Menopause Herbs: 6 Facts on Black Cohosh, Hot Flashes and Safety
Menopause Herbs: Why So Many Women Look for Them
Menopause is defined as 12 months in a row without a period, and it usually happens between the ages of 45 and 55. Many women go through hot flashes, night sweats, poor sleep, mood changes and vaginal dryness. Plenty of them prefer to try menopause herbs before medicines, assuming that natural always means safe. In reality, the evidence for menopause herbs is mixed and some carry real interactions. Here are 6 facts to help you choose safely.
1. Black Cohosh: The Best Known of the Menopause Herbs
Black cohosh is the root of a North American plant and the most studied of all menopause herbs. Some trials found a small reduction in hot flashes, while others found no difference from placebo, and a Cochrane review concluded that the evidence is insufficient to prove a benefit. Rare cases of liver injury have been reported. Stop it at once if you notice dark urine, yellow eyes, upper abdominal pain or unusual tiredness, and avoid it if you have liver disease.
2. Dong Quai: The So-Called Female Ginseng
Dong quai is one of the traditional Chinese menopause herbs, a root used for menstrual and menopausal complaints. In a controlled trial, it did not reduce hot flashes more than placebo when used alone. It contains coumarin compounds, so it may raise bleeding risk with warfarin and other blood thinners, and it can make the skin more sensitive to sunlight, so use sunscreen.
3. Red Clover and Soy
Both contain isoflavones, plant compounds that act like a very weak oestrogen. Some studies suggest that soy isoflavones reduce hot flashes modestly, while results for red clover have been inconsistent. Soy and red clover are among the most common menopause herbs in supplements. Eating soy foods as part of a normal diet is fine for most women.
4. Licorice and Blood Pressure
Licorice root appears in many blends of menopause herbs, but its glycyrrhizin can raise blood pressure, lower potassium and cause fluid retention, especially with regular use. The risk is higher with diuretics, digoxin, heart disease and kidney disease. Read more in licorice and blood pressure. This is why the Solaray SP-7C label clearly says not to use it if you have high blood pressure.
| Herb | Evidence | Main caution |
|---|---|---|
| Black cohosh | Mixed | Rare liver injury |
| Dong quai | Weak | Bleeding with warfarin, sun sensitivity |
| Soy and red clover | Modest for soy, inconsistent for red clover | Hormone-sensitive cancers |
| Licorice | Unproven | Raises blood pressure, lowers potassium |
5. Hormone-Sensitive Cancers and Other Special Cases
- If you have had breast, uterine or ovarian cancer, or take tamoxifen or an aromatase inhibitor, do not use menopause herbs without your oncologist’s approval.
- Endometriosis and fibroids also need your doctor’s opinion first.
- Thyroid disease: some blends contain kelp, which is rich in iodine.
- Diabetes: fenugreek may lower blood sugar and add to the effect of medicines.
- Any bleeding after a full year without periods needs urgent medical assessment.
6. When Is Hormone Therapy or a Gynaecologist the Right Path?
Hormone replacement therapy (HRT) is the most effective treatment for hot flashes and night sweats. For healthy women under 60, or within 10 years of their last period, the benefits usually outweigh the risks, although the decision is personal and depends on your history. There are also non-hormonal prescription options. Vaginal dryness responds well to local treatments; read vaginal dryness after menopause. See your gynaecologist if symptoms disturb your sleep or work, or if your periods stop before the age of 40. Do not delay this visit by relying on menopause herbs alone when symptoms are severe.
Lifestyle Before Any Menopause Herbs
- Dress in light layers and keep the bedroom cool.
- Track hot flash triggers such as spicy food, caffeine, alcohol and stress.
- Walk regularly and add strength training to protect bones and heart, and keep a healthy weight.
- Get enough calcium and vitamin D, and stop smoking.
- Paced breathing and cognitive behavioural therapy can make hot flashes less bothersome.
Menopause Herbs Available at No Style Like
The SP-7C blend combines black cohosh, dong quai and licorice with other herbs. It is a traditional herbal formula, not hormone therapy and not a contraceptive. Evening primrose is sometimes suggested for hot flashes, but its evidence is weak; read evening primrose oil. For cycle-related symptoms in younger women, see PMS supplements. Products available:
- NOW Super Primrose 1300 mg: 1,300 mg of cold-pressed, hexane-free oil from Oenothera biennis seed per softgel (bovine gelatin), typically providing 8-10% GLA, about 104-130 mg; 60 softgels. Take 1 softgel 1 to 2 times daily with food. For adults only.
- Solaray Female Hormone Blend SP-7C: a 910 mg proprietary herbal blend per 2-VegCap serving with black cohosh, dong quai, passion flower, red raspberry leaf, fenugreek, licorice root, cramp bark, chamomile, saw palmetto, wild yam, butternut bark and kelp; 100 VegCaps. Take 2 VegCaps three times daily with a meal or a glass of water. Do not use if pregnant or nursing, or if you have high blood pressure (it contains licorice).
- Solaray Inositol 500 mg: 500 mg of inositol per VegCap, 100 VegCaps; 1 VegCap daily with a meal or a glass of water. PCOS studies mostly used 2-4 g of myo-inositol a day, so this is a much lower dose, and it is not a PCOS or fertility treatment on its own.
Frequently Asked Questions About Menopause Herbs
How long do menopause herbs take to work?
Most studies lasted 8 to 12 weeks. If you notice no difference after three months, talk to your doctor.
Are menopause herbs safe with blood pressure medicines?
Blends containing licorice are not suitable for people with high blood pressure; ask your pharmacist about each product.
Do they prevent pregnancy?
No. Keep using contraception until your doctor confirms that you no longer need it.
Can I combine several herbal products?
Avoid doubling up on the same herbs, such as two products that both contain black cohosh or licorice.
Conclusion
The evidence for menopause herbs is modest and mixed. Black cohosh is the best studied, with a rare risk to the liver. Avoid licorice blends with high blood pressure, avoid these herbs with hormone-sensitive cancers unless your doctor agrees, and remember that HRT is the most effective option for many women. Find Solaray Female Hormone Blend SP-7C at No Style Like Pharmacy.
This article was reviewed by the No Style Like pharmacy content team. It is for general awareness only and does not replace advice from your doctor or pharmacist.
Herbs are not a substitute for hormone therapy or gynaecological care, and should not be used in pregnancy or with high blood pressure without a doctor. For more information see the NCCIH black cohosh fact sheet.