Scientific Support for Natural Treatments During Menopause

March 24, 2014

En el silencio y de perfil... By Dr. Lisa Watson, ND

Menopause is the natural transition out of the childbearing years of a woman’s life.  For most women symptoms begin between 46-55 years of age and can persist for 2-20 years (8 years is average).  With significant risks associated with synthetic hormone replacement therapy (HRT) more and more women are looking for natural alternatives. Emerging scientific studies support the use of many natural therapies during menopause. Here are seven of the best evidence-based natural treatments for menopause and how they may help you transition smoothly through menopause.

Black cohosh (Actaea racemosa)

Black cohosh is one of the most important and popular natural remedies for menopause.  Several large studies have found that daily use of black cohosh for a minimum of 8 weeks improved symptoms of menopause including hot flashes, night sweats, headaches, insomnia, mood swings, irritability and vaginal dryness.

Black cohosh is often self-prescribed but should be used under supervision of a Naturopathic Doctor.  Studies suggest that the effectiveness of black cohosh can be increased by combining it with other natural treatments.


Isoflavones are compounds found in plants that have estrogen-like actions in humans.  They are also known as “phytoestrogens”.  Clinical studies have shown that isoflavones can reduce symptoms of hot flashes and vaginal dryness in menopause.

Additionally some isoflavones (such as genistein) are also effective preventative agents for certain types of cancer, including breast cancer.  Isoflavones also protect the body against heart disease, increase good (HDL) cholesterol, decrease bad (LDL) cholesterol and triglycerides, and help prevent osteoporosis.

Red Clover (Trifolium pratense)

Red clover is a popular phytoestrogen supplement for management of menopausal symptoms.  Studies have found it to be effective for hot flashes and night sweats.  It contains isoflavones so it also has many of the same benefits listed above (decreasing bad cholesterol, prevention of osteoporosis).

There are multiple drug-herb interactions for red clover, so it should only be taken under supervision by a Naturopathic Doctor.  Red clover interacts with blood thinners and antivirals and may not be appropriate if you are taking these medications.

Siberian Rhubarb (Rheum rhaponticum)

While not a common natural treatment for menopausal symptoms, Siberian Rhubarb is making an impression on the natural health community with its impressive clinical results in managing the symptoms of menopause.

Siberian rhubarb extract (also known as ERr 731) has been used in Germany for nearly 20 years and is now available in international markets.  Studies of this extract have shown it to be as effective as hormone replacement therapy in the treatment of menopausal hot flashes.  It has also shown promise in stabilizing mood and reducing sleep disturbances – a symptom that many women find worsens as menopause progresses.

Siberian rhubarb tends to act quickly, making it a favourite with women currently experiencing menopausal symptoms.  Decrease in hot flashes is seen in as little as four weeks with optimal results seen in twelve weeks.

Eating rhubarb from your garden will not give you these same benefits.  Garden-variety rhubarb is used in natural medicine primarily as a laxative.

Vitamin C

Vitamin C and citrus bioflavonoids are known to improve the integrity of blood vessels and promote healthy blood flow.  This has been shown in preliminary studies to improve symptoms of hot flashes.  Vitamin C is also incredibly safe and can be taken in food form.  Good sources of vitamin C include citrus fruits, papaya, bell pepper, strawberries, cauliflower and dark green leafy vegetables.


Exercise should be incorporated into a healthy lifestyle during the menopausal transition and beyond.  Some of the benefits of exercise in menopause are listed below.  Exercise has been demonstrated in clinical studies to improve quality of life in menopausal symptoms, and decreases the frequency and severity of hot flashes.  A combination of weight bearing and aerobic exercise at least 3.5 hours per week is recommended for women in menopause and postmenopausal women.

Health Benefits of Regular Exercise in Menopause

  • Relief from hot flashes
  • Decreased bone loss
  • Improved cardiovascular function and circulation
  • Decreased blood pressure
  • Decreased cholesterol levels
  • Increased self-esteem, mood, endurance and energy levels


Acupuncture is one of the most researched natural menopause treatments the world over and the mainstream media has taken notice!  Acupuncture, when individually tailored to a woman’s menopausal symptoms can be extremely effective in decreasing discomfort and relieving symptoms.  A range of 6 to 12 sessions over an 8 to 12 week period should be used to determine if acupuncture will be effective.

As with all natural therapies, the most effective approach is an integrative one.  Consultation with a qualified Naturopathic Doctor who can tailor a treatment plan to your symptoms, current health and lifestyle will allow you to reap all the benefits natural therapies have to offer.

Select References

Osmers R, Friede M, Liske E, et al: Efficacy and safety of isopropanolic black cohosh extract for climacteric symptoms.  Obstet Gynecol  2005; 105:1074-1083

Wuttke W, Seidlova-Wuttke D, Gorkow C: The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: Effects on menopause symptoms and bone markers.  Maturitas  2003; 44 (Suppl 1):S67-S77.

Tice JA, et al: Phytoestrogen supplements for the treatment of hot flashes: The Isoflavone Clover Extract (ICE) Study: A randomized controlled trial.  JAMA  2003; 290:207-214.

Wyon Y, et al: A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women.  Climacteric  2004; 7:153-164.

Lindh-Astrand L, Nedstrand E, Wyon Y, Hammar M: Vasomotor symptoms and quality of life in previously sedentary postmenopausal women randomised to physical activity or estrogen therapy.  Maturitas  2004; 48:97-105.

Nachtigall L, La Grega L, Lee W, Fenichel R. The effects of isoflavones derived from red clover on vasomotor symptoms and endometrial thickness. In: Proceedings of the 9th International Menopause Society World Congress on the Menopause. Yokohama, Japan: 1999.

Kaszkin-Bettag M, Ventskovsky BM, Solskyy S, et al. Confirmation of the efficacy of ERr 731 in perimenopausal women with menopausal symptoms. Altern Ther Health Med. 2009;15(1):24-34.

Nedeljkovic M, Tian L, Ji P, et al. Effects of acupuncture and Chinese herbal medicine (Zhi Mu 14) on hot flushes and quality of life in postmenopausal women: results of a four-arm randomized controlled pilot trial. Menopause 2014;21(1):15-24.

Aidelsburger P, Schauser S, Grabein K, Wasem J. Alternative methods for the treatment of post-menopausal troubles. GMS Health Technol Assess 2013;8:Doc03


Dr. Lisa Watson completed her pre-medical training at the University of Western Ontario in London with a Bachelors degree in Health Sciences (BHSc). Following this, she completed the four year full-time program at the Canadian College of Naturopathic Medicine in Toronto where she received the designation of Naturopathic Doctor (ND).

Lisa first encountered Naturopathic Medicine when investigating her own health issues during her teen years. A natural health care model that supports the body, mind, and spirit for a lifetime was a good fit for this aspiring doctor.

Dr. Watson’s philosophy of practice emphasizes a patient-focused approach where listening to and gaining understanding of a patient’s unique story is a top priority.

Lisa’s practice integrates natural treatments backed by scientific and traditional research to enhance the health of her patients and prevent future illness.

Dr. Watson maintains a general family practice in the Old Town Toronto neighbourhood of Toronto. She welcomes patients of all ages and stages of wellness and has a special interest in adolescent and pediatric health, teen health, women’s health, pregnancy, fertility, menopause, dermatology, headaches and healthy aging.

Dr. Watson is licensed by the Board of Directors of Drugless Therapy – Naturopathy. She is a member of the Canadian Association of Naturopathic Doctors and the Ontario Association of Naturopathic Doctors.

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