Herbal Medicine and Menopause

Dee Atkinson, Medical Herbalist, MNIMH

Over the last few years I have seen many patients who are looking for alternatives to hormone replacement therapy, or who are struggling with menopause symptoms. The onset of the menopause can bring with it a lot of unpleasant symptoms, both physical and mood wise. Every women is different and some sail through menopause while others experience many and varied symptoms.

The most common symptom is hot flushes and night sweats. Varying in intensity from mild episodes of heat to extreme fluctuations in temperature and sweating, they can make one’s life miserable.

It is this symptom, especially if it leads to lack of sleep, that can lead women look for solutions and it is often the reason that some women decide to try HRT.

In my clinic I work with many women who want to find an alternative to HRT to manage their symptoms, either before they start taking HRT, or if they are already taking it, they want help in coming off it.

Many of my patients are directly referred to me by their doctor and this has been increasing over the years as Herbal Medicine has moved more into the realm of mainstream medicine and worries about HRT have increased. The decision as to whether or not to take hormone replacement needs to be made by the patient themselves, in discussion with their Doctor or Herbal practitioner.


There are certain foods that can help to ease menopause symptoms and the buzz word here is ‘phytoestrogen’. These are plants and even foods that have oestrogen like actions. Their chemical structure resembles that of oestrogen, but is not identical. They are able to occupy oestrogen receptors in the body without actually activating them. A bit like putting a key in a lock but being unable to turn it.

Soya, linseeds, beans and pluses are some foods that exhibit these properties as well as the plants Liquorice, Red clover and Sage, too. By combining herbs such as these, making dietary changes and using gentle hormone regulators such as Vitex agnus castus, the herbalist is able to tailor make a prescription for the patient.

Exercise and diet are important parts of everyone’s health care, and this is especially important for women going through the change of life. Exercise helps to keep weight under control, the cardio vascular system healthy and helps prevent osteoporosis. This is a time when many women can feel particularly low and unable to motivate themselves to exercise and eat healthily.

Qualified practitioners will be able to help women work out a treatment plan that includes all aspects of the problem and will use natural remedies to help the body through what is, after all, a very natural process. The length of time one needs to take herbs for can vary but, the majority of my menopause patients are on herbs form anywhere between 6 to 18 months.


As a woman moves closer to menopause, she is said to be “peri-menopausal”. At this stage, it is often the case that by using herbs we can regulate the cycle and ease the peri-menopausal symptoms with a few months of herbs correcting most problems. However, the longer the gaps between periods, the more pronounced the menopause symptoms tend to become although one is not considered menopausal until a year has elapsed since their last period.

Menopause symptoms are varied and can include: hot flushes and night sweats, mood swings, forgetfulness, changes in the texture of skin and hair, palpitations, anxiety, sleeplessness, weight gain, joint pains, vaginal dryness and lack of libido. These symptoms can come and go and they don’t all happen at the same time. It can be a confusing time and often a time when women have other stresses, with teenage children and elderly relatives to care for. Herbal formulas, as prescribed by a herbal practitioner, are built for the individual and can have a profoundly beneficial effect.


One word of caution. Just as one would never take hormone replacement without first consulting their doctor, only embark on a course of herbs after consultation with a qualified practitioner. If you are on HRT and want to stop, consult a herbal practitioner before you stop. If you have undergone treatment for cancer and want to use herbs, you must never try and self treat. I help many women who have undergone cancer treatment to manage their health, and we can use herbs to reduce menopause symptoms, but we do need to make sure that we use the correct herbs. Many herbs are contra indicated in this situation.

If you are experiencing the symptoms of menopause and prefer to try an across the counter remedy first, here are some suggestions:


 Sage is one of the first remedies to try for Menopausal hot flushes and night sweats. It has a cooling drying action and contains plant oestrogens.  It not only reduces sweats but also helps the body adapt to the hormonal changes involved.  It has a long history of use as a nerve tonic, calming and stimulating the nervous system.  Cold sage tea is also great to use in the summer months.   

Sage is available as a liquid medicine tincture either on its own or as part of a blend. 



This is of most use in treating menopausal symptoms which exist prior to the cessation of menstruation.  It has a hormone balancing action and is best taken in the morning when the hypothalamic-pituitary axis in the brain is most active as it will have the best hormonal influence at this time.  It is, to date, the only herb with a progesterone–type activity.  Vitex may also help with migraines linked to the menstrual cycle. Vitex is usually used when there are still menstrual periods.

Vitex is available as a liquid medicine.



This is a very useful herb for menopause.  It is of particular use for symptoms of low mood or anxiety which are common in menopausal women.  Interestingly, St Johns wort has been show to reduce hot flushes.

St Johns wort is available in capsule or liquid form, either on its own or as part of a blend.

Caution – contraindicated with a number of medications please consult product leaflet or label for full list.


This is a formula that I developed for women who have uncomplicated menopause symptoms. It is a gentle formula that will support the management of a number of menopause symptoms. Black cohosh for hormone balance; Sage to reduce flushing; St Johns Wort for mood swings; Clivers for cooling and lymphatic help; and Red Clover for its hormone balancing properties.

Available as a liquid medicine. 


Hemp oil provides the essential fatty acids, omega 3,6, and 9. It can be used during the menopause to combat the dry skin that is often experienced when oestrogen levels fall.  A good vegetarian alternative to Fish oils.



 This is a useful supplement for menopausal women, with 400iu daily of vitamin E recommended to combat hot flushing.  It is also beneficial for dry skin complaints, including vaginal dryness, and can protect the heart and the arteries by keeping vessel walls clear of fats. Finally, because it is an antioxidant, it is useful in combating the signs of ageing.