Treatment with hormone therapy (HT) may relieve some symptoms of menopause, but also poses some health risks. Women also may use herbal products. Some herbal products may be helpful in the short-term treatment of symptoms, whereas others are not. Still others may cause harm.

What Is Herbal Medicine?
Healers have been using herbs as medicine for thousands of years. Many drugs we use today come from plants. Some drugs that are now manmade first came from plants.

Some people think of herbal medicine as being more "natural." They may think natural means safer and better. But natural things can hurt you too. Just because something is natural does not mean it is good for you.

Herbal products may interact with drugs prescribed by your doctor and cause problems. It also can be hard to know how safe a product is because herbs are not tested the same way as drugs are tested. Because of these factors, women who use herbal products for relief of menopause symptoms should consult their doctors.

Herbal Products
Herbal products can help relieve some symptoms of menopause for some women. There are many different types of products that vary widely. Because of this wide variety, it is hard to set a standard dose.

Soy Products
Some soy products contain high amounts of isoflavone. Isoflavone is a phytoestrogen, also known as plant estrogen. Plant estrogens act like a weak form of the hormone estrogen in the body.

If taken for a long time in large amounts, soy products may help protect against osteoporosis. They also may help relieve some symptoms of menopause, such as hot flashes and vaginal dryness. Because soy products may have some estrogen-like qualities they may have some risks.

Black Cohosh
Black cohosh is a North American plant. Some women use it to treat symptoms such as:

• Hot flashes
• Sleep disorders
• Depression

St. John's Wort
St. John's wort is an extract of the flower Hypericum perforatum. It has been used for hundreds of years to treat mild to moderate depression.

St. John's wort may cause problems when it is used with other antidepressants.

Wild Yam
Wild yam (and Mexican yam) is available in extracts, tablets and creams. There is no proof that yams can relieve symptoms of menopause. Although there is a hormone-like substance found in some yams, a woman would have to eat a large amount of raw yam to reach a level that would relieve symptoms.

Dong Quai
Dong quai is the root of the plant Angelica sinesis. It is the most commonly prescribed Chinese herbal medicine for problems that affect the female reproductive system.

Dong quai is given to make menstrual cycles more regular.

Studies have only looked at the use of dong quai by itself. When used in Chinese medicine, it is prescribed with other herbs. When used alone, it does not seem to be effective.

Evening Primrose
Evening primrose is a North American wildflower. Oil is expressed from the plant's seeds. This oil is used by some women to treat hot flashes. There is no proof that it works.

Valerian Root
Valerian root comes from the garden plant heliotrope. It is used mostly to treat sleep problems. Studies do not show valerian root to be a useful treatment.

Ginseng
There are many types of ginseng: Siberian, Korean, American, white and red.

For menopausal women, ginseng is said to increase a woman's desire to have sex, but there is no proof that it does.

Chasteberry
Chasteberry, or vitex, is the dried ripe fruit of the chaste tree. It is said to reduce the desire in men to have sex, but increase it in women. Some think that it helps to reduce vaginal dryness and depression at menopause. There is not enough proof that it works to recommend it.

Special Concerns
A concern about herbal products is that they are not approved by the federal government (see box). The herbal industry promotes its own standards for making herbal products. Some manufacturers have signed agreements to conform to these standards.

There is no government body to oversee herbal products. As a result, they can vary widely.

The same product made by different companies may not have the same amount of the active ingredient, even if the label says it is the same. Even two bottles of the same product by the same company may be different.

If a product meets the USP standards, it is awarded a certification mark that can be found on the product label.

Before You Try Herbal Products
Before you start taking herbal products for menopause symptoms, talk with your doctor. Herbs can interact with other drugs that you are taking already or that your doctor might prescribe.

Taking herbs can mask symptoms that your doctor needs to know about to diagnose a problem.

Finally ...
For some women, using herbs can help relieve symptoms of menopause. Some women may use herbs along with other forms of treatment. Others may find that HT alone meets their needs. Your doctor can help you decide what is best for you.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor.