Q. I have been reading about the problems of hormone replacement therapy on your website. Since discontinuing HRT I have been using St. John’s wort and it has relieved many symptoms, including sleeplessness, stress and fits of temper. I don’t know why doctors in the USA don’t suggest it, because it is safe and you don’t feel medicated taking it. Your thoughts?
A. We’re not surprised that you got benefit from St. John’s wort. This herb has been shown to be an effective treatment for symptoms of perimenopause and menopause in a double-blind, placebo-controlled trial.
A recent review in the journal Gynecological Endocrinology (Sept. 2012) concluded that when black cohosh (Cimicifuga racemosa) is combined with St. John’s wort (Hypericum perforatum) the benefits are better than placebo. The combination of black cohosh and St. John’s wort is recommended by many physicians in Europe, especially in Germany, though it has not achieved the same degree of popularity in the U.S.
American physicians like scientific support before they recommended an alternative approach. Here is a link to one study published in the highly respected journal Obstetrics and Gynecology. The authors concluded:
“This fixed combination of black cohosh and St. John’s wort is superior to placebo in alleviating climacteric complaints [menopausal symptoms], including the related psychological component.”
Here is what our visitors have reported:
“I have personally found Black Cohosh to be most effective for hot flushes. Occasionally I stop taking it just to check but the problem is back within a day. I have been taking this for several years now, with no problems.”
“Black Cohosh has worked wonderfully well for my night sweats and hot flashes. It truly is amazing. If I stop taking them for about three days the hot flashes start again, although it takes about a week before the night sweats reappear. Having just completed menopause (1 year), I may try to taper off of the Black Cohosh in about 6 months. So far, this regimen has been very effective for me.”
“I started using Remifemin (black cohosh, taken twice daily) at least 6 weeks ago. My most troublesome menopause symptom was insomnia. After 4 weeks on Remifemin I noticed I was sleeping better.”
Not everyone gets such results, however. Some women report that black cohosh doesn’t help at all.
“I tried everything as my hot flashes began – acupuncture, tofu, miso, soy milk, Chinese herbs, Remifemin (red clover), black cohosh, etc. All worked for awhile and then nothing worked at all. My hot flashes were debilitating!”
The combination of black cohosh and St. John’s wort may be better than either alone. But St. John’s wort does carry risks. For one thing, it can interact with a number of medications and should never be taken without double-checking to avoid dangerous incompatibility problems. Side effects may include nausea, stomachache, dry mouth and loss of appetite. It may also affect vision. We have a FREE Guide to St. John’s wort at this link.
If you would like to learn more about easing menopausal symptoms, you may find Graedons’ Guide to Menopause of value. We discuss in detail a number of natural approaches that may work well for you or someone you know. We also have an extensive chapter about dealing with menopause in our book, Best Choices From The People’s Pharmacy. Hormone replacement therapy or antidepressant medications are NOT the only way to deal with menopausal symptoms.