MENOPAUSAL SYMPTOMS

Research states that over 80% of women will experience menopausal symptoms of varying degrees. Nuffield Health conducted a questionnaire among 3275 women representative of the female UK population. The findings reported that 62% of participants experienced hormonal changes and menopausal symptoms that resulted in a change in behaviour or had a detrimental effect on their lives. Finally, one in four were concerned about their ability to cope due to menopause. 

As suggested, menopausal symptoms have a significant impact on quality of life and HRT is not always appropriate, so, many women are interested in natural options. Consequently, more research interest in the oestrogen buffering effect of Hops has occurred.

Initially the values of 8-PN that were used in pre-clinical studies were investigated in a small randomised controlled trial compared to placebo. A total of 24 healthy postmenopausal women were randomly allocated to receive a single dose of 50, 250 or 750 mg of 8-PN or placebo. The blood markers of 8-PN showed a rapid absorption, with a second peak at around 5 hours. The 750 mg dose demonstrated a decrease in luteinising hormone by 16.7%, elevated levels of luteinising hormone are associated with the cessation of ovulation.

A second randomised, double blind, placebo-controlled study investigated smaller quantities of 8-PN that were administered as a Hops extract. Over 12 weeks, 67 menopausal women were randomly allocated to receive a Hops extract standardised to 100 mcg and 250 mcg 8-PN placebo. The responses were measured using the Kupperman index and a patient’s questionnaire to assess menopausal symptoms. Both the Hops groups showed a significant reduction in the scores after both 6 and 12 weeks which indicated a significant reduction in menopausal symptoms. The 100 mcg Hops extract treatment effect was superior to 250 mcg Hops and placebo.  This suggests efficacy from smaller doses than those used previously.

To further investigate the lower and seemingly more efficacious dose of Hops extract standardised to 100 mcg of 8-PN was investigated for its effect on menopausal discomforts. At 8 weeks of the 16-week randomised, double blind, crossover study improvements in symptomatology were reported for the Hops group, this further improved at 16 weeks in all symptom outcomes.

OESTROGEN METABOLISM

A major concern in female health is the metabolism of oestrogen into harmful metabolites. The metabolism of oestradiol to oestrone is followed by one of 3 oestrogen metabolites: 2-OHE1, 4-OHE1 or 16α-OHE1. Whereby 16α-OHE1 is considered the most aggressive and harmful.

Given the impact of menopause depressive symptoms which can affect work, social life and the ability to cope, a random controlled trial investigated the effects of saffron on hot flashes in those with major depressive disorder. Sixty post-menopausal women suffering with hot flashes were randomly allocated to receive 15 mg of saffron extract or placebo given twice daily for 6 weeks. The data analysis demonstrated a significant effect for time x treatment, namely, the improvements increased with duration of saffron use.  Subsequently, the alleviation of hot flushes is a new discovery to add to the catalogue of benefits reported for saffron.

Lemon Balm

MENOPAUSAL SYMPTOMS

Lemon Balm is known for its improvement to mood, a major factor in menopausal symptoms. Subsequently, a group of researchers investigated the effect of lemon balm on menopausal symptoms using the Menopause Rating Scale (MRS). Sixty postmenopausal women were recruited and randomly allocated to receive 250 mg of Lemon Balm or placebo taken twice daily. By the 4-week mark the Lemon Balm group had a significantly lower MRS score than the placebo group, which perpetuated to 8 weeks. 

INSOMNIA

Issues with sleep is commonly reported by women during the menopause. The regulation of the stress and wakefulness hormone, cortisol is regulated by oestrogen. Subsequently when oestrogen levels decline as characterised in menopause, cortisol levels creep up to the extent that sleep is interrupted by cortisol’s inhibition of melatonin, the sleep hormone.

Subsequently, a triple blind randomised controlled trial that recruited 100 menopausal women aged 50-60 years who were suffering with insomnia investigated the effect of Lemon Balm on insomnia. The participants were randomly allocated to receive either 250 mg of Lemon Balm or placebo, twice daily for one month. A total of 20% of the Lemon Balm group showed sleep improvements. Additionally, the average sleep score was significantly higher in the Lemon Balm group when compared to placebo which indicated improved sleep. 

To evaluate the standard of efficacy, Lemon Balm was compared to citalopram, a commonly prescribed SSRI, to investigate the quality of life in menopausal women with a sleep disorder. Sixty postmenopausal women with a sleep disturbance diagnosis were recruited to randomly receive 500 mg of Lemon Balm, 30 mg of citalopram or placebo daily for 8 weeks. Menopause specific quality of life scores were significantly improved in the Lemon Balm group compared to citalopram and placebo. Significant improvements were shown in vasomotor, psychomotor-social, physical and in the sexual domain symptoms. 

Sage

MENOPAUSAL SYMPTOMS

Revered in traditional medicine Sage is rich in phytoestrogens and along with its antibiotic, anti-anxiety, anti- fungal, hypoglycaemic effects, it has been historically used to manage the symptoms of menopause. To gain research evidence Sage was investigated its effect on the full range of menopausal symptoms, 30 postmenopausal women were recruited, they experienced varying degrees of hot flushes. The women were given 100 mg of Sage for 4 weeks. The results showed a decrease in the severity of hot flashes, night sweats, panic, fatigue and concentration by the end of the study. 

HOT FLUSHES

Hot flushes are a sudden feeling of warmth in the upper body which becomes intense in the face, neck and chest and triggers sweat and a flushing of the skin. Women are often very sensitive to the effects of this symptom. It may contribute to self-consciousness, for example, that their clothes may have sweat marks, that they smell sweaty, or their makeup has run. In Switzerland, 71 patients who had been menopausal for at least 12 months and experiencing hot flushes were recruited to use Sage each day for 8 weeks.

There was a significant decrease in the total score of the mean number of intensity-rated hot flushes by 50% in the first 4 weeks and by 64% within 8 weeks. The mean total number of hot flushes per day decreased significantly each week from week 1 to 8. The mean number of mild, moderate, severe, and very severe flushes decreased by 46%, 62%, 79% and 100% over 8 weeks, respectively. 

Both the Sage studies would be improved if repeated and compared the intervention to placebo; however, the positive findings support anecdotal evidence and traditional use.

Ingredients

Dosage

• Taken as a food supplement the directions for adults are one capsule daily with food. Recommended use:

• Not recommended for the use of children, during pregnancy or lactation.

Pregnancy and breast-feeding

• Not to be used during pregnancy and lactation.