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Black Cohosh

Possibly one of the most helpful herbs in low oestrogen conditions such as the
menopause. The major active compound, 27-deoxyactein possesses the ability to
selectively reduce serum concentrations of luteinising hormone (LH) – LH levels are
often consistently high in menopause, a factor that is thought to be linked to many of
the typical symptoms of menopause. Studies have shown black cohosh to relieve
common menopausal symptoms such as hot flushes, vaginal dryness, depression, low
self esteem etc. In fact, comparison studies have shown black cohosh to be far superior
to HRT in reducing menopausal complaints. Although research into the effect of black
cohosh on bone density is currently lacking, there is justification for its use in
combination with bone-building nutrients in prevention of osteoporosis.

Vitamin E
Vitamin E has been shown to help reduce menopausal symptoms such as hot flushes
(due to correcting the associated vascular dysfunction), pains in muscles and joints,
palpitations, nervousness and depression.

Dong Quai
Dong quai’s use in Chinese medicine dates back to ancient times. Today it is one of the
most heavily used female tonics throughout the world, and is commonly used for
relieving menopausal symptoms (e.g. hot flushes, night sweats, palpitations and
irritability). It appears to have an oestrogen regulating effect and may be especially
valuable in perimenopause – the period between normal menstruation and full
menopause – when periods become irregular and menopausal symptoms begin to

Pueraria mirifica
Pueraria mirifica (PM) contains several phytoestrogens including genestein and
diadzein, but is the only known source of one particular phytonutrient called
miroestrol. Miroestrol is similar to oestriol, the weakest of the three major oestrogens
in the female body. Miroestrol occupies the body’s oestrogen receptor sites. If the
oestrogen level is high, miroestrol will compete with receptors, weakening the effects of
the hormones. If the oestrogen level is low, miroestrol will exert its oestrogenic effect of
potentiation. In clinical trials assessing the use of PM to relieve menopausal symptoms,
every woman who participated experienced immediate positive results and after six
months, every woman reported a decline in all symptoms. The symptoms assessed
included hot flushes, night sweats, depression and loss of sex drive, amongst others.
Daily occurrences of hot flushes were reduced from 2.1 to 0.5 per day, night sweats
from 1.5 to 0.26, headaches from 2.03 to 0.8 and mood stability from 2.2 to
0.9. Sixteen other symptoms also improved accordingly. These results are more
consistent than those gained with other phytoestrogens.

Essential Fatty Acids
The steroid hormones (oestrogen, progesterone and testosterone) are made from
cholesterol. Essential fatty acids are crucial in the control of cholesterol levels,
particularly in relation to maintaining a good ratio between HDL and LDL cholesterol.
Essential fats are also required for the production of prostaglandins, groups of
hormone-like chemicals that play an important role in controlling the process of steroid
hormone synthesis. EFAs are therefore an important foundation to menopausal
hormone health and an appropriate balance of omega 3 and 6 fatty acids is especially
important during this life-stage.

Bone Nutrients
Bone loss accelerates as oestrogen levels reduce. Oestrogen reduction happens from
approximately the mid 30s, but is particularly prominent at menopause, hence the
association with increased osteoposrsis risk. See ‘Osteoporosis’ section

Menopause Summary
Nutrient/Herb Typical intake range
Black cohosh (2.5% triterpene glycosides)1 200 – 400mg per day
Vitamin E2 100 – 400IUs per day
Dong quai (1% ligustilides)3 150 – 450mg per day
Pueraria mirifica4 80-160mg per day
Omega 3 fatty acids5 1000 – 2000mg fish oil per day
Omega 6 fatty acids6 150 – 300mg GLA per day

Excess protein
Carbonated soft drinks
Red meat
Trans/hydrogenated fats
Refined/processed foods
Caffeinated beverages


Complex carbohydrates
Nuts and seeds
Oily fish
Whole grains

Lifestyle Factors

Minimise exposure to stress (employ stress management techniques)
Minimise exposure to environmental toxins
Take regular exercise

1. Do not use during pregnancy or lactation. Avoid concurrent use with anti hypertensives unless
directed by a medical practitioner
2. Avoid concurrent use of high dose vitamin E supplements with Warfarin and other anticoagulant
medication. May reduce insulin requirement in insulin-dependent diabetes and should therefore
be used under supervision by diabetics.
3. Do not use during pregnancy or lactation. Do not use with Warfarin or anti-coagulant
4. Do not use during pregnancy. Do not use in conjunction with HRT and the contraceptive pill.
5. Some reports suggest GLA is contraindicated in epilepsy. Epileptics should use only under
medical supervision.
6. Do not take in conjunction with anticoagulant medication