Using herbs to treat menopause symptoms

Bowl of herbs with natural medicine sign

If you’re experiencing menopausal symptoms, then a trip to your herbalist could help if you’d like to take a natural approach to managing your menopause.

Herbs with natural medicine sign

Herbalists treat the body as a whole and each person as an individual. So it’s tricky to give generic advice. But there are some herbs and combinations which are commonly used to great effect.

What type of herbs are used?

Herbalists may use a combination of oestrogenic herbs such as red clover, wild yam, sage and hops alongside progesterone-modifying herbs such as black cohosh, Vitex agnus-castus and, less commonly, the endangered false unicorn root. The aim of treatment is to encourage the body to balance its hormones gently and naturally.

The plant oestrogens (known as phytoestrogens) in sage, wild yam and red clover help to bolster levels of falling oestrodiol in your body, reducing symptoms of flushing, heavy bleeding and breast pain. There are two theories of how this works. One is that they make the body think there is more oestrogen by binding to oestrogen receptors. The other is that by binding to oestrogen receptors the phytoestrogens prevent oestrogens from being reabsorbed and increase the amount of circulating oestrogen.

Red clover

Increases the amount of a hormone called Sex Hormone Binding Globulin (SHBG), which helps the body to dispose of old oestrogens. This means that oestrogen circulating is a good-quality new hormone and the body isn’t overpowered by old hormones. Clover is particularly useful in the early part of menopause.

Because high oestrogen and low progesterone can often lead to depression, confusion, heavier bleeding and pelvic pain, herbalists work to improve the relative levels of these hormones as both reduce toward the end of ovulation.

Peony root

Acts on the balance between the pituitary gland, the hypothalamus and the ovaries and helps balance the whole range of female hormones. Peony is also used for uterine cramps as it reduces overactivity so can help with menstrual issues.

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St John’s Wort

This is a herb used mainly to help with nervous states such as depression and anxiety. It increases the speed the liver clears out toxins. It’s important not to use it alongside the oral contraceptive pill or other important medicines such as antidepressants or immune-suppressing drugs, as it may stop them working properly. It also shouldn’t be used alongside SSRI-type antidepressants, because it could increase the amount of circulating serotonin to dangerous levels. St John’s Wort can be very useful in improving mood during perimenopause and menopause.

Black cohosh

This one of the best-known herbs for treating perimenopausal symptoms. It has an anti-spasmodic, anti- inflammatory action which is helpful for relieving muscle pain and painful cramping spasms during your period. It can help lift your mood, and is also thought to have a positive effect on bone density, vaginal dryness and hot flushes.

There were some concerns about the use of black cohosh after some reports of liver failure in the United States. Careful assessment of the cases reported showed that the people who suffered were self medicating. Some were buying pre-blended teas from unreliable sellers and others were picking and preparing their own. There was no accurate data as to how much was taken or for how long and in each case there were other health problems and other doctor-prescribed drugs being taken. People treated by a qualified medical herbalist have reported no health problems.

If you have any history of liver disease, hepatitis or unstable liver enzyme tests then it is best to avoid this herb unless under the care of a qualified herbalist.

Red raspberry leaf

Raspberry leaf is found in many gardens and you’ll find it in most health food stores. It helps improve the tone of the uterus and can relieve cramping and painful periods associated with menopause.

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These are particularly useful in treating sleep disturbed by night sweats or hot flushes. The oestrogenic compounds can help reduce incidences by more than half.


This herb is useful for people who are exhausted and struggle to sleep. It is considered to have mild aphrodisiac effects so can help boost a lowered libido, but also helps nurture and nourish women through menopause. Ashwaganda may raise thyroid hormone levels so it’s an excellent choice for women with low thyroid but should be avoided by anyone who has Grave’s disease or Hashimoto’s thyroiditis, where thyroid levels can swing wildly.


This herb is associated with wound healing and is also traditionally used to improve circulation to the pelvic organs and to improve uterine tone. Over time it can help reduce cramps and normalise menstrual bleeding. Marigold can also be used in the form of a pessary made with plant butters to help improve the health of the lining of the vagina, reducing dryness and increasing comfort during lovemaking. Oil-based lubricants should not be used with latex condoms if they are needed for personal protection or to prevent pregnancy as they can cause them to weaken and split.

Vitex agnus-castus

Often called plain agnus castus or chaste tree berry has a long tradition of helping women manage difficult periods. Its anti-inflammatory action can reduce the pain and cramping associated with periods during perimenopause. Research carried out in Germany has shown that Vitex can help correct irregularities like absent periods, breast pain and spotting.

The herb contains constituents that are very like dopamine so it can help improve mood and relieve pain. It has also been shown to correct imbalances in prolactin, which can affect fertility.

Motherwort, hops and black cohosh can be an effective combination for controlling menopausal night sweats – ask your herbalist whether they think it will help you.

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Common sense advice when choosing your supplements

The NICE guidelines say that doctors must explain to women that the quality, purity and constituents of products may be unknown.

When choosing a supplement it is a good idea to consult a nutritional therapist or herbalist. They will recommend food-state vitamins (those absorbed in the same way as when you’re eating them in food), minerals and herbal supplements that are both safe and worth taking.

Many supplements are not easily digested and you can end up spending a lot of money on products that basically end up in your urine or poo.

It’s best not to buy supplements online unless you know the brands and they are manufactured in the European Union. If herbal supplements are made in the EU they must have a Traditional Herbal Remedies (THR) License under Traditional Herbal Medicinal Products Directive (THMPD) regulations. This guarantees the manufacturer has acquired a license which says they reach certain standards of manufacturing practice and that their products are tested to ensure they aren’t adulterated. This is unlikely to change in the foreseeable future, regardless of changes within the EU.

For herbal products, a THR license generally indicates quality of manufacture but doesn’t necessarily guarantee that the product is right for you. In order to be sure of that you have the right herbs for your health you should consult a medical herbalist.

Products bought online from non-European sources are not supposed to be sold in the EU, but it’s virtually impossible to police the ban. The reason non-European overseas supplements and herbal products are not allowed here is because a small but significant number have been shown to contain adulterants, incorrect species of plants and, in some cases, pharmaceutical drugs such as steroids or proton pump inhibitors (indigestion medicines).

If in doubt, here’s a website to find a qualified herbalists in your area:

About Katherine Bellchambers-Wilson

Passionate about looking good and feeling great, I’m a BSc qualified herbalist who won’t make you give up your chocolate, coffee or alcohol (unless you have a stomach ulcer and then only for a while). I believe a little of what you fancy does you good and that all work and no play just spoils a perfectly good Sunday. Herbal medicine harnesses the power of plants to help nudge your body into balance so you can get on with doing what’s important. BSc MNIMH