The treatment package from herbal practitioners improved menopausal symptoms, particularly hot flushes and low libido. This offers evidence to support herbal medicine as a treatment choice during the menopause.

This paper reports on the complex prescriptions designed by practitioners of western herbal medicine in a pilot randomised, waiting-list controlled trial carried out in primary care in the UK. Herbal practitioners recorded their prescriptions and advice contemporaneously during the pragmatic trial investigating five months of treatment for symptoms associated with the menopause. Treatment was modified so that the 35 participants received 141 prescriptions between them during the course of their treatment. These complex prescriptions were shown to contain varying combinations of a total of 80 herbs. Between 4 and 9 herbs were used in each prescription. The three most commonly prescribed herbs were Leonurus cardiaca, Cimicifuga racemosa and Salvia officinalis. Care included not only herbal prescriptions but also support, dietary and lifestyle advice and discussion of self care in an evolving therapeutic relationship. The care was individually reviewed and adjusted at each consultation over the course of treatment.

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