Tired of your doctor offering you the Pill for every female problem? Fortunately, there are other options. Herbal medicine is effective female hormone balance.
1) Bupleurum (Bupleurum falcatum)
Best for: PMT
Bupleurum is the most commonly used herb in Chinese medicine, primarily because it has a soothing and protective action on the liver. The herb is anti-viral, anti-spasmodic and anti-inflammatory. It also relieves pain, normalises bowel function, and has a slight tranquilising effect. No wonder that Bupleurum is the most effective herb for premenstrual tension!
When it comes to PMT, Bupleurum has a number of direct hormonal effects. It contains a unique active ingredient called saikosaponin, which increases cortisol, and helps the body to deal more effectively with stress. Cortisol also reduces muscle pain and headaches, and is necessary for the production of progesterone, the ‘calming' female hormone. Saikosaponin has also been shown to directly mimic the effect of progesterone.
Bupleurum has another benefit for PMT. By improving oestrogen clearance through the liver and bowel, this herb can be used to correct oestrogen dominance, a common condition for women in their late thirties or early forties. Oestrogen dominance, or oestrogen excess, occurs when there is too much oestrogen compared to progesterone. This causes mood swings, as well as physical symptoms, such as enlarged breasts and fluid retention. When combined with other herbs, such as Peony, Bupleurum has been shown to significantly decrease the amount of circulating oestrogen, and to correct oestrogen dominance.
Use this herb is your PMT is characterised with anxiety, breast tenderness and fluid retention. These symptoms indicate an oestrogen-dominant type PMT. If your PMT is the oestrogen deficient type with depression and fatigue, you need another approach.
How to take: For PMT, Bupleurum is usually combined with Peony and Dong quai. The most famous formula for PMT is the Chinese patent Hsiao yao, which means the "Sedative pill to invigorate the liver".
Tip: Bupleurum is meant to be taken throughout the month to prevent PMT, but it works fairly quickly if you need it in a pinch. Take 200mg of solid extract per day.
Precautions: Bupleurum increases bowel motility, so there is some danger of diarrhoea and flatulence. The addition of mint and licorice to most Bupleurum formulas will prevent this problem. Bupleurum should not be used during pregnancy.
2) Dong quai (Angelica sinensis).
Best for: Painful periods
Dong quai is a female tonic. According to Traditional Chinese Medicine, it is a warming blood tonic. This means that it promotes the healthy production of red blood cells, and increases circulation. The result is easier blood flow to the uterus, and fewer painful spasms during the period.
In western medicine, period pain is understood to be caused by inflammatory compounds called prostaglandins. Conventional drugs for period pain block prostaglandin synthesis. This works for periods, but with long term use, they also damage ‘good' prostaglandins, causing problems with the heart and the kidneys.
Dong quai is different. It regulates prostaglandins, but it does not block them completely, so it works for periods without causing side effects. Furthermore, because Dong quai is beneficial for ‘good' and ‘bad' prostaglandins, the herb can be used for more than just pain. Studies have shown that it benefits other prostaglandin-related conditions, such as allergies and inflammatory bowel disease.
Use Dong Quai if you need your bleeding to be easier, with smoother flow and less pain. The herb may even be effective as part of a treatment for endometriosis, which is an inflammatory condition causing painful periods. If you are prone to fatigue during your period, Dong quai will help. It is slightly oestrogenic and may promote fertility.
How to take: Dong quai is a popular ingredient in most "female" herbal mixes. To prevent menstrual cramps, it combines well with peony and cinnamon. This warming combination is best suited for "cold" period pain, which means pain that feels better with a hot water bottle. To work, it must be taken throughout the month, not just during the period itself.
Tip: If you need this herb, then you are "blood deficient" according to Traditional Chinese Medicine. It is very likely that you also need an iron supplement.
Precautions: Do not take during pregnancy, as it may produce unwanted contractions. It should also be avoided if you take a blood-thinning drug, such as warfarin, and before surgery.
3) Black cohosh (Cimicifuga racemosa).
Best for: hot flushes.
In Europe, Black cohosh has been prescribed by doctors for menopausal symptoms since the 1950's. There have been numerous controlled studies, and for most women, the herb has been proven to reduce hot flushes as effectively as oestrogen replacement. The benefit is slower than conventional HRT, however. It may take four to six weeks to see an effect.
Black cohosh does not contain oestrogen. There a couple of mild phytoestrogens present, but they are not the primary active ingredients when it comes to hot flushes. New research shows that Black cohosh works primarily by lowering LH (a pituitary hormone), and by binding to serotonin receptors, much like popular anti-depressant medications. This activity of Black cohosh coincides with what we are learning about hot flushes.T he exact cause of hot flushes is still not well understood, but current research suggests that flushes are actually caused by a change in brain chemistry associated with menopause, rather than by oestrogen deficiency alone. Some anti-depressants have shown promise for flushes, and it is because they work in a manner similar to Black cohosh.
Use Black cohosh for hot flushes, but do not switch directly from conventional HRT. Because the herb requires some weeks to take effect, the best strategy is to begin Black cohosh when you are still on conventional HRT. After four weeks, you can start to wean off your patch or your tablets.
How to take: The dose used in most of the studies is 40mg per day of the solid extract. It is available as a single herb, or as part of a menopause complex with wild yam and ginseng. Results may take six to eight weeks.
There are concerns about the safety of Black cohosh, and two issues have been raised. The first is that Black cohosh may increase the spread of oestrogen-sensitive cancers. This concern was generated by one study on mice, and most experts believe that it does not stand up against the safety record of five decades of widespread use in Europe. The cancer claim is further contradicted by the fact that Black cohosh is not oestrogenic to any measurable degree.
The second safety concern is liver damage. World-wide, there have been 47 cases of reported liver reactions to Black cohosh. Most were transient cases of jaundice, but one was more serious. According to Australian herbalist Kerry Bone, however, there are inconsistencies in the evidence. Although it was not initially reported, the patient was also taking three pharmaceuticals that are known to cause liver damage. Kerry believes that there is an unconscious bias at work, in which the herb is always the first item to be blamed. The TGA still believes Black cohosh to be safe, and states that "given the widespread use of Black cohosh, the incidence of liver reaction appears to be very low'. They do require that a warning be placed on products containing Black cohosh.
4) Turmeric (Curcuma longa).
Best for: Breast cancer prevention
This yellow Indian spice is related to ginger, and has been long been loved for its anti-inflammatory properties. Researchers are now taking a long look at its potential activity against tumours. Last year alone, there were over 250 studies published about curcumin, the active ingredient in turmeric.
Curcumin has multiple effects. It is anti-bacterial and anti-fungal. It inhibits leukotriene, which is an inflammatory compound associated with different types of arthritis. It prevents auto-immunity and protects the nervous system. It also increases the production of glutathione, an important anti-oxidant made by the liver.
With regard to cancer, turmeric induces cell-death in cancer cells, while leaving healthy cells undamaged. According to Dr. Dennis Liotta, an American biochemist, curcumin inhibits the release of a transcription factor that is made by cancer cells.
With specific regard to breast cancer, turmeric has been shown to potentiate the action of certain types of chemotherapy. It does this by increasing the sensitivity of the cancer cell to the drug. Curcumin has also been shown to prevent the spread of breast cancer to the lungs and other parts of the body.
How to take: An average serving of curry contains 250mg of turmeric. Most herbal tablets contain between 300 and 1000mg of turmeric. Concentrated tablet form is recommended for those with a more serious risk of breast cancer. Consult your health care practitioner.
Tip: For daily prevention of breast cancer, consider using turmeric regularly as a spice and condiment. It adds yellow colour and a pungent flavour to meals, and there is no hassle of taking a tablet. Remember that turmeric is more than just curries. It is a prime ingredient in Worcestershire sauce, chutneys, and mustards. Turmeric powder can be used instead of saffron or dry mustard in some recipes.
Precautions: Do not take turmeric if you are pregnant or trying to become pregnant. There is some evidence that it causes DNA damage, and theoretically could damage the foetus. There is no actual record of this occurring, and millions of pregnant women do eat curry, however, a concentrated tablet may be a different story. The effect on DNA is largely neutralised by vitamin E, and it is recommended that turmeric tablets should always be taken together with a 400iu vitamin E capsule.
5) Licorice (Glycyrrhiza glabra)
Best for: PCOS (Testosterone excess)
Liquorice root extract is best known as the flavour in black licorice candy. The active ingredient glycerrhizin is popular as a condiment because it is 50 times sweeter than sucrose.
The herb has many medicinal uses including as a cough syrup and relief for peptic ulcers.
When it comes to hormones, licorice root is probably the strongest herb around. It increases cortisol and oestrogen, and it also decreases testosterone. The latter effect is desirable for polycystic ovarian syndrome, a condition of excessive testosterone, which causes infertility, weight gain, facial hair and acne.
Liccorice really works for testosterone. In some studies, the herb has been shown to reduce blood testosterone levels in women by 50%. The benefit is due to an active ingredient called glycrrhetinic acid, which inhibits 17B-hydroxysteroid dehydrogenase, the enzyme responsible for testosterone production in the ovary and the hair follicle. Liquorice also helps PCOS symptoms by acting locally at the skin and hair, where it inhibits the action of testosterone on receptors.
How to take: For PCOS, liquorice is nearly always combined with the herb Peony. Peony also decreases testosterone production by the ovary, and when taken together, the two herbs appear to have a synergistic effect. Peony has the added benefit of inducing ovulation, and improving progesterone production. The two herbs should be administered in a 1:1 ratio, with a dose of liquorice extract of about 50mg per day.
Precautions: Large doses of licorice cause the body to lose potassium, which can result in a high blood pressure. The herb should really not be used by those who are at risk for high blood pressure. For PCOS, the blood pressure concern is not likely to be a problem because the treatment protocol requires a low dose of the herb to be taken over many months.
Preparations of licorice root used for peptic ulcer have had certain active constituents removed. This makes them less likely to raise blood pressure, but it is not known if these altered preparations will have any benefit for PCOS.
6) Withania (Withania somnifera)
Best for: Thyroid
Known also as ashwagandha, Indian ginseng, or winter cherry, this herb has a 3000 year old history of use in the Ayurvedic tradition. It has generally been regarded as a tonic herb, and clinical studies support its use for anti-aging, cognitive disorders and Parkinson's disease. It improves white blood cell count during chemotherapy, and helps the body repair after stress.
Of more particular interest to women, Withania looks promising as an herb to support thyroid function. At least 10% of women have a diagnosed problem with thyroid, and many more suffer from subclinical symptoms, such as fatigue, fluid retention and weight gain.
How does Withania help? Withania does not actually contain thyroid hormone. Instead, it works by supporting the body's own thyroid hormone production. In one clinical trial, mice given Withania extract produced significantly more T4 hormone compared with control. Researchers believe that the benefit may not be a direct stimulatory effect, but rather, may be the result of Withania's effect on cellular metabolism. The herb is a strong antioxidant, and by protecting thyroid tissue itself, the herb allows the thyroid to function more optimally. Withania is also an immune modulator, which means that it can reduce the autoimmune inflammation that is the most common cause of under active thyroid. The autoimmunity is also improved by Withania's mild sedative effect.
There is another reason why Withania is a good choice for underactive thyroid. It normalises the amount of stress hormone produced by the adrenal glands. This is important, because too little or too much stress hormone can have a very detrimental effect on thyroid function. Many women make the mistake of taking thyroid medication without treating an underlying deficiency of the adrenal glands. This will result in a need for a greater doses of thyroid hormone, and a greater possibility of side effects including heart palpitations and anxiety.
Use this herb for thyroid if you have autoimmune thyroid disease, or if you are noticeably fatigued, and sensitive to stress.
How to take: Withania can be taken as a fluid extract or a tablet. Because the herb is so gentle, a relatively large dose must be used to see an effect on thyroid function. Consult your Naturopath. Withania is safe to be taken together with conventional thyroid medication.
Tip: Although autoimmunity is the most common reason for thyroid underactivity, iodine deficiency must also be addressed. Australian soil simply does not contain as much iodine as the thyroid needs. If you do not eat fish or seaweed every day, you should use an iodised sea salt, or take kelp.
Precautions: Withania has no known side effect, however because it is mildly sedative, it can interact with barbiturate drugs.
7) Vitex (Vitex agnus-castus)
Best for: Irregular periods
As far back as the 1st century, Vitex berries were used to promote menstruation. (It was also used to suppress the sex drive of male monks, hence the name Chaste berry.)
The main action of Vitex is to suppress prolactin, which is a pituitary hormone best known for its involvement in lactation. When prolactin is too high, it causes the periods to become irregular, or to stop altogether. The most common causes of prolactin-related period problems include stress, excessive exercise and the birth control pill.
Vitex lowers prolactin because it mimics dopamine, which is an important neurotransmitter involved in mood and libido. Studies have shown that Vitex can re-establish regular periods within three months. With continued use, Vitex promotes cycles that have a stronger ovulation and an increased production of progesterone.
Because it promotes ovulation and the healthy response of the ovaries, Vitex has the effect of lowering FSH. This means that it can be used to enhance fertility when age and rising FSH is a factor.
Use Vitex if your periods are absent or irregular. Because it works on the communication between the pituitary and the ovaries, Vitex should not be used by girls under 18 years old. This is a time when the pituitary-ovarian axis is still developing and can be disrupted.
How to take: Vitex needs to be taken in the morning because this is when the body has a natural surge in hormones. It should be started early in the menstrual cycle, before ovulation, and stopped for five days when the period begins.
Tip: Cycles will become regular within two to three months, and the benefit should continue even once the herb is discontinued. Most Naturopaths recommend that the herb be taken for three to nine months, and then stopped. If necessary, a second course can be taken after a three month break.
Precautions: Vitex should not be taken together with conventional hormonal treatment. Because it induces ovulation, it will interfere with the contraceptive effect of the Pill. It will also interfere with the stimulation cycles of IVF, and may result in ovarian overstimulation, a dangerous complication of IVF.
That said, Vitex is an important fertility herb, and there is no reason why it cannot be used be used between collection cycles in order to revitalise the ovaries and to lower FSH.
8) Coleus (Coleus forskohlii)
Best for: for weight loss
Coleus is generating excitement for its promise as a weight loss treatment. In one study in India, women lost an average of 4% of total body weight, while lean body mass was preserved.
Coleus is a desirable weight loss herb because it has minimal side effects. Conventional weight loss herbs such as Ephedra work by increasing adrenalin, and this causes problems such as anxiety and high blood pressure. Coleus is different. It stimulates something called cyclic AMP, which is a chemical that communicates between adrenalin in the blood stream and the actual machinery of metabolism, which is located inside the cell. Cyclic AMP essentially amplifies the message of anabolic hormones to fat and muscle cells, without causing any measurable change in the hormones themselves.
Coleus has other benefits for weight loss. It directly activates a fat-burning enzyme (hormone sensitive lipase), which releases fatty acids from storage. It also stimulates thyroid hormone and may improve insulin sensitivity.
Use this herb if you have sluggish metabolism. Because it increases stomach acid and increases bowel activity, Coleus was traditionally eaten as a pickle to accompany a meal,
How to take: A Coleus extract containing 50mg of the active ingredient forskolin should produce a result within six weeks. Use together with a diet of fresh food and regular exercise.
Tip: Because Coleus works on the cell's inner machinery, it combines well with other supplements that fuel the mitochondria. In particular, it can be combined with carnitine, an amino acid, and coenzyme Q10, an important nutrient for the cell's metabolism.
Precautions: Coleus lowers blood pressure, so it should not be used by anyone at risk for low blood pressure, or before surgery. The other concern is increased stomach acid. This can be a positive effect for someone with sluggish digestion and bloating, but those who suffer from gastric reflux should steer clear.
9) Shatavari (Asparagus racemosus)
Best for: Libido
Shatavari is an Ayurvedic herb, whose name in Sanskrit means "having one hundred roots" or "having one hundred husbands". It has long been regarded as a sexual tonic, or an aphrodisiac that is specific for women.
A cousin of the vegetable asparagus, this herb is described in the Ayurvedic literature as nourishing, soothing, cooling, and lubricating. It has been used traditionally to increase breast milk, sooth heartburn and thrush, and to enhance female fertility. The root is the part that is used medicinally.
The active ingredients in Shatavari are saponins, which are a type of steroid molecule. Shatavari contains two main saponins, shatavarin-I, which is unique to Shatavari, and Protodioscin, which is also found in the male libido-enhancer Tribulus. These saponins are hormonally active, and have been demonstrated to increase follicle-stimulating hormone in women. This, in turn, causes an increased production of oestrogen, which stimulates the libido centre in the brain, and also softens and lubricates the pelvic organs. Shatavari may also be a mild testosterone-enhancing effect in women, which can stimulate libido.
Use this herb if you are run-down and depleted of oestrogen. It may also be helpful during menopause. However, women with oestrogen dominant symptoms such as fibroids may find natural progesterone or progesterone-enhancing herbs a better choice for their libido.
How to take: In Australia, Shatavari is usually given as part of a mix of herbs that are extracted with alcohol. There is some concern that saponins may not transfer well in an alcohol base, so a tablet or water extract may be preferable. The traditional Ayurvedic tradition prescribes 2-6 grams of powder in water or milk.
Tip: For libido, Shatavari combines well with the amino acid tyrosine. Tyrosine assists female libido because it converts to dopamine, a brain neurotransmitter important for mood and sexual arousal. Dopamine also increases oestrogen production.
Precautions: Shatavari has been used in Ayurvedic medicine for thousands of years, and it is believed to be very safe, even during pregnancy. Studies in mice have shown no toxicity even with a massive dose.
10) Schisandra (Schisandra chinensis)
Best for: Anti-aging
This herb is actually a berry. Schisandra berries have gained a reputation as an anti-aging herb because they are particularly high in anti-oxidant compounds and other phytonutrients.
In its traditional use in China, Schisandra was an herb for royalty. It was believed to contain all three primary life energies: Jing, Qi and Shen, and was used to restore vitality and extend life. It was often included in other herbal formulas in order to smooth and strengthen the effect of the accompanying herbs.
Schisandra is not a simple medicine. It contains multiple active ingredients, including Schizandrin B, which enhances glutathione production from the liver. Glutathione is critical to protect the body from chemicals and toxins in our modern environment. Schisandra contains lignans to restore the nervous system, and even a mild phytoestrogen that protects the heart in post-menopausal women.
Schisandra is renowned for its beauty effects, both with internal and external use. In particular, it has been shown to maintain collagen production in the skin, and to maintain moisture content.
These vital berries also improve memory, prevent deterioration of eyesight, and have a mildly calming effect. What more could you want from an anti-aging herb?
Use Schisandra if you have been exposed to things that accelerate the aging process such as stress, smoking and environmental pollutants.
How to take: Traditional use of Schisandra was to chew dried berries daily for 100 days. Recommended dose is 2-10 grams of dried fruit daily. The dried berries are also commonly prepared as a tea or in an alcohol extract. For skin health, a wine formulation is recommended. For optimal glutathione production, Schisandra should be taken together with 50mcg of the mineral selenium.
Tip: Schisandra is a godsend for those who rely on long-term use of pain-killers or other pharmaceuticals. Because it protects liver cells, Schisandra can be used to prevent the mild liver damage that occurs with chronic use of drugs such as paracetamol. At the same time, it is so gentle, that it will not interfere with the action of the drug itself.
Precautions: It is an edible fruit, so Schisandra is almost more of a food than a medicinal herb, and it is considered to be very safe. Those with kidney disease need to be cautious, however, as it can act as a diuretic. It is also wise to choose herbs from reputable companies. If the source is not known, there is some danger that Chinese herbs may have been sprayed with pesticides. Being a fruit, Schisandra is particularly vulnerable to this sort of contamination.