A natural transition
Every woman passes through menopause, yet few are told what is happening inside the body or what can ease it. Dr Abdul Basit, an Egyptian biochemist, gives it a full chapter in his book The Green Medicine and he treats it as a transition the body can be helped through.
He describes it as a stage that lasts anywhere from five to twenty years. From around the age of thirty-five the ovaries release a little less oestrogen each year until the monthly cycle stops altogether. By his count about 85 percent of women experience hot flushes along the way. A flush is a sudden wave of heat through the neck and upper body that brings sweating and a reddening of the skin. It usually passes in minutes but it often arrives at night and breaks sleep. Headaches, anxiety, poor concentration and dryness of the skin and vagina can follow. Lower oestrogen also leaves the bones more fragile and the heart less protected.
What the pharmacy offers
The standard medical answer is to put back what the body has stopped making. Hormone replacement therapy supplies oestrogen directly. Dr Abdul Basit writes that it often controls the hot flushes, the vaginal dryness and the urinary symptoms and that it helps protect the bones. He also lists the newer bone drugs alendronate (Fosamax) and raloxifene (Evista).
Then he points to a third route. Many plants carry compounds called phytoestrogens, which are shaped closely enough to human oestrogen that the body responds to them. This is where his green medicine begins.
The green medicine
Soybean. Soy holds two phytoestrogens called genistein and daidzein. He explains that they take the place of the body's own oestrogen as its production falls. He uses soy to ease the heat of the flushes and to prevent vaginal dryness.
Black cohosh. He calls this the herb most often prescribed for women's troubles. It contains substances that act like oestrogen and he uses it for sudden flushes and dryness. The powdered root is stirred into boiled water and taken as a hot drink.
Liquorice root. Liquorice carries isoflavones and glycyrrhizin. He describes a double action: it lowers oestrogen when the level is high and raises it when the level is low.
Strawberry. Strawberries are rich in boron, a mineral he credits with raising the level of oestrogen in the blood. He names other good sources too: fig, apricot, pear, apple, cherry, peach, cabbage, tomato, beetroot, dill and parsley.
Alfalfa. The dried herb has clear oestrogenic activity. He has it powdered and made into a herbal drink.
Chasteberry. He uses chasteberry to regulate the female hormones through the pituitary gland. It has been taken for the monthly cycle since the time of the Greeks.
Angelica. Angelica has an old reputation as a tonic for women. He uses it for dryness and for excess heat, one spoonful of the dry herb in a hot cup sweetened with liquorice or honey.
Celery seed. The seeds contain a compound he uses for the symptoms that follow the end of the cycle. They are also rich in beta-carotene, an antioxidant he values for ageing and exhaustion. The seeds can be added to food, ground into baking or brewed as a drink.
Four more plants for this stage of life
Red clover. Dr Abdul Basit lists red clover elsewhere in the same book for its plant oestrogen formononetin, which he says helps balance the hormones. That family of compounds has made red clover one of the most studied herbs for menopause. A 2021 analysis of eight trials and 1,043 women found that red clover extract cut hot flushes by almost two a day compared with placebo.
Red maca. Maca is a root from the high Andes of Peru that has been eaten for strength and vitality for centuries. It carries no plant oestrogens, so it is a different approach from the herbs above. Four small trials have tested maca in menopausal women and all four reported fewer symptoms. Reviewers want larger studies before the result is called settled.
Bee pollen. The Quran says of the bee that from its belly comes a drink of varying colours in which there is healing for people. Pollen is the other gift of the hive. In a 2015 trial of women with hot flushes brought on by hormone-blocking treatment, about 71 percent improved on a mixture of pollen and honey. About 68 percent improved on honey alone, which says as much for the honey as for the pollen. Anyone allergic to bee stings or pollen should avoid it.
Dandelion. The botanical name Taraxacum is traced to the Arabic tarakhshaqun, the name under which the classical physicians recorded it. Dandelion has not been tested in menopause trials. Herbalists use the root as a bitter tonic for the liver, the organ that clears used hormones from the body. The leaf is used to ease the bloating and fluid retention many women notice at this stage.
What modern research has found
Soy is the best studied of his plants. A 2012 analysis in the journal Menopause pooled 17 clinical trials. Women taking soy isoflavones, at an average of 54 milligrams a day, had 21 percent fewer hot flushes than women on placebo and the flushes they did have were 26 percent less severe. Extracts richer in genistein worked best, which is the same compound Dr Abdul Basit names.
Liquorice has early support as well. In a 2012 trial of 90 menopausal women, those given liquorice root extract three times a day for eight weeks had fewer and milder flushes than the placebo group. The flushes returned within two weeks of stopping.
Black cohosh is less settled. A Cochrane review of 16 trials and 2,027 women found the results too mixed to draw a firm conclusion and called for better studies. Many women and herbalists continue to rely on it.
Plants that act on hormones deserve the same respect as any medicine. Liquorice can raise blood pressure when taken daily for long periods. Any woman with a history of breast cancer or another hormone-sensitive condition, or who takes hormone therapy, should speak with her doctor before using phytoestrogen herbs.
The habits he prescribes first
Before any herb, Dr Abdul Basit starts with daily life. He advises easing nervous tension, avoiding spicy and fatty foods, cutting back on coffee and other stimulants, keeping the room cool and dressing in light layers that do not trap heat.
None of it is complicated. A bowl of strawberries, a handful of celery seed in the bread, a cup of angelica sweetened with honey. With the right plants and a little care menopause can be a far gentler passage.
References
- Dr Abdul Basit. The Green Medicine (al-Tibb al-Akhdar), Part Four: Diseases of the Pelvis.
- Quran 16:69.
- Taku K et al. Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause, 2012.
- Nahidi F et al. Effects of licorice on relief and recurrence of menopausal hot flashes. Iranian Journal of Pharmaceutical Research, 2012.
- Leach MJ and Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database of Systematic Reviews, 2012.
- Kanadys W et al. Evaluation of clinical meaningfulness of red clover extract to relieve hot flushes and menopausal symptoms in peri- and post-menopausal women: a systematic review and meta-analysis. Nutrients, 2021.
- Lee MS et al. Maca (Lepidium meyenii) for treatment of menopausal symptoms: a systematic review. Maturitas, 2011.
- Münstedt K et al. Bee pollen and honey for the alleviation of hot flushes and other menopausal symptoms in breast cancer patients. Molecular and Clinical Oncology, 2015.