Natural Hormone Replacement Therapy: 8 Options for Menopause

Updated in April 2024

Natural hormone replacement therapy may involve the use of medicinal plants such as black cohosh or motherwort, which contain substances that help balance hormones and alleviate symptoms of menopause, such as insomnia, waves heat, night sweats, anxiety or depression, for example.

Menopause is characterized by the interruption of estrogen production by the ovaries, so the use of medicinal plants can be a good option to alleviate symptoms. However, plants should only be used with medical advice, as they are not recommended for all cases, especially for women with a history of breast cancer or who are undergoing cancer treatment.

Another way to do natural replacement is through dietary supplements such as soy lecithin or soy isoflavone, whose effectiveness is safe and proven, helping women feel better during the climacteric period until the onset of menopause.

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Some options for natural hormone replacement during menopause are:

1. Black cohosh (Cimicifuga racemosa)

Black cohosh has flavonoids, glycosides, tannins and volatile oils, that act in a similar way to serotonin reuptake inhibitor antidepressants, like  fluoxetine or sertraline. These medications are sometimes prescribed by doctors to relieve menopause-related discomfort and symptoms.

Black cohosh is a natural option for relieving menopause symptoms such as hot flashes, excessive sweating, anxiety, mood changes or insomnia.

Also recommended: Menopause Symptoms: 12 Signs to Monitor & Treatment tuasaude.com/en/menopause-symptoms

How to use: Black cohosh can be consumed as a tea, which can be prepared with 1 tablespoon of dry leaves and 180 mL of boiling water. Add the leaves to the water and let them infuse for 3 minutes, then strain and drink while warm. Another way to use black cohosh is in the form of tablets, which can be purchased at pharmacies or drugstores. 

Possible side effects: Using the plant in the doses recommended by your doctor usually does not cause side effects. However, large quantities and prolonged use can lead to liver damage. Black cohosh tablets may cause possible side effects like diarrhea, itching, increased body weight and skin redness.

2. Vitex (Vitex agnus-castus)

Vitex is rich in flavonoids, essential oils, diterpenes and glycosides, which have an effect on LH and FSH. They help to maintain normal levels, which can relieve menopause symptoms such as mood changes or insomnia.

How to use: Vitex can be consumed as a tea by adding 1 teaspoon of vitex fruit to 300 mL of water and boiling this for 3 to 4 minutes. Cover and infuse for an additional 10 minutes, then strain and drink up to 2 cups per day. Vitex can also be used in the form of capsules or tablets sold in pharmacies or natural health stores.

Possible side effects: Side effects of vitex appear when this plant is consumed very frequently and in higher-than-prescribed doses. Side effects that may appear include headaches, allergies, hair loss, itching, nausea, vomiting and dry mouth.

3. Motherwort (Leonurus cardiaca)

Motherwort contains alkaloids, sterols and flavonoids that help to balance female hormones, making it a natural hormone replacement option during menopause. It can help to relieve symptoms such as anxiety, heart palpitations or insomnia.

This plant should not be used by women who use antipsychotic or non-steroidal anti-inflammatory drugs.

How to use: Motherwort can be consumed as tea. Place 2 tablespoons of the dried motherwort in a cup of boiling water and infuse for 5 minutes, then strain and drink a cup in the morning and a cup at night. Read about other teas for menopause that you can prepare to help manage symptoms.

Possible side effects: When used in large quantities, motherwort can cause diarrhea, drowsiness, changes in blood pressure, uterine contractions and uterine bleeding.

4. St. John's Wort (Hypericum perforatum)

St. John's wort is a medicinal plant that is rich in hypericin and hyperforin, which have antidepressant effects. It also contains flavonols, biflavones and naphthodianthrones, which help to reduce and improve menopausal symptoms such as depression and hot flashes.

Read more about the health benefits of St. John's Wort and what it can be taken for.

This plant should not be used by women who are already using antidepressant medications such as sertraline, paroxetine or nefazodone.

How to use: St. John's wort can be used in the form of a tincture, capsules or as a tea prepared with the dried plant. To prepare the tea, place 1 teaspoon (2 to 3g) of dry St. John's wort in 250 mL of boiling water and let it rest for 5 to 10 minutes. Then strain, let cool and drink 2 to 3 times a day, after meals.

Possible side effects: Frequent consumption of St. John's wort can lead to side effects such as stomach pain, allergies and agitation.

5. Lady's mantle (Alchemilla vulgaris)

Lady's mantle is a plant that can help reduce heavy periods, which is common for many women during the climacteric period. It can be combined with other plants such as chinese angelica (Dong quai) and black cohosh for faster, more effective action.

How to use: You can use lady's mantle in the form of a tea by adding 1 teaspoon of dried lady's mantle leaf to 180 mL of boiling water. Infuse for 5 minutes, strain and drink warm.

6. Siberian Ginseng (Eleutherococcus senticosus)

Siberian Ginseng is rich in eleutherosides which contain antidepressant action  that help to improve mood and libido. This plant can help women to adapt to the hormonal changes that occur during menopause, as well as reduce stress and boost energy.

This plant should not be consumed by women who have high blood pressure, rheumatoid arthritis, Chron's disease, heart disease or mental illnesses.

How to use: To use Siberian ginseng, you can prepare tea by boiling 1 cm of Siberian ginseng root in 200 mL of water. Strain after 5 minutes and drink while warm.

Possible side effects: The use of Siberian ginseng is not associated with side effects, but in some cases, especially when used in large doses, it can cause vaginal bleeding, dizziness and dysregulation of blood pressure.

7. Black mulberry (Morus Nigra L.)

Black mulberry leaves can help to combat menopausal symptoms, especially hot flashes, because they contain phytoestrogens that help to regulate hormonal levels. Read more about hot flash relief and other natural treatments you can utilize.

Furthermore, this plant helps improve memory, energy, mental health and sleep quality, making it a great option for natural hormone replacement during menopause.

Black mulberry should not be used by women who have gastrointestinal problems, such as gastritis or ulcers, hyperthyroidism, anxiety, insomnia, cardiovascular or kidney diseases.

How to use: Black mulberry leaves can be consumed as tea. To prepare this tea boil 5 mulberry leaves in 500 mL of water. Strain after 5 minutes and drink while warm.

Possible side effects: The main side effect related to black mulberry consumption is diarrhea, especially when consumed in excess.

8. Sage (Salvia officinalis)

Sage is a medicinal plant that has sweat-inhibiting properties, and is especially recommended to combat hot flashes and night sweats during menopause. It helps to correct hormonal levels, and is effective and generally well-tolerated by the body.

How to use: Sage can be consumed as a tea or tincture. To prepare the tea, add 10 g of dried sage leaves to 1 liter of boiling water. Strain after 10 minutes and drink 1 cup of warm tea up to 3 times a day.

Possible side effects: When sage is consumed in high doses, some adverse effects may occur, such as increased heart rate, nausea and excessive heat, for example.