Herbs For Healthier Hormonal Balance

An Introduction Into Hormones

Before exploring how herbs can impact hormones, an overview of what hormones are is important.

Hormones are a part of the endocrine system which is made up of special glands.

These glands are responsible for the production of hormones which are chemical messengers.

These chemical messengers travel to different parts of the body where they are recognized by specific target receptors.

In this way, each hormone is able to interact with its receptor, making them specific, like a lock and key. 

Below is a diagram that shows where the endocrine organs are found and a chart that summarises what each gland does. 

References:

ME Freeman

Physiology 1988 3:131-32

Herbs and Hormones

Signs of hormonal imbalances range from subtle to overwhelmingly obvious.

For example, in women the menstrual cycle is tightly controlled by hormones and any fluctuations can point to hormonal imbalances.

While many women seek medical advice, often the treatment options are unsuitable due to side effects.

With the rise of patient empowerment, many healthcare practitioners are happy to consider their patient’s viewpoints regarding treatment.

While this is a hugely positive step forward for health care and patient integrity, it is important that patients gain a greater understanding of how supplements and herbs work to avoid undesirable outcomes. 

Herbal remedies have always been popular choices for self-care and a Google search on the effectiveness of herbs on hormones yielded more than 29 000 results.

This suggests that herbalism is not only a popular consumer choice, but there is growing research body.

This is particularly supportive for cultures that do not rely on Western medicine or who have a high consumption of herbs in their diet.

For example the use of soy which is high in many Asian countries is believed to be a key factor in the decreased rate of hormonal diseases including cancer.

Soy is a complete source of dietary protein (contains all essential amino acids) and can be consumed in a variety of ways.

The estrogenic effects of the isoflavones in soy have been demonstrated to deliver many  health benefits including prevention of cardiovascular disease, bone strength, prevention of cancer and modulation of menopause.

There are other cultures who use to flavour food.

While this is a promising way to reduce salt intake, excessive use can interfere with medications and impact hormonal function. 

For example, diets that have high consumptions of lemongrass and anise have been shown in animal models to impact estrogen and progesterone levels. 

Away from dietary intake, most herbalists use herbs deliberately in an attempt to support normal function and encourage the body to self-regulate.

A study conducted in 2009 by Cassileth, Hetizer and Wesa researched the public health impact of herbs and nutritional supplements and found that herbs are complex, active agents that have a number of effects and should be used carefully by professionals.

This is especially true for those with cancer or who are on multiple medications as herb-drug interactions may interfere with efficacy and cause unwanted side effects.

The study also identified that immune health and menopause were the largest reasons for people to purchase herbal remedies.

For menopause, this was largely a response to the major safety issues associated with conventional estrogen therapy.

Another systematic review conducted in 2018 aimed to examine the role herbs had on the levels of hormones including gonadotrophin releasing hormone, follicle stimulating hormone and luteinizing hormone in women.

The study showed that herbs including vitex agnus-castus, thuja occidentalis, cimicifuga racemosa and yucca were able to increase gonadotrophin releasing hormone to impact fertility.

They also demonstrated that other herbs were able to bring on early puberty such as Radix Ginseng and isoflavones.

There are many ways that herbs can impact hormones.

Herbs are traditionally known by their “actions” rather than their individual constituents. For example, galactagogues that are used to increase breast milk production include herbs such as aniseed, milk thistle, lemongrass, goat’s rue, and fennel, yet they have different mechanisms for action.

Fennel contains the volatile oil anethole which is a phytoestrogen. In contrast, milk thistle is high in silymarin and is also used for liver support. 

An example of some of the actions herbs may have on hormones can be seen in the table below:

The question of whether herbs can impact health is clear, however unless the herbs are being used in food as part of a diet, it would be safer to seek out the advice of a professional herbalist before commencing any kind of supplement regime, particularly if there are other health issues or medications being used. 

References:

Cassileth, B. R., Heitzer, M., & Wesa, K. (2009). The public health impact of herbs and nutritional supplements.Pharmaceutical biology, 47(8), 761-767.

Barrett J. R. (2006). The science of soy: what do we really know?.Environmental health perspectives, 114(6), A352–A358. https://doi.org/10.1289/ehp.114-a352

National Women’s Health Network: Herbs and Phytoestrogens (2015) https://nwhn.org/herbs-and-phytoestrogens/

Rahbod, Farinaz and Heidari Soureshjani,, Saeid (2018) Medicinal herbs affecting gonadotopin hormones in women: An updated systematic review. International Journal of Life Science and Pharma Research, 8(1)

Dougkas A, Vannereux M, Giboreau A. The Impact of Herbs and Spices on Increasing the Appreciation and Intake of Low-Salt Legume-Based Meals.Nutrients. 2019; 11(12):2901. https://doi.org/10.3390/nu11122901

Herbs for Pre-Menopausal Women

The following health conditions are fairly common yet can be quite distressing and impact greatly on women’s health.

Please note that this information is not designed to diagnose or treat but provide general information.

Amenorrhoea

Defined as the absence of normal menstruation, amenorrhoea may be classed as either primary or secondary.

Primary amenhorrea refers to when periods fail to start during puberty (usually by aged 17) while secondary amenorrhoea refers to when periods which normally arrive, fail to. 

In the case of primary amenorrhoea, medical tests may be undertaken to find out if there is a physical cause such as abnormal growth.

Secondary amenorrhoea may be the result of stress, physical / environmental or dietary changes.

For example many professional athletes  (up to 65%) note that periods become scanty or absent during peak training periods as a result of unstable stress hormone production favouring recovery and lowering estrogen levels. 

Emmenagogue herbs include: Ginger, yarrow, rosemary, parsley, sage, black cohosh and vitex agnus castus.

Please note many emmenagogue herbs work by stimulating blood flow to the pelvic area and may also have abortifacient actions so use in dietary amounts only or seek professional advice. 

Endometriosis

Endometriosis affects up to 15% of women or reproductive age. 

It is characterised with the endometrial tissues growing outside of the uterus where it behaves in the same way – thickening and shedding with the menstrual cycle.

This leads to excessive menstrual flow, pain, immune dysfunction, inflammation and in some cases infertility.

Depending on where the tissue grows, it may also impact digestion and bowel function. 

This is a complicated disease and an area of growing research.

Currently known risk factors include early period onset, low body weight, high intake of caffeine and prenatal exposure to oestrogens and estrogenic compounds such as bisphenols. 

Herbs that may support normal menstruation, reduce pain and improve bowel function include turmeric, boswellia, ginger, cinnamon, green tea, broccoli, vitex agnus castus and paeony. 

Polycystic Ovarian Syndrome (PCOS)

Characterised by multiple cysts growing on the ovaries, this hormonal condition affects up to 10% of all women in their reproductive years.

It is one of the leading causes of infertility and is believed to be linked to increased levels of insulin which is why symptoms include sugar cravings and weight gain.

As the cysts that grow on the ovaries are hormonally driven, they may exacerbate mood changes, sleep and fatigue.

Physical symptoms include missed or irregular periods, excessive facial hair and acne. 

Exercise and dietary changes greatly support the treatment of PCOS while high doses of indole 3 carbinol (broccoli) promote health metabolism of hormones, thereby reducing excess estrogen production.

Other herbs that have been shown to benefit women with PCOS include cinnamon (also helps to regulate blood sugar levels), vitex agnus castus, ginger, paeony, licorice, shatavari and St John’s wort.

Black cohosh and hops have been shown to re-balance follicle stimulating hormone and luteinising hormone ratios while green tea and saw palmetto have demonstrated abilities to reduce testosterone levels. 

Infertility

There may be many causes that contribute to female infertility.

Chief among those causes include endometriosis and PCOS.

Stress and changes in diet and environment can also greatly impact fertility.

Apart from menstruation, it would be wise to ensure that normal ovulation is occurring (this may be measured via daily temperature and/or cervical mucous checks).

If both menstruation and ovulation are occurring then ensuring that libido is increased would be beneficial.

Herbs to increase libido in women include tribulus terrestris, damiana, avena sativa, shatavari, ginkgo biloba  and ashwaganda (withania).

It should come as no surprise that herbs that increase libido are also shown to reduce stress.

Other herbs that may reduce inflammation and stress include licorice, chamomile and turmeric. 

Pre Menstrual Syndrome (PMS)

Pre-menstrual symptoms are very common and characterised by both physical and behavioural changes in women up to 14 days before the onset of their menstrual cycle.

Each woman is different but common symptoms include abdominal bloating, breast tenderness, changes in bowel habits, cramps, fatigue, increased appetite, altered sleeping and altered mood.

A key aspect to relieving symptoms is to ensure that oestrogen metabolites may be cleared through the liver quickly to reduce excess.

Broccoli and other cruciferous vegetables, which are high in indole 3 carbinol, support this process well. 

Other herbs to reduce oestrogen include rosemary and turmeric. 

Herbs that will support the nervous system include licorice, chamomile, lemon balm, passionflower and valerian.

For women suffering from altered sleep, kava, lavender and zizyphus are also beneficial. 

References

  • Prescott, H., & Khan, I. (2020). Medicinal plants/herbal supplements as female aphrodisiacs: Does any evidence exist to support their inclusion or potential in the treatment of FSD?. Journal of ethnopharmacology251, 112464. 

Oregon State University

Herbs for Post-Menopausal Women

Fibroids

Fibroids are benign uterine tumours that are usually made up of smooth muscle cells and connective tissues that occur in women usually aged between 31 – 50. As they are hormonally driven by oestrogen, they tend to decrease as a woman enters into menopause. 

There are many different kinds of fibroids that are classified by location:

  • Submucosal fibroids – under endometrium
  • Intramural – within the wall of the uterus
  • Subserosal – on the outer wall of the uterus
  • Interligamentous – broad ligaments of the uterine wall
  • Pedunculated – attached to a stalk

Symptoms can include painful and/or heavy periods, pain during intercourse, pressure in the pelvic area, changes in urination, constipation and anaemia.

Herbs that may improve oestrogen and progesterone ratios include vitex agnus castus and paeony.

To reduce inflammation and pain, boswellia, turmeric, ginger, willowbark and californian poppy have been shown to be useful.

If there are changes in mood, withania, lemon balm and chamomile may be indicated. 
To try and reduce the presence of the fibroids, green tea extract taken daily has demonstrated an ability to reduce fibroid volume and symptom severity. 

Menopause

Menopause marks the end of a woman’s reproductive phase.

With that comes the end of her menstrual cycle and her ovarian cycle as eggs are no longer produced.

The production of oestrogen and progesterone which fuels these cycles also decrease resulting in a variety of symptoms that impact every aspect of health.

These symptoms include:

  • Changes in sleep patterns and quality
  • Mood changes
  • Changes in memory and cognition
  • Hormonal headaches
  • Reduced skin thickness, elasticity leading to increase in wrinkles
  • Loss of hair 
  • Loss of muscle tone
  • Decreased bone density
  • Increased weight
  • Vaginal dryness
  • Changes in urinary frequency and urgency
  • Decreased libido
  • Joint pain

The symptoms may vary in intensity and duration between individuals – some women experience hot flushes for more than a decade.

Increasing intake of phytoestrogenic herbs such as lemongrass, lavender and soy may  help to curb drastic hormonal fluctuations. Herbal 

Herbs for hot flushes: black cohosh, chaste tree and sage

Herbs for mood and cognition: rosemary, chamomile, withania, turmeric, skullcap and saffron

Herbs for anxiety and sleep: kava, lemon balm, St John’s wort, passionflower

Herbs for healthy ageing: grape seed, green tea, turmeric, rosemary

References:

  • Amato, P., Christophe, S., & Mellon, P. L. (2002). Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause, 9(2), 145-150.
  • Newton, K. M., Reed, S. D., Grothaus, L., Ehrlich, K., Guiltinan, J., Ludman, E., & LaCroix, A. Z. (2005). The Herbal Alternatives for Menopause (HALT) Study: background and study design. Maturitas, 52(2), 134-146.
  • Sharan, F. (1995). Natural treatment of menopause using herbs. Alternative and Complementary Therapies, 1(3), 147-153.

Herbs for Men

Men also experience changes in hormones that can lead to a variety of symptoms.

As men age, levels of circulating testosterone decline leading to a state known as andropause or “male menopause”. Symptoms include:

  • Changes in sleep quality and duration
  • Mood changes with increased irritability
  • Changes in memory and cognition
  • Reduced skin thickness, elasticity leading to increase in wrinkles
  • Loss of hair 
  • Loss of muscle tone
  • Decreased bone density
  • Increased weight
  • Changes in urinary frequency and urgency
  • Decreased libido
  • Joint pain

Herbs that may improve sleep include withania, lemon balm, kava, valerian and chamomile

Herbs that may improve memory and cognition include turmeric, saffron, rosemary, ginkgo biloba and gotu kola

Herbs that may improve mood and energy include avena sativa, damiana, withania, St John’s wort, saffron, Siberian ginseng and Korean ginseng

Herbs that may support bone health include epimedium, damiana and nettle

Herbs to support muscle mass and improve testosterone levels: tribulus and maritime pine bark.

Benign Prostatic Hyperplasia

Most commonly seen in men between 51 and 60, benign prostatic hyperplasia is also known as BPH.

As men age and circulating levels of testosterone decline, the prostate gland shifts to its second and final growth phase.

The first growth phase occurs during puberty when the prostate doubles in size.

This final stage of growth can cause issues as the enlarged prostate presses against the bladder and urethra.

Combined with a thickened bladder wall and loss of bladder muscle tone, common signs and symptoms include:

  • Feelings of urgency to urinate
  • Weak and/or interrupted urine flow
  • Urinary hesitation
  • Needing to push or strain to urinate

Weight loss and sitting down to urinate (which has been shown to improve urinary flow and relieve discomfort) may be good options to explore.

Herbs that may further support healthy testosterone levels and decrease the size of the prostate gland include saw palmetto, stinging nettle, pygeum,  pumpkin seeds, tribulus.

Although not a herb, zinc would also be highly beneficial for men suffering from BPH. 

References:

  • Rogerson S, Riches CJ, Jennings C, Weatherby RP, Meir RA, Marshall-Gradisnik SM. The effect of five weeks of Tribulus terrestris supplementation on muscle strength and body composition during preseason training in elite rugby league players. J Strength Cond Res. 2007 May;21(2):348-53. doi: 10.1519/R-18395.1. PMID: 17530942.
  • Ko, J. W., Park, S. W., Shin, N. R., Kim, W. I., Kim, J. C., Shin, I. S., & Shin, D. H. (2018). Inhibitory effects of Pycnogenol®, a pine bark extract, in a rat model of testosterone propionate-induced benign prostatic hyperplasia. Laboratory animal research, 34(3), 111–117. https://doi.org/10.5625/lar.2018.34.3.111 
  • Shrivastava, A., & Gupta, V. B. (2012). Various treatment options for benign prostatic hyperplasia: A current update. Journal of mid-life health, 3(1), 10–19. https://doi.org/10.4103/0976-7800.98811 

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