What Does The Science Say About Natural Remedies?

Liz Wilson, BSc, MBBS Susan Reed, RGN, BSc

EarlyMenopause.com does not recommend specific supplements or brands. Please speak to your doctor or health professional before beginning any new course of treatment.

This helpsheet explores herbs and supplements that are commonly touted as solutions to a range of menopausal symptoms.

We’ve highlighted some of the most popularly utilized products by women experiencing an early menopause. As always, evaluate your plans in conjunction with your doctor.

Assortment of herbal remedies and supplementsMany women deal with early menopause or premature ovarian failure (POF) — the symptoms like hot flashes, night sweats and mood swings, and the risks of osteoporosis and heart disease — by taking hormone replacement therapy (HRT).

But HRT isn’t the only solution looked to by women experiencing POF, perimenopause, or indeed menopause at a normal age.

Some vitamins, herbs and nutrients have been studied with respect to menopausal symptoms — and they are often sought out by women not on HRT. And, in fact, even for women on HRT, these natural supplements are commonly utilized.

Why did we write this helpsheet?

This helpsheet was compiled partly in response to the exploitative practices of some manufacturers in the way they market nutritional supplements to menopausal women.  Some (but not all) of these products come with claims severely lacking in evidence-based truths.

To date only a small number of dietary supplements and herbal products have been studied in relation to tackling menopausal symptoms, and the results have been mixed.

With all that said, let’s get right into it — here’s your quick rundown:


Large container of soybeansSoy is rich in phytoestrogens (specifically isoflavones). It’s cholesterol-free and also contains protein, omega-3 fatty acids, calcium, folic acid, iron and other vitamins and minerals.

It may be one of your best bets to add to your diet to gain a wide range of health benefits when you’re coping with premature ovarian failure (POF) or early menopause.

What does the science say?

Specifically, a number of studies have found that soy can help reduce hot flashes, night sweats, and other menopausal symptoms (1, 2). However, reviews of a wide range of studies suggest that the benefit may be only “modest” (3).

However, it can also help lower your cholesterol — which often rises when you enter premature menopause — and help your coronary blood vessels dilate, both of which are important in fighting heart disease (4).

In addition, it may help lower triglycerides — which often rise when you take estrogen.

Finally, soy may help prevent osteoporosis. Studies have shown that soy isoflavones help cut down on bone resorption, keep calcium from leaching from your bones, and increases bone density and bone mineral content (5).

How much should I consume?

It’s a good idea to aim for at least 25 grams of soy protein daily to help with symptoms.

You can get soy from a variety of sources — including soy milk, tofu, roasted soy nuts, tempeh, soybeans and even products that are made to taste like other foods (like soy meat substitutes and soy cheese).

And, if you don’t like the taste of soy (something that’s relatively common!), you can also get soy and soy isoflavone powder at vitamin or health food stores, or take soy isoflavone capsules.  However, keep in mind that isoflavones alone may not replicate the benefits found in studies using whole soy.

One important note: High amounts of soy isoflavones can affect your thyroid, so if you have thyroid disease, speak with your doctor before using soy as a symptom reliever.


Brown flaxseed and wooden spoonAnother nutrient high in phytoestrogens (especially lignans), flaxseed is also high in omega-3 fatty acids — a key helper in fighting heart disease. And, like soy, it’s a good all-round helper in your body.

More specifically, because it’s high in phytoestrogens, flaxseed may help minimize symptoms like hot flashes (6).

Studies have shown that it can help lower LDL (the “bad”) cholesterol (7).

According to a recent systematic review, flax may help fight breast cancer (8).  It has also been linked with protective effects against other cancers.

And, because it’s high in omega-3 acids, flax may help ease symptoms like breast tenderness, cramping, and other PMS-like discomfort (9).

Some women have also reported benefits using flax to prevent heavy bleeding — a common symptom when you’re first beginning to enter premature menopause and going through erratic periods. However, more data is needed before we can conclusively tell whether flax is helpful in this regard.


You can get whole flaxseed at health food stores and grind it — to sprinkle in cereal, smoothies, yogurt, salads, and so forth — or buy flaxseed oil and/or high lignan flaxseed capsules, which are filled with ground flaxseed.

Red Clover

Red clover plantRed clover is another phytoestrogen and it is also high in bioflavonoids.

Like the other phytoestrogens, attempts have been made to evaluate red clover for its potential to reduce hot flashes.

The results have been inconclusive, with some studies finding modest benefits and others finding only minimal benefit or no improvement at all (10, 11, 12).

Nevertheless, it’s possible red clover may have wider benefits other than simply alleviating hot flashes and night sweats. A review conducted in 2005 found positive health effects on cholesterol and triglycerides, suggesting a possible role for red clover in reducing heart disease risk (11).

Animal studies have suggested a possible role for red clover in helping fight osteoporosis (13).  This study was conducted with estrogen-deficient rats and requires much further investigation before any conclusions can be drawn.

Many women have reported success using red clover to generally minimize their menopausal symptoms but, as with so many other supplements, the jury is still out.

Vitamin C / Vitamin E and Citrus Bioflavonoids

Partially peeled tangerine orangeThis combination is touted as a hot-flash buster. Studies have shown that Vitamin E may help combat hot flashes (14).

One possible regimen includes 400 IUs of Vitamin E along with 1200mg of bioflavonoids taken in the morning and again before bedtime. Several women have reported success in taking these two supplements together to combat the frequency and severity of hot flashes.

Unfortunately there has been little recent research, but one dated study (Smith, 1964) found that, after only one month, over 50 percent of the 94 participating women taking 1200mg of bioflavonoids along with 1200 milligrams of Vitamin C stopped having hot flashes completely and another 34 percent had a drop in hot flash frequency and intensity.

Some individuals report that bioflavonoids may help to relieve moodiness, anxiety, irritability and other emotional side effects of menopause. Some women have also reported benefits in fighting vaginal dryness with bioflavonoids. However, high quality trials are lacking and so these potential effects must be considered unproven.

One note: Vitamin E isn’t safe for everyone. If you have rheumatic heart disease, high blood pressure, or diabetes, or take digitalis drugs, Vitamin E can be harmful. So be sure to check with your doctor about the appropriate dosage.

Vitamin E

Vitamin E is useful for the relief of vaginal dryness (you can even use it as a vaginal suppository — just putting the capsule in your vagina).

B Vitamins

An assortment of colorful legumesThis family of vitamins may be helpful in coping with premature menopause, both in terms of combating symptoms and fighting negative long-term risks.

They also help maintain your adrenal gland function — which is where the precursor to estrone (the form of estrogen still produced by your body after menopause) is produced (15).

Last, but definitely not least, B vitamins are considered stress fighters — so can help you to deal with the emotional symptoms that crop up during premature menopause such as anxiety, irritability, mood swings, even insomnia (15).

In addition, if you’re on HRT, it’s a good idea to be sure you’re getting B-vitamins either through your diet (whole grains, beans and brewer’s yeast are all good sources of B vitamins) or in a multi-vitamin or B-complex supplement, since HRT may cause a deficiency in B2, B12, B6 and Biotin (16).


Calcium is useful in the battle to reduce osteoporosis risk. It also has a role in helping to regulate blood pressure (that sometimes rises in women on some forms of HRT).


Sometimes found in calcium supplements, magnesium is an important “calcium helper” — and also may help fight the often crashing fatigue at the start of premature or early menopause by regulating energy levels.


Another important mineral, potassium also has a role to play in regulating your energy levels. In addition, it can help you cope with water retention and bloating, both of which are side effects with certain forms of HRT, particularly progestins such as Provera (17).

Black Cohosh

Black cohosh branch growing in the wildThis herb has been used to help cut down on hot flashes and other menopausal symptoms.  Black cohosh may also help with cramps, heavy periods and other menstrual irregularities.

Studies conducted using black cohosh have shown that it appears to be quite effective, especially for hot flashes (10, 11).

And some researchers believe it may help prevent osteoporosis and reduce bone resorption, although no long-term studies conducted on humans have substantiated this.

Most studies recommend that you take black cohosh extract that contains either 20 or 40 mg twice a day — and keep in mind that it may take two to four weeks before you notice results.

The German Commission E (which was a body setup to investigate herbal supplements) published guidelines recommending use of black cohosh for no longer than 6 months in a course of treatment. Data from clinical trials has generally shown black cohosh to be safe. However, caution has still been urged as researchers look into the impact of black cohosh on the liver and on breast tissue (source).

The latter concern relates to worries that black cohosh might encourage the growth of breast cancer tumors. It’s advisable to speak with your doctor before starting on the supplement if you’re a cancer survivor or have concern about this risk.

Chasteberry (also known as Vitex agnus castus)

Chasteberry plant floweringChasteberry (like black cohosh) appears to “act” like a progesterone (a hormone commonly prescribed in a course of HRT).

It has been used in Europe for many years to alleviate premenstrual syndrome (PMS) symptoms as well as menopausal symptoms — particularly hot flashes and irregular bleeding (18, 19).

It also appears to have some potential role in reducing breast tenderness, possibly because chasteberry suppresses prolactin production (20).

Typically, it takes about three to four weeks notice results.

Evening Primrose Oil

A good source of GLA (gamma linoleic acid), evening primrose oil has been used by many women to help fight PMS symptoms — many of which are the same as menopausal symptoms.

Some individuals have reported success using evening primrose oil to prevent bloating, water retention, breast tenderness, cramps and vaginal dryness; but more research is needed to substantiate this.

St. John’s Wort

If you’re finding yourself more easily depressed, St. Johns Wort may help. Widely touted as a natural tranquilizer, this herb may be moderately useful in relieving irritability, depression, and fatigue.

Dozens of studies have found that it’s effective in fighting mild to moderate depression — which often affects women when their hormone levels plunge suddenly, such as after surgical menopause.

Most notably, it appears to be effective in improving the mood-related symptoms of menopause specifically (11).

Keep in mind that St. John’s Wort can interact with other medications, including birth control pills. Remember to ask your pharmacist for more information.


Valerian has been used widely in Europe to treat sleep disturbances and insomnia, as well as for anxiety relief and menstrual problems.

However, evidence for its effectiveness in relieving sleep problems is limited and large studies have produced conflicting results (21, 22).


Kava is another herb that’s been used in reducing anxiety, fighting depression, and leveling mood swings.

One study found reductions in anxiety among perimenopausal women treated with kava (23), however, further studies are needed. Before taking kava you should discuss potential side effects with your doctor.

Note: check with your doctor before starting any herbal remedies — and, if you’re already taking any vitamins or herbs, be sure to tell him/her what you’re taking and at what dosages.

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