Herbal Therapies for the Management of Menopausal Vasomotor Symptoms: A Systematic Review and Meta-Analysis

Abstract

Introduction: Vasomotor symptoms, such as hot flashes and night sweats, are hallmark features of menopause. Many women seek herbal alternatives to hormone replacement therapy. This review assesses the efficacy of common herbal therapies for these symptoms.

Methods: We searched PubMed, CINAHL, and Scopus up to December 2019 for RCTs comparing herbal medicines (e.g., black cohosh, red clover, soy isoflavones) to placebo in peri- or postmenopausal women. The primary outcome was the frequency and severity of hot flashes.

Results: Sixty-two RCTs were included. Meta-analysis showed that phytoestrogen-based therapies, particularly soy isoflavones, provided a small but statistically significant reduction in hot flash frequency compared to placebo. Evidence for black cohosh was inconsistent and did not show a clear benefit over placebo. Most therapies were well-tolerated.

Discussion: Certain herbal therapies, especially those containing phytoestrogens, may provide mild relief from menopausal vasomotor symptoms. The effect size is modest and may not be clinically significant for all women. The quality of the available evidence is variable.

Conclusion: Based on evidence available up to 2019, some herbal medicines like soy isoflavones may be considered for women with mild menopausal symptoms, but they are less effective than conventional hormone therapy.