Herbs as an Alternative to HRT
by Pamela Spence
Menopause is arguably one of the most impactful stages of a woman’s life. The end of fertility to some, a blessed release from monthly suffering for others. For some a sign of aging, for others an era of new horizons. One thing is for certain, what menopause means for each woman can be as varied as we are.
Some of us dread it, many cultures largely dismiss it. Some of us sail through it while others are stopped in their tracks. Not only are there symptoms to be dealt with, but there is also a weight of meaning. Add to that the fact that the body hasn’t had to manage such a dramatic change since pregnancy or puberty, and managing menopause is no small feat.
Some women who have troublesome symptoms will happily choose to navigate the transition by taking HRT. However a recent study has shown that side effects may be worse and persist for longer than previously thought, and reports of issues with HRT supplies means that many women are not keen – or worse, more confused – than ever.
Symptoms are wide-ranging and many women who come to my clinic just don’t realise that they are all connected. Some feel like they are simply unravelling. We all know about flushes: in the night, in the day, sometimes sweaty, sometimes not. There can be mood swings – often anger, irritability or weepiness. Sometimes periods become heavy, with flooding even, other times erratic. Loss of confidence is common, feelings of overwhelm, inability to deal with stress, aching joints, hangovers from one glass of wine… and did I mention loss of libido?
It may seem overwhelming but there is a way through, and my job is to help women identify it and walk it with them as best I can. Often those who have the most trouble have led busy, stressful lives. Stress causes the adrenals to work very hard, and at menopause they are asked (as well as other sites in the body) to take a role in oestrogen production for the first time. If your adrenals have been overworked (for example by deadlines, pressure, little time for self-care and so on) and are just coping, just imagine what impact a whole new task has on them. They can’t maintain their current workload and they certainly can’t keep up with the new demands for oestrogen, so the result is anxiety, overwhelm and sometimes even panic. That’s why supporting adrenals is such a key part of my strategy.
My go-to herbs for this are ashwagandha (Withania somnifera) and liquorice (Glycyrrhiza glabra) – both prized adrenal tonics. Ashwagandha is my favourite herb where anxiety is also an issue and as its name ‘somnifera’ suggests, it can also promote better sleep. In terms of diet it is important to reduce caffeine, because drinking a lot of it is a bit like poking your adrenals with a stick. Herbal teas containing oatflower (Avena sativa flos.) for prolonged stress, or even simple chamomile (Matricaria chamomilla) can be helpful here. If a caffeine-type boost is needed, chewing cardamom (Elletaria cardamomom) seeds or adding them to hot water and drinking can help lift energy. In clinic I often add Huang Qui (Astragalus membranaceous) which is an adaptogen that helps the body function better under stress and is particularly good at building sustainable stamina.
The liver is also asked to do a lot at this time, and commonly women recognise this because they are unable to tolerate alcohol in the same way as they have previously. Using herbs like milk thistle (Carduus marianus) we can support the liver, which in turn helps with digestion and often improves headaches and migraines too. Taking bitters before meals will help prime digestion and if alcohol is becoming less of a treat and more about dreading the morning after, then of course going alcohol-free for a while is recommended.
Finally, we give the body a source of plant oestrogens to use while the adrenals get up to speed. Think of hot flushes as the body shouting for oestrogen – plant oestrogens can help out until the adrenals get on top of their workload, and then the body doesn’t shout so much. Herbs like hops (Humulus lupulus), red clover (Trifolium pratense) and black cohosh (Cimicifuga racemose) are all high in plant oestrogens. Medical herbalists don’t tend to use single herbs as they are often found in over-the-counter remedies, rather, we create a mix to suit each person’s individual symptoms. People with minor symptoms may find that a single herb is enough. Dietary sources like soya products are helpful, but be aware that many are made from GM soya so try to look for organic, traditional preparations like tofu and tempeh.
So far so physical, but menopause can also be a time of great emotion – particularly around children. Maybe there are no children, more children wished for, a lost child, a lost pregnancy, an estranged child, regrets about ways of mothering. Over the years I’ve observed that unresolved issues often come up to be healed at this time. This may be time for the expert help of a counsellor and from a herbal point of view, rose (Rosa damascena) is the ultimate ally for allowing difficult emotions to surface, providing feelings of comfort and calm while this happens. I often suggest to my patients that they simply wear rose oil as a perfume, or choose herbal infusions with rose in them.
I am so glad to see menopause becoming less and less of a taboo subject these days. It is definitely a time where one solution will not fit all, and each woman’s journey needs to be honoured and supported in the best ways specific to her. Many women look outside the mainstream offerings to find this individualised help. If this is where you find yourself at the moment, reach out: there is help available to make sense of what can be a challenging time. Remember that if you have underlying health conditions or take prescription medication, you should contact your local medical herbalist for expert advice.