Your Questions Answered
What are the Benefits of Herbal Therapy in Women's Healthcare?
Integrative medicine is an approach that brings together the best of conventional medicine with complementary and alternative medicines (CAM). Some of the different types of treatments used include Chinese medicine, yoga therapy, homeopathy, and evidence-based herbal therapy, all of which have been proven to benefit women through the childbearing and menopausal years.
Over the last decade herbal therapies have become increasingly popular. Our society is shifting from treating disease to preventing disease and promoting overall wellness. There has been extensive evidence linking herbal therapy to success in treating menopausal symptoms, irregular menstrual cycles, menstrual breast pain, urinary tract infections, and more. Herbal therapy is also a method, if used correctly and wisely, that often goes hand in hand with traditional treatments and has been found to be a convenient supplement to medications.
While there has been an overall positive response to herbal therapy, there are precautions that must be followed by both the provider prescribing the herb and the patient. For instance, many herbs are not recommended in pregnancy or in lactating women. Some may cause drug interactions if used in conjunction with another herb or medication. Others can cause severe side effects that could rival the original pain or illness. It is extremely important to fully research any herb in question for these reasons and also because herbal therapy is a relatively new treatment method.
Finding a quality product can be a challenge. With so many companies marketing herbal therapy, it is difficult to choose among them the one that would be of best help. Because herbal therapy has recently sparked public awareness in terms of treating pain and illness, the best sources we have in regard to quality herbal products are based on what has been proven effective in clinical trials. Four such companies include Boehringer-Ingelheims Pharmaton Division, Nature's Way (bought by Schwabb), Lichtwer Pharma, and Enzymatic Therapy. In addition, there are pharmaceutical companies whose marketing schemes have outweighed the competition and are more easily found in local stores, such as Whitehall-Robbins, Centrum Herbals, Bayer Once-A-Day Herbals, SmithKlineGlaxo, and Upsher-Smith.
When trying to unravel the mysteries behind a particular herbal product and its effectiveness and usage, look for a "seal of approval" on the product. Anyone can then research the product in question by logging onto the following websites:
www.naturalstandard.com ($99.00 a year)
www.intelihealth.com (for disease, drug, herb, CAM info)
Medline
NCCAM website
Natural Medicine News-fbatz@sonic.net (weekly herbal updates)
Alternative Medicine Alert: www.ahcpub.com (monthly newsletter)
A meta-analysis of various herbs used in women's healthcare has been reviewed by pharmacologists and the conclusions are listed below. These therapies proved "better than placebo" in the studies reviewed. Keep in mind this is not an all-inclusive list and to receive the most complete information regarding any one of the following herbs or others not mentioned below speak with your healthcare provider.
Black Cohosh-Used for menopausal symptoms consisting of hot flashes, nervousness, depression, insomnia, anxiety, and vaginal dryness.
Side effects: stomach upset; high-dose usage can promote dizziness, headache, sweating
Cautions: Safety not established with history of breast cancer or pregnancy.
Chasteberry-Used for premenstrual symptoms, irregular menstrual cycle, menstrual breast pain.
Side effects: stomach upset, rash, headache
Avoid in pregnancy and lactation due to effects on prolactin levels.
Echinacea-Used for cold treatment, urinary tract infections (UTI), and wound healing. Activates immune system; shortens duration and severity of cold if taken at onset and in appropriate quantity.
Safe in pregnancy; continuous use limited to 8 weeks; avoid if immune or autoimmune disease.
Ephedra-Used for stimulant and anorexic effect, structurally related to amphetamines.
Contraindications: anxiety, restlessness, high blood pressure, glaucoma, etc.
Side effects: insomnia, motor restlessness, irritability, headaches, nausea, vomiting, disturbances of urination, tachycardia (fast heartbeat). In higher dosages: drastic increase in blood pressure, cardiac arrhythmia, development of dependency.
Not recommended in pregnancy.
This herb is an ingredient in many "natural" diet pills. It is extremely controversial and has been implicated in severe side effects.
Garlic-Improves total cholesterol, lowers blood pressure, thins blood, antisclerotic, anti-cancer effects, anti-infective, positive effects on glucose.
Precautions: Do not take if on other blood thinning medications, e.g., aspirin; do not take before or after surgery.
Ginkgo biloba- Used for cerebral insufficiency (cognitive impairment), peripheral vascular disease, vertigo, and tinnitus (ringing in the ears). Potential use in antidepressant related sexual dysfunction and acute mountain sickness.
Precautions: Discontinue 2-4 weeks before surgery; do not take with aspirin. No known restrictions during pregnancy or lactation.
Horse Chestnut Seed Extract- Used for Chronic Venous Insufficiency (varicose veins), hemorrhoids. Also used for symptoms of swelling, leg pain, fatigue, and burning.
*Effectiveness compared to compression stockings
Precautions: May cause nausea, pruritis, gastric upset. No contraindications known; no restrictions known in pregnancy or lactation; no drug interactions known.
Kava Kava-Used for anxiety, menopausal symptoms, insomnia. Onset less than a week with continued improvement over 6 months.
Precautions: Do not mix with alcohol, may cause yellowing of the skin and nails with heavy use, do not use in pregnancy or lactation or liver disease.
Milk Thistle-Used for mild liver dysfunction (alcoholic liver disease)
Precautions: Increases bile solubility, may cause diarrhea; no restrictions known in pregnancy; no drug interactions known.
St. John's Wort-Used for mild to moderate depression, restlessness, anxiety, nervousness, premenstrual syndrome (PMS), menopausal symptoms, and seasonal affect disorder (SAD).
Side effects: Photosensitivity in extremely large doses (wear sunscreen)
Precautions: Not shown to be effective for major depression. No restrictions known in pregnancy or lactation. Discontinue use 2-3 weeks before surgery; do not take with prescription antidepressants.
Drug interactions: endeavor, theophylline, cyclosporine, ethinylestradiol (i.e., birth control pills), warfarin, digoxin
Valerian-Used for insomnia, anxiety, pain
Well tolerated, no adverse effects, low abuse potential; no contraindications known; safe in pregnancy and lactation
It is strongly recommended that you talk to your provider - physician, nurse-midwife, or nurse practitioner - about any herbal therapy you are using in order that he or she may best provide care for you. It is important that many prescription medications are not duplicated with herbal treatments, so any questions that arise, please feel free to ask.
Disclaimer: In accordance with FDA regulations, this information is not to be used for purposes of diagnosis or treatment. This information is not intended to be taken as a replacement for medical advice. It is strongly recommended that you talk to your provider - physician, nurse-midwife, nurse practitioner, or physician assistant - about any herbal therapy you are using or would like to use in order that he or she may best provide care for you. It is important that many prescription medications are not duplicated with herbal treatments
Harbour Women’s Health has a commitment to providing you the option of combining traditional medicine with alternative approaches, many of which they provide. If you have any questions regarding Herbal Therapy in Women’s Healthcare please feel free to ask.
Maribeth Quinn, CNM
Harbour Women's Health