Is St. John's Wort Good for Menopause?

Is St. John's Wort Good for Menopause?

The road to a woman’s midlife years brings about many changes; and for most women, it may not be a walk in the park. This transition often brings about a range of symptoms, including mood swings, hot flashes, and sleep disturbances.

St. John’s Wort, a herb with a long history of medicinal use, has gained attention for its potential role in alleviating some of these menopausal symptoms.

What is St. John’s Wort?

The name St. John’s Wort (Hypericum perforatum) was actually named after St. John the Baptist, as it blooms around his celebration day (June 24). It is not native to a specific country as it grows in many parts of the world. The medicinal part of the plant is made up of the dried above-ground parts. These include the stem, petals, and flowers.¹

Specifically, this herb grows in the wild and has been used for centuries for mental health conditions. It’s widely prescribed for depression in Europe due to its known antidepressant properties, primarily attributed to compounds like hypericin and hyperforin.^2-3

While its effectiveness in treating mild to moderate depression has been studied extensively, its impact on menopausal symptoms is a relatively emerging area of research to which many studies have already been vouching on.  

Benefits of St. John’s Wort in Menopause

1. Managing Mood Swings and Anxiety

One of the notable challenges during menopause is the increased prevalence of mood swings and anxiety.

St. John’s Wort is believed to influence neurotransmitters in the brain, such as serotonin, which plays a crucial role in regulating mood.⁴

In one study, this herb, together with black cohosh, appeared to be the most useful compared to other botanicals studied, particularly in alleviating mood and anxiety changes during menopause.⁵

2. Reducing Hot Flashes and Other Vasomotor Symptoms

Hot flashes, characterized by sudden sensations of heat and sweating, are prevalent during menopause. While the primary focus of St. John’s Wort has been on mood-related symptoms, several studies suggest that it has a positive impact on alleviating hot flashes and other vasomotor symptoms. 

In one study, treatment with St. John’s Wort was shown to be an efficient way in reducing the frequency and severity of hot flashes, menopausal symptoms, as well as depression in postmenopausal women.⁶

The same results were found in another study on 100 women treated with St. John’s Wort for 8 weeks, where a significant decrease in the severity of hot flashes were observed.⁷

 3. Addressing Sleep Disturbances

Sleep disturbances during menopause are attributed to hormonal fluctuations. St. John’s Wort has been shown to provide a positive impact in improving sleep quality.

This has been backed up by a study wherein it showed that women treated with St. John’s Wort extract for 12 weeks had better quality of life, including significantly fewer sleep problems as compared to those taking placebo.⁸

Side Effects

While St. John’s Wort is generally considered safe for many people when used appropriately, it may cause some side effects especially when taken in large doses, such as:⁹

1. Photosensitivity

St. John’s Wort may increase sensitivity to sunlight, which may increase risk of sunburn or skin irritations.

2. Gastrointestinal Discomfort

Some people may experience digestive distress, such as upset stomach, diarrhea, or nausea when taking the herb.

3. Other Side Effects

In rare cases, people may have allergic reactions to St. John’s Wort as well as other side effects like headache, dizziness, dry mouth, or fatigue.

Recommended Dosage and How to Consume

St. John’s Wort can be consumed in various forms, with common options including capsules or tablets, liquid extracts, or teas.

For capsule or tablet form, the standard dosage is 300 mg three times a day¹⁰, which should be taken with meals or as directed by a healthcare professional.

For liquid extracts, on the other hand, this should be mixed with water; while tea enthusiasts can opt for pre-packaged St. John’s Wort tea bags or prepare tea by steeping dried flowers.¹¹

Possible Interactions

Some possible interactions of St. John’s Wort with other medicines include:¹²

1. Antidepressants
2. Oral Contraceptives
3. Anticoagulants
4. Immunosuppressants
5. HIV medications
6. Digoxin
7. Cyclosporine
8. Chemotherapy drugs

It is important for individuals to inform their healthcare providers about any dietary supplement, including St. John’s Wort in order to assess potential interactions.

Final Words

St. John’s Wort holds promise in alleviating certain menopausal symptoms. But still, while it may offer benefits, consulting with healthcare professionals should be emphasized before incorporating it into a menopausal management plan in order to take into consideration its possible interactions with certain medications.

References:

1. St. John’s Wort -  Health Encyclopedia - University of Rochester Medical Center. (n.d.). https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=19&contentid=StJohnsWort.
2. St. John’s wort. (2023, August 10). Mayo Clinic. https://www.mayoclinic.org/drugs-supplements-st-johns-wort/art-20362212.
3. St. John’s Wort and Depression: In depth. (n.d.). NCCIH. https://www.nccih.nih.gov/health/st-johns-wort-and-depression-in-depth.
4. St. John’s wort. (n.d.). Mount Sinai Health System. https://www.mountsinai.org/health-library/herb/st-johns-wort.
5. Geller, S. E., & Studee, L. (2007). Botanical and dietary supplements for mood and anxiety in menopausal women. Menopause (New York, N.Y.), 14(3 Pt 1), 541–549. https://doi.org/10.1097/01.gme.0000236934.43701.c5.
6. Alieh Eatemadnia, Somayeh Ansari, Parvin Abedi, Shahnaz Najar. The effect of Hypericum perforatum on postmenopausal symptoms and depression: A randomized controlled trial, Complementary Therapies in Medicine, Volume 45, 2019, Pages 109-113, https://doi.org/10.1016/j.ctim.2019.05.028.
7. Abdali, K., Khajehei, M., & Tabatabaee, H. R. (2010). Effect of St John's wort on severity, frequency, and duration of hot flashes in premenopausal, perimenopausal and postmenopausal women: a randomized, double-blind, placebo-controlled study. Menopause (New York, N.Y.), 17(2), 326–331. https://doi.org/10.1097/gme.0b013e3181b8e02d.
8. Al-Akoum, M., Maunsell, E., Verreault, R., Provencher, L., Otis, H., & Dodin, S. (2009). Effects of Hypericum perforatum (St. John's wort) on hot flashes and quality of life in perimenopausal women: a randomized pilot trial. Menopause (New York, N.Y.), 16(2), 307–314. https://doi.org/10.1097/gme.0b013e31818572a0.
9. St. John’s Wort. (n.d.). NCCIH. https://www.nccih.nih.gov/health/st-johns-wort#:~:text=John's%20wort%20may%20cause%20increased,%2C%20headache%2C%20or%20sexual%20dysfunction.
10.  Peterson B, Nguyen H. St John's Wort. [Updated 2023 May 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557465/.
11.  ST. JOHN’S WORT: Overview, uses, side effects, precautions, interactions, dosing and reviews. (n.d.). https://www.webmd.com/vitamins/ai/ingredientmono-329/st-johns-wort.
12. Interactions with St. John’s Wort (Hypericum perforatum) Preparations. (n.d.). https://www.medsafe.govt.nz/profs/puarticles/sjw.htm.