In a study, women who took black cohosh to reduce their menopausal symptoms were about 60% less likely to develop breast cancer than women who didn’t take black cohosh. Does this mean black cohosh lowers breast cancer risk? Maybe. But this study all by itself DOESN’T answer that question.
This small study does show that taking black cohosh was ASSOCIATED with a decrease in breast cancer risk. This isn’t the same thing as concluding that black cohosh caused the decrease in risk. As the researchers point out, much more research needs to be done to prove conclusively that black cohosh lowers breast cancer risk.
Black cohosh seems to help decrease menopausal symptoms because it contains phytoestrogens, substances that act a lot like estrogen. When you go through menopause, your estrogen levels drop significantly. This is why many women experience hot flashes. Herbal remedies such as black cohosh that contain phytoestrogens are thought to help because the phytoestrogens take the place of the missing estrogen. Phytoestrogens also can have anti-estrogen effects. Since estrogens can cause hormone-receptor-positive breast cancer to develop and grow, it’s possible that the anti-estrogen effects of black cohosh explain the reduced risk in the women who used it.
Very little research has been done on the effectiveness and safety of black cohosh or other supplements to treat hot flashes. Until doctors know more, we can’t recommend black cohosh to lower breast cancer risk. If you’re considering taking black cohosh or any other herbal supplement for menopausal symptoms, talk to your doctor before taking the supplement. Some dietary supplements can interfere with breast cancer treatment and prescription medications. To learn more about supplements, visit the breastcancer.org Nutrition Section. To learn more about risk reduction, visit the breastcancer.org Lower Your Risk Section.
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- Black Cohosh for Menopause Symptoms
- Topic Overview
- 7 Benefits of Black Cohosh
- The History of Black Cohosh
- Proper Supplementation Instructions
- What is Black Cohosh?
- Health Benefits of Black Cohosh
- Black Cohosh Side Effects & Precautions
- Estroven Weight Management Capsules
- Using Herbs Can Help You Lose Weight During Menopause
- Other natural supplements for menopause and sleep
Black Cohosh for Menopause Symptoms
Black cohosh, also known as black snakeroot or bugbane, is a medicinal root. It is used to treat women’s hormone-related symptoms, including premenstrual syndrome (PMS), menstrual cramps, and menopausal symptoms.
Black cohosh contains potent phytochemicals that have an effect on the endocrine system. How it works is not yet clear.
Black cohosh is widely used in the United States, Australia, and Germany. The German government has approved it as a prescription alternative to hormone therapy. In the U.S., black cohosh is available without a prescription. Be sure to talk to your doctor before you take it.
You can buy black cohosh as a standardized extract in20 mg pill form (such as Remifemin), which is taken twice a day. Root, extract, and tincture forms are also available in health food stores.
When black cohosh is used at regular doses, its only known side effect is occasional stomach discomfort.footnote 1 But black cohosh may have risks that are not yet known, including possible effects on liver function. More research needs to be done before experts can recommend it for long-term use.
Is it effective?
Studies on black cohosh have had mixed results. Some studies have shown that black cohosh can relieve menopause symptoms such as hot flashes.footnote 2 But other studies have shown that black cohosh does not relieve symptoms.
These mixed results may mean that black cohosh can relieve symptoms in some women, but does not relieve symptoms in others. Or the different results may be because different preparations were used in the studies.
In the studies where black cohosh relieved symptoms, it reduced hot flashes, night sweats, and sleep problems.footnote 2
Is it safe?
Large, long-term studies have not yet been done to confirm whether long-term use of black cohosh is safe. Because black cohosh has benefits somewhat like estrogen therapy, it may also have some risks like those of estrogen.
Experts do not know for sure if black cohosh causes liver problems. But they have determined that black cohosh products should be labeled with a statement of caution. Stop using black cohosh if you notice that you are weak or more tired than usual, you lose your appetite, or your skin or the whites of your eyes are yellowing. Call your doctor because these symptoms may mean you have liver damage.footnote 3
If you plan to take black cohosh, talk to your doctor about how to take it safely. You may be able to take it short-term (no more than 6 months), or possibly longer but with regular checkups to look for estrogen-related changes in the uterus and breasts.
Estrogen may increase the risk of cancer in women who have a history of uterine cancer or breast cancer or who are at high risk for breast cancer. Since black cohosh may work in ways similar to estrogen, these high-risk women should avoid using black cohosh until more is known about the long-term risks.
As with any medicine, be careful to avoid overdosing with black cohosh. Symptoms of overdose include vertigo, headache, nausea, vomiting, impaired vision, and impaired circulation.
What to avoid
Black cohosh should not be used during pregnancy or while you are breastfeeding. Do not take black cohosh if there is any chance that you might be pregnant.
Black cohosh should not be combined with birth control pills, hormone therapy, or tamoxifen. It should not be used by women who are allergic to aspirin.
With research revealing the dangers of HRT (Hormone Replacement Therapy) in treating hormonal issues, health-conscious women are looking elsewhere for safer, natural treatments for hormonal problems like menopause symptoms. One surprising treatment is black cohosh, a herbal remedy that studies indicate relieve symptoms of menopause (especially hot flashes) among other significant health benefits. (1)
I encourage women to understand the transitional period of life known as menopause as well as you can, which will allow you to embrace the changes it brings. When prepared with knowledge about what menopause really is, you can make informed, educated decisions on the best avenues of treatment that don’t put your health further at risk (as many hormone-based drugs may do). In fact, this can be one of the best times of your life!
Recent studies have shown links between black cohosh and relief of multiple other hormonal problems, not just menopause. One such systematic review (a long-term study of multiple research trials) is being conducted as of August 2015 to review the effects of this herbal supplement as an intervention in breast and prostate cancer patients, male and female, managing hot flashes after endocrine therapy and chemotherapy. (2)
Medicinal Background of Black Cohosh
Part of the family Ranunculaceae, black cohosh, or Actaea racemosa (also known as Cimicifuga racemosa) is also called by several nicknames, including “black bugbane,” “black snakeroot” and “fairy candle.” This flowering plant is native to North America, growing in a variety of woodland habitats.
The underground parts of the plant, the roots and rhizomes, are the sections used for medicinal purposes. They are made up of glycosides (sugar compounds), isoferulic acids (anti-inflammatory substances), and (possibly) phytoestrogens (plant-based estrogens), as well as other active substances. The leaves and other external parts of black cohosh aren’t used for food or nutrition.
The specific preparation of black cohosh supplements affects what it will treat. One such manufacturer, Remifemin, is one of the most researched compounds in the reduction of hot flashes caused by menopause. (3)
7 Benefits of Black Cohosh
1. Reduces Hot Flashes
A great number of studies have been done on the effect black cohosh has on menopause symptoms, such as hot flashes. While some research is inconclusive, this is generally due to the fact that many of them have been based on a scale, rather than placebo-based observation. In addition, the specific compounds and dosages of the supplement have been inconsistent in many studies.
However, there is little doubt that black cohosh is an effective treatment for hot flashes and a natural remedy for menopause relief in general. Taking it regularly reduces the number and severity of hot flashes, greatly decreasing the negative symptoms that often overwhelm women with hormone problems.
And there’s more good news! Menopausal women aren’t the only ones who suffer hot flashes. Breast cancer survivors who have completed treatment have shown a decrease in hot flashes and sweating when using black cohosh. (4) As I mentioned earlier, a current study is also examining the management of hot flashes in men who have had treatment for prostate cancer.
2. Aids Sleep
One factor that worsens other symptoms of menopause is the sleep disturbance that often accompanies this transition. Sleep is vital to balancing hormones naturally, as lack of sleep disturbs hormone production and management, even in normal periods of life.
A recent medical trial for postmenopausal women with sleep complaints found supplementing their diet with black cohosh effectively improved sleep and may be a safe measure in managing menopausal sleep disturbance. (5)
If you find that you frequently can’t sleep in the midst of menopause, it’s also important to sleep at the right time. To sleep best, endocrinologists (hormone experts) suggest sleeping at least 7–8 hours a night and ensuring that four of those hours fall between 10 p.m. and 2 a.m. This will ensure the most effective and hormonally balanced sleep.
3. Promising for Treatment of Diabetes
A breakthrough study recently showed positive impact of an extract of this plant, Ze 450, on type II diabetes. While this was a pilot study, the results indicated that Ze 450 may help reduce body weight and improve the processing of insulin within the body of a diabetic patient. (6)
4. Helps Manage PCOS (Polycystic Ovary Syndrome)
Maybe related to its effects in potentially treating diabetes, black cohosh has also been studied regarding PCOS and the benefits it may give to women with the disorder. Initial results suggest black cohosh had a positive impact on the disorder and could match the treatment of the pharmaceutical agent it was tested against. (7)
PCOS patients should do their best to use natural remedies that balance hormones without chemicals or medication, including using essential oils for hormones.
5. Provides a Safe Alternative to HRT (Hormone Replacement Therapy)
HRT is a dangerous therapy to choose for menopause relief. Women on estrogen replacement drugs have been proven to be 24 percent more likely to develop breast cancer than women on no hormone therapy medications (8). I understand that menopause is dreaded by most women, as the side effects often become debilitating. However, I don’t see the bright side of treating this drop in estrogen with drugs that are likely to cause even more health problems.
That’s why I like the idea of alternative options! There are several safe, natural remedies for menopause relief, and black cohosh is an important item on that list. Recent clinical studies have sought to find other menopause treatments to replace HRT, including the use of Actaea racemosa supplementation. (9)
6. Reduces Bone Loss in Osteoporosis
Most plants, including black cohosh, contain many organic compounds with biological activity. In the tissues and organs of Actaea racemosa, there is already evidence of phytoestrogens (plant-derived estrogens).
In addition, some of the biological molecules within the plant have been proven to reduce bone loss caused by osteoporosis. One particular molecular compound (deemed ACCX) has presented an encouraging lead in a new class of treatment for osteoporosis. (10)
7. Treats Uterine Fibroids
Uterine fibroids are benign growths of the uterus, often appearing during years where a woman’s fertility is at its peak. In countries outside of the United States, these are often treated with a synthetic steroid drug, Tibolone. Inside the U.S., various other hormone-based drugs are commonly used.
However, a 2014 study compared the use of Tibolone to black cohosh to treat these fibroids, and found that the extract of Actaea racemosa tested was actually more appropriate than the synthetic alternative to treat uterine fibroids. (11)
8. May Reduce Anxiety
One historic use of this perennial herb was treatment of anxiety and depression. While it has long been considered nothing more than a false remedy, recent research has proposed that it may have significant impact on anxiety, just as studies indicate how effective essential oils for anxiety can be. This is encouraging, considering that anxiety is another intimidating symptom of menopause.
One component of Actaea racemosa was shown to have sedative side effects and greatly reduce anxiety-related behavior in rats, suggesting further studies might be promising for the treatment of anxiety with black cohosh (12).
The History of Black Cohosh
Actaea racemosa is a member of the buttercup family, native to North America. The roots and rhizomes have been used as a folk medicine for centuries to treat pain, anxiety, inflammation, malaria, rheumatism, and many other disorders. Its use as a remedy for rheumatism was especially popular in 19th century America. (13)
The spread of black cohosh across Europe took place after Native American Indians introduced the herb to European colonists. It became a common treatment for women’s health issues in Europe in the mid-20th century. Traditional Chinese medicine also shows record of the use of black cohosh to serve as an anti-inflammatory and painkiller. (14)
One of its nicknames, “Bugbane,” was coined because of its use as an insect repellent, though it’s no longer used for that purpose. Another, “snakeroot,” was derived from the habit of frontiersmen using it to treat rattlesnake bites. Its efficacy against snake bites has never been tested by modern researchers, but it’s an interesting theory!
Be careful not to confuse black cohosh with its sister plants, blue cohosh and white cohosh. These plants are similar in structure, but don’t have the same effects as black cohosh and may be dangerous to ingest.
Proper Supplementation Instructions
Black cohosh isn’t found in any food products. Therefore, to supplement your diet with it, you’ll take an herbal supplement. As I previously mentioned, proper dosages have been debated for years, but I recommend taking 80 milligrams, one to two times per day, to relieve menopause-related symptoms. The most common brand of preparation, Remifemin, contains 20 milligrams per tablet.
You are considered to overdose on this supplement if you take more than 900 milligrams of black cohosh in one day.
In addition to supplements in capsules and tablets, you can also find black cohosh in liquid tincture and extracts that can be mixed into water, and dried black cohosh root that may be used to make tea.
Potential Side Effects and Drug Interactions
A few side effects may exist, though most of them are generally unsupported by thorough research. Some patients have complained of stomach discomfort, headaches, seizures, diarrhea, nausea and vomiting, constipation, low blood pressure, and weight problems. (15) Many of these complaints are more likely due to mis-identification of black cohosh in the wild by certain manufacturers. In addition, it’s suggested to inform your healthcare professional if you take this supplement for more than six months consecutively. (16)
The only potential side effect that has been consistently linked to black cohosh consumption is a negative effect on the liver. (17) While there is still no concrete evidence that black cohosh causes liver toxicity, I suggest consulting your primary care physician about consuming this supplement along with other medications or supplements that may be linked to liver damage, or if you already suffer from liver disease. If you develop symptoms of liver illness while taking black cohosh (e.g., abdominal pain, dark urine, or jaundice), discontinue use immediately and contact your doctor.
Until further research can be completed, you should also not take black cohosh while you are pregnant or nursing, as the effects on fetuses and newborns have not been determined. Black cohosh has not been reported to have any negative drug interactions or influence laboratory tests.
Read Next: Natural Progesterone Cream — Boost Fertility & Relieve Menopause Symptoms
Black cohosh is a medicinal plant native from eastern North America. Known for its anti-inflammatory, sedative, and pain-relieving properties, black cohosh has the potential to relieve menopausal symptoms and support reproductive health. However, clinical research is limited and far from conclusive. Keep reading to discover the benefits and side effects of black cohosh.
What is Black Cohosh?
Scientific name: Actaea racemosa/Cimicifuga racemosa
Common names: Baneberry, black cohosh, black snakeroot, bugbane, cimicifuga, rattleroot, rattleweed, rattletop, traubensilberberze, squawroot, and wanzenkraut.
Actaea racemosa, also known as black cohosh, is a medicinal plant from the Ranunculaceae family, and native from Eastern North America. Before the arrival of the Europeans, Native Americans used black cohosh to relieve various disorders including several conditions unique to women such as menopause and amenorrhea .
Black cohosh became an official drug in the United States Pharmacopeia in 1820. Yet, black cohosh grew in popularity in 1844 when Dr. John King, an eclectic physician, published its use as a treatment for a variety of conditions including chronical ovaritis, endometriosis, and menstrual derangements .
Today, black cohosh is still used to treat several disorders like anxiety and menopausal symptoms. However, there is an ongoing debate on the efficiency of black cohosh to treat these conditions .
- Relieves menopausal symptoms
- Supports female fertility and reproductive health
- Might help with diabetes and anxiety
- All benefits lack solid clinical evidence
- May damage the liver
- May interact with different medications
- Not safe for pregnant women
The key medical components in black cohosh include triterpene glycosides, phenolic acids, flavonoids, volatile oils, and tannins.
- Actein is found in the roots of black cohosh and can inhibit the growth of breast tumors .
- 23-epi-26-deoxyactein is similar to actein, and this compound is a triterpene glycoside that can be extracted from black cohosh roots .
- Cimicifugosidase is obtained from black cohosh roots and also has anticancer effects .
Currently, more than 20 polyphenolic derivatives have been found in the roots of black cohosh, including caffeic acid, isoferulic acid, fukinolic acid, and cimicifugic acids. These compounds have anti-inflammatory and antioxidant properties .
Also known as essential oils, volatile oils are insoluble in water and come from a variety of plants. Volatile oils may be helpful in the prevention and treatment of different chronic conditions .
Tannins are polyphenolic compounds present in many plant foods. They have anti-cancer, antioxidant, and antimicrobial properties .
Mechanism of Action
Although several clinical studies have shown the effectiveness of black cohosh extract in treating menopausal symptoms, its mechanism of action is still unknown .
One proposition states that black cohosh extract may act as a selective estrogen receptor modulator, meaning that it may “simulate” the normal activity of estrogen. Yet, several studies have shown that black cohosh extract does not have any estrogenic effects .
Another theory proposes that the effects of black cohosh derive from its antioxidant properties. However, a study on fish did not detect antioxidant properties from black cohosh .
A more accepted theory states that a serotonin derivative (Nw-methylserotonin) found in black cohosh may activate serotonin receptors .
Health Benefits of Black Cohosh
1) Menopausal Symptoms
In one study of 84 postmenopausal women, black cohosh tablets decreased hot flashes, compared to placebo .
In another study, 48 postmenopausal women with sleep disturbances received a daily dose of either black cohosh or placebo during a 6-month period. The results showed that, compared to placebo, black cohosh improved the sleep quality of postmenopausal women .
A specific standardized product made of back cohosh (Remifemin) successfully reduced hot flushes and other menopausal symptoms in multiple clinical trials .
However, a meta-analysis reviewed 16 different studies to test the effectiveness of black cohosh for treating menopausal symptoms. The main conclusion of the study was that there was insufficient evidence to prove that black cohosh is an effective alternative to treat menopausal symptoms .
The authors remarked the overall poor quality of the studies and warranted further research. Many studies showed incomplete data outcomes, poor reporting, statistical insignificance, and vague conclusions.
In one study of 119 infertile women, adding black cohosh to clomiphene citrate improved pregnancy rate .
A systematic review involving 33 studies analyzed the effect of 6 plants including black cohosh on women with PCOS. In this review, it was concluded that black cohosh may increase ovulation and improve fertility .
3) Uterine Fibroids
A uterine fibroid is a non-cancerous tumor in the uterus. In a study of 244 patients, black cohosh extract was more effective against uterine fibroids than a drug tibolone .
Animal and Cellular Research (Lacking Evidence)
No clinical evidence supports the use of black cohosh for any of the conditions listed in this section. Below is a summary of the existing animal and cell-based studies; they should guide further investigational efforts but should not be interpreted as supportive of any health benefit.
In an animal study, black cohosh extract was administered orally and by injection to mice over a span of 7 days, which resulted in significant blood glucose reduction .
Black cohosh extract was administered intravenously to rats in different doses, which resulted in reduced bone mass loss .
In a cell-based study, 83 chemicals from different plants were evaluated for anti-HIV activity. Of these chemicals, actein (a key component of black cohosh extract) elicited a strong response against HIV .
Black cohosh extract reduced anxiety-related behavior in mice by promoting a state of sleepiness .
Black Cohosh Side Effects & Precautions
Black cohosh is possibly safe when taken in adequate amounts, up to six months. Mild side effects linked to black cohosh use include :
- Upset stomach
- Breast pain
Caution is warranted due to its potential to cause the following more serious side effects:
1) Liver Damage
A 44-year old woman that used black cohosh for a month developed liver damage. Since the woman was not taking any other drugs, it was concluded that liver injury was caused by the use of black cohosh .
There have been other reports of liver damage in people who used this herb, but the exact underlying cause was not clear in most cases .
2) Breast Cancer Worsening
In one study, mice with breast cancer received 0.3 mg/day of black cohosh extract. The results of the experiment showed that black cohosh increased the spread of cancer cells (metastasis) from existing tumors .
Pregnant women should avoid black cohosh due to its potential to impact reproductive hormones and stimulate the uterus .
- Tamoxifen (Nolvadex): A cell-based study showed that using black cohosh and tamoxifen at the same time might reduce the effectiveness of this drug .
- Atorvastatin (Lipitor): A case study of a 53-year-old woman taking black cohosh and atorvastatin simultaneously found that the combination resulted in a dangerous increase in liver enzymes that may indicate liver damage .
- Chemotherapy: In a cell-based study, the interaction between black cohosh and common drugs used in cancer therapy was tested. The results showed that black cohosh increased the toxicity of doxorubicin (Adriamycin) and docetaxel (Taxotere) on cancer cells. However, black cohosh also decreased the efficiency of cisplatin on cancer cells .
- Drugs metabolized by the liver: Black cohosh reduces the activity of cytochrome P450 (CYP450) enzymes, which break down several drugs. The inhibition of these enzymes may lead to liver damage .
Black cohosh supplements have not been approved by the FDA for medical use. In general, regulatory bodies aren’t assuring the quality, safety, and efficacy of supplements. Speak with your doctor before supplementing.
The most common method of taking black cohosh is by tablets. However, black cohosh is also available in capsules, liquid tinctures, and extracts that can be mixed in water and dried root for tea .
The below doses may not apply to you personally. If your doctor suggests using balck cohosh, work with them to find the optimal dosage according to your health condition and other factors.
There is no standardized dose for the use of black cohosh, but a dose of 40 mg/day is commonly used in studies for a variable period of time, depending on the metabolism of the patient and the severity of the symptoms .
In several studies, women have used black cohosh at a dose of 160 mg/day without any visible side effects .
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Using Herbs Can Help You Lose Weight During Menopause
Herbs for weight loss are a common subject of discussion among women who are going through menopause. Weight gain is a real issue for many menopausal women. Changes in hormone levels can decrease energy, increase appetite, and contribute to water retention, all of which can lead to excess weight, particularly centered around the mid-section.
There are many different potential methods for addressing this weight gain, among them herbs for menopause. Which herbs are most effective is a matter of some debate, but there are a few that are generally believed to counter the symptoms of menopause and could be a positive factor in losing weight. As with any treatment plan, you should always consult with your doctor before taking herbs or herbal supplements.
Among the herbs for weight loss most often mentioned are dandelion, chasteberry, black currant and black cohosh. All of these herbs have been used for years to ease a variety of symptoms related to menopause and each can also be beneficial when it comes to losing weight. They should be taken in moderation and you should pay heed to the potential side effects they may cause.
Dandelion is a well-known and documented diuretic. Women in Europe have used it for generations to treat urinary tract infections. It is also among the many herbs for menopause weight loss because it helps to control water weight gain without flushing important nutrients from the system at the same time. Some people have experienced allergic reactions to dandelion, so some caution should be applied.
Since hormone imbalance is such a central part of menopause, the chasteberry is one of the most important herbs for weight loss as it directly affects hormone production. Chasteberry stimulates the production of progesterone, which can help to balance out the lack of estrogen during menopause. By balancing hormone levels, you can improve appetite and increase energy, all of which may make it easier to stick to a weight loss regimen.
As one of many herbs for menopause treatment, black currant is effective on two separate counts. Not only can it help regulate water weight gain, it also contains Omega 6 and Omega 3 fatty acids, which are central to hormone production. By ensuring that you are getting the proper amount of these vital nutrients, you can help to ease side effects of hormone imbalance that lead to weight gain.
Black cohosh has been one of the more controversial herbs for weight loss, but it is proven to combat some of the symptoms of menopause that lead to weight gain. Things like depression, mood swings and fatigue may be alleviated by taking black cohosh, and easing these symptoms can lead to increased energy and a lessened tendency to overeat.
Of course, herbs to do not provide a cure-all for any problem, including losing weight. The best method for losing weight at any stage of your life remains eating a balanced diet and exercising. But during menopause, when it can be difficult for women to deal with the effects of hormonal changes, having a little natural boost may be just what the doctor ordered.
Other natural supplements for menopause and sleep
Last week, I talked about my favorite supplements to improve sleep—and the surprising ways they can also help women in menopause with other symptoms. There’s a broad range of supplements available to women who are interested in managing their menopause symptoms as naturally as possible. Judging from the interest and enthusiasm of the women I talk with—that’s most of you!
Let’s take a closer look at some of the supplements that target menopause symptoms, with an eye on how they also might affect sleep.
A decision to use supplements should be made in consultation with your physician, taking into account your individual health history and risks. This is not medical advice, but I hope this discussion will give women a starting point for those conversations with their physicians about natural therapies to improve their sleep, protect their health, and reduce their uncomfortable symptoms during menopause.
When you talk to your doctor, be sure to discuss any supplements you’re considering and review potential interactions with any medications or other supplements you’re already using.
Many women who are interested in boosting their estrogen levels during and after menopause, but don’t want to use hormone replacement therapy, turn to phytoestrogens. Phytoestrogens are chemical compounds found naturally in plants—compounds that both act like estrogen and affect the body’s own estrogen, when ingested.
Foods rich in phytoestrogens include:
- Soy and soy products (these are particularly high in phytoestrogens)
- Many vegetables and fruits, including oranges, broccoli, and carrots
- Other legumes, including peanuts, beans, and peas
Women who eat a plant-based diet, and particularly those who regularly consume soy products, are getting phytoestrogens through their diet—a factor that they should consider with their doctors when determining whether to further supplement with phytoestrogens during menopause.
There are three main types of phytoestrogens:
Research shows phytoestrogens may reduce menopause symptoms including hot flashes and night sweats, anxiety and other mood problems, and cognitive difficulties including poor memory and lack of concentration. Phytoestrogens may also offer women in and beyond menopause protection against osteoporosis and bone loss, as well as benefits for cardiovascular, metabolic health, and cognitive performance. There’s also evidence suggesting phytoestrogens may have anti-cancer effects, including reducing risks for breast cancer.
Scientific studies have shown phytoestrogens improve sleep, lowering sleep disturbances, reducing insomnia symptoms, diminishing daytime tiredness, and increasing sleep efficiency.
The effects of phytoestrogens from food sources and supplements are complex. Because of their ability to act like and influence estrogen, a hormone, phytoestrogens directly affect the body’s endocrine system. Phytoestrogens can have both estrogenic (estrogen-promoting) and anti-estrogenic (estrogen-blocking) effects. Using phytoestrogens is a decision best made in consultation with a physician, considering a woman’s diet, age, individual health conditions and risks, other medications and supplements she’s already using, and the severity of her menopause symptoms. Because they can function like estrogen in the body, long-term use of phytoestrogens may carry similar risks as estrogen replacement therapy, and women with breast and other estrogen-influenced cancers, or who have risks for these cancers, may be advised not to use phytoestrogen supplements. Be sure to discuss both the potential benefits and potential risks with your physician before using phytoestrogen supplements.
Let’s look more closely at some of the phytoestrogen supplements used by women in menopause:
Genistein. This isoflavone may reduce the frequency and intensity of hot flashes and night sweats, and may also improve symptoms of depression and anxiety, according to research. genistein may offer protection to the cardiovascular system, and make it easier to avoid gaining weight. There’s also evidence linking genistein to a reduction in bone loss. Research shows this isoflavone may be helpful to sleep—thanks to its anxiolytic properties—and may increase amounts of non-REM sleep.
Daidzein. Another isoflavone, Daidzein works similarly to genistein. It’s been shown to relieve hot flashes, and may help reduce bone loss, on its own and in combination with calcium.
Red clover. An isoflavone extracted from the red clover plant, some studies show that this supplement can reduce hot flashes and night sweats—while other studies indicate the benefits of red clover to hot flashes is not significant. There’s also evidence suggesting red clover may have anti-anxiety effects, helping reduce stress and promote relaxation. For this reason, red clover may also help sleep.
Resveratrol. This phytoestrogen—best-known for its presence in red wine—has been shown to reduce chronic pain in post-menopausal women, many of whom will experience pain from osteoarthritis. Other research indicates resveratrol can benefit mood, improve brain function and improve cognitive performance in post-menopausal women. Studies show dietary resveratrol may help strengthen sleep-wake cycles. It’s ability to alleviate chronic pain and improve mood may also contribute to the sleep-promoting effects of resveratrol.
Flaxseed. A popular supplement for all-around health, flaxseed contains lignans that studies show may reduce hot flashes and night sweats. Research also indicates the benefits of flaxseed to cardiovascular health, and its role in lowering cholesterol.
Black cohosh. I hear from a lot of women wondering about this supplement for menopause symptoms. The root of the black cohosh plant has a long history of use in Native American traditional medicine to treat menstrual symptoms and symptoms of menopause. Black cohosh is often regarded as a phytoestrogen, but more recent research suggests it may not have estrogenic effects in the body—however, the precise mechanisms of black cohosh are not yet fully understood. Research shows black cohosh may alleviate night sweats and hot flashes, as well as lowering anxiety, and reducing vaginal dryness. It’s also been shown to improve sleep, likely because of its stress and anxiety lowering capabilities. Some scientists raise questions about the research of black cohosh and its effectiveness for menopause symptoms, pointing specifically to inconsistency in the analysis and reporting of black cohosh studies.
Evening primrose oil. While not a phytoestrogen itself, evening primrose is sometimes found in combination with phytoestrogens in supplements that target women’s health and menopause symptoms. It is also available on its own, and used to treat menopause symptoms including hot flashes. High in omega-6 fatty acids, evening primrose oil may reduce inflammation, ease pain, help support brain function, and contribute to bone health.
Vitamins for sleep and menopause
Here are some of the vitamins most often recommended for women in menopause. It’s important to consult with your physician before adding a new vitamin to your regimen. Also, some research shows vitamins, when taken as a multivitamin or multiple individual vitamins taken simultaneously, may have disruptive effects on sleep. We need more research into the effects of vitamin supplements on sleep, to better understand what sleep-promoting or sleep-disrupting side effects may exist.
Vitamin E. Vitamin E is a powerful antioxidant, and may help lower inflammation. Vitamin E also may contribute to reduced stress and risk for depression, as well as providing protection for your heart and your brain. Research also suggests Vitamin E may help menopausal women with hot flashes and night sweats.
B Vitamins. The B vitamins have a broad range of benefits that may be useful to women in menopause, including stress reduction, immune system protection, a rise in energy and mood, and protection for cognitive functions including memory. In particular Vitamin B6 increases the production of serotonin, which can help with symptoms of depression and anxiety. (Serotonin is also involved in the production of melatonin, the essential sleep hormone.) Vitamin B12 has been shown to increase energy and to reduce mental and physical symptoms of fatigue.
Vitamin D. Vitamin D is an important nutrient for women of all ages, and can have particular value for women in menopause. Technically, Vitamin D is considered a hormone when produced by the body naturally, in response to sunlight. It’s important for bone health: a lack of vitamin D can put women at risk for weakening bones, bone injury, and bone pain, especially with age. Vitamin D can also assist in maintaining a healthy weight. I’ve written before about the potential benefits of Vitamin D for sleep, and the science that suggests maintaining healthy levels of Vitamin D can improve both the quality of sleep and the amount of sleep you get.
Maca is the common name for a plant native to Peru, which has a long history of use in traditional medicine. One species of this plant, Lepidum peruvianum, is scientifically recognized for its broad array of health benefits for both men and women. Lepidum peruvianum has several natural, active compounds that are biochemically related to the hormones women lose throughout the menopausal transition, including estrogen, progesterone, and testosterone. This natural supplement may be a beneficial therapy for women in menopause who are seeking non-hormonal treatments for their symptoms, and to protect and enhance their long-term health, sleep, and performance.
However it is important to be aware that not all maca is created equal. This is a complex plant species, with an array of active compounds. Lepidum peruvianum has no fewer than 13 phenotypes, each with its own different physiological effects. Most are beneficial, but some potentially harmful for women if they use the wrong phenotype for them. When seeking out maca as a supplement, it’s critical to know you’re getting the right phenotypes of the maca plant for your needs—and that the product you’re purchasing is accurate in its label and contents.
Recently I’ve been studying up on Maca-GO®, which has been shown in a growing body of scientific research to be more effective than any other natural alternative to date in relieving menopausal symptoms and it is the first to demonstrate in published clinical trials statistically significant support in helping balance women’s hormones during perimenopause and menopause. Maca-GO® (commercially known as Femmenessence) has been developed with specific, concentrated and standardized phenotype formulations of Lepidum peruvianum to support women’s health and address symptoms during a woman’s reproductive years, perimenopause and postmenopause.
Scientific studies of Maca-GO® show it may deliver some pretty broad benefits for women in perimenopause and postmenopause, including:
- Restored hormone balance, including increases in estrogen and stabilization of progesterone and FSH levels
- Cardiovascular benefits, including reductions in blood pressure, rises to the “good” HDL cholesterol and reductions to the “bad” LDL cholesterol, a lowering of overall cholesterol levels, and significant reductions to triglycerides
- Maintenance of a healthy body weight
- Bone health, including increase to bone density
- Improvements to mood, including alleviation of depression, anxiety and stress
- Reductions in hot flashes and night sweats
- Improvements to sleep
- Increases to energy and physical performance
This is an impressive list, and in the clinical trials it worked for 17 out of 20 women (85 percent). I look forward to seeing more research on the benefits of maca. While the studies on Maca-GO® demonstrated benefits for sleep in peri- and postmenopausal women, I will be interested to see if there is a specific phenotype ideal for men and women just for sleep.
Michael J. Breus, PhD, DABSM
The Sleep Doctor™