Resource Category: Active Ingredients

Brain fog, sleepless nights, seesawing hormones – the journey through menopause can be tough. But we can help our minds and bodies weather the storm by making sure we’re getting all the nutrients we need to stay healthy during the transition.

One key example is vitamin B complex. This group of 8 different B vitamins has numerous benefits for our mood, energy levels, and physical health. 

Getting enough of these B vitamins is important at every stage of life. However, it may be especially beneficial during peri-menopause and menopause, because vitamin B complex helps with many of the same things that women commonly struggle with in this stage of life.

In this blog post, we’ll look in more detail at the different B vitamins that make up vitamin B complex and their benefits during menopause.

We’ll also give some tips on how to integrate more B vitamins into your diet.

What is vitamin B complex?

There are 8 different vitamins that make up vitamin B complex. Each has slightly different benefits, but they all have an important role to play in maintaining our overall health and wellbeing.

The 8 main B vitamins are:

• B1 – also known as thiamin
• B2 – also known as riboflavin
• B3 – also known as niacin
• B5 – also known as pantothenic acid
• B6
• B7 – also known as biotin
• B9 – also known as folate and folic acid
• B12

There are other types of B vitamin too, but these 8 are the main ones and are the ones most usually included in vitamin B complex.

What are the benefits of vitamin B complex for menopause?

As we’ve already seen, there are lots of different types of vitamin B and each has slightly different benefits for our minds and bodies during the menopause. Overall though, B vitamins are considered essential in this stage of life because of their role in hormone regulation, energy production, and nervous system function.

Let’s look in more detail at how vitamin B complex can support us during menopause and the role of specific B vitamins in bringing us those benefits.

1. Mental health and cognition

Menopause can bring with it many surprises, not least the effect it can have on our mental health and cognition. Mood swings, anxiety, stress, and depression are some of the commonly reported symptoms of peri-menopause and menopause, as are memory loss and mind fog.

Interestingly, stress, anxiety, depression, and cognitive decline are also common signs of vitamin B deficiencies. In particular, studies have linked higher levels of vitamin B6, vitamin B9 (folate) and vitamin B12 with reduced depression, anxiety, and memory issues.

Vitamins B6 and B12 are involved with the production of serotonin, a neurotransmitter that helps to regulate your mood (and your sleep). 

Meanwhile, research suggests that supplementing with folic acid (B9) can help to boost cognitive performance, especially when it comes to tasks related to memory.

2. Bone health

One of the longer-term impacts of decreasing oestrogen is the effect it has on our bones, leaving post-menopausal women more vulnerable to bone density loss and osteoporosis.
Vitamin D and calcium are the nutrients most often associated with bone health. However, B vitamins also have a vital role to play here. According to the Royal Osteoporosis Society, vitamins B6, B12, and folate (B9) all contribute to bone strength and help to avoid breaks.

3. Hormone regulation

B vitamins also play a role in the production and regulation of various hormones, including sex hormones like oestrogen, sleep hormones like melatonin, and mood hormones like dopamine and serotonin.

In particular, vitamin B6 is often associated with hormone balance in women. Although most of the research has focused on the relationship between B6 and PMS, this vitamin may also be useful during the hormonal rollercoaster that is menopause.

4. Hot flushes

Other common symptoms of menopause are hot flashes and night sweats. Not only can these be uncomfortable and irritating, but they also contribute to sleep disturbance and insomnia – which in turn can affect our mood, as well as our physical wellbeing.

Research indicates that supplementing with folic acid (vitamin B9) can help to reduce the severity, frequency, and duration of hot flashes. Excellent news for anyone struggling with this unpleasant side-effect of menopause.

5. Sleep and energy

Many peri-menopausal and menopausal women report low energy and sleep issues. When you are already feeling stressed and irritable because of changing hormone levels, disrupted nights and lack of energy only make these symptoms worse.

B vitamins are important here for two reasons. First, as a group, B vitamins are involved in energy production, supporting our bodies to release the energy we need from our food and helping us avoid low energy and fatigue.

Second, various B vitamins are associated with better sleep. According to the Sleep Foundation, vitamins B3, B6, B9, and B12 are all involved in the production of sleep hormones. 

In particular, B12 is required for the production of melatonin, one of the key hormones that regulates our sleep cycles. B12 and B6 are also involved in serotonin production, which again is necessary for healthy sleep.

How to get enough B vitamins

Your body can’t store most B vitamins, so you need to make sure you have sufficient amounts in your daily diet to meet your body’s needs.

Fortunately, there are plenty of dietary sources of the different B vitamins. Here are some of the main food groups to look out for:

• Milk: B2, B6, B12, 
• Eggs: B2, B3, B5, B12
• Meat and poultry: B3, B5, B6, B12
• Fish: B3, B6, B12
• Peas: B1, B9
• Liver: B, B5, B9
• Some fortified breakfast cereals: B1, B2, B6, B9, B12
• Wholegrain bread: B1, B3
• Mushrooms: B2, B5
• Leafy greens: B9

You may notice that this list is heavy in animal products. While many B vitamins can also be found in plant-based foods, such as wheat, legumes, mushrooms, avocados, and leafy greens, the exception is B12, which is only found naturally in meat, fish, eggs, and dairy products. 

As a result, if you are vegan, you’ll need to supplement your diet with B12. Many vegan products are now fortified with B12, but most vegans also take supplements to make sure they are getting the right amount.

While most non-vegans should, in theory, be able to meet their vitamin B requirements through diet alone, it is also worth noting that many older adults are deficient in B vitamins, especially B12 and folate (B9).

This is partly because many of us don’t get enough through our diets, but also because our ability to extract nutrients like B12 from our food can decrease as we get older. Certain medications can also play a role in vitamin B deficiencies.

As a result, it can be worth supplementing your diet with a vitamin B complex that contains the different B vitamins we’ve discussed in this blog post.

The important thing here is balance – while supplementing with a vitamin B complex can be a great way to make sure you are meeting your needs, taking too much of some B vitamins can cause issues.

The NHS recommends the following daily maximum limits for B vitamins:

• B1: 100 mg
• B2: 40 mg
• B3: 17 mg
• B5: 200 mg
• B6: 10 mg unless instructed otherwise by a doctor
• B7: 0.9 mg
• B9: 1 mg
• B12: 2 mg

This doesn’t mean you need to take as much as this every day, just that these are the safe upper limit that you shouldn’t exceed if you do choose to take a vitamin B complex in addition to a balanced diet.

Ultimately, taking a vitamin B complex won’t make your menopause symptoms disappear. But making sure your body and mind are well nourished makes you better able to cope with the various symptoms that menopause throws your way.

And, in some cases, getting enough B vitamins in your diet might also help to reduce the severity of some of your symptoms and support your long-term mental and physical health.

References

B vitamins and folic acid, the NHS, https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/, consulted 27/06/2024 

Milart, P., Woźniakowska, E., & Wrona, W. (2018). Selected vitamins and quality of life in menopausal women. Przeglad menopauzalny = Menopause review, 17(4), 175–179. https://doi.org/10.5114/pm.2018.81742 

Williams, A. L., Cotter, A., Sabina, A., Girard, C., Goodman, J., & Katz, D. L. (2005). The role for vitamin B-6 as treatment for depression: a systematic review. Family practice, 22(5), 532–537. https://doi.org/10.1093/fampra/cmi040 

Horvat, P., Gardiner, J., Kubinova, R., Pajak, A., Tamosiunas, A., Schöttker, B., Pikhart, H., Peasey, A., Jansen, E., & Bobak, M. (2016). Serum folate, vitamin B-12 and cognitive function in middle and older age: The HAPIEE study. Experimental gerontology, 76, 33–38. https://doi.org/10.1016/j.exger.2016.01.011 

Ma, F., Wu, T., Zhao, J., Song, A., Liu, H., Xu, W., & Huang, G. (2016). Folic acid supplementation improves cognitive function by reducing the levels of peripheral inflammatory cytokines in elderly Chinese subjects with MCI. Scientific reports, 6, 37486. https://doi.org/10.1038/srep37486 

Vitamins, The Royal Osteoporosis Society, https://theros.org.uk/information-and-support/bone-health/nutrition-for-bones/vitamins-minerals-and-nutrients/vitamins, consulted 27/06/2024

A Guide To The Best Supplements To Balance Hormones, Forbes Health, https://www.forbes.com/health/womens-health/best-supplements-to-balance-hormones/ , consulted 28/06/2024

Hanna, M., Jaqua, E., Nguyen, V., & Clay, J. (2022). B Vitamins: Functions and Uses in Medicine. The Permanente journal, 26(2), 89–97. https://doi.org/10.7812/TPP/21.204 

Bani, S., Hasanpour, S., Farzad Rik, L., Hasankhani, H., & Sharami, S. H. (2013). The effect of folic Acid on menopausal hot flashes: a randomized clinical trial. Journal of caring sciences, 2(2), 131–140. https://doi.org/10.5681/jcs.2013.016 

Vitamins for sleep, The Sleep Foundation, https://www.sleepfoundation.org/sleep-aids/vitamins-for-sleep, consulted 28/06/2024

Settling the debate on serotonin’s role in sleep, Science Daily, https://www.sciencedaily.com/releases/2019/06/190624173822.htm, consulted 28/06/2024

Porter, K., Hoey, L., Hughes, C. F., Ward, M., & McNulty, H. (2016). Causes, Consequences and Public Health Implications of Low B-Vitamin Status in Ageing. Nutrients, 8(11), 725. https://doi.org/10.3390/nu8110725 

Found in temperate areas of Europe and Asia, sea buckthorn can often be spotted growing among the sand dunes on England’s east coast, where it’s spiky foliage and eye-catching orange berries brighten any autumn walk.

A nutritional powerhouse, sea buckthorn has a long history of use in natural medicine and is mentioned in Tibetan medical texts as early as the 8^th century BCE. Traditionally used as a remedy for stomach ulcers, digestive complaints, liver issues, and cardiovascular disease, sea buckthorn remains a popular medicinal plant to this day and researchers continue to discover new uses for this spiky seaside shrub.

When it comes to menopause, it is sea buckthorn’s benefits for our vaginal health that draw the most attention. Vaginal dryness, itching, and pain are common symptoms of peri- and post-menopause, but there’s evidence that taking sea buckthorn may help to ease these issues.

Sea buckthorn has other potential benefits for menopausal women too. It is often found in skincare because of its high levels of vitamins, fatty acids, and polyphenols, which help to support skin health. And it may also relieve dry eyes, another common symptom of menopause.

In this blog post, we’ll look more closely at the benefits of sea buckthorn during menopause. We’ll also briefly cover ways to incorporate sea buckthorn into your own daily routine.

Vaginal dryness is a common symptom of menopause. As our oestrogen levels drop, it causes a weakening and thinning in the tissues of the vagina – known as vaginal atrophy.

Plunging oestrogen also reduces our bodies’ ability to produce lubrication. And all of this can add up to dryness and itching in our vaginas.

You can read more about vaginal dryness and how to manage it in our blog post here.

But what does all this have to do with sea buckthorn? Well, various studies have found that sea buckthorn can help to reduce vaginal dryness and improve the health of vaginal tissues.

For example, a study published in Maturitas followed 98 women for 3 months. Some took a daily sea buckthorn oil supplement, while others took a placebo. At the end of the 3 months, the group that took the sea buckthorn showed significant improvements in their vaginal health, including vaginal pH and moisture.

Similarly, a 2024 study looked at the effects of sea buckthorn oil capsules on women over 45 over a 12-week period. This study mainly focused on the impact on skin health, but also collected data on vaginal issues and eye dryness.

After 12 weeks, the participants reported reduced vaginal dryness, as well as improvements in redness, itching, and odour. However, it is worth noting that women in the control group also reported improvements in their vaginal health, although not as frequently as the women who took the supplements.

These two studies looked at the benefits of taking sea buckthorn oil orally, but there’s also evidence that it can work topically. In 2021, researchers looked at the effects of a new vaginal gel that contained sea buckthorn oil. After 12 weeks, the postmenopausal women who used the gel reported reduced dryness, itching, and burning.

Researchers are still investigating exactly how sea buckthorn helps to reduce vaginal dryness, but the benefits likely come from a range of different components. For example, sea buckthorn oil is rich in Omega-7, which helps to keep mucous membranes (like those found in the vagina) hydrated.

Sea buckthorn also contains high levels of vitamin E, which helps with vaginal dryness, and a wide range of polyphenols, including flavonoids like quercetin. As well as reducing inflammation, quercetin supports the production of collagen and elastin, which help to keep the tissues of the vagina strong and elastic. 

So, it seems that sea buckthorn’s rich range of nutrients mean that it can support vaginal health in several ways. And those nutrients don’t just benefit the tissues of the vagina either.

The wide range of vitamins, polyphenols, antioxidants, and fatty acids found in sea buckthorn are also great news for our skin and eyes. Many of us find that we struggle with dry, itchy eyes during menopause and changing oestrogen levels can also affect our skin, often leaving it drier, thinner, and more sensitive.

But taking an oral supplement of sea buckthorn oil can improve both our eye and skin health. And so can topical applications – one study found that spraying a sea buckthorn oil emulsion over closed eyelids significantly decreased eye dryness and it is regularly used in skincare products aimed at reducing skin dryness and preventing visible signs of skin aging.

How to take sea buckthorn

While you can find sea buckthorn berries in various forms, such as dried, powdered, or fresh, the most commonly used form of sea buckthorn is an oil made from the berries and seeds.

You can choose to take sea buckthorn oil orally – usually as a capsule or combined with other oils in a dropper. Or you can find creams, gels, and sprays that contain sea buckthorn oil. These can be applied directly to the skin.

Which should you opt for? That depends on what you want to achieve.

If you have an isolated issue that you want to try sea buckthorn oil on, then a topical treatment might work well for you. For example, for vaginal dryness, you might use a vaginal gel enriched with sea buckthorn oil.

However, if you prefer to see widespread benefits, you likely want to opt to take sea buckthorn oil orally, as an oil or a capsule. This was the delivery method for most of the studies we discussed earlier in this blog post, so it seems to be an effective way to use sea buckthorn for vaginal dryness, eye dryness, and skin issues all in one go.

As always, when looking for a supplement, make sure you choose one made from high-quality, natural ingredients. 

References

Sea-buckthorn, the Wildlife Trusts, https://www.wildlifetrusts.org/wildlife-explorer/trees-and-shrubs/sea-buckthorn, consulted 02/02/2025

Wang, Z., Zhao, F., Wei, P., Chai, X., Hou, G., & Meng, Q. (2022). Phytochemistry, health benefits, and food applications of sea buckthorn (Hippophae rhamnoides L.): A comprehensive review. Frontiers in nutrition, 9, 1036295. https://doi.org/10.3389/fnut.2022.1036295 

Larmo, P. S., Yang, B., Hyssälä, J., Kallio, H. P., & Erkkola, R. (2014). Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: a randomized, double-blind, placebo-controlled study. Maturitas, 79(3), 316–321. https://doi.org/10.1016/j.maturitas.2014.07.010 

Chan, L. P., Yen, T. W., Tseng, Y. P., Yuen, T., Yuen, M., Yuen, H., & Liang, C. H. (2024). The impact of oral sea-buckthorn oil on skin, blood markers, ocular, and vaginal health: A randomized control trial. Journal of Functional Foods, 112, 105973. https://doi.org/10.1016/j.jff.2023.105973

Larmo, P., Järvinen, R., Laihia, J., Löyttyniemi, E., Maavirta, L., Yang, B., Kallio, H., & Sandberg-Lall, M. (2019). Effects of a sea buckthorn oil spray emulsion on dry eye. Contact lens & anterior eye : the journal of the British Contact Lens Association, 42(4), 428–433. https://doi.org/10.1016/j.clae.2018.11.011 

Vaginal dryness, the NHS, https://www.nhs.uk/conditions/vaginal-dryness/, consulted 02/02/2025

Porterfield, L., Wur, N., Delgado, Z. S., Syed, F., Song, A., & Weller, S. C. (2022). Vaginal Vitamin E for Treatment of Genitourinary Syndrome of Menopause: A Systematic Review of Randomized Controlled Trials. Journal of menopausal medicine, 28(1), 9–16. https://doi.org/10.6118/jmm.21028 

Mihal, M., Roychoudhury, S., Sirotkin, A. V., & Kolesarova, A. (2023). Sea buckthorn, its bioactive constituents, and mechanism of action: potential application in female reproduction. Frontiers in endocrinology, 14, 1244300. https://doi.org/10.3389/fendo.2023.1244300 

Hadi, T. H. S., Hardianto, G., Kurniawati, E. M., Parathon, H., Yudaniayanti, I. S., Utomo, B., & Santoso, B. I. (2024). The Effects of Quercetin on the Expression of Collagen I, Collagen III and Elastin in Vaginal: An Experimental Animal Study. Clinical and Experimental Obstetrics & Gynecology, 51(10), 217. https://doi.org/10.31083/j.ceog5110217

Zielińska, A., & Nowak, I. (2017). Abundance of active ingredients in sea-buckthorn oil. Lipids in health and disease, 16(1), 95. https://doi.org/10.1186/s12944-017-0469-7 

When we surveyed over a hundred women about their experience of menopause, 34% told us that their symptoms included vaginal dryness.

And the prevalence of vaginal dryness may even be on the low side among our community – some research suggests that as many as 50% of women over 60 experience this symptom of decreased oestrogen.

While women are increasingly talking about their experience of perimenopause and menopause, the conversation still tends to focus on symptoms like hot flushes and brain fog, as well as the mental impact of changing hormones.

These are important and necessary topics and anything that raises awareness of the realities of menopause is fantastic in our book.

But we also need to talk about some of the more “embarrassing” symptoms of menopause. Incontinence, period flooding, and vaginal dryness are all common symptoms that many women will experience.

So, in this blog post, we will look more closely at vaginal dryness – what causes it, how it can affect us, and what some of the options are for treatment.

Above all, we want to encourage women reading this to not just accept vaginal dryness as a natural part of aging. Yes, our bodies change as we get older, which includes our vaginas. But that doesn’t mean we need to just live with irritation, itching, and discomfort or pain during sex.

What causes vaginal dryness in menopause?

Like so many of the symptoms of perimenopause and menopause, vaginal dryness is caused by decreasing oestrogen.

Oestrogen plays many roles in our bodies, and one of them is keeping the tissues of the vagina healthy, moist, supple, and elastic. So, as oestrogen begins to drop, it can lead to changes in the vagina.

This is known as vulvovaginal atrophy (VVA). Often described as one of the genitourinary symptoms of menopause (GMS), vaginal atrophy leads to the thinning and weakening of the tissues of the vagina. For many of us, this translates to dryness, itching, irritation, difficulties with arousal and lubrication, and discomfort or pain during sex.

VVA also causes a change in vaginal pH, which may disrupt the natural microbiome of the vagina and leave us more vulnerable to yeast infections and bacterial vaginosis.

What are the treatments for vaginal dryness?

Although there aren’t currently any complete cures for vaginal dryness, there are various treatment options that can help to alleviate symptoms and reduce discomfort.

Many of these treatments are available without prescription, but you could also speak with your GP about treatment options. 

If you are talking to your doctor already about menopause symptoms, it’s important to let them know if you are experiencing vaginal dryness or other genitourinary symptoms. Many of us don’t bring up vaginal dryness and the issues it causes when we consult medical professionals, but if we stay silent, the scale of the issue goes underestimated.

The more we can talk about our shared experiences with menopause, including symptoms like vaginal dryness, the more likely it is that better treatment options will be developed and that women will have a realistic idea of what to expect.

1. Lubricants

If you notice the effects of vaginal dryness mostly during sex, you could start simple by exploring different types of lube to use during intimate moments. There are various options available, so you could try a few different ones to see what you prefer.

It’s important to note that oil-based lubricants make condoms less effective, so opt for a water or silicone-based option if you use condoms. And you will want to steer away from flavoured or scented versions, as these can contain ingredients that contribute to vaginal dryness and irritation.

2. Moisturisers

Lubricants are typically used just during sex, while moisturisers can be used regularly regardless of sexual activity – at least twice a week, according to the British Menopause Society.

The tissues of the vagina are sensitive, so you need to choose a moisturiser that is specifically targeted to this area, not just whatever you use on your face or body. You might also want to look out for a vaginal moisturiser that contains hyaluronic acid, as research suggests this ingredient can be especially affective at relieving symptoms associated with vaginal atrophy.

3. Phytoestrogens

Phytoestrogens are plant-based compounds that weakly mimic the effects of oestrogen in our bodies, so many women opt to supplement their diet with plants that are high in these compounds when going through menopause.

Creams and oils containing phytoestrogens from plants can also be applied topically to the vagina itself. Some examples that show promise are fennel cream, red clover oil, and Pueraria mirifica cream.

4. Pelvic floor exercises

Hopefully you already know about the importance of pelvic floor exercises (also known as Kegel exercises) to keep the pelvic floor strong as you age.

Because pelvic floor exercises are linked to improved sexual function, they may also help to alleviate some of the symptoms associated with vaginal dryness, especially those around arousal and sexual satisfaction.

There hasn’t been much research into how effective pelvic floor exercises for vaginal dryness are as yet, but it is another reason to make sure you do them regularly!

5. Topical hormone treatments

For those who are comfortable taking hormone treatments, another option is creams, gels, and pessaries containing oestrogen or dehydroepiandrosterone (DHEA). These can often be suitable even for women who can’t usually take HRT because they have a higher risk of hormone-related cancers like breast cancer. However, you should consult your doctor first before trying these treatments.

6. Laser therapy

It might sound a little sci-fi, but there’s increasing evidence that laser therapy can be effective in reducing vaginal dryness. The treatment encourages increased blood flow to the vaginal tissues, encouraging collagen production and leading to improvements in lubrication and elasticity.

This is a newer treatment option, but one that seems to be showing some promise, especially for women who can’t take hormonal treatments or prefer to seek alternatives. Despite what the name might imply, it is minimally invasive and only takes a few minutes.

However, more research is needed to see if improvements after laser therapy continue long-term.

7. Lifestyle tweaks

Although lifestyle changes alone are unlikely to alleviate vaginal dryness entirely, there are some things that you can do to minimise symptoms, especially if you combine them with one of the treatment options listed above.

For example, the British Menopause Society recommend that women experiencing vaginal dryness try to quit smoking, which can exacerbate the issue. Getting regular exercise may also help, as genitourinary symptoms like VVA can be more common in people who are sedentary.

Similarly, maintaining an active sex life might help – sexual activity increases the blood flow to the vagina, which supports collagen production and helps to maintain elasticity. 

Of course, if vaginal dryness is making sex painful or uncomfortable, this might not be a welcome bit of advice. Don’t forget though that sex can come in many different forms – it doesn’t need to include penetration, and it also doesn’t require a partner. 

Finally, the NHS recommends avoiding perfumed soaps and body washes, which can contribute to vaginal dryness. Look instead for fragrance-free soaps and washes to use around your vulva and avoid washing inside your vagina at all – it is essentially self-cleaning and washing inside, even with water, can increase the risk of infections.

References

Survey data of 111 women collected by WOW Worthy Women CIC during March-April 2024

Lethaby, A., Ayeleke, R. O., & Roberts, H. (2016). Local oestrogen for vaginal atrophy in postmenopausal women. The Cochrane database of systematic reviews, 2016(8), CD001500. https://doi.org/10.1002/14651858.CD001500.pub3 

 Sarmento, A. C. A., Costa, A. P. F., Lírio, J., Eleutério, J., Jr, Baptista, P. V., & Gonçalves, A. K. (2022). Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review. Eficácia das abordagens hormonais e não hormonais para atrofia vaginal e disfunções sexuais em mulheres na pós-menopausa: Uma revisão sistemática. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 44(10), 986–994. https://doi.org/10.1055/s-0042-1756148 

Briggs, P. (2024) BMS consensus statement: Urogenital atrophy, https://thebms.org.uk/publications/consensus-statements/urogenital-atrophy/ 

Dos Santos, C. C. M., Uggioni, M. L. R., Colonetti, T., Colonetti, L., Grande, A. J., & Da Rosa, M. I. (2021). Hyaluronic Acid in Postmenopause Vaginal Atrophy: A Systematic Review. The journal of sexual medicine, 18(1), 156–166. https://doi.org/10.1016/j.jsxm.2020.10.016 

Dizavandi, F. R., Ghazanfarpour, M., Roozbeh, N., Kargarfard, L., Khadivzadeh, T., & Dashti, S. (2019). An overview of the phytoestrogen effect on vaginal health and dyspareunia in peri- and post-menopausal women. Post reproductive health, 25(1), 11–20. https://doi.org/10.1177/2053369118823365 

Nazarpour, S., Simbar, M., Majd, H. A., & Tehrani, F. R. (2018). Beneficial effects of pelvic floor muscle exercises on sexual function among postmenopausal women: a randomised clinical trial. Sexual health, 15(5), 396–402. https://doi.org/10.1071/SH17203 

Mortensen, O. E., Christensen, S. E., & Løkkegaard, E. (2022). The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state-of-the-art review. Acta obstetricia et gynecologica Scandinavica, 101(6), 657–692. https://doi.org/10.1111/aogs.14353 

Vaginal dryness, the NHS, https://www.nhs.uk/conditions/vaginal-dryness/, consulted 26/10/2024

Douching, Office of Women’s Health, https://www.womenshealth.gov/a-z-topics/douching, consulted 26/10/2024

Evening primrose oil is made from the seeds of Oenothera biennis, a plant native to the Americas. This roadside plant is commonly known as evening primrose because its fragrant yellow flowers open at sunset during summer and early autumn.

Like many plants, evening primrose has a long history of medicinal use. The indigenous people of the Americas use the leaves for digestive complaints and sore throats, and the juice from the stems and leaves in healing skin issues, including inflammation, bruising, and minor wounds.

Its skin-soothing properties also make evening primrose oil a common ingredient in skincare products, especially those that target redness or inflammation. It is sometimes used as a herbal remedy for eczema.

This is mainly down to evening primrose oil’s high levels of linoleic acid and gamma-linolenic acid, which are both types of omega-6 fatty acid. Like omega-3 fatty acids, omega-6 fatty acids are polyunsaturated fats that can have many benefits for our health, including reducing the markers of inflammation.

But what does this have to do with menopause? 

Evening primrose, like many other herbs, produces compounds that weakly mimic oestrogen in our bodies. Called phytoestrogens, these plant compounds may help to reduce the symptoms of menopause, which are mainly caused by decreasing levels of oestrogen (chiefly oestradiol) in our bodies.

Since evening primrose oil appears to act as a phytoestrogen, researchers are interested in whether it might help to ease some of the symptoms of menopause.

In this blog, we’ll look at the findings so far.

We never cease to be amazed at the varied ways oestrogen affects our bodies. And one of the impacts of decreasing oestrogen is the associated loss of muscle strength and elasticity.

What does research tell us about evening primrose oil for menopause?

It is still early days for much of the research into herbal remedies for menopause and evening primrose oil is no exception. A recent meta study published in the Journal of Menopausal Medicine found just 8 studies, and the researchers only considered 4 of these in their analysis.

These studies mostly focused on the effect of evening primrose oil on hot flushes and night sweats, which are common and disruptive symptoms of menopause.

All four studies were relatively small – the largest included just 100 women. So, it is fair to say there is more research to be done before we can draw really firm conclusions about the benefits of evening primrose oil for menopause.

However, some of these studies did show promising signs. For example, several noted that women taking evening primrose oil reported significant improvements in the severity of hot flushes compared with women taking a placebo.

These studies did not find any significant difference in the frequency or duration of hot flushes, however.

These results were supported by further research published in the Journal of Menopausal Medicine in 2021. This study, which included 170 women, also found no significant difference in the frequency and duration of hot flushes. However, the authors did discover significant improvements in night sweats in the group taking evening primrose oil, with women reporting reductions in both the frequency and severity of sweating at night.

So, mixed results so far for evening primrose oil – but if you are especially struggling with night sweats or the severity of hot flushes, it might be an interesting option to try.

Other benefits of evening primrose oil during menopause

We’ve looked at the potential benefits of evening primrose oil for hot flushes and night sweats, but what about other menopause symptoms?

As already discussed, there is more research to be done into the effects of evening primrose oil during menopause itself. However, there are two other areas where the benefits of evening primrose oil may be of particular interest to women during and after menopause.

The first is in skincare. As many of us know all too well, menopause can bring with it changes to the skin, as seesawing hormones make our skin thinner, drier, and more prone to injury.

Evening primrose oil has been linked to skin health for centuries. And, as a paper published in the International Journal of Cosmetic Scienceconfirmed in 2022, this oil is indeed effective in supporting the integrity and repair of the stratum corneum (the outmost layer of skin, which acts as an important protector against water loss and infection).

The second (and even more important) potential benefit of evening primrose oil is for heart health. Women are at increased risk of heart disease after menopause, because of the loss of the protective effects of oestrogen on our cardiovascular systems.

However, the high levels of omega-6 fatty acids found in evening primrose oil might help to reduce this risk, at least a little. A 2020 meta-analysis of 6 studies found that supplementing with evening primrose oil significantly increased levels of HDL cholesterol (the heart-protective type of cholesterol) and reduced levels of triglycerides, which are linked to higher risk of cardiovascular issues.

None of the papers included in this meta-analysis focused specifically on menopausal women, but these findings are still interesting for those looking to protect their heart health.

Of course, exercise, a balanced diet, and stress management are all also important in lowering your risk of heart issues (and relieving menopause symptoms), so it is likely that you’ll want to consider evening primrose oil as part of a range of interventions, instead of on its own.

And, as always with herbal remedies, make sure you consult your doctor if you are taking any medications and are also considering trying evening primrose oil.

References

Evening Primrose Oil, National Center for Complementary and Integrative Health, https://www.nccih.nih.gov/health/evening-primrose-oil, consulted 09/03/2025

No need to avoid healthy omega-6 fats, Harvard Health Publishing, https://www.health.harvard.edu/newsletter_article/no-need-to-avoid-healthy-omega-6-fats, consulted 09/03/2025

Kazemi, F., Masoumi, S. Z., Shayan, A., & Oshvandi, K. (2021). The Effect of Evening Primrose Oil Capsule on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial. Journal of menopausal medicine, 27(1), 8–14. https://doi.org/10.6118/jmm.20033 

Thevi, T., De, S., & Soe, H. H. K. (2024). Evening Primrose Oil for Menopause Hot Flashes: Systematic Review and Meta-Analysis. Journal of menopausal medicine, 30(3), 127–134. https://doi.org/10.6118/jmm.23038 

Motaghi Dastenaie, B., Safdari, F., Raisi, Z., & Karimian, Z. (2017). The effect of evening primrose plant on physical symptoms of menopause. Journal of Babol University of Medical Sciences, 19(2), 34-40. http://dx.doi.org/10.22088/jbums.19.2.34 

Kazemi, F., Masoumi, S. Z., Shayan, A., & Oshvandi, K. (2021). The Effect of Evening Primrose Oil Capsule on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial. Journal of menopausal medicine, 27(1), 8–14. https://doi.org/10.6118/jmm.20033 

Blaak, J., & Staib, P. (2022). An updated review on efficacy and benefits of sweet almond, evening primrose and jojoba oils in skin care applications. International journal of cosmetic science, 44(1), 1–9. https://doi.org/10.1111/ics.12758 

Ryczkowska, K., Adach, W., Janikowski, K., Banach, M., & Bielecka-Dabrowa, A. (2022). Menopause and women’s cardiovascular health: is it really an obvious relationship?. Archives of medical science : AMS, 19(2), 458–466. https://doi.org/10.5114/aoms/157308 

Khorshidi, M., Zarezadeh, M., Moradi Moghaddam, O., Emami, M. R., Kord-Varkaneh, H., Mousavi, S. M., Alizadeh, S., Heshmati, J., Olang, B., & Aryaeian, N. (2020). Effect of evening primrose oil supplementation on lipid profile: A systematic review and meta-analysis of randomized clinical trials. Phytotherapy research : PTR, 34(10), 2628–2638. https://doi.org/10.1002/ptr.6716 

One of the longer-term effects of the menopause is the impact it has on our bones. Without the protective powers of oestrogen keeping our bones strong we start to lose bone density. We can become more vulnerable to complications like osteoporosis.

Indeed, researchers say that women generally experience a 10%-20% reduction in bone density due to menopause. Bone density loss slows after the first 4-8 years after the menopause, but still continues as we age.

So, if we want to remain healthy and mobile as we move through menopause and beyond, taking measures to support our bone health is a must.

HRT or supplements can help here, replacing the oestrogen that our bodies no longer make naturally to protect against bone density loss, as well as other symptoms of menopause.

And lifestyle changes can also make a difference. Research shows that regular exercise is important in protecting against osteoporosis – aim for a combination of weight-bearing, balance, and resistance exercises to keep bones strong and help avoid breaks.

Diet has a role to play too. If we want to support our bone health, we need to make sure that our bodies have the right nutrients to build new bone tissue and slow the loss of bone density.

One of the most important nutrients for bone health is vitamin D – especially when paired with calcium. And vitamin D has other benefits for our bodies during menopause too, such as alleviating vaginal dryness, supporting the immune system, and improving our mood.

In this blog post, we’ll look more closely at the role vitamin D plays in supporting our bone health as we journey through menopause and give you some tips for how to get enough.

What is vitamin D?

Vitamin D is a fat-soluble vitamin. It comes in two forms – D₂, which is made by plants (mushrooms), and D_3, which is made by animals, including humans.

Some foods contain vitamin D, such as oily fish, red meat, liver, and egg yolks. Mushrooms are the only plant-based food to naturally contain vitamin D, but it is also added to some breakfast cereals and oil-based spreads.

However, vitamin D is unique in that our bodies can also make it themselves. Vitamin D production is triggered by exposure to sunlight, which is why it is often nicknamed the sunshine vitamin.

Vitamin D plays many different roles in our bodies, but in this blog post we’ll focus on its relationship with our bone health.

How does vitamin D support our bones?

There are several reasons why vitamin D is integral to building and maintaining healthy bones.

Firstly, it helps our bodies to absorb and use calcium – the mineral that is one of the main building blocks of bones (and teeth). Even if we have enough calcium in our diets, we can’t use it properly unless we also have sufficient levels of vitamin D.

Vitamin D also supports the absorption of phosphorous from the gut. Like calcium, phosphorous is a mineral that is used to build bones and teeth.

Finally, vitamin D acts as a hormone and plays a role in promoting bone formation, alongside oestrogen.

Indirectly, vitamin D may also contribute to our long-term bone health because it supports muscle growth. Without enough vitamin D, our muscles weaken, and we are more likely to experience falls, which in turn can lead to bone fractures.

Vitamin D and menopause

Since vitamin D is intimately connected with bone health, and menopause is known to cause loss of bone mineral density. There has been quite a bit of research into the effects of vitamin D on bone health during and after menopause.

For example, a long running study of 72,337 postmenopausal women found that those who consumed higher levels of vitamin D had a 37% lower risk of hip fractures than those who consumed low levels, regardless of how much calcium they had in their diets.

More recently, a 2020 meta-study examined the current research into the effect of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women. The authors found that supplementing with calcium and vitamin D significantly increased bone mineral density and decreased the risk of hip fractures.

Other studies indicate that supplementing with vitamin D can help postmenopausal women to increase muscle strength and avoid falls, in turn helping to protect their bone health. 

Getting enough vitamin D

So, we’ve seen that vitamin D is important to protect our bone health as we move through menopause. But how can we make sure we’re getting enough?

While there are some foods that contain vitamin D, few have high enough levels for us to meet our needs through diet alone. This is especially the case for anyone who is vegetarian or vegan, as most natural dietary sources of vitamin D are derived from animals.

The exception is mushrooms, which can contain vitamin D_2, as long as they are grown in sunlight. Since many mushrooms are grown inside, you’ll need to keep an eye out for those that are specifically marked as grown in natural light or containing vitamin D.

Supermarkets increasingly make this clear on the packaging, which helps. Vegetarians and vegans can also increase the amount of vitamin D in their diets by opting for fortified breakfast cereals and other foods that have added vitamin D.

Our bodies can also make vitamin D when our skin is exposed to sunlight. While this is great news in theory, those of us who live in the UK will usually find that we don’t get enough sunlight during the winter months to meet our vitamin D needs.

Even in the summer, we need to balance the need to expose our skin to the sun for vitamin D formation against the risk of sunburn, skin damage and cancer that can come from prolonged exposure. 

As a result, the NHS recommends taking a vitamin D supplement that contains 10 micrograms of vitamin D for osteoporosis prevention. 

Of course, it is also a great idea to combine vitamin D supplementation with other strategies to protect your bone health. Make sure you get enough calcium and phosphorous in your diet and exercise regularly to give your bones the best chance of remaining strong through menopause and beyond. 

References

What’s the menopause got to do with bone health?, The Royal Osteoporosis Society, https://theros.org.uk/blog/2021-03-22-what-s-the-menopause-got-to-do-with-bone-health/, consulted 21/07/2024

Ji, M. X., & Yu, Q. (2015). Primary osteoporosis in postmenopausal women. Chronic diseases and translational medicine, 1(1), 9–13. https://doi.org/10.1016/j.cdtm.2015.02.006 

Mohebbi, R., Shojaa, M., Kohl, M., von Stengel, S., Jakob, F., Kerschan-Schindl, K., Lange, U., Peters, S., Thomasius, F., Uder, M., & Kemmler, W. (2023). Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 34(7), 1145–1178. https://doi.org/10.1007/s00198-023-06682-1 

Essential nutrients your body needs for building bone, Harvard Health, https://www.health.harvard.edu/staying-healthy/essential-nutrients-your-body-needs-for-building-bone, consulted 21/07/2024 

Mei, Z., Hu, H., Zou, Y., & Li, D. (2023). The role of vitamin D in menopausal women’s health. Frontiers in physiology, 14, 1211896. https://doi.org/10.3389/fphys.2023.1211896 

Vitamin D, NHS, https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ 

Menopause and Bone Loss, Endocrine Society, https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss 

Laird, E., Ward, M., McSorley, E., Strain, J. J., & Wallace, J. (2010). Vitamin D and bone health: potential mechanisms. Nutrients, 2(7), 693–724. https://doi.org/10.3390/nu2070693 

Feskanich, D., Willett, W. C., & Colditz, G. A. (2003). Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. The American journal of clinical nutrition, 77(2), 504–511. https://doi.org/10.1093/ajcn/77.2.504 

Liu, C., , Kuang, X., , Li, K., , Guo, X., , Deng, Q., , & Li, D., (2020). Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Food & function, 11(12), 10817–10827. https://doi.org/10.1039/d0fo00787k 

Iolascon, G., Moretti, A., de Sire, A., Calafiore, D., & Gimigliano, F. (2017). Effectiveness of Calcifediol in Improving Muscle Function in Post-Menopausal Women: A Prospective Cohort Study. Advances in therapy, 34(3), 744–752. https://doi.org/10.1007/s12325-017-0492-0 

Osteoporosis – prevention, NHS, https://www.nhs.uk/conditions/osteoporosis/prevention/, consulted 21/07/2024 

Red clover is a common wild herb, and you are sure to have spotted it growing in lawns, meadows, and roadsides across the UK.

A favourite of bees and livestock alike, red clover is actually a member of the pea family – making it a useful nitrogen fixer, as well as a source of protein. However, red clover isn’t just a handy plant for soils, animals, and insects.

This familiar grassland plant also has potential benefits for humans, especially women going through menopause.

This is because red clover is rich in a group of plant compounds called isoflavones. These compounds mimic the effects of oestrogen in our bodies, so there is plenty of interest in whether they might help to reduce menopausal symptoms.

Red clover has one of the best sources of isoflavones – and it is also a prolific plant that is cheap and easy to grow. As a result, it is becoming increasingly popular as a herbal remedy for menopause.

In this post, we’ll explain a little bit more about isoflavones and look at the potential benefits of red clover during menopause.

What’s the big deal about isoflavones?

You might have heard of phytoestrogens, or plant-derived oestrogens. These are chemicals found in plants that have a similar chemical structure to oestradiol, the main form of oestrogen found in women’s bodies during their reproductive years.

Although these plant-based compounds aren’t an exact match for oestradiol, they do weakly mimic the hormone in the body. The effect seems to be strongest when natural levels of oestradiol are lower, so it is likely that these compounds will have the greatest effect on women during and after menopause.

There are four main groups of phytoestrogens:

• Stilbene
• Coumestan
• Lignan
• Isoflavones

Isoflavones are the best studied of the group. They are typically found in legumes, such as soybeans. And, of course, they are also found in red clover.

Since most menopausal symptoms are caused by decreasing levels of oestrogen (mainly oestradiol), it seems logical that a diet rich in phytoestrogens should help to alleviate some of these symptoms.

Research is ongoing into the exact effects of phytoestrogens during menopause and many studies so far have either been small or conducted on animals. However, these plant compounds do show some promise for reducing certain symptoms and side effects of menopause.

Benefits of red clover in menopause

Now that we know a little bit about isoflavones and their potential role in reducing menopause symptoms, let’s look more closely at red clover and what the research says so far about its benefits in menopause.

1. Bone density

The area where red clover has shown the most promise so far is in protecting against one of the most common longer-term impacts of menopause – reduced bone density.

Oestrogen plays a vital role in maintaining bone density and keeping our bones strong. As a result, women typically experience an accelerated loss of bone density post-menopause, which leaves us at greater risk of developing osteoporosis.

However, the isoflavones found in red clover might help to protect against this loss of bone density and keep our bones stronger for longer.

For example, a 2015 study found that healthy menopausal women who took a red clover supplement for 12 weeks showed significantly less loss of bone density than the control group.

2. Hot flushes

Other common symptoms of menopause are hot flushes and night sweats. And red clover may help here too, although the current evidence suggests the effect may be short-term.

A 2014 meta-study into the effects of red clover on hot flushes concluded that it does help to reduce the frequency of flushes over a period of 3-4 months. However, the effect seemed to wear off over time.

Still, as anyone going through menopause knows, symptoms can come and go as you move through this period of life. So, if your hot flushes are particularly intense, supplementing with red clover may help to give you some relief, even if it is only for a few months.

3. Skin and hair 

One of the more surprising impacts of the menopause is the effect it can have on your hair and skin.

When we surveyed over 100 women about their experience of perimenopause and menopause, several told us that they’d experienced changes to their hair, skin, and nails as a result of their changing hormones.

But red clover’s phytoestrogens might reduce some of those changes. According to one 2011 study, after supplementing with red clover for 90 days, women reported improvements in their skin and hair. They also noticed improved mood, libido, and sleep.

4. Cholesterol and heart health

According to a review published in the Journal of the International Menopause Society in 2018, red clover might also protect our heart health after menopause, reducing harmful LDL cholesterol and increasing beneficial HDL cholesterol.

This is noteworthy because menopause often comes with an increase in cholesterol, which can leave us at higher risk of cardiovascular issues, such as heart attacks or strokes.

Should you take red clover for menopause?

There is definitely more research to be done into the benefits of red clover and other sources of phytoestrogens on menopause symptoms.

However, the evidence so far is positive, if not always completely conclusive.

Most people can take red clover without any negative side effects, although you should always speak to your doctor about trying herbal remedies if you are taking any medications or are at increased risk for developing hormone sensitive conditions like breast cancer.

Ultimately, what works for one person might not work for another, so the best way to know if red clover is right for you is to try it for a few months and see.

References

Red Clover, Wildlife Trusts, https://www.wildlifetrusts.org/wildlife-explorer/wildflowers/red-clover , consulted 05/10/2024

Gartoulla, P., & Han, M. M. (2014). Red clover extract for alleviating hot flushes in postmenopausal women: a meta-analysis. Maturitas, 79(1), 58–64. https://doi.org/10.1016/j.maturitas.2014.06.018 

Herbal remedies and complementary medicines for menopause symptoms, the NHS, https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/alternatives-to-hormone-replacement-therapy-hrt/herbal-remedies-and-complementary-medicines-for-menopause-symptoms/ 

Ehsanpour, S., Salehi, K., Zolfaghari, B., & Bakhtiari, S. (2012). The effects of red clover on quality of life in post-menopausal women. Iranian journal of nursing and midwifery research, 17(1), 34–40. https://pubmed.ncbi.nlm.nih.gov/23493172 

Desmawati, D., & Sulastri, D. (2019). Phytoestrogens and Their Health Effect. Open access Macedonian journal of medical sciences, 7(3), 495–499. https://doi.org/10.3889/oamjms.2019.044 

Alabadi, B., Civera, M., Moreno-Errasquin, B., & Cruz-Jentoft, A. J. (2024). Nutrition-Based Support for Osteoporosis in Postmenopausal Women: A Review of Recent Evidence. International journal of women’s health, 16, 693–705. https://doi.org/10.2147/IJWH.S409897 

What’s the menopause got to do with bone health? , The Royal Osteoporosis Society, https://theros.org.uk/blog/2021-03-22-what-s-the-menopause-got-to-do-with-bone-health/, consulted 05/10/2024

Thorup, A. C., Lambert, M. N., Kahr, H. S., Bjerre, M., & Jeppesen, P. B. (2015). Intake of Novel Red Clover Supplementation for 12 Weeks Improves Bone Status in Healthy Menopausal Women. Evidence-based complementary and alternative medicine : eCAM, 2015, 689138. https://doi.org/10.1155/2015/689138 

Gartoulla, P., & Han, M. M. (2014). Red clover extract for alleviating hot flushes in postmenopausal women: a meta-analysis. Maturitas, 79(1), 58–64. https://doi.org/10.1016/j.maturitas.2014.06.018 

Survey data of 111 women collected by WOW Worthy Women CIC during March-April 2024

Lipovac, M., Chedraui, P., Gruenhut, C., Gocan, A., Kurz, C., Neuber, B., & Imhof, M. (2011). Effect of Red Clover Isoflavones over Skin, Appendages, and Mucosal Status in Postmenopausal Women. Obstetrics and gynecology international, 2011, 949302. https://doi.org/10.1155/2011/949302

Luís, Â., Domingues, F., & Pereira, L. (2018). Effects of red clover on perimenopausal and postmenopausal women’s blood lipid profile: A meta-analysis. Climacteric : the journal of the International Menopause Society, 21(5), 446–453. https://doi.org/10.1080/13697137.2018.1501673 

Menopause and your heart, the British Heart Foundation, https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease, consulted 05/10/2024

Red clover, National Centre for Complementary and Integrative Health, https://www.nccih.nih.gov/health/red-clover, consulted 05/10/2024

Hot flushes are one of the most common symptoms of perimenopause – indeed, when we surveyed 111 women about their menopause journeys, 68% told us that they had experienced hot flushes, while 62% said they had night sweats.

As well as being disruptive and uncomfortable in their own right, hot flushes can contribute to making other symptoms of menopause worse. When you are already feeling irritable or struggling to sleep at night, the last thing you want is sudden rushes of heat and sweating to add to your discomfort.

While there aren’t currently any cures for hot flushes, there are remedies that can reduce their frequency and severity, providing you with some much-needed relief.

For example, you can try to identify things that trigger your hot flushes, so that you can reduce your exposure to them. Common triggers include alcohol, spicy food, hot drinks, caffeine, and smoking. Stress is another factor that can increase hot flushes.

You can also reduce some of the discomfort that comes with hot flushes and night sweats by wearing lightweight, breathable clothing, keeping your bedroom cool at night, having cold showers and keeping handheld fans or cooling sprays to hand.

HRT can be an option for some women too and is generally considered an effective treatment for hot flushes and night sweats, as well as other symptoms of menopause.

There’s also increasing interest in how herbal remedies and good nutrition can alleviate menopausal symptoms, including hot flushes. One potential option for reducing hot flushes is sage, a herb that has a long history of use in both cooking and traditional medicine.

In this post, we’ll look at some of the research around sage and hot flushes. We’ll also discuss some of the other potential benefits of sage during menopause.

What is sage?

You’ve likely encountered sage most often in the kitchen. A popular culinary herb, it gives flavour to any number of dishes, from a comforting sage and onion stuffing to a simple but luxurious sage butter pasta dish.

However, sage has a long history of use in herbal medicine. Native to the Mediterranean and considered sacred by the Romans, it is also an important herb in Traditional Chinese Medicine, where it is used as a tonic for vitality and mental stimulation.

There are many different varieties of sage, some edible and some ornamental (usually known as salvias). The most common types of sage for cooking and herbal medicine are Salvia officinalis and Salvia lavandulaefolia.

The genus name for sage, Salvia, comes from the Latin word salvere, meaning “to save” or “to heal”. This hints at how valued sage has been through the ages for its medicinal properties.

Historically, sage was said to treat digestive issues, skin disease, circulation problems, and inflammation in the mouth and throat, among other illnesses.

Nowadays, sage is used in herbal medicine for a range of conditions, including sore throats, diabetes, high cholesterol, and memory loss.

Most importantly from our perspective, sage is also used to treat menopausal symptoms – mainly hot flushes and night sweats.

Sage and hot flushes: The evidence

As is so often the case with herbal remedies, there’s comparatively limited research into the role that sage plays in reducing hot flushes and night sweats.

However, the research that has been done to date shows some promising findings.

For example, a clinical trial published in 2011 looked at the effects of sage on 71 menopausal women who experienced at least five hot flushes each day.

The women in the trial supplemented with fresh sage leaves every day for 8 weeks and each week saw significant decreases in the frequency of their hot flushes. They also noted improvements in other menopausal symptoms, such as psychological issues and vaginal dryness.

Similarly, a 2020 study of 66 postmenopausal women found that supplementing with sage for three months improved hot flushes and night sweats, as well as reducing heart palpitations, muscle and joint pain, depression, and sleep issues.

Another clinical trial, this one in Iran, used dry sage over a period of 4 weeks. Again, the women in this study who received the sage supplements reported reductions in hot flushes and night sweats, as well as decreased fatigue and anxiety, and increased concentration.

This study, as well as a further three, was discussed as part of a 2023 meta-study into the effectiveness of sage for reducing hot flushes. The authors concluded that sage does indeed reduce the frequency and severity of hot flushes in postmenopausal women, based on evidence so far.

These studies have relatively small numbers of participants, but their findings are certainly encouraging for anyone looking for natural ways to reduce hot flushes and other menopausal symptoms.

Other benefits of sage during menopause

Many of the studies into the benefits of sage during menopause have focused on hot flushes – and there are promising signs that this herb really can help to reduce both the frequency and severity of flushes and night sweats.

But these studies also indicate that sage might help with other menopausal symptoms. Sadly, there’s not enough research yet to provide a strong evidence base, but the studies we discussed above found potential for sage to support with both mental and physical symptoms of menopause.

Sage is high in antioxidants, like many herbs, and has long been associated with a healthy old age. Traditionally, sage is linked to wisdom, memory, and mental sharpness – which may be especially interesting to anyone struggling with the brain fog and memory loss that so often accompany menopause.

So far, much of the research around sage and memory has focused on dementia and Alzheimer’s Disease, instead of menopause. However, studies have also found that sage has a positive effect on memory and cognition in healthy older adults, which is an encouraging sign.

What is clear is that we still have a lot to learn about the benefits of herbal remedies like sage during menopause and beyond. 

But sage shows great potential as a natural treatment for hot flushes and night sweats, so is definitely one to try out if you are struggling with symptoms like these.

References

Survey data of 111 women collected by WOW Worthy Women CIC during March-April 2024

Menopause: Things you can do, NHS, https://www.nhs.uk/conditions/menopause/things-you-can-do/, consulted 28/07/2024

Swartzman, L. C., Edelberg, R., & Kemmann, E. (1990). Impact of stress on objectively recorded menopausal hot flushes and on flush report bias. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 9(5), 529–545. https://doi.org/10.1037//0278-6133.9.5.529 

Menopause: Treatment, NHS, https://www.nhs.uk/conditions/menopause/treatment/, consulted 18/07/2024

Hamidpour, M., Hamidpour, R., Hamidpour, S., & Shahlari, M. (2014). Chemistry, Pharmacology, and Medicinal Property of Sage (Salvia) to Prevent and Cure Illnesses such as Obesity, Diabetes, Depression, Dementia, Lupus, Autism, Heart Disease, and Cancer. Journal of traditional and complementary medicine, 4(2), 82–88. https://doi.org/10.4103/2225-4110.130373

Sage, White Rabbit Institute of Healing, https://www.whiterabbitinstituteofhealing.com/herbs/sage/, consulted 28/07/2024

Sage, National Center for Complementary and Integrative Health, https://www.nccih.nih.gov/health/sage, consulted 28/07/2024

How to grow sage, RHS, https://www.rhs.org.uk/herbs/sage/grow-your-own, consulted 28/07/2024

Bommer, S., Klein, P., & Suter, A. (2011). First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes. Advances in therapy, 28(6), 490–500. https://doi.org/10.1007/s12325-011-0027-z 

Futher references

Zeidabadi, A., Yazdanpanahi, Z., Dabbaghmanesh, M. H., Sasani, M. R., Emamghoreishi, M., & Akbarzadeh, M. (2020). The effect of Salvia officinalis extract on symptoms of flushing, night sweat, sleep disorders, and score of forgetfulness in postmenopausal women. Journal of family medicine and primary care, 9(2), 1086–1092. https://doi.org/10.4103/jfmpc.jfmpc_913_19 

Dadfar, F., & Bamdad, K. (2019). The effect of Saliva officinalis extract on the menopausal symptoms in postmenopausal women: An RCT. International journal of reproductive biomedicine, 17(4), 287–292. https://doi.org/10.18502/ijrm.v17i4.4555 

Moradi, M., Ghavami, V., Niazi, A., Seraj Shirvan, F., & Rasa, S. (2023). The Effect of Salvia Officinalis on Hot Flashes in Postmenopausal Women: A Systematic Review and Meta-Analysis. International journal of community based nursing and midwifery, 11(3), 169–178. https://doi.org/10.30476/IJCBNM.2023.97639.2198 

Lopresti A. L. (2017). Salvia (Sage): A Review of its Potential Cognitive-Enhancing and Protective Effects. Drugs in R&D, 17(1), 53–64. https://doi.org/10.1007/s40268-016-0157-5

Scholey, A. B., Tildesley, N. T., Ballard, C. G., Wesnes, K. A., Tasker, A., Perry, E. K., & Kennedy, D. O. (2008). An extract of Salvia (sage) with anticholinesterase properties improves memory and attention in healthy older volunteers. Psychopharmacology, 198(1), 127–139. https://doi.org/10.1007/s00213-008-1101-3 

It’s fair to say that perimenopause likes to keep us on our toes, with a range of surprising symptoms that we wouldn’t, at first glance, think had anything to do with changing reproductive hormones.

But the effect these hormones have in our bodies is broader than you might think. And one of the lesser-known symptoms of menopause is the impact it has on our eye health.

So, if you’ve been noticing drier, more irritated eyes since the start of perimenopause, it is entirely possible that this is yet another side-effect of seesawing hormones. Over 64% of women will experience dry eyes during menopause, so this unexpected symptom is also a relatively common one.

In this blog, we’ll explore the link between dry eyes and the menopause further and suggest some options to alleviate the discomfort and care for your eye health through menopause and beyond.

How does menopause cause dry eyes?

Although there are plenty of different factors that can be involved in dry eyes, hormonal changes often play a major role. 

Notably, we’re more likely to experience dry eyes as we age – and women over 50 are 70% more likely to have dry eyes than men in the same age group, pointing to the link between dry eyes and the menopause.

Dry eyes are also associated with conditions like polycystic ovary syndrome (PCOS), which again indicates the important role that sex hormones play in our eye health.

Usually when we talk about the impact of changing hormones during menopause, we focus on oestrogen. And this hormone does seem to have some impact on eye health. However, research suggests that it is androgens that are the main culprit here.

Androgens are a group of sex hormones that include testosterone. Like other sex hormones, levels of androgens in our bodies decrease as we age, with a particularly noticeable drop after the onset of perimenopause.

This can cause a range of different symptoms, but when it comes to our eyes, the most noticeable is that our tear ducts become less effective at keeping our eyes properly hydrated.

As a result, we may experience dry, itchy, or gritty eyes. Dry eye can also be associated with blurred vision, light sensitivity, and gummy or “sleep” filled eyes.

How to treat dry eye during menopause

Dry eye is an uncomfortable and irritating condition that can affect our quality of life. Long-term, it may also lead to other eye complications, so it is worth seeking out treatment options to alleviate this menopause symptom.

Options can include both lifestyle tweaks and medical interventions. As always, we advise seeking the opinion of your doctor, especially if you are experiencing other menopausal symptoms too.

Treatments you can try for dry eyes include:

1. Reduce screen time 

Spending long hours looking at computer and phone screens can make dry eyes worse, mainly because we typically blink less when we look at screens. If you can, find ways to reduce your daily screentime.

If this isn’t an option – which it often isn’t for those of us who rely on screens for work – try to take regular breaks and to blink more often while working at the computer or looking at your phone or the TV.

2. Use a humidifier 

Avoiding dry environments can help to ease dry eyes by slowing down the evaporation of tears, keeping your eyes better hydrated. Using a humidifier can help here by adding moisture to the air. 

3. Avoid irritants 

Dust, smoke, and other pollutants can make dry eyes worse, so avoid these as much as you can. Similarly, if you wear eye makeup, make sure you thoroughly remove it before going to bed, and consider having some makeup-free days each week.

4. Switch to glasses 

Contact lenses have come a long way but can still contribute to dry eyes, so switch to glasses instead to give your eyes a break. 

Even if you don’t need glasses to see, if you are a keen cyclist or runner, you might want to try wearing wrap-around sunglasses to protect your eyes from dust and dirt.

5. Increase omega-3 intake

Omega-3 fatty acids play an important role in tear production and eye health, so making sure you get enough may help to alleviate dry eyes. Choose a high-quality supplement or look for foods that are high in omega-3, such as oily fish, nuts and seeds, and avocados.

6. Get enough vitamin A 

Another key nutrient for eye health is vitamin A, which can help to increase the quality of your tears and reduce the symptoms of dry eye. Again, oily fish is a good source of vitamin A, as are leafy green vegetables, dairy, eggs, and organ meats. You can also take a supplement to increase your vitamin A levels.

7. Use eyedrops 

Eyedrops, also known as artificial tears, can provide some relief from the symptoms of dry eyes. There are numerous over-the-counter and prescription options available, so it is best to consult a pharmacist, optometrist, or GP to discover the option that is best for you.

Also, be careful of using eyedrops that contain preservatives, since these can irritate your eyes and make dry eye worse in the long run.

8. Hormone treatments 

Evidence is mixed, but there’s some reason to believe that the HRT treatments that can be so effective for other menopause symptoms are less successful at treating dry eyes. Some studies even indicate that HRT can make dry eyes worse.

However, those treatments typically contain oestrogen and progesterone. And, as we’ve already seen, it is actually androgens like testosterone that are more involved in tear production and quality. 

Although further research is needed, there’s emerging evidence that topical androgen treatments (such as ointments and eyedrops) may be an effective treatment option for dry eyes during menopause.

References

De-Hita-Cantalejo, C., Sánchez-González, M. C., Silva-Viguera, C., García-Romera, M. C., Feria-Mantero, R., & Sánchez-González, J. M. (2022). Efficacy of hyaluronic acid 0.3%, cyanocobalamin, electrolytes, and P-Plus in menopause patients with moderate dry eye disease. Graefe’s archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 260(2), 529–535. https://doi.org/10.1007/s00417-021-05415-6 

Gorimanipalli, B., Khamar, P., Sethu, S., & Shetty, R. (2023). Hormones and dry eye disease. Indian journal of ophthalmology, 71(4), 1276–1284. https://doi.org/10.4103/IJO.IJO_2887_22 

Sriprasert, I., Warren, D. W., Mircheff, A. K., & Stanczyk, F. Z. (2016). Dry eye in postmenopausal women: a hormonal disorder. Menopause (New York, N.Y.), 23(3), 343–351. https://doi.org/10.1097/GME.0000000000000530 

Dry eyes – symptoms and causes, Penn Medicine, https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/dry-eyes, consulted 24/11/2024

Akkaya, S., Atakan, T., Acikalin, B., Aksoy, S., & Ozkurt, Y. (2018). Effects of long-term computer use on eye dryness. Northern clinics of Istanbul, 5(4), 319–322. https://doi.org/10.14744/nci.2017.54036 

A Dietary Approach to Dry Eye Disease Management, Modern Optomerty, https://modernod.com/articles/2021-mar/a-dietary-approach-to-dry-eye-disease-management, consulted 24/11/2024

Alanazi, S. A., El-Hiti, G. A., Al-Baloud, A. A., Alfarhan, M. I., Al-Shahrani, A., Albakri, A. A., Alqahtani, S., & Masmali, A. M. (2019). Effects of short-term oral vitamin A supplementation on the ocular tear film in patients with dry eye. Clinical ophthalmology (Auckland, N.Z.), 13, 599–604. https://doi.org/10.2147/OPTH.S198349 

Dang, A., Nayeni, M., Mather, R., & Malvankar-Mehta, M. S. (2020). Hormone replacement therapy for dry eye disease patients: systematic review and meta-analysis. Canadian journal of ophthalmology. Journal canadien d’ophtalmologie, 55(1), 3–11. https://doi.org/10.1016/j.jcjo.2019.05.012 

Erdem, U., Ozdegirmenci, O., Sobaci, E., Sobaci, G., Göktolga, U., & Dagli, S. (2007). Dry eye in post-menopausal women using hormone replacement therapy. Maturitas, 56(3), 257–262. https://doi.org/10.1016/j.maturitas.2006.08.007 

Wang, L., & Deng, Y. (2020). The applications of androgen in the treatment of dry eye disease: a systematic review of clinical studies. Endocrine journal, 67(9), 893–902. https://doi.org/10.1507/endocrj.EJ20-0178