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feature article - herbal alternatives

Herbal Alternatives to Hormone Replacement Therapy and Hormonal Balance

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I wanted to give a few herbal ideas on a big subject about which advanced science is still learning much about. Latest studies are showing more long-term side effects from Hormone Replacement Therapy. While realizing there are women with severe imbalances that can benefit from the manufactured hormones, there are many women who I believe can look to some of the traditional herbs for aid in coming back into balance. In an ideal world in which herbs can truly work with the body, women would use herbal aids before things get too far out of whack. It is a little harder to expect an overnight success with herbs when one has been suffering from various symptoms for many years or have been on the Pill for many years. Which doesn't mean that herbs may not aid, but that long-term imbalances of the hormones takes a little time to work with.

There are so many factors that effect our hormones, and these should be considered first, for there are some that we can have control over ourselves. Our emotions and thoughts and stresses all effect the hypothalamus which works with the pituitary gland in regulating the bodies hormones; stress alone can cause cessation of the menses, a case which clearly shows the connection. Since estrogens are stored in body fat, too much or too little body fat can effect hormone levels. A woman falling too far below her ideal weight can have the menses cease. Vitamin and mineral deficiencies can cause problems. Be aware that Soy, which the medical world had started to embrace for hormone balance, can cause certain nutrient deficiencies and thyroid symptoms in certain folks if overdone. Hormones and hormone mimickers in meat, milk, pesticides and plastics are, I believe, what has caused increasing problems for the hormonal systems of both men and women. Candida infection and various allergies can cause problems.

A first line of defense would be in helping reduce stress with nerve relaxant and restorative herbs. Especially during hormonal fluctuations a tea or extract of chamomile (cranky, agitaion, darting pains) or lemon balm (moodiness, mild depression), may be just the thing. Skullcap or Valerian for calming and stress. Green Oats extract for long-term stress with low energy and frayed nerves. Motherwort has long been used for calming, as well as calming heart palpitations. A little American Ginseng for flagging adrenals and low energy can be tried; Licorice is a nourisher for the adrenals as well. As menopausal changes progress, there is a greater need to nourish the adrenals, as they will be taking over in the production of a woman's hormones as the output from the ovaries slows down. Don't overlook the value of reducing stress. At the same time, it is my belief that at times of hormonal changes, and at the menopause, women who are thought of as moody or sensitive may be dealing with things they need to get out or express in constructive ways. They can speak a lot of truth if those around them will hear.

Since the liver has to work overtime in breaking down hormones, herbs that aid the function of the liver should be used along with balancing herbs when dealing with hormonal highs and lows. Dandelion Root and Yellow Dock are two that can be used as aids. Both can also aid in anemic conditions.

In approaching the herbs that are traditionally used for hormonal balance, I would first remind that herbs do not contain the actual hormones; they either stimulate the body's own production of hormones or provide building-blocks, or pre-cursors of hormones that trigger their release. Even scientists will speak of the hormones in herbs, but actually know (or should know) better. One should keep in mind that it is not usually the case that one is attempting to choose one hormone over the other; even most HRT now combines hormones. In the body, the ovaries produce both estrogen and progesterone, and while herbs may tend to promote one or the other hormone, it does not usually do so at the risk of suppressing other hormones, but bringing levels to a balnce.

The traditional herbs are thought to provide a number of benefits besides just triggering hormones; some are uterine tonics as well, bringing circulation and energy to the female organs; others aid the nerves as well. As far as their hormonal effects, a number herbs are classified as to their net hormonal effects on either estrogen or progesterone balance in the body, though I believe many act as overall balancers.

Herbs that are generally thought of as promoting estrogen balance include Alfalfa, Black Cohosh, Blue Cohosh, Fennel, Fenugreek, Ginseng, Hops, Licorice, Red Clover, Sage and Wild Yam.

Herbs believed to promote progesterone balance include: Chaste Berry, False Unicorn, Black Haw, Lady's Mantle, Yarrow, and Wild Yam.

By informing herself on the wide range of uses of each of the herbs (see our website under "Single Herb Extracts" for many traditional herb uses), a woman can choose a single herb ally. Others will want to balance with herbs from both categories. By being informed about the symptoms associated with surges or lows of these two hormones (as well as the andorgen hormones), a woman can vary the herbs she uses according to the cycles of her life and health. In general women who have dealt with functional amennorhea (absence of menses) or nervous symptoms or cramping with the onset of the menses with will tend toward the estrogenic herbs; those with PMS in advance of the menses and/or irregular or prolonged or heavy periods will tend toward the progesteronic herbs, as well as those dealing with conditions aggravated by excess estrogen (endometriosis, fibroids, fibrocystic breast, history of breast cancer).

Unlike artificial, high dose hormones, the herbs produce mild changes; some need to be used over several months to obtain their full benefits. Any excess will be broken down by the body, which gives some room for experimentation. A woman who is in touch with her body should soon be able to tell if an herb is aggravating or aiding certain symptoms associated with the hormones. Again, women who are sensitive to medicines should begin with one or two herbs, or at least a pretty simple formula.

Most medical authorities will warn women with a history of breast cancer to steer clear of any of the herbs that are thought to promote estrogen. There are studies that suggest they tend to promote beneficial estrogens that bind to receptor sites (as in breast tissue), that actually prevent harmful estrogens from binding. I believe a woman can still be safe using a balanced formula, with the above provision of listening to the body. Others will want to stick with the progesteronic herbs, especially if other symptoms call for such herbs.

By being informed of the changes that are likely to come, a woman can be informed that, for instance many pre- and peri- menopause symptoms call for progesteronic herbs; it is usually later in menopause that estrogen levels begin to steeply decline. Women who have been on birth control pills can be aided by the hormonal herbs, especially progesteronic herbs, to nudge the body to produce the hormones it has forgot to make on its own. Associated conditions to consider:

Hot Flashes
For some women an herb like the Chaste Berry can give relief; others turn to Black Cohosh, especially at the stage in menopause when estrogen levels start to decline more rapidly. Motherwort is valuable for some women. Sage, with its nervine, estrogenic and astringent properties has been used for night sweats. Maca has made a big difference for easing cycles of hot flashes, especially for women with low thyroid function. Two cooling herbs that I have seen help in "cooling down" (which made a big difference) are Chickweed and Elder Flower.

Low Libido
Many women have given positive feedback on Maca for low sexual interest and low energy; several have seen other symptoms greatly eased with the use of this root.

Osteoporosis
A look at what women are most at risk for osteoporosis can give an idea of how to prevent this condition: Women who have less body fat than they should, or have suffered from anorexia. Those with low estrogen levels through life. Women who do not do much weight-bearing excersize (walking, tennis, dancing, etc.), and such excersize can act as both prevention and aid in reversing osteoporosis. Women who use much caffeine, alcohol or smoke. Certain drugs can leach calcium and other vitamins and minerals from the system; antacids (even with the "calcium" added), cortisone, thyroxin, tamoxifen and diuretics. Women who have malabsorption problems. Lack of Vitamin D (get some sunlight!). There is also a genetic pre-disposition for some.
Weight-bearing exercise 20 minutes, 3 times a week is number one. A calcium/magnesium supplement can be used; although foods and herbs rich in minerals are to be preffered as more assimilable and usable. Horsetail herb is widely used for its absorbable calcium and magnesium, as well as silica that aids in assimilation. Nettles is another to use as herbal food. Raspberry Leaf is high in minerals, and a uterine tonic. For high-risk cases the use of the Wild Yam/Progesterone creams may be a good compromise.

Going Off of HRT
Women should not suddenly go off of hormone therapy. For some women it will be a matter of several months while they reduce the amount hormone taken and add the herbs; as the body goes through its changes, the hormone may have to be temporarily raised again while the body adjusts to the herbs and re-learns how to balance its own hormones. Again, the liver herbs will help to adjust levels.

A few notes on some of the herbs traditionally used for hormonal balance and menopausal symptoms will give an idea of what traditional herbalists see as the versatility of herbs in general, beyond what is usually brought out in articles and books based strictly on narrow scientific studies:

Black Cohosh
An herb used as an alternative to estrogen-replacement therapy. Giving relief in symptoms such as hot flashes and water retention. Menstrual pain. It can promote energy while having a calming action on the nerves. Symptoms of sadness, weeping, and very gloomy depression are sometimes dramatically improved. Black Cohosh's anti-inflammatory and anti-spasmodic properties have made it a pain-reliever in arthritis and rheumatism and some types of headaches. Breast tenderness. Uterine and bladder prolapse and incontinence. Not used where there is severe flooding or severe symptoms of estrogen excess. Tends to lessen luteinizing hormone.

Black Haw
Not a lot of research has been done on this bark of the Haw tree, but I have found it to be invaluable in many female conditions. It has anti-spasmodic and calming properties; while acting on the ovaries to regulate hormones. Menstrual pain and cramp. Heavy or prolonged menses. Muscle cramps in general. Ovarian pain and conditions. Irritable bowel. Gently lowers blood pressure. For generally promoting well-being and a smooth transition through the change of life, I believe it to be one of the prime herbs.

Chaste Berry (Vitex)
The micro-nutrients in Chaste Berry stimulate the production of hormones by acting on the pituitary gland. In general it promotes progesterone and reduces effects of estrogen (and FSH) excess. Women whose hot flashes are due to excess estrogen will benefit. PMS with moodiness, anxiety (not with depression though). Menstrual irregularities. Flooding and spotting from corpus luteum deficiency. Endometriosis and fibroids (must be used over a year or more). Uterine/ovarian cysts (with small doses of Thuja). Acne that is hormonally related. Fibro-cystic breasts. Reduces prolactin levels. To establish menstrual regularity after coming off the pill, after pregnancy, to enhance fertility (all combined with False Unicorn or Black Haw).


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