Botanical Modulation of Menopausal Symptoms: Mechanisms of Action?

Abstract

Menopausal women suffer from a variety of symptoms, including hot flashes and night sweats which can affect quality of life. Although hormone therapy (HT) has been the treatment of choice for relieving these symptoms, HT has been associated with increased breast cancer risk leading many women to search for natural, efficacious, and safe alternatives such as botanical supplements. Data from clinical trials suggesting that botanicals have efficacy for menopausal symptom relief, have been controversial and several mechanisms of action have been proposed including estrogenic, progestogenic, and serotonergic pathways. Plant extracts with potential estrogenic activities include soy, red clover, kudzu, hops, licorice, rhubarb, yam, and chasteberry. Botanicals with reported progestogenic activities are red clover, hops, yam, and chasteberry. Serotonergic mechanisms have also been proposed since women taking antidepressants often report reduction in hot flashes and night sweats. Black cohosh, kudzu, kava, licorice, and dong quai all either have reported 5-HT7 ligands or inhibit serotonin re-uptake, therefore have potential serotonergic activities. Understanding the mechanisms of action of these natural remedies used for women’s health, could lead to more efficacious formulations and to the isolation of active components which have the potential of becoming effective medications in the future.

A Cycloartane Glycoside Derived from Actaea racemosa L. Modulates GABAA Receptors and Induces Pronounced Sedation in Mice

“…Understanding its molecular mechanism(s) of action is, however, a conditio sine qua non for considering potential beneficial and unwanted side effects. The initially suggested estrogenic activity of lipophilic components, such as triterpenoids, was disproved by later studies (Gaube et al, 2007;Mercado-Feliciano et al, 2012;Hajirahimkhan et al, 2013). There, however, is evidence that A. racemosa L. preparations interact with distinct neurotransmitter systems in the central nervous system, including m-opioid receptors (Rhyu et al, 2006;Reame et al, 2008), serotonin (5-HT) receptors (subtypes 5-HT 1A , 5-HT 1D , and 5-HT 7 ) (Burdette et al, 2003), and dopamine subtype 2 receptors (Jarry et al, 2003).…”

Use of Phytoestrogens for the Treatment of Psychiatric Symptoms Associated with Menopause Transition

“…It is agreed that black cohosh is not estrogenic and its mechanism of action may involve modulation of the serotonergic system in a similar manner than antidepressants [1]. This botanical product has been tested in several trials given contradictory results.…”

“…Ohwi (Fabaceae) is a traditional Chinese medicine for the treatment of the symptoms of menopause [1]; the major isolavone in kudzu is puerarin, which is metabolized to daidzein by gut microbiota. Clinical trials with kudzu reported no signiicant changes in the menopausal complaints compared with control group [53].…”

“…Most of the menopausal women sufer from a variety of symptoms such as hot lashes, night sweats, mood swings, insomnia, vaginal dryness and osteoporosis [1,2]. Also, the menopause transition could be a vulnerable period to develop some diseases related to mental disorders (i.e., anxiety and depression) and chronic non-degenerative pathologies (metabolic diseases) in addition to menopausal symptoms [3,4].…”

“…However, many women refuse it because of their association with increased risk of breast cancer and are considering botanical products or dietary supplements as therapy because they are regarded as safer products [1,2,5]. For example, black cohosh is widely employed for hot lashes and mood disorders; others are compounds with estrogenic activity (phytoestrogens) as soy food products, red clover, kudzu, hops, licorice, rhubarb, yam and chasteberry [1].…”