Phytomedicines for menopause

Concerns regarding the safety of hormone replacement therapy are causing women to seek out alternative treatments, particularly botanicals. Of these botanicals, black cohosh appears to be the most promising; however, reports of hepatotoxicity have reached high enough numbers that the FDA has decided to take the action of posting warning labels on products containing the herb. Soy and red clover are also popular phytotherapies for menopause despite the fact that their efficacy has yet to be proven. Although the hops plant contains the potent phytoestrogen 8-prenylnaringenin, it has only been tested in two clinical trials as a therapy for menopause. Based on positive results in these two trials, further studies on hops are warranted. Other herbs, such as dong quai, licorice, ginseng, kava, chasteberry and St. John's wort, are marketed as therapies for menopause; however, there is no evidence that they have any effect on the vasomotor symptoms associated with menopause. This review is focused on the relevant clinical trials, chemistry and pharmacology of these phytomedicines.