As menopause progresses, women’s estrogen levels fall and various discomforts can arise: 85 percent of menopausal women experience the infamous hot flashes, but there are many other symptoms, including breast tenderness, dry skin, anxiety, depression, incontinence, insomnia, and night sweats. Hot flashes can occur without warning, but it’s thought that emotional stress, exercise, alcohol, and hot, spicy foods can help to bring them on.

The Downside of Hormone Replacement Therapy

Hormone replacement therapy with synthetic hormones was once considered the gold standard for medical treatment of menopausal discomforts. Now we know that using synthetic hormones for an extended period of time (5 years or more) increases your chances of developing breast and ovarian cancers, heart attacks, strokes, blood clots, lung tumors, Alzheimer’s, and other degenerative diseases.

Andrew Weil, MD, a proponent of herbs and natural medicine, believes that women should avoid estrogen replacement altogether if they have a family history of any of the diseases that have been linked to HRT, but if you decide to go for it, he says, ‘Use the lowest dose possible (1.25 mg/day maximum) and be sure to take progesterone for at least part of the monthly cycle.’

Herbal Alternatives to Hormone Replacement Therapy

Those determined to take a pass on hormones have herbal and nutritional options. Hot flashes and other symptoms of menopause are rare in vegetarian cultures, especially in countries where women consume a lot of beans, like black beans (Cuba), chili beans (Mexico), mung beans (Japan), and fava beans (Lebanon). Beans have mild estrogenic activity because they contain phytoestrogens, compounds that are similar to human estrogen but weaker. Phytoestrogens compete with a woman’s own estrogens, lowering the total human estrogen burden. Foods include isoflavones, lignans, phytosterols, and saponins. There is no evidence that phytoestrogens naturally occurring in food cause harm, and some laboratory studies show that phytoestrogens can prevent tumors in breast tissue. In addition to eating more beans and vegetables, some specific herbs are helpful in relieving menopause symptoms.

Black Cohosh (Cimicifuga racemosa )

Prized by Native Americans, who use it for a variety of conditions from rheumatism to diseases of women, this herb enjoys a long history of relieving menopause discomforts, especially hot flashes. It has been shown to increase estrogen activity in women, to reduce the intensity and frequency of hot flashes, and to relieve many other symptoms of menopause, including night sweats, depression, anxiety, lowered libido, and vaginal dryness.

Black cohosh is the most well-documented, natural alternative to hormone therapy, and the best-selling women’s herbal product in Germany. It was popular among American women 150 years ago, as a main ingredient in America’s first mass-marketed patent medicine for women, Lydia Pinkham’s best-selling, 19th century remedy, “Vegetable Compound.”

In addition, black cohosh is a cardiotonic herb that improves blood pressure and circulation, causes dilation of the blood vessels and thins the blood. It also increases energy, calms the nerves, treats incontinence, and alleviates water retention and breast tenderness.

Other Herbal Menopause Remedies

• Herbs with estrogenic effects are: dong quai, burdock root, blue cohosh, Chinese ox knee root, Chinese three-edge root, sage, alfalfa concentrate, and motherwort. All of these herbs are good for hot flashes, with blue cohosh said to be the best.
• Chasteberry, a tonic, normalizing herb, boosts the body’s own progesterone levels, and is said to mitigate many of the emotional and physical effects of menopause as well as PMS.
• Most successful herbs for increasing estrogenic activity, according to Dr. Michael Murray, author and professor of natural and herbal medicine at Bastyr Univeristy in Seattle, are: dong quai, licorice root, chasteberry, and black cohosh;
• Essential fatty acids (EFAs) are important additions to a natural medicine regimen in midlife, as they help maintain prostaglandin production, balance brain chemistry, and create healthy cell membranes. Good sources are: flaxseed, borage, evening primrose, and black current oil.
• Bioflavonoid-rich herbs have remarkable healing properties, including anti-inflammatory, anti-hepatotoxic, anti-tumor, antimicrobial, antiviral, antioxidant, and analgesic effects, and strengthening effects on the cardiovascular system. The richest source of bioflavonoids is the inner skin of citrus fruits, but they also are found in brightly colored (red, blue, and purple) fruits and vegetables, where they are found bound together with vitamin C, needed for absorption.

There are many other herbs you can use for support in menopause and after, including: buckwheat greens, elder (berries and flowers), hawthorn, horsetail, knotweeds, roses, shepherd’s purse, sea buckthorn, toadflax, and white dead nettle.

For women concerned about osteoporosis, build these two herbs into your daily regimen:

• Seaweed contains generous amounts of all the minerals needed to maintain strong bones. Kelp is an especially rich source. Seaweeds also both restore and increase cardiac efficiency, and lower blood pressure and cholesterol levels. They are a superior source of all the most critical nutrients needed by the endocrine, circulatory, and immune systems.
• Stinging nettle has the ability to heal, restore, and nourish the adrenal glands and kidneys, create strong, flexible bones, stabilize blood sugar, reduce fatigue and exhaustion, improve stamina, nourish the endocrine glands, normalize weight, and promote supple skin and healthy hair.

Get to know these herbs over time. Add them to your daily regimen one at a time so you can judge their benefits and your comfort with them. For advice on how to take them, and what forms to collect or buy, talk to a local naturopath or herbalist. For more about herbs see Herbal Remedies.

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