The Everything Guide to Herbal Remedies: An easy-to-use reference for natural health care

CHAPTER 3

Herbs for Women

Quite often the symptoms and treatments of certain health conditions vary enormously between the genders, and men and women typically manage their health concerns very differently. In addition, several important health problems, including depression, osteoarthritis, chronic fatigue syndrome, osteoporosis, and autoimmune diseases, are significantly more common in women than in men.

Women Are Different

Most often, women are physically smaller—they weigh less and have smaller organs, less muscle mass, and more body fat—than men. Women also produce less of certain chemicals, such as those that synthesize the brain chemical serotonin (which plays a big role in depression and other mood disorders, as well as appetite and eating habits).

While men and women perform equally on intelligence tests, women’s brains have more gray matter (the part that allows thinking) and less white matter (the part that transfers information among various regions). This may explain why women seem to be better at verbal and memory challenges, while men excel at spatial tasks.

Many of the differences in health concerns can be traced to hormones. For example, research has shown that female sex hormones might be related to the development and progression of allergies and asthma, both of which are more prevalent in women. Estrogen, the best known of the women’s hormones, has been linked to women’s greater susceptibility to lung cancer as well as the “hormonal cancers” that include breast and ovarian cancer.

Migraines strike women far more often than men. In any given year, roughly 18 percent of women over the age of twelve will experience at least one, compared to about 6 or 7 percent of men. Experts think that hormones—and hormonal fluctuations—are responsible for the gender discrepancy.

Hormones can partly be blamed for women’s greater sensitivity to pain and to stimulants like cocaine and amphetamines. This sensitivity also fluctuates with a woman’s menstrual cycle. Hormones might explain why women often react differently than men to anesthesia (women wake up more quickly but are more prone to side effects such as post-operative vomiting or nausea).

Herbs for Women’s Health

Women have been relying on herbal medicines for centuries, and more women than men turn to herbs today. Recent surveys indicate that 79 percent of U.S. women take herbal medicines. Statistics also show that women are much more likely to take charge of their own health—they see their primary physician regularly and typically act on medical concerns instead of ignoring them. Women are also more likely to try a novel or unconventional type of health care treatment, both to treat a specific condition as well as to promote general well being.

Natural Estrogens

Many medicinal and edible plants contain compounds called phytoestrogens, which are chemically similar to the sex hormone estradiol (the primary estrogen in humans). Estradiol is critical to many body processes, including reproduction, sexual functioning, the synthesis of bone, and the modulation of several diseases (including cancer and heart disease). Phytoestrogens seem to modulate estrogen levels in the body, which can cause a host of beneficial effects and may avert certain diseases.

Many of the so-called women’s herbs contain a group of phytoestrogens known as isoflavones, which are found in soy (Glycine max). Another type, lignans, are found in soy and flax (Linum usitatissimum). A third type, coumestans, is found in red clover (Trifolium pratense) and alfalfa (Medicago sativa).

Research has linked phytoestrogen intake with many health benefits, including preventing osteoporosis, managing cholesterol, and reducing the risk of some cancers.

However, consuming excessive amounts can cause problems. Experts suggest sticking to recommended doses of herbal remedies and eating a sensible amount of phytoestrogen-containing foods (like soy). See Chapter 18 for more.

Using Herbs Wisely

Following are some tips for women on using herbal preparations.

·        • Talk with Your Doctor. Be sure to tell your doctor about any herbs you’re considering, especially if you’re pregnant or are being treated for a serious and/or chronic condition.

·        • Don’t Assume That “Natural” Means “Good.” Herbal medicines are considered supplements—or foods—and not drugs, so they’re handled much differently than pharmaceuticals. The Food and Drug Administration (FDA) doesn’t require that the manufacturer prove an herb’s safety, quality, or efficacy. This certainly doesn’t mean that all supplements are suspect, just that you should use them with care.

·        • Know Your Body. Everyone responds differently to chemical agents, whether they’re from a plant or a pharmacy, so different people will require different doses. If you know you’re sensitive to medications, start with a very small dose of the herbal preparation. Even if you’re not overly sensitive, you should never exceed the recommended dosage.

·        • Pay Attention. Most herbs have very low risk of interactions or side effects, but you should monitor yourself when starting any new therapy.

·        • Be Patient. Most herbal remedies take a bit longer to produce effects than prescription or over-the-counter (OTC) medicines do. Most experts advise patients to allow several weeks before deciding if a remedy is working or not, and note that some herbs may take up to eight weeks to deliver any benefits.

Gamma-linolenic acid, or GLA, supports immune, endocrine (hormonal), and cardiovascular functioning and is used to treat several women’s health issues, including menstrual and menopausal symptoms. The best-known herbal source is evening primrose (Oenothera biennis) oil, which can be expensive. Other good sources of GLAs are borage (Borago officinalis) and black currant (Ribes nigrum) oils.

Breast Health

The breasts are made up of several types of tissue: glandular tissue (including mammary glands that produce milk and ducts that transport it), connective tissue, and fat. Breast tissue changes throughout a woman’s life, with menstrual cycles as well as general aging.

Breast Pain

Breast pain, also known as mastalgia, is fairly common, affecting about 70 percent of women at some point in their lives. Severe mastaglia, which occurs more than five days a month and can be quite debilitating, affects about 10 percent of women.

Breast pain can be cyclic (changing with the menstrual cycle) and noncyclic (constant or intermittent pain that’s not tied to your period). Cyclic pain, which is the most common, typically affects both breasts and involves dull pain, swelling, tenderness, and lumpiness in the entire breast. Noncyclic breast pain is more common in postmenopausal women, usually affects just one breast, and is localized.

Although the exact causes of breast pain aren’t known, most experts think that cyclic pain is tied to hormonal fluctuations, while noncyclic pain is caused by physical factors such as breast cysts (see below) or trauma. Taking oral contraceptives, menopause treatments, and antidepressants has also been tied to breast pain. Some experts think it might be tied to an imbalance of fatty acids like gamma-linolenic acid (GLA), which makes the breast tissue more sensitive to hormonal changes (and pain).

Lumps and Bumps

Lumps in the breast can be caused by many things—some dangerous, most benign. In the majority of cases, a lump is a harmless swelling or thickening of tissue caused by a group of conditions termed fibrocystic breast changes(FCCs), which affect at least half of all women, most often between the ages of twenty and fifty. FCCs include fibrosis, which is the development of fibrous tissue, and cysts, which are small sacs created when an overgrowth of tissue blocks the milk ducts and causes the glands to fill with fluid. Cysts are typically smooth, with defined edges, and feel like small, soft grapes; they can occur singly or in groups. Breast cysts generally disappear after menopause. One exception: Postmenopausal women taking hormone replacement therapy (HRT), which can trigger the formation of cysts.

Cysts can get to be one or two inches in diameter, and larger cysts can put pressure on surrounding tissues, causing pain. In most cases, cysts will resolve themselves without any treatment, although doctors can drain the fluid from large cysts that have become uncomfortable.

Does a lump in the breast always mean cancer?

Finding a lump is rarely a sign of cancer, but if you notice a mass in your breast that doesn’t go away after one menstrual period and/or is accompanied by other symptoms, such as redness or changes in breast shape or skin texture, you should schedule an appointment with your doctor. Localized pain that doesn’t change with your menstrual cycle also warrants an exam.

Drug (and Nondrug) Treatments

Most doctors recommend OTC pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) to treat breast pain. In severe cases, prescription medicines might be prescribed, such as danazol (Danazol), which is a synthetic steroid. NSAIDs can cause gastrointestinal damage and other side effects, and danazol can cause acne and unwanted hair growth.

Herbalists offer a few natural approaches to breast pain and fibrocystic breast changes:

• Evening primrose (Oenothera biennis)

The seeds of this flowering plant contain gamma-linolenic acid (GLA), which is a valuable anti-inflammatory. Evening primrose oil has been shown to reduce both cyclic and noncyclic breast pain.

• Red clover (Trifolium pratense)

Red clover is a traditional remedy for cyclic mastalgia. Recent research has shown that an extract of the herb significantly reduces breast pain and tenderness in nearly half the women who try it.

• Vitex (Vitex agnus-castus)

Vitex seems to have estrogenic activity in the body and has been shown to relieve cyclic breast pain.

Menstrual Issues

Menstruation, or menses, is the cyclical process that women go through roughly once a month from around age fourteen to age fifty. During menstruation, the uterus sheds its lining (the endometrium) through the vagina. In most cases, it’s a fairly uneventful process. But for some women, menstruation can bring serious discomfort.

PMS, or premenstrual syndrome, occurs in the week or two weeks before a woman’s menstrual period and generally stops as soon as menstruation begins. PMS affects about 75 percent of women. Common symptoms are breast tenderness, acne, insomnia, headache and backache, tension, and irritability. PMS is tied to changing hormone levels and can be exacerbated by stress.

About 8 percent of women experience a particularly severe form of PMS known as premenstrual dysphoric disorder (PMDD), which is a serious, often debilitating condition that can include marked depression, anger, flu-like symptoms, and appetite and sleep changes.

Stress affects everyone, but it can be especially tough on women (and trigger PMS and other problems). The American Psychological Association reports that mothers in the “sandwich generation” (ages thirty-five to fifty-four) feel more stress than any other group. And while two out of every five Americans say they feel overextended, more women than men report extreme stress.

Treatment of PMS generally includes OTC medicines like Midol, which contain an NSAID or other pain reliever, plus a diuretic to fight bloating. Women with PMDD are often given antidepressants as well.

Serious menstrual cramps, also known as dysmenorrhea, can strike at any age, although teenagers are more likely to have painful periods than older women. Postmenopausal cramps warrant a doctor’s visit, as they can be caused by endometriosis, a painful condition in which tissue similar to that in the endometrium is found elsewhere in the body.

Many women treat the cramps and other symptoms of dysmenorrhea with OTC pain medications. In severe cases, doctors may prescribe oral contraceptives. Herbal remedies for premenstrual and menstrual problems include the following:

• Dandelion (Taraxacum officinale)

Dandelion is a traditional remedy for the water retention of PMS. It’s an herbal diuretic (it increases urine volume and sodium excretion to relieve bloating). Juniper (Juniperus communis) is another bloat-relieving option.

• Ginkgo (Ginkgo biloba)

Ginkgo, better known for its memory-boosting benefits, can also relieve the moodiness and breast tenderness of PMS.

• Maritime pine (Pinus pinaster)

Extracts of the bark from this French pine tree have been shown to relieve the pain of menstrual cramps and endometriosis.

• Saint John’s wort (Hypericum perforatum)

This mood-lifter has been shown to improve symptoms of PMS by as much as 50 percent; it’s also effective against PMDD.

• Vitex (Vitex agnus-castus)

Clinical trials show that vitex can reduce the psychological symptoms of both PMS and PMDD (its effects are comparable to the drug Prozac). It’s also effective at relieving physical symptoms like headaches, water retention, and acne.

Female-Specific Infections

Because of their anatomy, women are prone to a few infections that seldom, if ever, strike men. Women also can blame their susceptibility to certain infections on their hormones.

UTIs

Urinary tract infections (UTIs) are about fifty times more common in women than in men, mostly because a woman has a shorter urethra (the tube that carries urine from the body), meaning bacteria have a shorter distance to travel in order to establish themselves in the bladder. Sexual activity—especially if you’re using a diaphragm or spermicide—as well as douching, taking long baths, or holding urine for long periods of time all can increase your risk of UTIs.

If you think you’ve got a UTI, schedule a visit to the doctor right away. Conventional treatment almost always includes antibiotics, such as trime-thoprim-sulfamethoxazole (Bactrim, Septra) or ciprofloxacin (Cipro).

The most common type of UTI is cystitis, which affects the lower urinary tract. Symptoms include increased urinary frequency, urgency (the desire to urinate), and painful urination. Infections of the upper urinary tract, called pyelonephritis, are much more serious because they involve the kidney. Symptoms can include chills, fever, nausea, and internal pain.

Vaginal Infections

Bacterial vaginosis is characterized by watery vaginal discharge with an unpleasant odor, sometimes accompanied by burning, itching, or redness. It’s caused by an overgrowth of bacteria, which can be aided by wearing tight, nonbreathable clothing, douching, and using “feminine deodorant” sprays. Conventional treatment typically involves antibiotics like metronidazole (Flagyl).

A vaginal yeast infection, also known as candidiasis, is caused by an overgrowth of an organism called Candida albicans. Candida infections show up in other parts of the body, as well: Thrush (which affects the mouth and throat), jock itch, and athlete’s foot are examples. Most of the time, Candida yeasts live in body without any problem but can trigger symptoms if their numbers get out of control.

Yeast infections are characterized by sticky white or yellowish discharge, burning, and itching. They’re fairly common—nearly 75 percent of adult women will have at least one episode in her lifetime—but occur more frequently and more severely in people with weakened immune systems.

Overuse of broad-spectrum antibiotics, which kill off the so-called “good” bacteria that keep yeast under control, has been implicated in candidiasis, as have corticosteroid drugs and high-sugar diets.

Conventional medicine treats candidiasis with antifungal drugs, including suppositories and topical creams like miconazole (Monistat) and singledose oral medications such as fluconazole (Diflucan).

Herbal Alternatives

UTIs can be treated with the following herbs:

• Cranberry (Vaccinium macrocarpon)

Cranberry juice is rich in antioxidants and one of the best-known natural remedies for urinary tract infections. Lab tests show that it prevents bacteria from adhering to the tissues in the urinary tract. Blueberry (Vaccinium angustifolium) juice and extract contain similar chemicals.

• Dandelion (Taraxacum officinale)

Research shows that a combination of dandelion and uva ursi (Arctostaphylos uva-ursi, Arbutus uva-ursi) can reduce the incidence of UTIs.

• Juniper (Juniperus communis)

Juniper extracts are antibacterial and stimulate the flow of urine. Juniper berries were a standard treatment for UTIs for several Native American tribes.

Herbal remedies for bacterial vaginosis and candidiasis include:

• Echinacea (Echinacea purpurea)

This classic immune-boosting herb can help pharmaceuticals do their job even better. Recent research has shown that echinacea extracts can boost the effectiveness of antifungal drugs in treating candidiasis.

• Goldenseal (Hydrastis canadensis)

This herb is a powerful antibacterial and antifungal and can be taken orally or used topically to fight bacterial vaginitis or candidiasis. Goldenseal’s infection-fighting powers have been attributed in large part to the chemical berberine, which is also plentiful in barberry (Berberis vulgaris).

• Tea tree (Melaleuca alternifolia)

Known for its antibacterial and antifungal properties, this Australian import has been shown in several studies to eradicate both the bacteria and the yeast cells responsible for vaginal infections when applied topically or used as a douche.

The ready availability of OTC antifungal remedies has made it much easier for women to treat vaginal candidiasis themselves, but these medications are often misused. According to the Centers for Disease Control and Prevention, as many as two-thirds of the OTC drugs sold to treat vaginal candidiasis were used by women who didn’t actually have a Candida infection, a habit that can lead to the development of drug-resistant infections.

Sexual Health and Fertility

Being sexually healthy—having an interest in sex, being able to function sexually, and being able to get pregnant (if she so chooses)—is a key part of a woman’s overall well being.

A woman’s sexual desire, or libido, can go up and down naturally, for many different reasons (and usually for a short time). However, sex drive that’s perpetually stuck in neutral deserves attention. Some medications, notably antidepressants, can cause a drop in libido, as can shifts in hormone levels and changes in sleep patterns and stress levels.

Most women can expect to be fertile—capable of getting pregnant—for the full extent of their reproductive years (the time between the first menses and the onset of menopause). A woman is considered “infertile” if she and her partner have been trying for a year to get pregnant (and her partner’s fertility has been verified by a doctor).

Can herbs work as contraceptives?

Several herbs traditionally used to prevent pregnancy are now being seriously studied for more widespread use. For example, the Indian herb neem (Azadirachta indica) works as a safe and reversible contraceptive. In one study, rats given an intrauterine shot of neem were infertile for up to 180 days, then had healthy litters with no apparent problems.

Female infertility can be caused by a physical problem (such as ovarian cysts or a blocked fallopian tube), a hormonal imbalance, or various other factors (such as age, stress, or poor nutrition). In most cases, it’s a temporary condition.

Conventional and Other Approaches

Conventional medicine typically addresses women’s sexual irregularities with things like counseling and stress reduction. Fertility treatments typically include drugs that stimulate ovulation, such as follicle-stimulating hormone, or FSH (Follistim), which can cause pulmonary and vascular problems and other side effects. Other options include in vitro fertilization. Here are some herbs that can help:

• Ashwagandha (Withania somnifera)

Ashwagandha is considered a sexual stimulant for both men and women in Ayurvedic tradition, as is the herb schisandra (Schisandra chinensis). Both appear to increase sensitivity in the genitals (and thus stimulate the libido).

• Rhodiola (Rhodiola rosea)

Rhodiola seems to restore fertility to women who have minor hormonal imbalances or are suffering the effects of stress.

• Shatavari (Asparagus racemosus)

Shatavari, which means—no kidding—“she who has hundreds of husbands” in Sanskrit, is used in Ayurvedic medicine to increase sexual vitality and fertility.

• Vitex (Vitex agnus-castus)

Research has shown that vitex can increase a woman’s chance of getting pregnant.

• Yohimbe (Pausinystalia yohimbe)

Yohimbe is an African herb used as an aphrodisiac and sexual function treatment for both men and women. In women, it seems to work by dilating vaginal blood vessels to increase circulation.

Pregnancy

Pregnancy can be a time of chaos for many women: They’re experiencing any number of new sensations (and discomforts)—and they’re worried about putting anything even potentially dangerous into their bodies.

Stretch marks—small, raised marks that develop on the skin in areas that are experiencing rapid growth—are a concern for many pregnant women. Gotu kola (Centella asiatica), an Ayurvedic herb known for its ability to speed healing and reduce scarring, can help, as can ultramoisturizing cocoa (Theobroma cacao) butter and almond (Prunus dulcis) and sesame (Sesamum indicum) oils.

In many ways, pregnant women are the toughest group of people to treat—both conventionally and herbally—because so little is known about the effects of various compounds on the developing fetus.

Nausea, or morning sickness, is a common complaint during pregnancy, especially in the first few months. Other pregnant women suffer from constipation, heartburn, gas, and bloating. Pregnant women are generally advised to skip the usual OTC remedies for nausea and other gastrointestinal problems. The good news is that herbal medicine has a few alternatives:

• Ginger (Zingiber officinale)

Taking extracts (or drinking tea) made from gingerroot has been shown to reduce nausea and vomiting.

• Peppermint (Mentha x piperita)

Peppermint tea is another classic remedy for pregnancy-related nausea (and inhaling peppermint oil can relieve headaches). Skip the peppermint if you’ve got heartburn, however, as it might make your symptoms worse.

• Psyllium (Plantago ovata, P. psyllium)

The seeds of this plant are a safe and effective remedy for constipation and its attendant symptoms.

Many herbs—including several “women’s herbs”—should be avoided during pregnancy. They include: red clover (Trifolium pratense), black cohosh (Actaea racemosa, Cimicifuga racemosa), dong quai (Angelica sinensis), feverfew (Tanacetum parthenium), kava (Piper methysticum), Saint John’s wort (Hypericum perforatum), and vitex (Vitex agnus-castus), plus caffeine-containing herbs like mate (Ilex paraguariensis), guarana (Paullinia cupana),coffee (Coffea arabica), and tea (Camellia sinensis).

Pregnancy can bring on headaches, backaches, and other kinds of aches—yet pregnant women are generally told to avoid NSAIDs and other pain-relieving pharmaceuticals. Happily, there are some herbal alternatives:

• Cayenne (Capsicum annuum, C. frutescens)

These peppers contain the chemical capsaicin, which has been shown to reduce muscle pain and headaches when applied topically.

• Maritime pine (Pinus pinaster)

Pine extracts have been shown to reduce the incidence of lower back pain, hip joint pain, pelvic pain, and pain due to varicose veins or calf cramps.

• Witch hazel (Hamamelis virginiana)

Witch hazel can reduce the swelling, itching, and discomfort of hemorrhoids.

Menopause

The transition between fertility and menopause is technically known as perimenopause (or climacteric), but most people simply call it menopause. Menopause is the end of menses, and it’s official when a woman hasn’t had a period for twelve consecutive months. The average age of menopause is fifty-one, but anything between forty-one and fifty-nine is considered normal.

Symptoms

Menopause produces a few distinct symptoms, all the result of the shortfall in the hormones estrogen and progesterone created when the ovaries stop producing them.

The best-known menopause drug, Premarin, contains conjugated estrogens taken from the urine of pregnant female horses (its name is an abbreviation of “pregnant mares’ urine”). Despite its side effects (including cramping, bloating, breast pain, hair loss, irregular bleeding, and Candida infections) and protests against the inhumane treatment of the “donor” mares, it’s still routinely prescribed by conventional doctors.

These symptoms, which can go on for as little as a few weeks or as long as a few years, vary greatly among women. The most common include:

Vasomotor Symptoms

Menopausal vasomotor symptoms—those involving constriction or dilation of blood vessels—include hot flashes and night sweats.

Hot flashes are the most common symptom of menopause; almost all menopausal women have them. They are marked by a warm sensation that travels from your chest up into your head, often in waves, accompanied by a flushing in your skin and, in some cases, dizziness, nausea, headache, and rapid heartbeat. Hot flashes that come on at night are called night sweats (for obvious reasons).

Emotional and Cognitive Changes

Many women experience changes in mood—including depression and anxiety—during menopause. Other problems, like difficulty with concentration or memory, are also common.

Help for Menopausal Symptoms

Conventional medicine generally treats menopausal symptoms with hormone-like drugs that mimic the effects of estrogen and progesterone.

Until fairly recently, conventional doctors routinely prescribed the long-term use of drugs known as hormone replacement therapy (HRT) to both ease the symptoms of menopause and protect postmenopausal women against estrogen-mediated diseases like osteoporosis, Alzheimer’s disease, and cardiovascular disease.

Insomnia is a common complaint among menopausal women. But several herbs used in aromatherapy (and inhaled or applied to the skin via massage), including lavender (Lavandula angustifolia) and jasmine (Jasminum officinale),can help you get to sleep without the side effects of pharmaceutical sedatives.

But recent research has shown that HRT actually increases the risk of cardiovascular problems (including stroke and heart attack), breast cancer, gall bladder disease, and dementia. These days, doctors usually prescribe HRT only for the short-term relief of menopausal symptoms.

However, even when it’s used for a limited time, HRT has its side effects, including bloating, weight gain, and emotional problems like irritability and depression. But herbalism has a few alternatives:

• Black cohosh (Actaea racemosa, Cimicifuga racemosa)

Black cohosh extracts can significantly reduce hot flashes (one study showed an effect similar to a pharmaceutical estradiol patch).

• Dong quai (Angelica sinensis)

In a recent study, menopausal women who took a combination of dong quai and chamomile (Matricaria recutita) showed significant improvement in hot flashes.

• Flax (Linum usitatissimum)

Taking flaxseed has been shown to reduce mild menopausal symptoms just as well as hormone therapy—without the side effects.

• Kava (Piper methysticum)

Research has shown that kava extracts can reduce symptoms of anxiety and cognitive impairment in menopausal women—and results were seen after just one week.

• Kudzu (Pueraria lobata)

Extracts of this Chinese vine, which is a traditional Chinese menopause treatment, seem to improve cognitive function in postmenopausal women.

• Red clover (Trifolium pratense)

Red clover is a traditional remedy for menopausal complaints, and there is some evidence that it can reduce hot flashes, lower cholesterol levels, and improve cognitive functioning.

• Soy (Glycine max)

Soy—both the dietary and the supplemental kind—can decrease the severity and frequency of hot flashes. In some studies, the effects were similar to those of pharmaceutical hormone therapy.

• Saint John’s wort (Hypericum perforatum)

Research shows that a combination of Saint John’s wort and black cohosh (Actaea racemosa, Cimicifuga racemosa) can reduce depression and other psychological symptoms of menopause.