Black Cohosh, St. John's Wort Combo for Menopause Symptoms
A mixture of black cohosh (Cimicifuga racemosa) and St. John’s wort (Hypericum perforatum) may help relieve menopausal symptoms, reports Obstetrics and Gynecology (2006;107:247–55). The combination appears to be especially useful for women who suffer from menopause-related depression.
Menopause marks the natural transition from a woman’s childbearing years to the postreproductive period. Most women go through menopause at about age 50. As hormonal levels gradually decline, many women experience discomforts such as hot flashes, fatigue, sleeping problems, vaginal dryness, incontinence, decreased libido, mood swings, anxiety, and depression. In some women, these symptoms are severe enough as to interfere with their quality of life.
Traditionally, moderate to severe menopausal complaints were managed with hormone replacement therapy (HRT). However, since recent studies have linked the use of HRT with increased risks of breast cancer and heart disease, the search for safer alternatives has intensified.
Numerous studies support the use of black cohosh for relieving menopausal symptoms. In fact, previous trials have shown black cohosh to be as effective as HRT for reducing hot flashes. St. John’s wort has been found to help relieve mild to moderate depression in many trials. The new 16-week study investigated the use of a combination of black cohosh and St. John’s wort in 301 women suffering from menopausal symptoms with a strong psychological component.
The women received either two capsules two times per day of the herbal supplement (each tablet was standardized to contain 1 mg of triterpene glycosides from black cohosh and 0.25 mg of hypericin from St. John’s wort) or a placebo for the first eight weeks. For the remainder of the study, the women took one capsule two times per day. The women rated their symptoms using the Menopause Rating Scale and the Hamilton Depression Rating Scale at the beginning of the study and after 8 and 16 weeks.
After 16 weeks, women receiving the herbs had a 50% improvement in their symptoms—significantly greater than that seen in the placebo group. The herbal combination improved all of the menopause symptoms measured, and women in the herbal supplement group had a 42% reduction in depressive symptoms, compared with a 13% reduction in the placebo group. The supplement combination was generally well tolerated and free of major side effects.
These findings suggest that the combination of black cohosh and St. John’s wort can effectively relieve menopausal complaints, especially when depression is a predominant symptom.
Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI. Dr. Beauchamp practices as a birth doula and lectures on topics including whole-foods nutrition, detoxification, and women’s health.
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