Herbal Medicine
for Midlife Women
Throughout her menstruating life, a woman will experience highs and lows of estrogen, progesterone, luteinizing hormone, and follicle stimulating hormone. Though perfectly natural and normal, these cycles can sometimes contribute to imbalances that present as pre-menstrual syndrome (also called pre-menstrual tension) or that can lead to infertility.
Pre-Menstrual Syndrome (or Pre-Menstrual Tension)
Women’s hormones are an extremely complex system of the human body and, to date, not much is known about them. Science has pinpointed the provenance of certain hormone production—identifying particular organs in the body as manufacturing and distribution points—and it has a good handle on the general menstrual cycle and even a woman’s hormonal cycle throughout her lifetime. But science doesn’t understand a great deal about the particulars of how tender hormones act, why they affect the emotions, or how they instigate weight gain, etc. What about painful menses? Or the absence of menses? It can take years of careful observation for a young healthy woman to determine why she’s anovulatory, for example. Medical science hasn’t pinpointed how stress affects hormonal balance, how to accurately gauge the amount of progesterone or estrogen in the body at a particular time, whether skin eruptions are the result of changing hormones, or how diet affects the chemical reaction of hormones in the female body.
We need to know the herbal answers to these questions. We are gaining ground, especially since herbalists look at the body holistically and take into consideration issues that are often ignored by medical science, such as stress, diet, and environmental factors.
Mild pre-menstrual syndrome appears to affect 40 percent of women of reproductive age, with 85 percent of women reporting at least one symptom each month. Moderate to debilitating PMS affects about 3 percent. Debilitating symptoms include severe anger, anxiety, mood swings and depression—enough that daily life ceases to function normally; this is referred to as pre-menstrual dysphoric disorder (PMDD).
Women often experience a conglomerate of symptoms during the late luteal phase of the cycle: headaches, fatigue, emotional duress, anxiety, fluid retention, sore and swollen breasts, acne, nosebleeds, confusion, insomnia, and many more common physical and emotional symptoms associated with a drop in estrogen and a spike in progesterone. Just before the period begins, progesterone plunges. Many women experience a reduction or elimination of symptoms once bleeding begins, or within a day or two of menses.
Herbal Actions for PMS
The following conditions can be alleviated by the appropriate herbal actions:
Hormone Imbalance
Balancing the varying levels of estrogen and progesterone is the job of the tier 2 specific:
Inflammation of the Pelvic Area
Herbs that relieve pelvic congestion and inflammation of the uterus can help with cramping, bloating, gas, diarrhea, pain, dysmenorrhea, and PMS symptoms. Consider wild yam, black cohosh, licorice, and motherwort.
Emotional Irritability
If emotional extremism is the key issue the woman is experiencing, use motherwort, skullcap, and black cohosh as tier 2 Specifics; otherwise consider them tier 1 tonics.
Breast Tenderness and Swelling
Caused by fluid retention, believed to be caused by increased aldosterone levels, breast tenderness is a noncritical symptom of PMS that causes discomfort. Sodium intake can aggravate breast tenderness and increase the risk of cardiovascular problems. In addition to the diuretic herbs dandelion and parsley for edema and PMS-related swelling, consider:
PMS Forumlas
A Formula for PMS with Breast Tenderness (as a tincture or tea)
A Formula for PMS with Headache (as a tincture or tea)
A Formula for PMS with Mood Swings (as a tincture or tea)
Fibroids
Among the most common issues a woman faces (approximately half of all women will develop one or more fibroids by age fifty, with African and African-American women more susceptible than Caucasian), these noncancerous tumors are nevertheless important to understand as they can cause side effects such as bloating, pain, heavy bleeding (menorrhagia), and in-between bleeding (metrorrhagia). Fibroids are suspected to be caused by excess estrogen and they can range in size from microscopic to as large as the entire uterus, requiring surgery.
Symptoms associated with fibroids include heavy bleeding and bleeding between periods, extended length of menses, excessive urination or the urge to urinate, pelvic cramping, pelvic fullness or congestion, pain, and/or pain during intercourse. Treatment for fibroids can involve doing nothing (most fibroids shrink and disappear at the onset of menopause or they may be so small that they cause no symptoms) to surgery, as well as treatment for corollary symptoms such as pain, swelling (edema), lethargy, the sensation of fullness, and anemia.
Herbal treatment for fibroids focuses on hormone modulators that balance the levels of estrogen and progesterone in the blood. The best tier 2 specific is chaste tree berry (Vitex agnus-castus). Tier 3 and tier 4 symptomatic support comes from:
Because fibroids cause excessive bleeding, anemia can be an issue. 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 and can replenish iron lost during heavy menses. Animal meats provide both heme and non-heme iron while plant sources provide non-heme, which is slightly less bioavailable than heme.
Iron-Rich Herbs and Foods
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amaranth |
dried apricots |
bladderwrack & kelp |
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dandelion leaf and root |
dates |
lamb’s quarters |
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licorice |
pumpkin seeds |
blackstrap molasses |
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mustard greens |
nettles |
oatstraw |
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parsley |
prunes |
raisins |
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sarsaparilla |
watercress |
thyme |
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yellow dock |
lentils, beans and chickpeas |
chocolate |
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oysters and seafoods (heme) |
red and white meats (heme) |
Take iron-rich foods alongside bitters or vitamin C foods, such as oranges or citrus fruits. Avoid alcohol and coffee, which sap iron from the body. Soy should be eaten separately. Include bitters when eating iron-rich foods to aid in absorption. For instance, consuming iron-rich dandelion roots along with bitter dandelion greens is an ideal way to get balanced nutrition. Other bitters include motherwort (in limited quantities during pregnancy), chamomile, green tea, and mustard greens.
Though fibroids that cause pain and other symptoms should be evaluated by a health care provider, these formulas provide support and secondary symptomatic relief in addition to a healthy diet and careful monitoring by a professional.
Fibroid Formulas
A Formula for Fibroids with Edema
A Formula for Fibroids with Pain
A Formula for Fibroids with Heavy Bleeding
Fertility
Infertility is diagnosed when a couple has unsuccessfully attempted to conceive for twelve months. Nine out of ten couples successfully conceive in this timeframe, so that absence of success indicates imbalances in either the man or the woman. These imbalances can come from a wide range of causes, including ovulatory disorders (defects in the ovaries or the lack of ovulation), thyroid disorders, adrenal insufficiency, pelvic infection or inflammation, and (rarely) sperm antibodies in the vaginal mucus. Stress is a large contributor to infertility, creating a self-inflicting cycle where more stress creates more infertile months that create more stress.
Careful work with a health care practitioner to rule out physical illness is especially important so that appropriate remedies can be given. Again, black cohosh and chaste tree berry are tier 2 Specifics, which raises concerns of over-harvesting for black cohosh. Though black cohosh contains no estrogen-like compounds itself, it has clinically demonstrated estrogen-modulating activity and the ability to reduce elevated LH levels while not affecting FSH and prolactin. 72
This makes it useful for infertility derived from anovulation and amenorrhea. Chaste tree’s positive effects on balancing the pituitary gland make it valuable in cases of metrorrhagia (bleeding between cycles), polymenorrhea (too frequent cycles), and oligomenorrhea (too few cycles).
Nervine tonics and anxiolytics are key herbs for infertility treatment due to the effects of stress and anxiety. Consider oats, lemon balm, motherwort (but cease motherwort as soon as pregnancy begins), passionflower, skullcap, verbena, and St. John’s wort. Ashwagandha is a wonderfully supportive herb in that it will provide a strong basis from which the body can exert its energies for conception.
I don’t recommend aphrodisiac herbs, such as damiana, for fertility, except to enhance energy and give the woman a sense of vigor and self-confidence. Combining damiana with roses, clove, vanilla, chocolate, and/or gotu kola can be a fun way to boost arousal and create in-the-moment awareness in anticipation of making love. But long-term efforts that involve hormone balancing and nervous system support should form the foundation of the formula.
Fertility Formulas
A Formula for Infertility
For women who have been menstruating for years, herbs are a natural choice for supporting their health and addressing the more common imbalances that can occur. This is a prime opportunity to use tonics and to introduce women to the mineral-rich and nourishing herbs that they can rely on long-term.