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St. John's Wort Relieves Menopause
Symptoms
Menopausal symptoms affect approximately
two-thirds of women as they transition out of their reproductive
years. The scientific literature on St. John's wort (Hypericum
perforatum L., Clusiaceae) briefly mentions the herb as a
possible treatment for menopausal complaints (Roth, 1990; Wagner
et al., 1995), but the first clinical trial to investigate
this use was conducted only last year.
While depression is one symptom of menopause
that St. John's wort (SJW) might be expected to improve, German
researchers designed a trial to assess its effects on other problems
more specific to menopause (Grube, et al., 2000). Their
results suggest that SJW not only helps relieve psychological
and physical symptoms, but also helps enhance sexual well-being
for menopausal women. Specifically, 76 percent of study participants
experienced a statistically significant lessening or disappearance
of symptoms after 12 weeks of treatment with SJW, and participating
physicians observed improvement in 79 percent.
For the open trial, 106 women took three
Kira® tablets (Lichtwer Pharma, Germany) per day for 12 weeks.
Each tablet contained 135 to 225 mg SJW extract standardized to
300 mcg hypericin. None of the women had received hormone replacement
therapy. Study participants were assessed at baseline and then
again after 5, 8, and 12 weeks of treatment. At each assessment,
the participants reported the frequency and severity of psychological,
physical, and vasomotor menopausal symptoms she was experiencing,
according to the Menopause Rating Scale. (Psychological symptoms
included irritability, poor concentration, tension, anxiety, and
depression. Physical symptoms included headaches, heart palpitations,
and disturbed sleep. Hot flashes, excessive sweating, and dizziness
were considered vasomotor symptoms.) She also responded to a short
sexual health questionnaire designed for this study. A physician
scored each patient according to the Clinical Global Impression
scale to document therapeutic efficacy and side effects. At the
start of the study, 80 to 90 percent of all symptoms (except dizziness
and heart palpitations) were "moderate" or "marked" in severity.
By the end of the study, only 20 to 30 percent of women were still
experiencing psychological and physical symptoms of "moderate"
or "marked" severity. The researchers reported, "The overwhelming
majority were symptom-free, or their symptoms had become merely
'slight' by this time." Scores for intensity of symptoms on the
Menopause Rating Scale were also significantly different after
treatment, dropping from 63.4 (marked) to 23.5 (slight). Apparently,
there was no significant change in vasomotor symptoms. Only four
patients reported adverse events during the trial.
Responses to the Sexuality Assessment questionnaire
showed that patients felt more physically attractive, saw sexual
intercourse as more valuable, and were more likely to initiate
sex at the end of treatment than they had before taking SJW. Of
82 women who said they no longer felt physically attractive at
their first interview, 77 had changed their view by the end of
the study. Overall, approximately 80 percent of the patients agreed
that their sexuality had been "substantially enhanced" by SJW
treatment. The investigators noted, "This represents a significant
advantage over synthetic antidepressants, especially in these
patients."
- Nancy Hoegler, Herb Research Foundation
[Grube B, Walper A, Wheatley D. St. John's wort extract: efficacy
for menopausal symptoms of psychological origin. Advances in
Therapy 1999; 16(4): 177-186. Roth L. Hypericum-Hypericin.
Botanik, Inhaltsstoffe, Wirkung. Landsberg: Ecomed Verlag;
1990. Wagner H, Wiesenauer M. Hyperici perforati herba
(Johanniskraut). In: Phytotherapie. Phytopharmaka und pflanzliche
Homoöpathika. Stuttgart: Gustav Fischer Verlag; 1995]
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