It's no coincidence that most herbalists and their patients are female. Herbs seem to work particularly well in women, especially where conventional treatment has failed. Covered below are three commonly treated areas of female hormomal health in herbal clinical practice: the menopause, fertility & pregnancy, and polycystic ovarian syndrome.
Due to concerns about the potential dangers of HRT (hormone replacement therapy), more and more women are searching for alternatives to help control menopausal symptoms and I see many cases like this in herbal practice.
The menopause is not a disease, but a very difficult menopause can be seen as a disorder - and herbalists believe that a smooth transition is possible and achievable. Supporting overall health is key, but there are a few specific things to look out for as well, such as stress, a lack of phyto-oestrogens in the diet, exposure to pesticides, plastics and other environmental chemicals, and the health of the gut and its ability to properly metabolise oestrogen.
One herb that has a long history of traditional use in the treatment of menopausal symptoms is black cohosh - other herbs that alleviate oestrogen withdrawal symptoms in the body include sage, wild yam, false unicorn, asparagus and vitex.
Nervines such as st. john’s wort, hops, skullcap and withania can also come in handy when managing poor sleep, low mood and general fatigue. A huge array of other herbs can be used to treat different symptoms of the menopause, and this depends entirely on the individual case.
Fertility & Pregnancy
Herbal medicine has its place in the treatment of both female and male infertility and can be useful in supporting a woman’s health during pregnancy, helping to reduce the risk of things like gestational diabetes and pre-ecclampsia, or to treat these conditions (alongside conventional medication) if they appear.
There are many possible causes of infertility - in women it might be due to hormonal conditions like PCOS (see below), autoimmune issues like hypothyroidism and endometriosis, fibroids, stress, toxicity, diet or weight-related problems. Herbal treatment will depend on the cause, but things like stress management techniques will often be useful alongside the herbal prescription, as stress can be both the cause and the result of fertility issues. This may include a regular exercise prescription, yoga, meditation, relaxation exercises, visualisations or mindfulness practices.
Another common cause of fertility problems that is often overlooked is gluten intolerance and coeliac disease. According to a recent study, undiagnosed celiac disease may be the reason for 'all cause' infertility in 3.5% of women and 'unexplained' infertility in 5.9% of women. Even in healthy individuals, removing gluten from the diet reduces inflammation, improves nutrient absorption, encourages a healthy gut microbiome and reduces your risk of developing autoimmune diseases.
Herbs that can be used to promote general fertility are Vitex agnus-castus, black cohosh, withania, angelica, shatavari, lady’s mantle, rehmannia, Tribulus terrestris and wild yam.
In men, things like stress, diet and exposure to environmental toxins can have a big impact on sperm health, conception rates and also the future health of the baby. For example, many people don’t know that low folic acid in men as well as in women can lead to neural tube defects. In order to conceive a healthy baby, men should aim at improving their overall health at least 3 months before conception.
Polycystic ovarian syndrome
Polycystic ovarian syndrome (PCOS) is the most common hormonal disorder in women around the world, affecting 4-18% of reproductive-aged women. The conventional approach to treating the disorder is to use anti-diabetic medication, which helps one aspect of the condition, or oral contraceptives and ovarian stimulants, which mask the symptoms but do not address the underlying cause.
This condition is another another aspect of women’s health that herbal medicine can really help with. In the most simple of cases, a basic three-herb formula can bring on a period in a woman who hasn't ovulated for fifteen years in under a week. In more complex cases, the patient needs to make dietary and lifestyle changes or commit to losing weight and it may be months before results are seen.
It is not necessary to be overweight to be given a diagnosis of PCOS - in fact, many underweight women have the condition. Women may also have symptoms of high blood pressure, excessive hair growth, depression, acne or sugar cravings, but no ovarian cysts.
The most important diagnostic symptom is that of irregular or absent periods. Usually there is an increase in the follicular stage of menstruation and a delay in ovulation, resulting in a longer menstrual cycle. Stress is a big part of it, and stress management techniques are essential alongside a good dietary and herbal treatment plan.
Herbs commonly used to address the different types of hormonal imbalance seen in PCOS include Vitex agnus castus, white peony, liquorice root and black cohosh. One study found that black cohosh may be just as or more effective at inducing ovulation in women with PCOS than the conventional treatment clomiphene citrate.
Turmeric and Gymnema sylvestris are great for improving glucose metabolism and reducing inflammation, as are high potency fish oil supplements. And a good diet is essential - low in sugar, wheat and refined carbohydrates, with lots of healthy fats and fibre.