In a recent survey 95% of women said they would try alternative therapies before HRT to relieve their symptoms of perimenopause or menopause, because they think they are more natural. Many women want to find out more about how herbal medicine for menopause can be used. In many parts of the world, it is common to use herbs as a source of medicine, and in the UK, it is becoming increasingly popular. I was lucky to talk with Hannah Charman, a medical herbalist, who has written this article answering my questions, to help me advise my patients at Rowena Health Menopause Clinic.
What do you need to consider if you are buying herbal medicine for menopause symptoms?
If you are considering buying herbal medicine over the counter, then guidelines recommend that you look for the THR logo standing for traditional herbal medicines. These products have been approved and you can be sure that the product has the correct dosage, is of high quality and has suitable product information. The NICE guidelines also recommend that many available herbal medicines have unpredictable dose and purity, and some herbal medicines have significant drug interactions, so care is needed.
Where can you buy herbal medicine for menopause symptoms?
Hannah says that you could go to your local health food shop or look online for a suitable remedy. You might be lucky and choose one that works well for you, or you may end up wasting time and money on products that don’t help or could make you feel worse.
What is a medical herbalist?
Hannah described that a medical herbalist, will prescribe and dispense herbal treatments that are individualised for each person. Whilst it may be more expensive, there are lots of advantages to working with a medical herbalist. It’s important to know that unlike the term ‘Doctor’ or ‘Nurse,’ the term ‘medical herbalist’ is not a protected title, consequently anyone can call themselves a medical herbalist despite not having appropriate training. It is important to get advice from a medical herbalist who is appropriately trained, a diploma level of training can take between three to five years. This training shares some common topics with mainstream medical training.
Hannah explained that her training was at Middlesex University where she qualified in 1999 with a BSc Hons in Western Herbal Medicine. As well as modules on anatomy & physiology, clinical skills, and pharmacy, she had to learn about 200 herbs and how to use them, as well as carrying out 450 hours of hands-on clinical training. The largest and oldest body of western medical herbalists is the National Institute of Medical Herbalists (NIMH). They have strict entry criteria for new members, as well as ongoing CPD and ethical requirements. It is important, when choosing to see a medical herbalist that you consider this.
What does seeing a medical herbalist involve?
Hannah describes how she works in her own practice. The process starts with a free telephone call to discuss what is involved. Some ladies need support with diet and lifestyle, and others only need individual herbal remedies, so she would work out the best shared care agreement with each patient.
A first consultation she would aim to discuss:
- Your symptoms
- Your past medical history from birth, or sometimes before this.
- An assessment of all your body systems
- Your family history
- Your social history
- Your diet
- Iridology assessment of each eye
By the end of the consultation a decision would be made about which herbs to use for each individual case. It can be best to prioritise two or three main symptoms to work on initially. In time those symptoms may resolve, other symptoms can take priority, although herbs are excellent multitaskers and can tackle several symptoms at once.
It can take time to see the effect of herbal medicine, as is true with any treatment so a two-three-month treatment programme is recommended, and during this your progress is monitored.
The first herbal mix may include six or seven herbs, which are taken internally. These herbs are a blend aimed to address the underlying causes for the symptoms, and the symptoms themselves. The type of treatment commonly used in each prescription may contain nervines and/or adaptogens to help manage stress. Other herbs could be used to calm the wild fluctuations in hormones including phyto-oestrogenic herbs.
In addition, a mix of herbs to aid restorative sleep, can be used, herbal pessaries are available aimed at easing vaginal dryness, or herbal nasal inhalers aimed at reducing brain fog.
Are side effects possible with herbal medicine?
Hannah says that most herbs don’t have side effects in the traditional sense, when used correctly. Example of some which can cause side effects are Black Cohosh, and Vitex Agnus Castus, these need to be used with care and for limited periods, and this would be discussed at a consultation. Occasionally herbal treatment can have unexpected effects, such as a brief worsening of skin problems, or a detox reaction which creates temporary ‘flu like symptoms. If this occurs it is managed with extra support and sometimes a change in dosage or prescription is needed, and it often passes within a few days.
Can I use herbal medicine for menopause symptoms if I have had breast cancer?
Women who have breast cancer or are at high risk of breast cancer should receive care and advice from a healthcare professional with expertise in the menopause before they take any medicine in case it interacts with their breast cancer treatment.
What else is involved if I see a medical herbalist?
Hannah says that working with a herbalist involves more than just taking herbal medicine, there is also a package including support, healthcare advice, advocacy, and signposting. A medical herbalist will take a full history and in some cases can pick up symptoms of potential health issues, and refer this to a GP for further investigation. Prices can vary for different treatment packages.
What sort of herbs might you use?
Hannah describes that she has over 100 herbs, with which she works. There are so many products available, they can include herbal tinctures, teas, creams, oils, aromatic waters, essential oils and pessaries. Herbs are chosen according to their unique set of actions, and their energetics. The main actions are considered first, but all herbs have secondary actions too, and are either heating or cooling. For someone feeling hot, cooling herbs like the bitters, or peppermint can be used, for example. Heating herbs like Turmeric or Cayenne pepper would not be used in in that case. The herbs used are checked for interactions with any medication before they are prescribed.
Here are examples of some herbs Hannah uses, these are not recommended for everyone. She gives some fascinating information about them and how she uses herbal medicine for menopause symptoms.
Mexican Wild Yam – rather confusingly, although this herb is a main source of progesterone HRT, it has an oestrogen modulating effect when used as a whole herb. Wild Yam is a great anti-inflammatory and useful where there’s menopausal joint pain and/or a history of arthritis. It can also relax spasm in the uterus, bowel or bile duct and is specifically used in gall bladder problems. Animal studies have shown that it may have an effect on bone density, by stimulating the cells which create new bone.
Sage – this is quite a powerful phyto-oestrogenic herb. Traditionally it’s a specific herb for hot flushes and night sweats. Sage has also been associated with wisdom and numerous studies have found it effective in treating brain fog and poor memory as well as lifting mood. Over the past 20 years a number of studies have been published looking at its use in dementia.
Motherwort – this can be used for menopausal anxiety, it is a calming but non-sedating herb. Studies conducted so far indicate that it modulates levels of GABA, a neurotransmitter that calms the nervous system and relieves anxiety. Motherwort is a wonderful cardiac tonic which was reputed to make you live forever. It can be used for palpitations and can help to restore normal, natural cycles particularly when they’ve been upset by stress, and it calms night sweats, aiding restful sleep.
Who is herbal medicine suitable for?
With the right advice herbal treatments may be able to be considered by everyone, of any age. They could be used as an alternative to HRT, or as a complement to HRT. Hannah specialises in menopause, but her youngest patient is 4 and her eldest is in her 80’s. She is confident that you’re looking for a natural way through your menopause, it’s well worth considering.
Hannah Charman has also qualified in iridology and advanced hypnotherapy and now specialises in helping women find a natural way through their menopause, running a thriving practice from her home in south Shropshire. You can find Hannah at www.physichealth.uk or via her Natural Menopause UK groups on Facebook and LinkedIn.
Please contact the National Institute of Medical Herbalists for more information.
Written by Hannah Charman and Dr Carys Sonnennberg, Rowena Health
Updated July 2023