In the United States menopause occurs in women, on average, at age 51. Menopause is defined as cessation of menstrual periods for 12 consecutive months. Most women experience a variety of uncomfortable symptoms during perimenopause, which often lasts for 4 to 5 years or longer, and menopause, when the ovaries begin to excrete less and less of the female reproductive hormones, namely estrogen and progesterone. According to the Mayo Clinic, during this time of hormonal change, various symptoms may occur including hot flashes, mood swings, vaginal dryness and, most often, irregular menstrual periods.
Considerations
Though many uncomfortable physical and emotional changes occur during menopause, it is not an illness, but rather a natural process of aging associated with middle age. How a woman perceives the end of her child-bearing years is vital to mental health during this time of hormonal flux. In fact, a woman's attitude toward these major life changes highly impacts the emotional changes associated with perimenopause and menopause.
Study Review
A large, longitudinal review detailing the results of numerous medical research studies of botanical medicinal treatments and menopause, published from 1966 to 2004, was performed by Tieraona Low Dog, MD, of the University of Arizona College of Medicine. Using the Cochrane Library and Medline databases, the review carefully looked at the efficacy and safety of botanical herbs commonly used to treat menopause. The 19 different studies evaluated included research on black cohosh, soy, red clover, dong quai, ginseng and evening primrose seed oil.
Herbal Treatment Overview
Titled "Menopause: a Review of Botanical Dietary Supplements," the study provided an overview of six different natural, herbal modalities. However, overall, according to the review, published in the American Journal of Medicine, of all the single studies of dong quai (Angelica sinensis L.), evening primrose and ginseng, none showed promise for use in effective treatment of the uncomfortable symptoms of perimenopause or menopause.
Potential
Red clover, soy and black cohosh were also covered in the database study, and red clover was found to have conflicting results. Red clover, also known as Trifolium pratense L., was the the subject of the largest study, but showed no benefits when compared with the control placebo. No adverse effects of red clover were noted. The study of soy also had mixed results, though some potential in treating perimenopausal and menopausal women was shown. In comparison, black cohosh, also known as actaea racemosa L., black snakeroot, and squaw root, was the only botanical herb in the review that was shown to "improve menopause-related symptoms." However, notes the review, there have also been four cases published on Medline regarding hepatotoxicity related to black cohosh.
Availability
Black cohosh has been used for two centuries by Native Americans, and is available in capsules, tablets, liquid tincture, extracts and dried root for tea. According to the University of Maryland, black cohosh has been "widely used for 40 years in Europe and is approved in Germany for pre-menstrual discomfort, painful menstruation, menopausal symptoms." Short-term use is recommended, with dosage not to exceed 80 mg per day or 3 cups of black cohosh tea.
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