The idea that certain herbs might reduce hot flashes and treat other menopausal symptoms and conditions hardly seems far-fetched when you consider how much of our modern Pharmacopoeia is based on botanical compounds. For example, the root of a wild Mexican yam has been used as a progesterone source for the birth control pill. Soybean is the main active ingredient in Provera, the top-selling HRT progestin.

It is generally known that certain plant compounds can produce progestational and estrogenic effects on humans. Note that some herbs, just like processed drugs, can exacerbate certain medical conditions and that improper doses can have the wrong effect or no effect at all. In some cases, many different varieties of a particular herb exist (ginseng, for example), each of which may produce a different effect.

Two of the herbal roots most frequently cited for hot flash relief are dong quai and ginseng. Both substances, alternative practitioners believe, quell flashes by putting mild plant estrogens or plant hormones back into the system, which reportedly help to offset menopause's estrogen deficit. Other hot flash herbal remedies often prescribed include black cohosh, motherwort, caste tree or vitex, chickweed, hawthorn berries, and dandelion.

Just as it's not a good idea for a woman with an intact uterus to take pharmaceutical estrogens alone because of the increased risk for uterine cancer, using a single herb for hot flash relief may not be wise, caution many herbalists. In some herbs, the active ingredient is thought to be more progesterone-like; in others, more estrogen-like. For women with hot flashes who have a uterus, the herbalist may prescribe not only dong quai, an estrogen precursor, but also licorice root, a progesterone precursor. Herbs are often prescribed in response to the needs of the whole person, not a specific condition.

See Also: Traditional Chinese Medicine for Menopause for a description of the herbs commonly used in TCM.

Studies from around the world support the use of many natural alternatives to hormone replacement therapy. For example, a black cohosh extract can reverse all symptoms related to menopause within four weeks. Natural progesterone creams are the single most important natural substitutes for synthetic treatment of menopausal symptoms. Progesterone cream also promotes a more efficient use of the thyroid hormone by the body, and reverses osteoporosis, protects against breast cancer, decreases fibrocystic breast disease and reduces the incidence of ovarian cysts. It prevents fluid retention, fat deposits, vaginal dryness and urinary bladder infections.

Women who suffer from both stress and a loss of libido will benefit from this herbal remedy. Natural progesterone cream is absorbed through the skin and goes directly to where it is needed by the body. Apply it to soft, fatty-tissue areas such as breasts, underarms, inner thighs or abdomen. Absorption should take three to five minutes. If it is absorbed in less than two minutes, increase the amount of the cream to 3/4 tsp. until absorption exceeds two minutes, then return to 1/2 tsp. twice daily for twelve to fifteen days of the month. The cream also helps dry skin and brown spots on hands and arms.

Diets that regularly contain estrogenic plant components also may help stem hot flashes by adding to estrogen levels in the body. Researchers speculate that some plant factors obtained through diet might also reduce the risk for cancer: by binding to and blocking estrogen receptors, thus diminishing the effects of incoming natural estrogen that other- wise might lead to tumor growth. (Tamoxifen, an estrogenlike compound and a treatment for breast cancer, is thought to work in this manner.)

Researchers also speculate that the fibrous part of plants (lignin) may work to absorb excess estrogen in the system, helping to excrete it. Thus there would be less active estrogen in the system to perpetuate cellular overgrowth.

One of the few double-blind, placebo-controlled studies to investigate the effects of menopausal herbal treatment-with positive results-was led by Tori Hudson and Leanna Standish, naturopathic physicians, in 1993. When the study began, each of the participants was experiencing one or more menopausal symptoms. While one group was given a placebo, a second group received formulas containing herbs thought to ease menopausal symptoms: licorice, burdock, Mexican wild yam, dong quai, and motherwort. After three months' time, 71 percent of the group on herbs reported relief of all menopausal symptoms in comparison to 17 percent in the placebo group. Relieved symptoms included hot flashes, vaginal dryness, mood changes, and insomnia.

The study's major limitation was its small number of participants-13 women. Yet Hudson maintains, "The symptom relief in the group taking herbs was clearly there, well beyond the range of a placebo effect."

Herbs typically used to treat menstrual irregularity, hot flashes and vaginal discomfort include:

Blue cohosh (Caulophyllum thalictroides).

Chaste tree (Vitex agnus-castus).

Damask rose (Rosa damascene).

Golden seal (Hydrastis canadenis).

Ladies mantle Wchemilla vulgaris).

Motherwort (Leonurus cardiaca).

Sage (Salvia officinalis).

Vervain (Verbena officinalis).

Herbal Tea for Menopausal Symptoms

6 tbsp. Chamomile flowers

6 tbsp. Lemon balm leaves

6 tbsp. St. John's wort, tops

3 tbsp. Lavender flowers

2 tbsp. Orange flowers

2 tbsp. Rose hips, skin only

1 tbsp. Valerian roots

Pour 1 cup of boiling water over 3 tsp. of this blend, steep for five minutes; strain and drink 2-3 cups daily for four weeks.