Menarche and
Herbal Medicine for
Teenage Women
Women’s use of herbs for physical health dates back millennia; for thousands of years, we have concrete evidence that herbs have been used to heal the human body, and presumably, that includes women’s bodies, although many historians have incorrectly presumed “human” simply refers to “men.” Women have, undoubtedly, called on plants to heal their wounds, infections, cuts, scrapes, and indigestion, just as men have. But women have special body parts, unique to our gender, that require additional care and tending. The breasts are not just lumps on our chests; they are highly respectable organs with a unique function: providing nourishment to our babies. The uterus is not just a “receptacle” for pregnancy; it is a highly adaptable, flexible organ perfect for attracting the egg, cradling the fetus, squeezing the baby out at the right time, and then resuming its shape. Between babies, the uterus fills with menstrual blood, contains it effectively for twenty-eight days, then expels the blood in an orderly fashion. The ovaries supply essential hormones throughout a woman’s life until menopause. Our endocrine system regulates body temperature, emotional balance, water balance, weight gain, and monthly bleeding. The following herbs and formulas are to be used in tandem with the woman’s personal experience and, when necessary, with appropriate medical professionals.
Just like with the respiratory system, many of the traditional herbs that form the cornerstone of reproductive herbalism are, sadly, endangered or at-risk. The educational and advocacy organization United Plant Savers has created two lists of herbs that detail which medicinal plants are at-risk or are being watched; the following traditional “women’s” herbs are all on the lists (see Glossary E at the back of this book): helonias, or false unicorn root, blue cohosh, black cohosh, beth root (Trillium), lady’s slipper, wild yam, and partridgeberry.
Menarche
Menarche is the beginning of the menstrual cycle for a young woman and normally takes place between the ages of ten and sixteen, with twelve being a general average (though every young woman is different). While signs of puberty0 may begin as early as seven or eight, menarche generally happens later. Menarche is the production of the first egg from its follicle (eggs that have been inside the girl’s body since birth), its passage through the uterus, and the first shedding of blood from the uterus. This marks a profound and special time in a girl’s life: she is now a woman. Not only has she matured physically and is by nature capable of producing a child of her own, she is also growing into a helpful and thoughtful contributing member of society. This is a time for celebration and honor.
But it can also bring confusion and even fear to the girl who is not prepared to find blood on her underwear. As a facilitator for young women’s workshops, I’ve heard heart-breaking stories of girl’s first periods becoming nightmares, and the best antidote to this is proper education from the mother or other trusted adult. Letting girls know what they may soon expect prepares them to think ahead—a strategy they can use the rest of their lives, especially for their periods. Proper planning cultivates body awareness, which includes awareness of ovulation, self-care, body temperature fluctuations, and managing their own contraception when they are ready to become sexually active. Up-front education encourages self-confidence and self-respect. As always, encourage girls to speak freely and share their emotions, thoughts, and symptoms. Also plan to work in tandem with the child’s parent and primary care provider since some menstrual symptoms can indicate more serious illnesses.
Herbs can be successful for a variety of conditions, including:
Anovulation
The absence of ovulation, or egg production, can indicate a number of physiological issues that must be addressed by a health care practitioner, including physical obstruction, hormone imbalance, or other illness. Often herbalists can help coax the person’s body into wholeness and rhythm with herbal modulators (also called normalizers) that help bring estrogen and progesterone production into balance. Ovulation is dependent upon an increase in estrogen that stimulates follicle stimulating hormones (FSH), which in turn stimulates the follicle to release an egg. When estrogen fails to rise to necessary levels, FSH will not be stimulated and no egg will be produced. Estrogen levels depend on many factors, of which stress is one. Stress can form on several fronts: over-worked and exhausted women; women who are afraid or who live in fear; women who are very athletic and stress their bodies to the maximum possible; women who are dealing with other hormonal imbalance issues which affect their estrogen and progesterone output; women who experience physical blockages such as fibroids.
Teenagers generally first ovulate between the ages of ten and sixteen (average age twelve), and cycles tend to be sporadic and uneven for at least the first two years after the first cycle. It is not wise to try to stimulate the onset of ovulation and menses through any means; let nature take its course unless there is reason to believe an underlying issue poses a threat to the young woman’s health. In fact, most first menstrual cycles are anovulatory, with a full year to a year-and-a-half of a girl’s periods producing no eggs. In late onset ovulation, many years can pass before all menstrual cycles involve the production of an egg from the follicle. Educate your female clients about what they may expect with their menstrual cycle, including the fact that it may not be the same every month (duration, saturation, ovulation, and symptoms). However, menstruating women may experience short-term anovulation when, during a cycle, there is no oocyte or egg produced, or they may experience chronic or long-term anovulation which can cause infertility and medical problems such as polycystic ovary syndrome. Menstruation (bleeding) may continue normally despite the lack of ovulation, though light and scant menses occurs in about 40 percent of anovulatory women. Encouraging ovulation (during a normal menstrual cycle) can benefit from any of the following herbal actions:
Formulas for Anovulation
A Formula for Anovulation
Amenorrhea
The absence of menses can have many etiological factors. Primary amenorrhea is diagnosed when there are no periods by age fourteen with no secondary sexual signs of puberty, or by age sixteen regardless of other signs. Secondary amenorrhea is diagnosed when there are no periods for three to six months at any point after menstruation has already begun. Each case can benefit from herbs that balance hormones, though primary amenorrhea can be indicative of more serious underlying problems and merits further investigation by a health care professional. Basic nutrition must be addressed and other factors (such as extreme athleticism or stress) should be considered. For secondary amenorrhea, bitter herbs with emmenagogue or warming effects can prove useful, as well as balancing hormonal herbs. Some tier 2 specific herbs to “bring on” menses include:
Amenorrhea Formulas
A Formula for Primary Amenorrhea (as a tea, tincture, or capsule)
A Formula for Secondary Amenorrhea
Dysmenorrhea
Dysmenorrhea is painful menses, including cramps, a “pulling down” feeling in the vagina, often accompanied by headache, dizziness, sweats, irritability, and either constipation or diarrhea. Herbalists generally work symptomatically and use herbs as a nourishing foundation, as well as providing herbs that are anti-spasmodic, anti-inflammatory, warming, and anodyne. Tier 2 Specifics for painful menses include:
General anodynes that could be placed in tier 3 of a formula for pelvic pain include meadowsweet, willow, and Jamaican dogwood. Meadowsweet and willow, in my experience, truly benefit from the presence of a vehicle herb that will carry them to the desired location in the body. I’ve found they respond well to feverfew and ginkgo in the treatment of headaches, and to raspberry and wild yam in the treatment of painful menses and cramps. Jamaican dogwood is renowned as a muscle relaxer and muscle-pain reliever, particularly useful for nighttime cramps and insomnia.
Warming herbs can help both internally and externally and can be placed in the tier 3 of a formula for pelvic pain. Ginger can assist where dysmenorrhea causes nausea and dizziness, and externally it provides a warming compress over the lower abdomen to help reduce spasms and cramps. Yarrow can help eliminate pelvic congestion but both yarrow and ginger can be too stimulating in certain cases; some women find cooling herbs more helpful in “taming” the fire of menstruation. Cooling herbs such as chickweed, lavender and skullcap can be drunk as teas or soaked in cool cloths for external fomentations. Peppermint is generally more warming, while spearmint is more cooling.
Antispasmodics (to reduce muscle spasm and cramps) of primary importance to the pelvis include black haw (Viburnum prunifolium) and cramp bark (Viburnum opulus) and Jamaican dogwood.
Stress can aggravate the symptoms of dysmenorrhea, causing headaches, shoulder and neck tension, nosebleeds, nausea, and depression. Consider passionflower, chamomile, skullcap, and vervain (see Calming and Nervine Herbs in chapter six).
Dysmenorrhea Formulas
A Formula for Dysmenorrhea, Uterine Congestion, and Menstrual Pain
Another Formula for Dysmenorrhea,
Uterine Congestion, and Menstrual Pain
Menorrhagia, Metrorragia, and Anemia
The over-production and over-expulsion of menstrual blood from the uterus is menorrhagia, and is often caused by low blood levels of progesterone. Menorrhagic women experience a very high level of menstrual blood which often occurs over a longer period of time than normal menstrual cycles. Though normal varies per person, most women spend three to six days menstruating and lose thirty to eighty milliliters of blood, or approximately two to four tampons. Excess menstrual blood loss can lead to fatigue, mineral loss, uterine atony, and anemia. Metrorrhagia is irregular heavy bleeding.
Hormonal balancing herbs can help (the best include wild yam, chaste tree berry, and black cohosh), as well as pituitary and adrenal tonic herbs such as licorice or lemon balm.
Antispasmodics can reduce symptomatic cramping and possibly reduce blood loss; cramp bark (Viburnum opulus), black haw (Viburnum prunifolium), black cohosh, and wild yam are key possibilities. Motherwort (Leonurus cardiaca) and spearmint (Mentha spicata) are anti-inflammatory, aiding the body in its efforts to relax.
Astringents can help stem the tide of blood flowing and help the body reabsorb critical minerals instead of expelling them. Key astringent herbs for the uterus include shepherd’s purse, lady’s mantle (Alchemilla mollis, A. vulgaris), partridgeberry (Mitchella repens) and cranesbill (Geranium maculatum). Here, yarrow displays its contradictory nature; though normally warming and stimulating when drunk hot (and used as a classic emmenagogue to bring on menses), some herbalists use it for its astringency to curb excessive bleeding. In this case, use yarrow as a douche or drink it as a cold infusion.
Because menorrhagic women lose more blood than normally menstruating women, they are at greater risk for iron depletion and anemia. Symptoms of anemia include shortness of breath (especially during and after exertion), fatigue, dizziness, headaches, pale skin, and rapid heart rate and/or chest pains. Eating and taking iron-rich and folic acid–rich herbs can greatly benefit women’s endocrine system, skin, hair, nails, liver, and digestive systems. Iron-rich herbs include amaranth, dried apricots, bladderwrack, chlorella, dandelion leaf and root, dates, kelp, lamb’s quarters, licorice, pumpkin seeds, blackstrap molasses, mustard greens, nettle, oatstraw, and bran, parsley, prunes, raisins, sarsaparilla, thyme, watercress, and yellow dock. Take iron-rich foods alongside bitters or foods high in vitamin C, such as oranges or citrus fruits. Avoid alcohol and coffee, which sap iron from the body. Soy should be eaten separately.
Menorrhagia, Metrorrhagia, and Anemia Formulas
A Formula for Menorrhagia
A Formula for Anemia
Another Formula for Anemia (as a syrup)
To make the syrup, simmer the nettle, dates and apricots in enough water to cover for 15 minutes. Strain and add molasses to desired thickness. Refrigerate and take by the tablespoonful.
Growing Bones
Growing women have growing bones; they are not only a uterus, but an entire body! The teenage years are prime years for adding length and support to the skeletal structure. Be sure teenage women get plenty of calcium, as this necessary mineral contributes not only to bones and teeth but also to muscle control, nerve function, proper glandular secretion, blood clotting, and to future prevention of osteoporosis.
To maintain strong bones, encourage girls and women to indulge in the mineral-rich herbs listed here as well as foods that promote proper calcium absorption. Eat dairy products (especially yogurt), meat as desired, some seafood (especially oysters and sardines), and lots of beet greens and beans. Calcium is best absorbed along with sufficient vitamin D (sunlight exposure and vitamin-D fortified milk are best) and vitamin C. Avoid sodas with calcium-rich foods; the phosphorus that contributes to the carbonation can interfere with calcium absorption. A healthy infusion can be made by combining fennel seeds, poppy seeds, dried raspberry leaves, and dried nettle leaves, or a lightly salty snack can be made by combining mineral-rich sesame seeds, celery seeds, dill seeds, and fennel seeds. The following herbs are high in minerals:
Bones Support Formulas
A Formula for Bone Support
Depression
The onset of menses can bring about profound emotional changes, and coupled with normal life stress, these changes can produce feelings of depression, uncertainty, abandonment, hopelessness, and anger. Girls experiencing these feelings should be cared for with respect and compassion; severe depression requires immediate emergency response. For mild depression and hormonal swings, see chapter six.
Acne
A maddening and embarrassing skin condition, acne is usually the result of hormone imbalance, especially from the pituitary gland. Teens and adults suffering from acne can develop mild to disfiguring sores, pustules, boils, abscesses, and even long-term scarring.
Many herbalists use alterative herbs for internal balancing to realign the endocrine system and clear the skin from the inside out. Supporting and strengthening the lymphatic and hepatic systems are key in helping the body expel toxins and metabolic wastes through the proper channels. As mentioned earlier, herbs of particular importance in this process are chaste tree, dandelion leaf and root, and red clover, while others indicated in acne include yellow dock root, cleavers, and milk thistle. Externally, compresses and facial astringents can be made from astringent and emollient herbs such as witch hazel, calendula, burdock root, burdock seed, lavender, and mullein. These soothing and cooling herbs help clear the skin, reduce inflammation and heat, cool the face and neck, and tighten tissues.
Acne Formulas
A Formula for Hormone-based Acne (as a tea, tincture, or capsule)
Another Formula for Acne (as a wash or compress)
Bloating
Bloating is a common symptom during menstruation and typically goes away when bleeding ends. Be sure to distinguish common bloating from the more serious issue of fibroids, which can produce somewhat similar symptoms but are rare in women under age twenty (see next chapter). Pelvic congestion during menstruation often responds well to wild yam, black cohosh, and ginger, as these are anti-spasmodic and anti-inflammatory herbs with a special affinity for the uterus. Warming carminative herbs can also be very helpful: caraway, dill, fennel, chamomile, motherwort, lemon balm, lavender, and mint. Cramp bark and black haw can be effective antispasmodics to reduce spastic irritation in the uterus and pelvic area.
Bloating Formulas
A Formula for Bloating (as a tincture or tea to drink)
Supporting the young woman as she grows from a girl to an adult is a privilege we cannot take for granted. Introducing young women to the beauty and power of herbal medicines has been one of the rich joys of my herbal career, and it is so worthwhile to freely share our knowledge and heritage with the young people who will take over our traditions. Because the endocrine system is so delicate, especially during adolescence, be sure to work in tandem with other health care providers to develop a well-rounded approach to support the natural occurrences of menarche and menstruation.