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A Primer on Botanicals in Perimenopause/Menopause

Post courtesy content partners Labrix Clinical Services, LLC. Written by Tori Hudson, N.D, clinical professor and medical director, A Woman’s Time, and program director of the Institute of Women’s Health and Integrative Medicine.

LabrixLogoBotanical medicines have been a mainstay of addressing perimenopause and menopause symptoms for consumers, patients and alternative minded practitioners. Uses based on historical and traditional bodies of knowledge have been around for generations, but published research studies in this area of women’s health care have been in the literature for only the last 35 years or so. Most of these studies have focused on hot flashes/night sweats, but there is a respectable amount of research using scales and indices that rate a collection of perimenopause and menopause symptoms including hot flashes/nightsweats, irritability, depression, anxiety, insomnia, libido, fatigue, vaginal dryness and more. I have made considerable effort to stay up to date in this area of published research and I would list the top 5 single evidence-based herbs for symptom relief in perimenopausal / menopausal women to be black cohosh, maca, kava, St. John’s wort (especially with black cohosh) and Sibhiric rhubarb. Pine bark, red clover, valerian, grapeseed extract and soy round out the next top five. There are also many combination herbal products that have some research as well, but most of the combination herbal products are formulated by women, practitioners, and herbal supplement companies based on historical information, personal and clinical experience, and ideations.

One of the approaches to perimenopause/menopause symptom relief that I am fond of teaching is to use a botanical within a comprehensive strategy, to address the foundational issue— that of normal perimenopause/menopause hormonal changes, while then also adding specific treatments for symptom relief. An example of an exclusively botanical approach with this construct in mind might be:

  1. An adaptogen, such as ashwaganda or rhodiola, to enhance resilience and improve adaptation to these normal hormonal changes and the range of issues that can ensue
  2. Black cohosh, maca or Siberian rhubarb to address the foundational and broad spectrum of menopause symptoms.
  3. Addition of an individual plant such as valerian for insomnia, or kava for anxiety, or St. John’s wort for depression.

This same construct though can be used to include lifestyle changes, emotional/psychological approaches, body work, nutritional supplements, hormones and specific symptom-relieving pharmaceuticals. An example of this approach might be:

  1. Lifestyle changes to improve stress management and homeostasis. (Labrix recommends adrenal function testing for further depth and refinement of treatment options for “stress”).
  2. Hormone interventions to address the foundational and broad spectrum of menopause symptoms (Labrix recommends the Comprehensive (8 panel) salivary hormone test for baseline considerations).
  3. Amino acid therapies for depression or insomnia or oral lavender extract for anxiety (Labrix recommends Neuroadrenal test panel to delve further into specific treatments for these conditions).

A comprehensive medical history, select physical exam, and select use of laboratory tests can be used to help identify problem specific areas and enhance the accuracy of your assessment and the success of your strategic plan for immediate symptom relief, optimal preventive medicine and disease risk reduction, and current disease treatment.

Join us at Labrix Core Training and learn more from Dr. Hudson. She will share from her vast knowledge and wisdom regarding the uses of botanical medicine in menopause. This comprehensive BHRT and neuroendocrine training is being held in Portland, Oregon on August 1st, 2015. Registration is now open for this one day training event. Space is limited, register today!

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