Entering the season of menopause can bring up so many different emotions for a woman. It's a time of immense change that can mean a new chapter of freedom and wisdom. Unfortunately, the symptoms associated with menopause can seriously impact how a woman experiences this shift, ranging from bothersome to completely debilitating.
Menopause means you've not had a menstrual period for more than a year (assuming there aren't other reasons for amenorrhea). But many of the symptoms we usually associate with menopause can last for years leading up to actual menopause, known as perimenopause.
The median age for menopause is between 50 and 52 years old. That means that things start to change for women in their forties. While western medicine traditionally used synthetic hormones to help women through the transition, many are now looking for natural alternatives.
It's estimated that one out of every four women reports using herbs or other supplements for symptom relief. But it can feel a bit overwhelming to sort through the noise to understand what works and what doesn't.
This article focuses on some of the most commonly used herbs for menopause, so you can decide which, if any, are the right fit for you.
What are the Symptoms of Menopause?
As you get closer to menopause, hormone levels decline and change, exacerbating symptoms that can include:
- Vasomotor symptoms like hot flashes or night sweats
- Mood impacts like depression and anxiety
- Vaginal dryness or atrophy (tissue breakdown)
- Insomnia or disrupted sleep
- Changes in libido
- Cognitive changes or brain fog
- Heart palpitations
- Irregular periods or heavy bleeding
Studies suggest that vasomotor symptoms, like hot flashes and night sweats, are the most common, affecting nearly 80% of menopausal women. Some women experience mild symptoms, but for others, they can significantly interfere with the quality of life.
Why Do Women Turn to Herbal Menopause Support?
For a long time, women quietly struggled through the symptoms of menopause. It just wasn't something that anyone talked about. Fast forward to now, and thankfully women are sharing their stories and looking for additional avenues for support.
Hormone replacement therapy (HRT) was previously the standard treatment for menopause symptoms, but it turns out it’s not without risks. While HRT still has its place when used appropriately, it's linked to an increased risk of significant health concerns, including breast and ovarian cancer, heart disease, and pulmonary embolism.
While some of the early research also suggested that HRT may increase the risk of dementia, more recent research points to the protective effect of estrogen on a woman's brain. A North American Menopause Society study concluded that a longer duration of estrogen exposure from hormone therapy supports cognitive health, especially for older women.
Needless to say, the topic is complex, so it's no wonder that women are searching for alternatives to support this transition. Luckily, herbs can be powerfully effective, and many have been used for thousands of years in traditional medicine.
What are Common Herbal Remedies for Menopause?
Below are some of the most popular herbal remedies for menopause. It's helpful to remember that these botanicals have been used for thousands of years. You can weigh the current research with traditional uses.
You may be used to using sage in cooking, but its benefits extend outside of the kitchen. Sage is an herb that could help with hot flashes, mood swings, and night sweats. While the number of clinical studies isn't high, it's been used for thousands of years in traditional medicine to support women through this transition.
One study found that a fresh sage supplement significantly reduced hot flash intensity after one month. In this study, women reported drops in daily hot flashes over two months and improved psychological well-being. Another small study found similar positive results when sage was given in combination with alfalfa extract. Women reported reductions in hot flashes and night sweats.
Sage may work by supporting receptors in the brain that promote feel-good, calming neurotransmitters. It's also high in antioxidants and has anti-inflammatory properties.
Black cohosh is one of the most commonly used supplements for menopause. Studies on black cohosh are mixed, but there are some interesting positive results. In combination with other herbs, it may help reduce hot flashes.
A review of studies on treatments for vasomotor symptoms associated with menopause found that black cohosh effectively supported improvements more than placebo. Another review found that while studies on black cohosh aren't always well-designed, the herb could be helpful for hot flashes, sweating, anxiety, and insomnia.
You can find black cohosh as a single-ingredient supplement or as an ingredient in a targeted women’s hormone support blend.
Red clover contains phytoestrogens, which means it can mimic estrogen in your body. Phytoestrogens are not as potent as the estrogen made by the body, but they can support hormone balance.
A review examining red clover for menopausal symptoms found that it could reduce the frequency of hot flashes, vaginal dryness, and vaginal atrophy. These results were replicated in another meta-analysis that found red clover helped decrease the frequency of hot flashes.
Because of its estrogenic activity, women with a history of hormone-positive breast cancer may want to discuss it with a health care practitioner before using it.
Indigenous to the Pacific Islands, where it's used for celebration and ceremony, kava is an herb to calm feelings of anxiousness and mood changes. Studies suggest that it could help menopausal women with symptoms of irritability and insomnia.
However, you can't discuss kava without mentioning its rare but serious adverse effects. It's been linked to cases of liver toxicity, so people with liver diseases or who regularly drink alcohol should be mindful and discuss with a health care practitioner. If you’re taking over-the-counter or prescription medications, ask your prescribing doctor or pharmacist before taking kava.
Dong quai, or the “female ginseng,” is another traditional herb supporting reproductive health. It's used in Traditional Chinese medicine to nourish the blood and promote balance. It's said to help with hot flashes, night sweats, and vaginal dryness.
While it's been used traditionally for thousands of years, there is very little research from clinical studies about its effectiveness. Several studies suggest there is not enough conclusive evidence that dong quai alone is effective for menopause symptoms. However, it is often included in supplements that contain other hormone-supporting herbs.
Ginkgo biloba is a popular herb often used to support cognitive health. It may help by supporting healthy blood flow and nerve transmission in your brain. Since menopause can cause memory and cognition symptoms, ginkgo may help.
A systematic review concluded that ginkgo supported improvements in mood, cognition, and emotional function better than placebo. Studies that specifically examine perimenopausal women also report modest but positive results for memory and cognition.
St. John's Wort
St. John's wort is a popular supplement used for mood support as it may help increase serotonin levels. Serotonin is a feel-good neurotransmitter that acts to stabilize your mood and promote feelings of well-being. As a result, it may help with some of the psychological symptoms associated with menopause.
There are many positive studies on St. John's wort and feelings of depression, but most don't concentrate specifically on menopausal women. However, a study examining 30 menopausal women found that it supported improvements in feelings of anger or depression while also helping to reduce vasomotor symptoms and insomnia. Another small study reported that after 12 weeks, women who took St. John's wort noted improvements in mood and sexual well-being.
Passionflower is an herb typically used to promote rest and relaxation. It's often used to calm an anxious mind, especially before bed, to help with sleep. As a result, it may be beneficial for women struggling with insomnia, but it can also be taken during the day for anxiety.
Passionflower may also support serotonin. The same study that examined St. John's wort (mentioned above) also looked at passionflower and found similar improvements in vasomotor symptoms, anxiety, and insomnia.
Sleep supporting products that combine these soothing botanicals with other nutrients to calm your nervous system may help you get a restful night's sleep.
Adaptogen Herbs for Menopause
Adaptogens are botanicals designed to support your body's natural stress response. Their action in the body is said to help your body effectively manage stress without the crash that can happen from overextending yourself that can lead to burn-out.
For menopausal women, apoptogenic herbs may support healthy energy levels while promoting a sense of calm.
Holy basil, also known as Tulsi, is a traditional and Ayurvedic herb used to help with fatigue and anxiety. It also has anti-inflammatory properties to support whole-body wellness. Some studies suggest it even may have cognitive benefits.
Rhodiola, another adaptogen used for anxiety, can support your stress response, mental stamina, sleep, and mood. It's commonly used for longevity and healthy aging because of its impact on stress hormones and inflammation.
Ginseng is said to support energy and vitality. It could help with hot flash reduction while also promoting a healthy libido. One study on postmenopausal women found that ginseng supported improvement in mood and overall well-being. However, it didn't help with vasomotor symptoms.
Ashwagandha usually tops the list of popular adaptogens. It's calming, supports energy, and may help reduce oxidative stress (an imbalance between free radicals and antioxidants in your body that can damage tissues). Ashwagandha could help regulate your mood and stress levels throughout the day while helping you sleep more deeply at night. Another plus—ashwagandha may improve your sex drive.
Like all the other adaptogens, schisandra can help you feel less anxious, but it also can be supportive for cognitive function and mental clarity. A study on menopausal women found that schisandra supports reductions in heart palpitations, sweating, and hot flashes.
Maca root is popular for its impact on libido and hormone balance. It's said to support mood and sex drive. One study on menopausal women found that taking maca helped women with depression and even supported healthy blood pressure.
Additional Herbs for Hot Flashes
Since vasomotor symptoms are so common, many of the herbs already mentioned help with hot flashes alongside improvements in other symptoms. However, the herbs below are often touted as especially beneficial for hot flash reduction.
Licorice is sometimes considered an adaptogen by herbalists because of its impact on your adrenal glands and stress response. For women with menopause, licorice root may specifically support hot flashes because it contains phytoestrogens. Several randomized control trials found licorice was effective for supporting reductions in hot flashes. Licorice is one of those powerful herbs that can interfere with medicines and even increase blood pressure, so check in with your physician if you’re taking medication or if you have a history of hypertension.
Evening Primrose Oil
Evening primrose oil contains gamma-linolenic acid (GLA) that may support vasomotor symptoms, especially hot flashes. However, one study found that evening primrose performed only slightly better than placebo when it came to the severity of hot flashes. A review found no additional benefit, so herbs with stronger evidence are likely a better choice.
The extract of pine bark used to support menopause symptoms is called pycnogenol. Pycnogenol is an antioxidant that fights back against free radical damage in the body. It's also been shown to help reduce hot flashes.
Commonly known as vitex, chaste tree contains phytoestrogens and supports a healthy hormone balance. One small study found that after taking chaste tree, women experienced improvements in mood and hot flashes. Another randomized control study found that vitex supported improvements in anxiety and vasomotor symptoms more than placebo.
Chaste tree, or vitex, is available as a single supplement or as part of a comprehensive women’s hormone support formula.
Wild Yam Extract
Wild yam extract is worth mentioning because it seems to be a popular suggestion for hot flash relief, but the data doesn't seem to back up the claims. It's said to improve hormone levels. There are very few trials, but one randomized control trial found no difference between wild yam cream and placebo for symptom improvement. Still, many women seem to notice a difference.
So What Are the Best Herbs for Hot Flashes?
As you can see, when it comes to hot flashes, there's a lot of research to sort through. Some of the herbs are popular but aren’t necessarily as effective.. Based on the evidence shared above, the best herbal remedies for hot flashes include:
- Black Cohosh
- Red Clover
- Licorice Root
- Pine Bark
- Chaste Tree (Vitex)
Are Herbal Remedies for Menopause Right for You?
Herbs can provide a safe approach for menopause relief. The botanicals we've discussed can offer a natural and effective solution to help you get the relief you need.
If you are looking for extra guidance, you can also try our free hormone balancing starter kit to support foundational hormone balance.
- Gold EB. The timing of the age at which natural menopause occurs. Obstet Gynecol Clin North Am. 2011. 38. 425-440.
- Ebrahimi A, Tayebi N, Fatemeh A, Akbarzadeh M. Investigation of the role of herbal medicine, acupressure, and acupuncture in the menopausal symptoms: An evidence-based systematic review study. J Family Med Prim Care. 2020. 9. 2638-2649.
- Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Lancet. 2019. 394. 1159-1168.
- Manson JE, Chlebowski RT, Stefanick ML, et al.. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. JAMA. 2013. 310. 1353-1368.
- Bommer, S., Klein, P. & Suter, A. First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes. Adv Therapy. 2011. 28. 490–500.
- Vandecasteele, K., Ost, P., Oosterlinck, W., Fonteyne, V., De Neve, W. and De Meerleer, G. Evaluation of the Efficacy and Safety of Salvia officinalis in Controlling Hot Flashes in Prostate Cancer Patients Treated with Androgen Deprivation. Phytother Res. 2012. 26. 208-213.
- De Leo V, Lanzetta D, Cazzavacca R, Morgante G. Trattamento dei disturbi neurovegetativi della donna in menopausa con un preparato fitoterapico [Treatment of neurovegetative menopausal symptoms with a phytotherapeutic agent]. Minerva Ginecol. 1998. 50. 207-211.
- Briese V, Stammwitz U, Friede M, Henneicke-von Zepelin H. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment—Results of a large-scale, controlled, observational study. Maturitas. 2007. 57. 405-414.
- Sarri G, Pedder H, Dias S, Guo Y, Lumsden MA. Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause. BJOG. 2017. 124. 1514-1523.
- Mahady GB. Black cohosh (Actaea/Cimicifuga racemosa): review of the clinical data for safety and efficacy in menopausal symptoms. Treat Endocrinol. 2005. 4. 177-184.
- Ghazanfarpour M, Sadeghi R, Roudsari RL, Khorsand I, Khadivzadeh T, Muoio B. Red clover for treatment of hot flashes and menopausal symptoms: A systematic review and meta-analysis. J Obstet Gynaecol. 2016. 36. 301-311.
- Kanadys W, Barańska A, Błaszczuk A, et al. Evaluation of Clinical Meaningfulness of Red Clover (Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021. 13. 1258.
- Pittler MH, Ernst E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol. 2000. 20. 84-89.
- Warnecke G. Psychosomatic dysfunctions in the female climacteric. Clinical effectiveness and tolerance of Kava Extract WS 1490. Fortschr Med. 1991. 109. 119-122.
- Fu PP, Xia Q, Guo L, Yu H, Chan PC. Toxicity of kava kava. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2008. 26. 89-112.
- Geller SE, Studee L. Contemporary alternatives to plant estrogens for menopause. Maturitas. 2006. 55. 3-13.
- Kleijnen J, Knipschild P. Ginkgo biloba. Lancet. 1992. 340. 1136-1139.
- Birks J, Grimley EV, Van Dongen M. Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev. 2002.
- Matyi JM, Rattinger GB, Schwartz S, Buhusi M, Tschanz JT. Lifetime estrogen exposure and cognition in late life: the Cache County Study. Menopause. 2019. 26. 1366-1374.
- Elsabagh S, Hartley DE, File SE. Limited cognitive benefits in Stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba. J Psychopharmacol. 2005. 19. 173-181.
- Fahami F, Asali Z, Aslani A, Fathizadeh N. A comparative study on the effects of Hypericum Perforatum and passion flower on the menopausal symptoms of women referring to Isfahan city health care centers. Iran J Nurs Midwifery Res. 2010. 15. 202-207.
- Liao LY, He YF, Li L, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chin Med. 2018. 13.
- Baliga MS, Jimmy R, Thilakchand KR, et al. Ocimum sanctum L (Holy Basil or Tulsi) and its phytochemicals in the prevention and treatment of cancer. Nutr Cancer. 2013. 65. 26-35.
- Sampath S, Mahapatra SC, Padhi MM, Sharma R, Talwar A. Holy basil (Ocimum sanctum Linn.) leaf extract enhances specific cognitive parameters in healthy adult volunteers: A placebo controlled study. Indian J Physiol Pharmacol. 2015. 59. 69-77.
- Pu WL, Zhang MY, Bai RY, et al. Anti-inflammatory effects of Rhodiola rosea L.: A review. Biomed Pharmacother. 2020.
- Kiefer D, Pantuso T. Panax ginseng. Am Fam Physician. 2003. 68. 1539-1542.
- Wiklund IK, Mattsson LA, Lindgren R, Limoni C. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group. Int J Clin Pharmacol Res. 1999. 19. 89-99.
- Dongre S, Langade D, Bhattacharyya S. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. Biomed Res Int. 2015.
- Park JY, Kim KH. A randomized, double-blind, placebo-controlled trial of Schisandra chinensis for menopausal symptoms. Climacteric. 2016. 19. 574-580.
- Stojanovska L, Law C, Lai B, et al. Maca reduces blood pressure and depression, in a pilot study in postmenopausal women. Climacteric. 2015. 18. 69-78.
- Menati L, Khaleghinezhad K, Tadayon M, Siahpoosh A. Evaluation of contextual and demographic factors on licorice effects on reducing hot flashes in postmenopause women. Health Care Women Int. 2014. 35. 87-99.
- Farzaneh F, Fatehi S, Sohrabi MR, Alizadeh K. The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Arch Gynecol Obstet. 2013. 1075-1079.
- Low DT. Menopause: a review of botanical dietary supplements. Am J Med. 2005. 98-108.
- Kohama T, Negami M. Effect of low-dose French maritime pine bark extract on climacteric syndrome in 170 perimenopausal women: a randomized, double-blind, placebo-controlled trial. J Reprod Med. 2013. 58. 39-46.