The Use of Herbal and Botanical Therapies in Menopause

Abstract

Botanical supplements and medicines have been used for centuries to treat menopausal symptoms. Although scientific data on these remedies are limited, their current popularity is rooted in the naive hope that so-called plant-based estrogens, phytoestrogens, or botanicals will provide all the benefits of hormone therapy (HT) without the concomitant risks for neoplasm and venous thrombosis. Plant sterol molecules are used as precursors in the manufacture of synthetic steroids, and the hormones in most prescription sex steroids are derived from diosgenin, a weakly estrogenic compound found in varieties of yams and in soy. Plant sterols interact with estrogen receptors and should be thought of as selective estrogen-receptor modulators (SERMs, more correctly termed phyto-SERMs) rather than as phytoestrogens. Generally, the receptor interactions of phyto-SERMs do not induce activity of intensity equal to that of mammalian estrogens. Botanical substances commonly thought to be estrogenic include soy, black cohosh, evening primrose oil, dong quai, ginseng, red clover, and members of the dill family. Intact soy protein with active isoflavones (i.e., genistein and daidzein) appears to …