7 Herbal Remedies and Supplements for Menopause

Although there are medical treatments available for menopause symptoms, most notably hormone replacement therapy (HRT), it’s not always a suitable or preferred option for some women.

If that’s you, you may be considering herbal or natural remedies, like black cohosh, evening primrose oil, or St. John’s wort to provide relief from symptoms such as hot flushes, night sweats, or low mood. Here, we discuss 7 natural and commonly used menopause remedies, the evidence behind them, and, importantly, how safe they are. We’ll also look at the essential nutrients you’ll need to support your health during menopause and what you can do to support your wellbeing during the transition.

7 Natural Remedies

There is no definitive answer as to which natural or herbal remedies are best for relieving menopause symptoms. Because we are all unique, how our body responds to herbal remedies can differ, which may impact their effectiveness.

Some women have found that the following 7 herbal remedies can be beneficial for supporting them during menopause.

1. Black Cohosh

Black cohosh, also known as Cimicifuga racemosa, is a flowering plant native to North America that is commonly used to treat vasomotor menopause symptoms, such as night sweats and hot flushes.

A review of 22 randomised controlled trials published in 2023 found that black cohosh significantly improved overall menopause symptoms, hot flushes, and somatic symptoms^[1]. Further research has shown that black cohosh remedies can improve menopause symptoms by 26%^[2], while a Chinese-based study found that black cohosh may improve sleep in postmenopausal women^[3].

Black cohosh is not suitable if you have a hormone-sensitive condition such as breast or ovarian cancer or a history of liver disease.

2. Red Clover

Red clover is a flowering plant that belongs to the bean family and is commonly found in grassy areas across the UK. It contains isoflavones, plant-based chemicals that act like oestrogen in the body, making it a popular herbal supplement for symptoms like hot flushes and restoring hormone balance.

Research suggests that compared to placebo, women taking red clover experience a significant reduction in the daily occurrence of hot flushes^[4]. The decline in oestrogen levels during menopause can also negatively impact cardiovascular health. Yet a 2022 study has found that a 2 week supplementation of red clover, equivalent to 60 mg of isoflavones, reduces vascular inflammation in early postmenopausal women^[5].

3. Maca Root

Maca root grows in the central Andes and is a powerful superfood that’s packed with fibre, protein, carbohydrates, and many essential micronutrients. Maca root belongs to the brassica family, the same family as vegetables like cauliflower, broccoli, and cabbage. It’s widely recognised for its health benefits in South America, but some research shows it may also be useful for supporting hormonal regulation.

Research into the effects of maca root for menopause has found that gelatinised maca influenced hormone levels by decreasing follicle stimulating hormone (FSH) and increasing luteinising hormone (LH), oestrogen, and progesterone, reducing the discomfort associated with menopause symptoms^[6]. In postmenopausal women experiencing sexual dysfunction, maca root may increase testosterone levels to help restore sexual function^[7].

Maca is well-tolerated and is generally considered safe with few adverse effects. Although research into its effects for menopause are promising, more research needs to be conducted^[8].

4. Chasteberry

Chasteberry, also known as vitex agnus castus, is a shrub that grows in the Mediterranean and central Asia. It has been used to treat premenstrual syndrome (PMS) because it may act on the areas of the brain that secrete hormones, particularly the pituitary gland and the hypothalamus^[9]. By doing so, it’s believed that chasteberry or Vitex may reduce the production of prolactin, a hormone that’s linked to PMS.

A 2019 study compared the effects of Vitex and a placebo on menopause symptoms. The results found that Vitex significantly reduced total scores for menopause, anxiety, hot flushes, and night sweats^[10].

Vitex has also been shown to lower blood cholesterol, low-density lipoprotein (LDL), and triglyceride levels, and increase high-density lipoprotein (HDL) or good cholesterol in postmenopausal women^[11]. Therefore suggesting that Vitex may be a useful blood-fat lowering compound, particularly as poorer cardiovascular health, including circulating fat levels, are common adverse effects associated with menopause.

Because Vitex contains phytoestrogens, plant-based versions of oestrogen, it works to relieve menopause symptoms by increasing oestrogen levels. Chasteberry has caused some side effects in clinical trials, including itching, feeling sick, headaches, and mild digestive issues. It’s also not suitable for anyone who may have hormone-sensitive conditions, such as breast or ovarian cancer.

Dong Quai (ginseng)

Dong quai or angelica sinensis, also known as female ginseng,is a Chinese herb that’s commonly used to manage female health complaints. It may help to lower the frequency and intensity of hot flushes and improve sleep, but the research is mixed when it comes to its effect in menopause.

One study found that dong quai had no significant effect on endometrial thickness, vaginal maturation, or the number of hot flashes compared to a placebo, and so, the researchers concluded that it did not have oestrogen-like properties^[12]. However, a further study combining dong quai with another herb, matricaria chamomilla, found that over 12 weeks the herbal supplement reduced the number and severity of hot flushes by 90 to 96%^[13].

Dong quai may not be suitable for everyone, especially if you have any bleeding disorders or currently take any blood thinner like aspirin or warfarin, as it can increase the risk of bleeding.

6. Evening Primrose Oil

Evening primrose oil has many potential benefits, including antioxidant and anti-inflammatory effects. It is a rich source of the omega-6 essential fatty acid, gamma linoleic acid, which can reduce inflammation and support brain function^[14].

For night sweats, evening primrose oil lowers their frequency and severity, with 27.5% of women reporting no night sweats at all^[15]. An earlier study found that evening primrose oil can reduce the severity of hot flashes compared to a placebo^[16].

Evidence suggests that evening primrose oil is safe and well-tolerated for most adults with some of the mild side effects including feeling sick and tummy pain. However, these are usually short lasting and go away on their own.

7. St. John’s Wort

St John’s wort is a potent herbal remedy that’s commonly used for mood changes and mild depression because it has fewer side effects compared to antidepressant medications.

In a study involving 80 postmenopausal women, those given a supplement of St. John’s wort reported a reduction in the frequency and intensity of hot flashes while 80% of women reported no longer feeling depressed compared to 5.7% given a placebo^[17].

St John’s wort can cause side effects which may make it unsuitable for some people, such as dry mouth, dizziness, sensitivity to sunlight, gastrointestinal symptoms, and headaches^[18].

Essential Nutrients and Vitamins

Alongside natural remedies for managing menopause symptoms, there are several essential nutrients, including vitamins, minerals, and probiotics that are key to supporting your health and wellbeing during this important life stage. Below are some of the key nutrients you should be looking to include in your daily diet.

Lifestyle Changes for Menopause Relief

Several lifestyle changes can help to relieve symptoms and support your health and wellbeing during menopause. Most are relatively easy to incorporate into your daily routine and are inexpensive both financially and effort-wise.

Exercise

Exercise is important at all stages of life, but particularly so during menopause. It’s important to have a regular exercise routine that includes aerobic as well as strength-building activities to support cardiovascular health and promote strong bones to protect against osteoporosis.

Although exercise hasn’t been proven to relieve menopause symptoms such as hot flushes or night sweats, it can improve low mood, stress and anxiety. Exercise leads to the production of endorphins, or ‘feel good’ hormones, that lift your mood.

Exercising outside enhances this effect because it benefits your mental health, and between April and September, being outdoors helps to naturally boost vitamin D.

Diet

A healthy diet should not be underplayed when it comes to maintaining a healthy hormone balance.

Ensuring your diet is rich in a variety of colourful fresh fruits and vegetables will help you gain the key nutrients you need to support your long term health and maintain a good hormone balance.

Include foods such as soya, lentils, chickpeas, flaxseeds, oats and wholegrain rice to naturally support hormone levels because these foods all contain phytoestrogens.

Eating foods that contain B vitamins such as B1, B9 and B12, omega-3, vitamin D, calcium and magnesium will help support heart and bone health.

Read more in our menopause diet guide.

Stress management

Menopause can be a stressful time, there are so many changes taking place that it can get overwhelming. However, stress management during this time is crucial because stress can worsen your symptoms and further reduce your quality of life.

Some of the things you can do to help relieve stress include:

• exercise regularly
• practice relaxation techniques like deep breathing, meditation, and mindfulness
• spending time outdoors and in nature
• avoiding your stress triggers

Sleep hygiene

Between 40 and 60% of menopausal women report sleep issues, highlighting the importance of good and proper sleep hygiene^[28].

Hormonal fluctuations during menopause can contribute to insomnia, disrupted sleep patterns, and night sweats. These can significantly impact your mental and physical health, making good sleep habits essential for supporting a good night’s sleep.

Some of the things you can do to help you sleep during the menopausal transition include:

• Follow a routine – set a time you are going to go to bed and wake up each morning, use an alarm if you need to.
• Develop a bedtime routine – some people choose to read a book, listen to a relaxation playlist, have a soak in a warm bath, or practice meditation before going to bed to help them drift off.
• Avoid screens – avoid screens like your mobile phone, laptop, or television before going to bed as they emit blue light which tricks your brain into thinking it’s not ready for sleep.
• Avoid afternoon or evening naps – napping close to bedtime can disrupt your normal sleep pattern.
• Stick to caffeine-free drinks – choose decaffeinated tea or coffee or naturally caffeine free herbal teas after 2pm.
• Ensure your room is clean, cool, and dark – regularly changing your bedsheets, ensuring the room is cool, dark, and quiet can all promote healthy sleep.

When to Seek Professional Help

If your symptoms are severely impacting your quality of life, including hot flushes, night sweats, mood changes, or sleep disturbances, and you are finding them difficult to manage, you should contact your doctor for further help and advice.

You may need medical treatments such as hormone replacement therapy (HRT), antidepressants, or cognitive behavioural therapy (CBT) to help make your menopause journey more manageable.