Menopause & perimenopause

Phytotherapy — the key to hormonal balance?

by Marcelle Pick, OB/GYN NP

Believe me, I understand how disruptive menopause symptoms can be to a woman’s life — I’ve been there! Hot flashes, night sweats, weight gain, irritability, irregular periods, and worse — feeling exhausted most of the time. The good news is that when a woman comes to see me about menopause symptoms, I know I can help her.

Over the years, I’ve become fascinated with the way plants work to heal our bodies. Phytotherapy is the use of medicinal plants to heal and restore balance. And even though phytotherapy is an age-old tradition, new research is coming out all the time about how plant molecules act to naturally balance hormones.

Yet many are still unsure about the safety of herbs, or afraid they just won’t work. They think that a “real” medicine must be studied in a lab, regulated by the FDA, and prescribed by a practitioner in order to be safe and effective. But the majority of the world around us relies on both botanical medicine and a plant-based diet for survival — and the combination has worked for ages!

Evidence for phytotherapy is strong

Naturopathic physician Tori Hudson reminds us that using herbs for menopause isn’t a new concept in her article on Menopause Botanicals.

As Dr. Hudson explains, “Many herbs have been used traditionally by herbalists and women for decades, and in some cases centuries, to address menopausal symptoms. Although many of the traditionally used plants lack clinical studies for this purpose, the empirical evidence and tradition [are] strong.”

Let’s take a closer look at what we’re learning about phytotherapy, and how it really is one of the best ways to gently and effectively restore your hormonal balance.

Phytotherapy: at home with your hormones

Our endocrine system is the command center for our hormones. It consists of many small organs and tissues that secrete hormones throughout the body. Hormones are messengers that relay instructions from one place to another in the body.

Phytocrines are what we call biologically active plant molecules. Here are some of the features they share with our own hormones:

• Bind to hormone receptors. Plant molecules can weakly or temporarily bind to hormone receptors, promoting or blocking actions in ways similar to the body’s own hormones. (Phytoestrogens are probably best-known for this — see box at right.)
• Encourage hormone generation. Plants can gently encourage the body’s tissues to generate more of their own native hormones.
• Mimic hormone function. Plants can mimic hormone functions and can cause the same physiological responses of the hormones.

Phytoestrogens — a misunderstood term

Some hesitate to use herbs containing phytoestrogens because they’re worried they’ll increase estrogen in the body. But phytoestrogens like the isoflavones in soy and red clover are not estrogen, and they do not behave the same way as our body’s own estrogens or estrogen replacement drugs (ERT).

As you can see from the diagram, phytoestrogens resemble human estrogen, but only weakly bind to a particular type of estrogen receptor. This works to block the potentially damaging effects of excess estrogen, or quiets a woman’s need for estrogen when her estrogen levels are low.

Phytoestrogens don’t add to the amount of estrogen in your body. And there are no studies confirming that phytoestrogens increase the risk for cancer. In fact, new research suggests phytoestrogens commonly used in nutritional and botanical medicine may protect women from breast and other cancers, while benefiting many other aspects of health.

References

Making herbs work to relieve your menopause symptoms

From time to time, I hear that herbs don’t work for menopause symptoms. While this simply isn’t true, I think this disconnect happens because many patients and practitioners measure herbs against pharmaceutical drugs. Pharmaceuticals can overpower your body’s natural responses — I often refer to this as the “sledgehammer effect” — whereas the healing qualities of plants are usually gentler. That’s why herbs can sometimes take a little more time and adjustment to resolve menopause symptoms.

Here are some guidelines to consider with phytotherapy:

Choose a diverse product. The truth is, a one-size-fits-all cure for menopause symptoms simply doesn’t exist. I often recommend a selection of herbs, because diversity offers the benefits of several plants in small doses, instead of delivering one big hit. Science also suggests that combination formulations, like the one we offer in our Personal Program, work in an adaptogenic way (meaning they adapt to what your body needs) to restore hormonal balance within a range of variable circumstances.

Have patience. We can’t always expect instant results from phytotherapy because herbs work at the source of the imbalance, “upstream” of where most drugs take aim. People who are used to medicine taking immediate effect may be tempted to toss the herbs and look for something else if the effects don’t kick in right away. But with a little patience and the right combination of herbs, your body can even repair hormonal pathways that have been off-balance for many years.

Plants to explore for menopause

Since opening our doors at Women to Women, we have been drawing on the healing power of herbs to help women with hormonal imbalance. Especially when it’s used alongside a healthy lifestyle and sound nutrition, phytotherapy can safely and gently reverse hormonal imbalance and guide women to regain their equilibrium in menopause. With its adaptogenic effects, phytotherapy can help normalize, strengthen, and protect your system from many stressful events in menopause and further down the road.

Here are some of the plant species most widely used for menopausal symptoms. (Images courtesy of Natural Standard, an international research collaboration on integrative medicine.)

	Black cohosh (Actaea racemosa) a plant native to Eastern North America, has been used for generations by women the world over to help with hormonal balance. It is thought to act as a functional mimetic or imitator, primarily by binding to opioid receptors in the brain to affect tissues in the body. (To learn more about this herb, see our page on black cohosh for menopause symptoms.)
	Red clover (Trifolium pratense) is rich in phytoestrogens including lignans, coumestans, and isoflavones. As I described above, isoflavones can weakly bind to estrogen receptors in the body. This makes red clover a helpful herb for menopausal symptoms. (To learn more, see our page on red clover for menopause symptoms.)
	Chastetree (Vitex agnus-castus) contains molecules that may affect our neurotransmitters, particularly dopamine, which acts in the brain and other parts of the body. Recent studies show that properties of this herb may mimic the soothing actions of progesterone.
	Kudzu (Pueraria lobata) is a member of the pea family and is native to Asia. Much like red clover, it contains phytochemicals that function in a protective fashion. These include five major isoflavanoids that can bind weakly to estrogen receptors, quieting the body’s need for estrogen during times of hormonal imbalance.
	Passionflower (Passiflora incarnata) has strong Native American roots and contains natural monamine oxidase inhibitors (MAOI’s), which are known to have antidepressant and anti-anxiety properties.
	Ashwagandha (Withania somnifera) is an Ayurvedic herb with aphrodisiac and mood-stabilizing properties. Recent studies suggest it acts in an adaptogenic fashion when androgen levels are low, activating the hypothalamic-pituitary-gonadal axis to favor androgen balance. (For more information about Ayurvedic medicine, read our page on Ayurveda and menopause.)
	Wild yam The type of yam most used by women for both menopause and menstrual-related symptoms (Dioscorea villosa) is native to North America. The underlying mechanisms for the effects of wild yam are not well-defined, but one theory is that it may act as either a precursor to, or a functional mimetic or imitator of sex hormones.
	Soy (Glycine max), like red clover and kudzu, is a legume that contains several phytoestrogens. Soy has been studied extensively and found to decrease frequency and severity of menopausal discomforts, particularly vaginal dryness, hot flashes and night sweats. (To learn more, see our article on soy for menopausal symptoms.)
	Maca (Lepidium meyenii; Lepidium peruvianum ‘Chacón’). Cultivated at high altitudes in the Peruvian Central Andes, this traditional herb from the broccoli family has been shown in clinical trials to have favorable effects on energy and mood, along with improving sexual desire. Menopausal women taking maca report significant reduction in symptoms of anxiety, depression, and sexual dysfunction.
	Dong quai (Angelica sinensis). Sometimes referred to as “female ginseng” because of its mildly warming properties, dong quai has been used to heal a range of women’s gynecological ailments for thousands of years. With origins in traditional Chinese, Japanese, and Korean medicine, this member of the celery family is now in widespread use across the globe.

Herbs help us “listen” to our body’s messages

When my family and I visited Belize a few years ago, we toured the low-lying tropical rainforest for which the country is famous. What I found so amazing was that our guide knew which trees and plants cured certain disorders by watching the howler monkeys and what they ate. He would say, “That one might have diarrhea, that one indigestion, this one trouble sleeping.”

We’ve shared this intuitive wisdom about medicinal plants with our primate cousins since the dawn of ages, but only recently has modern medicine begun to reawaken to its power. You can start getting relief for your menopause symptoms today with the natural wisdom of phytotherapy.

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