Herbs and Menopause

Women by the millions are headed for a change-THE CHANGE, rather-that not-so-magical moment of a woman's life when her ovaries decide to call it quits. Doctors call it "menopause"; women have other names for the dreaded phenomenon they experience, usually between the ages of 45 and 55.

Traditional western medicine has been restricted in the ways it could support women who come to their doctor with classic menopausal complaints-hot flashes, night sweats, mood swings and memory or concentration difficulties. For these women, the options have been limited to two: 1) hormone replacement therapy with medications containing estrogen and progesterone, the hormones the ovaries quit making at the time of menopause, or 2) live with it.

Today, however, women are demanding more choices-ways they can be more comfortable without having to rely on synthetic hormone therapy. Setting aside traditional medical therapy, natural remedies have become increasingly popular for those women who want to make menopause a smooth but natural transition. In a three-part series of articles, I will discuss the various herbal remedies for menopause and help you make an informed decision about what's best for you.

One of the more popular herbs for menopausal symptoms is black cohosh root, harvested from a shrub-like plant native to parts of Eastern North America. It has been used widely in Europe as a treatment for menopausal hot flashes and is gaining in popularity in the USA. The way black cohosh works to control hot flashes is interesting and worth the discussion. Unfortunately it DOES involve a mostly painless mini-lecture on menopause and why hot flashes occur. So, if you're up for it...

When a woman approaches menopause, her ovaries basically give out and fail to produce the usual amount of estrogen and progesterone, the hormones normally produced cyclically in menstruating women. The brain, sensing the relative lack of female hormones, starts sending out chemical signals in an attempt to entice the ovaries to "pick up the pace a bit" and produce more hormones. These brain chemicals are called Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). Women in menopause have lots of these hormones in their bodies. Scientists believe that fluctuations in the higher levels of LH in particular are what causes hot flashes.

Enter black cohosh. When taken for menopausal symptoms, the herb attaches itself to some of the same receptors in the body that estrogen does and tricks the brain into thinking it's really estrogen. The LH levels are reduced and hot flashes are improved. Easy, huh?

Well, not exactly. If black cohosh can trick the brain into thinking it's estrogen, does it act like estrogen in other ways? More importantly, does it carry the same risk of stimulating the growth of estrogen-sensitive cancers (like some breast and uterine cancers) as does real estrogen?

While not completely understood scientifically, recent evidence suggests that black cohosh has minimal estrogenic properties. This means that while it attaches to estrogen receptors like estrogen, it doesn't "turn on" those receptors in the same way estrogen would. Other than its effect on the brain's secretion of LH, it is not known to stimulate the uterine lining or do any other of the commonly-known things estrogen does. In other words, part of the body is tricked into thinking black cohosh is estrogen, but not all of it.

So what does all this mean? If science can prove that black cohosh reduces LH levels but doesn't act completely like estrogen, this may be a wonderful option for menopausal women at risk for estrogen-sensitive cancers who otherwise wouldn't be candidates for traditional estrogen replacement therapy. The "jury" is still out on this but I, personally, am quite hopeful that this will be the case.

If you're willing to give black cohosh a try, this is what you need to know before heading to the store to buy some. Look for a reputable brand that gives you the dose of black cohosh as a "standardized extract". The daily dose should be approximately 80 milligrams of standardized extract. Sometimes other herbs are mixed in with the black cohosh and called a "menopausal formula". This is probably fine but as you will learn in subsequent articles, not every herb is as safe or effective as black cohosh and you may be inviting unwelcome side effects. Take it for a month or so and see how you feel. There haven't been any scientific studies on black cohosh beyond 6 months of use so see your healthcare provider if you want to use the herb longer than that.

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