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Current Women`s Health Reviews


ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Mini-Review Article

Highlights on Important Medicinal Plants for the Menopause Syndrome

Author(s): Rafaele de A. Rodrigues, Aline de S. Ramos*, José Luiz P. Ferreira, Jefferson Rocha de A. Silva, Ana Clara B. Maria, Maíra Martins H. de Almeida and Ana Claudia F. Amaral*

Volume 18, Issue 1, 2022

Published on: 23 February, 2021

Article ID: e221121191753 Pages: 7

DOI: 10.2174/1573404817666210223163845

Price: $65


Background: A reduction in ovarian hormones, which is distinctive of menopause, often involves signs and symptoms that compromise the quality of life and health of women. The transient manifestations are changes in the menstrual cycle, vasomotor symptoms, neuropsychological symptoms, and genitourinary changes. In some cases, the hormonal changes can evolve to nontransitory manifestations, which include urinary incontinence, changes in metabolism, osteoporosis, and cardiovascular diseases. Hormone replacement therapy is the treatment of choice to alleviate transient symptoms of menopause; however, there are many limitations, contraindications, and situations in which the risks of adverse effects are high, such as coronary artery disease, stroke, venous thromboembolism, dementia, type 2 diabetes, and the increased incidence of breast cancer.

Objectives: This work aims to highlight important medicinal plants for the treatment of the transient symptoms of menopause, with less side effects than traditional hormone replacement therapy.

Conclusion: There is sufficient information regarding the efficacy and safety for the use of the following plant species in the treatment of transient symptoms of menopause: Actaea racemosa, Glycine max, Trifolium pratense, Salvia officinalis, Humulus lupulus, Panax ginseng, Vitex agnus-- castus, and Trigonella foenum-graecum. Additionally, the search indicated the chemical classes related to the benefits of the selected species, adverse effects, and interactions with other drugs.

Keywords: Climacteric, medicinal herbs, hormone therapy, phytoestrogen, phytotherapy, flavonoid, triterpene, steroids

Graphical Abstract
NICE. Menopause: Diagnosis and management [NG23] 2019.
Brazil. Manual de atenção a mulher no climatério/menopausa. Série A [Normas e Manuais Técnicos] Série Direitos Sexuais e Direitos Reprodutivos – Caderno (9) 2008.
Potter B, Schrager S, Dalby J, Torell E, Hampton A. Menopause. Prim Care 2018; 45(4): 625-41.
[] [PMID: 30401346]
Kronenberg F. Hot flashes: epidemiology and physiology. Ann N Y Acad Sci 1990; 592: 52-86.
[] [PMID: 2197954]
Huang AJ, Grady D, Jacoby VL, Blackwell TL, Bauer DC, Sawaya GF. Persistent hot flushes in older postmenopausal women. Arch Intern Med 2008; 168(8): 840-6.
[] [PMID: 18443259]
Schneider HPG, Heinemann LAJ, Rosemeier H-P, Potthoff P, Behre HM. The Menopause Rating Scale (MRS): comparison with Kupperman index and quality-of-life scale SF-36. Climacteric 2000; 3(1): 50-8.
[] [PMID: 11910610]
Sydora BC, Fast H, Campbell S, Yuksel N, Lewis JE, Ross S. Use of the Menopause-Specific Quality of Life (MENQOL) questionnaire in research and clinical practice: a comprehensive scoping review. Menopause 2016; 23(9): 1038-51.
[] [PMID: 27300115]
Travers C, O’Neill SM, King R, Battistutta D, Khoo SK. Greene Climacteric Scale: norms in an Australian population in relation to age and menopausal status. Climacteric 2005; 8(1): 56-62.
[] [PMID: 15804732]
Pinkerton JV, Sánchez Aguirre F, Blake J, et al. The NAMS 2017 hormone therapy position statement advisory panel. The 2017 hormone therapy position statement of The North American Menopause Society. Menopause 2017; 24(7): 728-53.
[] [PMID: 28650869]
Pardini D. Hormone replacement therapy in menopause. Arq Bras Endocrinol Metabol 2014; 58(2): 172-81.
[] [PMID: 24830594]
Locklear TD, Doyle BJ, Perez AL, Wicks SM, Mahady GB. Menopause in Latin America: Symptoms, attitudes, treatments and future directions in Costa Rica. Maturitas 2017; 104: 84-9.
[] [PMID: 28923180]
Watkins E. Menopause: The best chapter of our lives. Physician Assist 2018; 3(3): 373-83.
WHO. WHO traditional medicine strategy: 2014-2023 2013.
Sousa IMC, Tesser CD. Medicina Tradicional e Complementar no Brasil: inserção no Sistema Único de Saúde e integração com a atenção primária. Cad Saude Publica 2017; 33(1): 8.
[] [PMID: 28125126]
Bibliographic database and search site
Bibliographic database and search site
PubMed, National Center for Biotechnology Information (NCBI); US National Library of Medicine, National Institutes of Health. Bibliographic database and search site
Nielsen ILF, Williamson G. Review of the factors affecting bioavailability of soy isoflavones in humans. Nutr Cancer 2007; 57(1): 1-10.
[] [PMID: 17516857]
Hairi HA, Shuid AN, Ibrahim NI, Jamal JA, Mohamed N, Mohamed IN. The effects and action mechanisms of phytoestrogens on vasomotor symptoms during menopausal transition: thermoregulatory mechanism. Curr Drug Targets 2019; 20(2): 192-200.
[] [PMID: 28814228]
Patisaul HB, Jefferson W. The pros and cons of phytoestrogens. Front Neuroendocrinol 2010; 31(4): 400-19.
[] [PMID: 20347861]
Setchell KDR. The history and basic science development of soy isoflavones. Menopause 2017; 24(12): 1338-50.
[] [PMID: 29189602]
Final assessment report on Glycine max (L) Merr, semen – First version EU: European Medicines Agency 2018.
Anandhi Senthilkumar H, Fata JE, Kennelly EJ. Phytoestrogens: The current state of research emphasizing breast pathophysiology. Phytother Res 2018; 32(9): 1707-19.
[] [PMID: 29876983]
WHO. Flos Trifolii. WHO monographs on selected medicinal plants 2004; 4: 335-52.
Mazaro-Costa R, Andersen ML, Hachul H, Tufik S. Medicinal plants as alternative treatments for female sexual dysfunction: utopian vision or possible treatment in climacteric women? J Sex Med 2010; 7(11): 3695-714.
[] [PMID: 20722793]
Shakeri F, Taavoni S, Goushegir A, Haghani H. Effectiveness of red clover in alleviating menopausal symptoms: a 12-week randomized, controlled trial. Climacteric 2015; 18(4): 568-73.
[] [PMID: 25581426]
Terzic MM, Dotlic J, Maricic S, Mihailovic T, Tosic-Race B. Influence of red clover-derived isoflavones on serum lipid profile in postmenopausal women. J Obstet Gynaecol Res 2009; 35(6): 1091-5.
[] [PMID: 20144173]
WHO. Folium Salviae. WHO monographs on medicinal plants commonly used in the Newly Independent States (NIS) 2010; 335-52.
Rahte S, Evans R, Eugster PJ, et al. Salvia officinalis for hot flushes: towards determination of mechanism of activity and active principles. Planta Med 2013; 79(9): 753-60.
[] [PMID: 23670626]
Khiya Z, Hayani M, Gamar A, et al. Valorization of the Salvia officinalis L. of the Morocco bioactive extracts: phytochemistry, antioxidant and anticorrosive activities. J King Saud Univ Sci 2019; 31: 322-35.
Štulíková K, Karabín M, Nešpor J, Dostálek P. Therapeutic perspectives of 8-prenylnaringenin, a potent phytoestrogen from hops. Molecules 2018; 23(3)
[] [PMID: 29543713]
Heyerick A, Vervarcke S, Depypere H, Bracke M, De Keukeleire D. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas 2006; 54(2): 164-75.
[] [PMID: 16321485]
Hamm AK, Manter DK, Kirkwood JS, Wolfe LM, Cox-York K, Weir TL. The effect of hops (Humulus lupulus L.) extract supplementation on weight gain, adiposity and intestinal function in ovariectomized mice. Nutrients 2019; 11(12): 8.
[] [PMID: 31817899]
WHO. Fructus Agni Casti. WHO monographs on selected medicinal plants 2004; 4: 9-29.
Zahid H, Rizwani GH, Ishaqe S. Phytopharmacological review on Vitex agnus-castus: a potential medicinal plant. Chin Herb Med 2016; 8(1): 24-9.
WHO. Rhizoma Cimicifugae Racemosae. WHO monographs on selected medicinal plants 2004; 2: 55-65.
Instituto Sírio-Libanês de Ensino e Pesquisa. Protocolos de atenção básica: Saúde das mulheres Brasilia (BR): Ministério da Saúde 2016.
Burdette JE, Liu J, Chen SN, et al. Black cohosh acts as a mixed competitive ligand and partial agonist of the serotonin receptor. J Agric Food Chem 2003; 51(19): 5661-70.
[] [PMID: 12952416]
WHO. Radix Ginseng. WHO monographs on selected medicinal plants 1999; 1: 168-82.
Lee HW, Choi J, Lee Y, Kil K-J, Lee MS. Ginseng for managing menopausal womanʼs health. Medicine (Baltimore) 2016; 95(38)
[] [PMID: 27661038]
Cho J, Park W, Lee S, Ahn W, Lee Y. Ginsenoside-Rb1 from Panax ginseng C.A. Meyer activates estrogen receptor-α and -β, independent of ligand binding. J Clin Endocrinol Metab 2004; 89(7): 3510-5.
[] [PMID: 15240639]
Park J, Bui PTC, Song H, et al. Ginseng on nuclear hormone receptors. Am J Chin Med 2017; 45(6): 1147-56.
[] [PMID: 28830207]
WHO. Semen Trigonellae Foenugraeci. WHO monographs on selected medicinal plants 2007; 3: 338-48.
Brogi H, Elbachir H, El Amrani N, Amsaguine S, Radallah D. Fenugreek seeds estrogenic activity in ovariectomized female rats. Curr Issues Pharm Med Sci 2019; 32(3): 138-45.
Shamshad Begum S, Jayalakshmi HK, Vidyavathi HG, et al. A novel extract of fenugreek husk (FenuSMARTTM) alleviates postmenopausal symptoms and helps to establish the hormonal balance: a randomized, double-blind, placebo-controlled study: effect of FenuSMART on postmenopausal discomforts. Phytother Res 2016; 30(11): 1775-84.
[] [PMID: 27406028]
Henneicke-von Zepelin H-H. 60 years of Cimicifuga racemosa medicinal products : Clinical research milestones, current study findings and current development. Wien Med Wochenschr 2017; 167(7-8): 147-59.
[] [PMID: 28155126]
EMA/HMPC. European Union herbal monograph on Cimicifuga racemosa (L) Nutt, rhizoma 2018.
Franco DL, Kale S, Lam-Himlin DM, Harrison ME. Black cohosh hepatotoxicity with autoimmune hepatitis presentation. Case Rep Gastroenterol 2017; 11(1): 23-8.
[] [PMID: 28203134]
Guo Y, Yin T, Wang X, et al. Traditional uses, phytochemistry, pharmacology and toxicology of the genus Cimicifuga: A review. J Ethnopharmacol 2017; 209(209): 264-82.
[] [PMID: 28826891]
Kristanc L, Kreft S. European medicinal and edible plants associated with subacute and chronic toxicity part I: Plants with carcinogenic, teratogenic and endocrine-disrupting effects. Food Chem Toxicol 2016; 92: 150-64.
[] [PMID: 27090581]
Li J, Gödecke T, Chen S-N, et al. In vitro metabolic interactions between black cohosh (Cimicifuga racemosa) and tamoxifen via inhibition of cytochromes P450 2D6 and 3A4. Xenobiotica 2011; 41(12): 1021-30.
[] [PMID: 21827327]
Drewe J, Bucher KA, Zahner C. A systematic review of non-hormonal treatments of vasomotor symptoms in climacteric and cancer patients. Springerplus 2015; 4: 65.
[] [PMID: 25713759]
Kargozar R, Azizi H, Salari R. A review of effective herbal medicines in controlling menopausal symptoms. Electron Physician 2017; 9(11): 5826-33.
[] [PMID: 29403626]
Kanadys W, Baranska A, Jedrych M, Religioni U, Janiszewska M. Effects of red clover (Trifolium pratense) isoflavones on the lipid profile of perimenopausal and postmenopausal women-A systematic review and meta-analysis. Maturitas 2020; 132: 7-16.
[] [PMID: 31883666]
Ghorbani A, Esmaeilizadeh M. Pharmacological properties of Salvia officinalis and its components. J Tradit Complement Med 2017; 7(4): 433-40.
[] [PMID: 29034191]
WHO. Strobilus Lupuli. WHO monographs on selected medicinal plants 2007; 3: 236-46.
Yuan Y, Qiu X, Nikolić D, et al. Inhibition of human cytochrome P450 enzymes by hops (Humulus lupulus) and hop prenylphenols. Eur J Pharm Sci 2014; 53: 55-61.
[] [PMID: 24342125]
EMA/HMPC. Final community herbal monograph on Panax ginseng CA Meyer, radix 2018.
Ghorbani Z, Mirghafourvand M. A meta-analysis of the efficacy of Panax ginseng on menopausal women’s sexual function. Int J Women’s Health Reprod Sci 2019; 7(1): 124-33.
Ghorbani Z, Mirghafourvand M, Charandabi SM-A, Javadzadeh Y. The effect of ginseng on sexual dysfunction in menopausal women: A double-blind, randomized, controlled trial. Complement Ther Med 2019; 45: 57-64.
[] [PMID: 31331583]
Malati CY, Robertson SM, Hunt JD, et al. Influence of Panax ginseng on cytochrome P450 (CYP)3A and P-glycoprotein (P-gp) activity in healthy participants. J Clin Pharmacol 2012; 52(6): 932-9.
[] [PMID: 21646440]
Mateo-Carrasco H, Gálvez-Contreras MC, Fernández-Ginés FD, Nguyen TV. Elevated liver enzymes resulting from an interaction between Raltegravir and Panax ginseng: a case report and brief review. Drug Metabol Drug Interact 2012; 27(3): 171-5.
[] [PMID: 23092794]
Ramanathan MR, Penzak SR. Pharmacokinetic Drug Interactions with Panax ginseng. Eur J Drug Metab Pharmacokinet 2017; 42(4): 545-57.
[] [PMID: 27864798]
Daniele C, Thompson Coon J, Pittler MH, Ernst E. Vitex agnus castus: a systematic review of adverse events. Drug Saf 2005; 28(4): 319-32.
[] [PMID: 15783241]
Momoeda M, Sasaki H, Tagashira E, Ogishima M, Takano Y, Ochiai K. Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label study. Adv Ther 2014; 31(3): 362-73.
[] [PMID: 24604699]
EMA/HMPC.. Final European Union herbal monograph on Vitex agnus-castus L, fructus 2018.
EMA/HMPC. Final community herbal monograph on Trigonella foenumgraecum L, semen 2011.
Yadav UCS, Baquer NZ. Pharmacological effects of Trigonella foenum-graecum L. in health and disease. Pharm Biol 2014; 52(2): 243-54.
[] [PMID: 24102093]

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