One of the most successful herbs for use during the menopausal transition is Hypericum perforatum, commonly known as St John's Wort. St John’s wort is a traditional European herb, it flowers around June 24, on John the Baptist’s birthday. Combine this with the traditional old English word for plant - which is wort and you have St John's wort.
Please understand that all supplements have cautions, interaction, and contra-indications. This is really important to consider with this herb, as St John's Wort possibly has one of the largest amounts of medication interactions. If you are on any pharmaceutical products, this herb may not be the one for you.
Like most herbal products St John's wort has a very long history of use, dating back over 2000 years. Hippocrates and Galen are known to have recommended it for nerve complaints. While Paracelsus in the middle ages was the first to specifically recognize its benefits for low moods.
Today it is one of our most celebrated and researched herbal medicine, on PubMed there are currently 3271 published trials on St John’s wort!
It’s highly prized when it comes to supporting healthy moods, lifting depression, easing anxiety, and reducing stress levels. Its mechanism of action when it comes to improving moods is mostly due to its ability to inhibit the reuptake of serotonin. It is a herbal SSRI. Without the side effects some women on anti-depressants experience. There is a 1-year safety study on St John's wort. Most research trials are very short term, to find a 1 yr safety trial on a herbal product is quite unique and it involved 440 people, taking 500mg St John's wort extract daily. This study found the extract to be a safe and effective way to treat mild to moderate depression over long periods of time and seemed like a good option in both the treatment and prevention of depression.
When it comes to other symptoms of the menopausal transition, hot flashes are another complaint where St John's wort shines in the research. One particular study called the “Effects of St John's Wort on severity, frequency and duration of hot flashes in premenopausal, perimenopausal and post-menopausal women, a randomised, double-blind, placebo controlled study (by the way this is the gold standard for research), found a significant improvement around the 4-8 week mark of treatment. So it's not a magic pill with instant results but it's a genuine treatment option especially for women not on any pharmaceuticals and who can’t or don’t want to use hormone replacement. In this study, there was no significant difference between the intensity of hot flushes in both the treatment and placebo group at baseline but by week 4 no participants were experiencing severe hot flushes in the treatment group, compared to 43% of the participants in the placebo group.
In the study “Improvements in estrogen deficiency-induced hypercholesterolemia by hypericum perforatum” they found 4 powerful and beneficial actions that often are looked for at midlife. They found St John's wort to be helpful in
In “Effects of hypericum perforatum on hot flashes and quality of life in perimenopausal women" they discovered significantly fewer sleep problems and better menopause-specific quality of life in the treatment group.
You can’t really ask for much more in a menopausal herbal remedy. There are some potential indications for its use:
Plus Hippocrates will be happy to know It is still used today for nerve pain.
If you have enjoyed hearing about this herb and want to learn about other herbs. I have previously covered
Improvements in estrogen deficiency-induced hypercholesterolemia by Hypericum performatum L. Extract are associated with gut microbiota and related metabolites in ovariectized rats
The effect of Hypericum perforatum on postmenopausal symptoms and depression, a randomised controlled trial
Hypericum perforatum L/ preparations for menopause: a meta-analysis of efficacy and safety
A review of effective herbal medicine in controlling menopausal symptoms
Effects of hypericum perforatum on hot flashes and quality of life in perimenopausal women
Long-term effects of St John’s Wort treatment: a 1-year safety study in mild to moderate depression