, although some evidence suggests the supplement may have health benefits.

• Red clover

What it is: An extract of a legume that contains substances (isoflavones) that mimic estrogen. It is found in products such as Promensil.

The evidence: A 2006 review in the Journal of the American Medical Association looked at six trials examining Promensil and hot flash frequency (two trials were of "poor" quality). The supplement outperformed placebo in just one. However, a 2009 study did suggest that it can help lower cholesterol in postmenopausal women.

The bottom line: The research on the efficacy of red clover isoflavones is limited and inconclusive.

• Soy

What it is: A protein found in foods such as tofu, edamame, and soy milk. Contains isoflavones, which are believed to have estrogen-like effects in the body.

The evidence: A 2009 review of randomized controlled trials said there is "no conclusive evidence" for the benefits of soy isoflavones on the frequency and severity of hot flashes. It also suggested that some of the studies might be unreliable due to quality concerns.

The bottom line: Taking soy isoflavone supplements (or altering your diet to include more soy) isn't likely to relieve your menopause symptoms.

• St. John's wort

What it is: A yellow-flowered plant, Hypericum perforatum.

The evidence: St. John's wort can help treat mild depression, but its effect on other symptoms of menopause--such as sleep problems--isn't proven. One three-month study did show that compared to a placebo group, perimenopausal women taking St. John's wort experienced a better quality of life as well as fewer sleep problems.

The bottom line: Although St. John's wort is a proven remedy in mild depression, more research is needed to confirm its effectiveness in treating other menopause symptoms.

• Vitamin E

What it is: A vitamin found naturally in nuts, vegetable oils, and green leafy vegetables.

The evidence: In a 2009 study, vitamin E outperformed placebo in reducing hot flashes among breast cancer patients. However, the study said the reduction had a marginal clinical impact. Another clinical trial that studied the efficacy of vitamin E for hot flashes showed that women taking it experienced one less hot flash per day than those on a placebo.

The bottom line: Study results have been encouraging, but vitamin E seems to have a relatively minor effect on hot flashes.

• Wild Yam

What it is: The extract of pale-brown vine native to North America.

The evidence: Often labeled a natural source of estrogen, little scientific evidence exists to support efficacy for treating menopausal symptoms. A 2001 study suggested that short-term topical use was free from side effects but provided little relief from menopausal flushing or night sweats.

The bottom line: There is no evidence to support the use of wild yam extract to treat menopausal symptoms.

Comments

[Alva Solomon]

12:57 PM on 08/19/2010

I am 53 and had hot flashes and night sweats for about 2 years. My menopause symptoms were pretty bad because they lasted about 10 to 15 minutes each. I found a product called femflax on the internet that is supposed to be all natural. Anyway, my hot flashes are just about gone and I can sleep through the night. Once in a while a get a warm flush but nothing like before.

[Rowan G]

05:39 PM on 07/24/2010

I've been pretty happy with Estrofil - my new menopause supplement that doesn't contain any of those ingredients - I chose to go with one based on Traditional Chinese Medicine (since they have been getting it right for centuries and western medicine is seriously lagging behind). It's readily available in the U.S. and contains only plant-based ingredients - rehmannia, Chinese dodder, Chinese Yam, etc. Plus it helps since I became a vegan and lost some weight by walking at least a couple times a week - being overweight is the worst heading into menopause.

[ctblue]

08:21 AM on 07/24/2010

I recently saw my doctor to ask about getting on HRT because my symptoms have become quite severe. I walked out of there vowing never to go back. She said that many of her patients are opting to ride out the storm, so to speak and that I should just see a psychiatrist and get a prescription for anti-depressants. I was thinking more along the line of bio-identicals but I guess that's above her pay grade.

[jacquelinenh]

08:01 AM on 07/26/2010

@ctblue: Here's a good article on getting off HRT -- whether or not you decide to switch to bHRT: http://www.womentowomen.com/bioidentical-hrt/gettingoffhrt.aspx

[Nancy Walker]

06:52 AM on 07/24/2010

The only way that I would listen to a doctor's advice on this subject is if she were a menopausal or post-menopausal woman. I'm sorry but I want my caretaker to have personal experience with the miseries I'm dealing with. And even then, putting faith in Big Pharma just seems to be a mistake. Of COURSE there are no convincing studies re natural remedies put forth by Pfizer et al. Approval would cut into their profits. Natural remedies are cheaper, just as effective in the long run and have fewer side effects. But no matter what you take, you still have to take care of yourself. Many menopausal women don't want to hear this but PHYSICAL ACTIVITY IS KEY TO FEELING GOOD. Get off the couch, turn off the TV and get out the door. There is no downside to taking a brisk walk for 30 minutes and your body will respond positively to that exercise because it's what it wants. My own goal is to remain off prescription drugs for as long as possible and avoid the pitfalls of my elderly parents' lives. They channel so much of their income into their meds, they take fistfuls of prescription pills around the clock and they struggle with side effects that seem at least as bad as the symptoms they are trying to address. I do not want to live my life that way.

[amtheone]

10:00 PM on 07/24/2010

Nancy, I agree with you about taking doctors advice who are either going through or has gone through menapause. I called a doctor one time and asked how old the doctor was and the receptionist laughed at me and said that was non of my business. Needlesstosay, I did not choose her. The doctor I go to now has experienced some of the same things I have and she is a great advocate of exercise, in which I do everyday and I feel sooo much better.
I occassionally have hot flashes at night and sometimes cry but I feel alot better then I did before; I am not not taking drugs and I am in control of my body and I look good too:)

[singermuse]

08:07 PM on 07/23/2010

Though the evidence may seem only anecdotal, Black Cohosh is used extensively in Europe with good results. I must assume it is the pharmaceutical industry in this country that has something to lose if more women turn to a more natural means to relieve their symptoms. Black Cohosh (which is a natural herb that cannot be patented) will not increase the risk of cancer, and at worse may only cause a slight loosening of the bowels. I would much prefer that to dieing of breast or other reproductive cancers. I have personally used Black Cohosh and other herbs/supplements with good results. I wouldn't touch HRT (especially premarin from mare's urine) with a ten foot pole!

[jacquelinenh]

08:03 AM on 07/26/2010

When studies focus on the effectiveness of traditional herbal remedies, I always look to see whether the study included a holistic approach to testing (changes to diet and exercise in addition to taking the supplement) or if it was just the standard "let's give this person a pill and see what happens" type of study. Black cohosh and other herbal treatments have been used for ages -- and across so many cultures -- because they do work for a majority of women. If not, the practical nature of traditional medicine would have weeded out these remedies long ago.

Practitioners of holistic and integrated medicine know that to use herbal remedies effectively, it's necessary to address diet, exercise, and other lifestyle factors. Our modern diet -- high sugar, low vegetable intake, and bad fats -- may work with the latest drug company creation, but to access the healing powers of herbs, we may need to eat more wholesome foods and move our bodies more to support the action of the herbs. A great example of this approach is the Women to Women program, where herbal supplements are used in concert with diet and exercise to address menopause symptoms. (The Women to Women clinic was cofounded by Dr. Northrup). They have a really wonderful article on how exactly herbs -- phytotherapy -- works in the body. If you are considering the "natural route" to address menopause and perimenopause symptoms, it's worth a read: http://www.womentowomen.com/menopause/phytotherapy.aspx

[Debbie338]

05:57 PM on 07/23/2010

The most effective tool against menopause is staying physically fit. Proven to relieve physical and emotional symptoms and make the transition very smooth. Unfortunately, it's the thing most women don't want to do. :-(

[pep1]

04:37 PM on 07/23/2010

I tried all this herbal nonsense and found it useless and expensive.

[katmeyster]

04:24 PM on 07/23/2010

The only menopausal symptoms I'm having is irritation and crankiness -- sometimes anything will drive me up a wall. I've had great success with wild yam natural progesterone to calm me down and relieve this particular symptom. I would love it if these natural resources were studied more (I'm not sure one study is always helpful), but in the meantime we have to rely on each other and try things out. Hey, if it works (and doesn't cause too much harm), then it works -- who cares why.

[burgar]

04:18 PM on 07/23/2010

Suplements can absolutely help with menopause. Of course, so can bioidentical hormones because they mimic what the body already produces naturally. The best time to start supplementing with both bioidenticals and herbals is during perimenopause. The trick is finding a doctor to supervise who knows what he/she is doing. If you get lucky in that department you can expect an easy transition in midlife.

[Holyhormones]

03:53 PM on 07/23/2010

I use bioidentical hormones ( I wouldn't take that synthetic crap on a bet) and it eliminated my hot flashes in less than three days. Also cured my restless leg syndrome, seasonal allergies, and acid reflux in less than a week. I'm off seven medications, and feel better than I have at any time in my adult life. Perhaps the supplements work for some people, but I needed a more aggressive protocol.

[StThomas]

02:15 PM on 07/23/2010

An article in Huffpo, talking about research and its application to health? No shilling of expensive herbs/ supplements which the poster can sell?
Keep up the good work!

[SchrodingersKatz]

01:14 PM on 07/23/2010

Black cumin oil. Rub it on your body, especially the feminine parts. You will notice a difference.

[mtwa]

11:39 AM on 07/23/2010

My oh my. Just sitting back and waiting for all the medical quacks to attack using herbs, as they always do. You know, all their medical training gives them this incredible knowledge but in truth they have no training when it comes to using herbs, supplements, or even foods!!!

[LiveinATL]

11:17 AM on 07/23/2010

I agree with bmermaid. I was stopped taking black cohosh and the hot flashes returned. Now I take it on a regular basis. I don't agree with some of the outcomes of these studies. I've also taken soy and found it very helpful in controlling the hot flashes. The bottom line is the medical community WANTS you to be dependent on chemicals. They make more money. There should be more studies from the holistic health community than medical community.

[thecoffeegod]

10:19 AM on 07/23/2010

I believe in herbs but I have yet to find anything that cures hot flashes except a walk in freezer or a fan on high. At this point in my life, I'm not loving menopause.