Finding balance: How herbal remedies can support perimenopause and menopause
Perimenopause is the transitional phase in which your body moves towards menopause. It usually lasts an average of three to four years and is often marked by some of the common symptoms of menopause, such as night sweats and brain fog. During this time, your periods may become irregular and fewer as your ovaries produce less oestrogen. When you have not had a period for 12 consecutive months, you are considered to be in menopause.
This is a completely natural stage of a woman’s life, as hormones begin to change and oestrogen decreases. For some people, the symptoms may be unbothersome, but for many, this life stage can present physical and emotional challenges for women and people assigned female at birth (AFAB). While it’s not something that needs to be ‘treated,’ many people will seek treatments to reduce the symptoms and minimise the impact it has on their lives. Herbal remedies are a common choice, but what are the best remedies and how do they work?
Why choose herbal remedies?
Herbal medicines contain active ingredients from plants such as leaves, roots and flowers. The NHS notes that they are thought to work by balancing oestrogen and progesterone hormones in the body, though there is little scientific evidence to support this.
Before we dive into the most popular herbs to support your body through perimenopause and menopause, it’s important to acknowledge that these therapies should be considered as a complement to conventional medicine, such as HRT. These remedies are not intended to replace modern-day medicine, but rather to be used alongside other treatments and lifestyle changes. What works for some people may not work for you, but it’s important to be transparent with your health professional if you’re considering trying herbal remedies.
5 herbal remedies to manage menopausal symptoms
1. Evening primrose oil
Evening primrose oil has anti-inflammatory, pain-relieving and antioxidant properties. This has been thought to help against hot flushes – reducing their severity, frequency and how long they last . Joint pain and stiffness can also occur during menopause, so the oil may be helpful in this instance as it is commonly used to support people with arthritis. The essential fatty acids found in evening primrose oil are thought to influence hormone levels, helping with digestion, fatigue and mood changes. For this reason, it can help manage pre-menstrual symptoms, too.
2. Black cohosh
Most commonly used for menopausal symptoms, black cohosh is a popular choice among women seeking herbal remedies. It can help against hot flushes, vaginal dryness, night sweats, irritability and sleep problems .
3. Red clover
Red clover has several benefits for perimenopausal and menopausal people, as it is high in isoflavones (or ‘phytoestrogens’) which mimic oestrogen. It is thought to help in the following ways :
- reducing night sweats
- reducing hot flushes
- may help manage depression and anxiety
- improving bone density (reducing the risk of osteoporosis)
- supports skin and hair health
4. St John’s Wort
St John’s Wort is thought to be effective in managing the psychological symptoms of menopause, such as anxiety and depression. It’s important to be aware that if you’re considering taking this alongside HRT, for example, it can make other treatments less effective. St John’s Wort has also been particularly identified as carrying the risks of side effects such as an upset stomach, fatigue and confusion.
Ginseng works like other herbal remedies in that it can influence hormone levels. This herb is thought to stimulate the growth of oestrogen-receptor-positive cells. Studies suggest that ginseng can reduce hot flushes, alongside other menopausal symptoms, and can improve the quality of life for (peri)menopausal women. There are three types of ginseng: white, red and American. Red ginseng is thought to be the best when it comes to supporting women through menopause, as well as improving memory, fatigue and antioxidant activity .
What to consider when taking herbal remedies
As with conventional medicine, herbal remedies are not without their risks. It can be easy to assume they’re safe as they come from ‘natural’ sources, however, they should be taken with caution and it’s important to keep the following in mind:
- Some herbal medicines can interfere with other treatments, triggering unexpected side effects or making the treatment less effective.
- Herbal remedies can cause side effects. Pay close attention to dosage and be aware of any reactions, such as dizziness, nausea, dry mouth and rashes, for example.
- Their effectiveness is yet to be thoroughly backed by scientific evidence. Many of the perceived benefits have been observed by reports from people who have used herbal remedies, rather than based on scientific research.
- Herbal remedies are unregulated in the UK. Keep a look out for packaging marked ‘THR’ (Traditional Herbal Registration) which means they comply with quality standards and inform you how to take the medicine.
In summary, while herbal remedies can be helpful in managing the symptoms of menopause, they should be taken with care. It’s important to consult with your healthcare professional, such as a GP or pharmacist, before taking any herbal remedies to ensure they’re right (and safe) for you.
Working with a holistic therapist who is qualified in herbal medicine can also be beneficial, especially if you’re just starting out. Remember, everyone’s menopause journey is different, so it may take some trial and error before you find what works for you.
 WebMD (2022), Health Benefits of Evening Primrose Oil, Available here: https://www.webmd.com/diet/health-benefits-evening-primrose-oil
 National Institutes of Health(2020), Black cohosh, Office of Dietary Supplements, Available here: https://ods.od.nih.gov/factsheets/BlackCohosh-HealthProfessional
 Holland and Barrett (2022), Red clover: overview, benefits, dosage, side effects, Available here: https://www.hollandandbarrett.com/the-health-hub/conditions/womens-health/menopause/what-is-red-clover/
 Hyun, Han et al (2022), Safety of red ginseng and herb extract complex (RHC) in menopausal women: A randomized, double-blind, placebo-controlled trial, Journal of Ginseng Research, Volume 46(4), Pages 601-608, DOI: https://doi.org/10.1016/j.jgr.2021.11.008