What natural supplements can be used for Hormone Replacement Therapy (HRT)?

From the Guidelines

Natural supplements such as black cohosh, phytoestrogens found in soy products, red clover, maca root, evening primrose oil, and wild yam cream can be used as alternatives or complements to conventional hormone replacement therapy (HRT) for managing menopausal symptoms. These supplements work by either providing plant-based compounds structurally similar to human hormones or by supporting the body's natural hormone production. However, their effectiveness varies significantly between individuals, and they generally produce milder effects than pharmaceutical HRT. It's essential to consult with a healthcare provider before starting any natural HRT alternative, as these supplements can interact with medications and may not be appropriate for those with certain health conditions, particularly hormone-sensitive cancers 1. Some of the key natural supplements that can be considered include:

• Black cohosh (40-80mg daily) for managing hot flashes
• Phytoestrogens found in soy products (50-100mg of isoflavones daily) for mild estrogenic effects
• Red clover (40-160mg daily) containing isoflavones similar to soy
• Maca root (1500-3000mg daily) to help balance hormones and reduce menopausal symptoms
• Evening primrose oil (500-1000mg daily) to help with breast tenderness and mood swings
• Wild yam cream applied topically containing diosgenin, a precursor to progesterone. The routine use of hormone replacement therapy has been associated with a slightly increased risk of breast cancer, cardiovascular disease, and thromboembolic disease and is not currently recommended 1. Therefore, natural supplements can be a viable alternative for managing menopausal symptoms while minimizing the risks associated with conventional HRT.

From the FDA Drug Label

ACTIVE INGREDIENTS: Aralia quinquefolia 3X, Arnica montana 3X, Avena sativa 3X, Carduus marianus 3X, DHEA 6X, Glandula suprarenalis suis 12X, L-arginine 6X, Natrum muriaticum 30C, Phosphoricum acidum 200C, Thuja occidentalis 200C, Vitamin E 10X. HOMEOPATHIC ORGANOTHERAPY Adrenal and DHEA proBLEN 1 FL OZ (30 ML)

The following natural supplements can be used for Hormone Replacement Therapy (HRT):

• DHEA: a hormone that the body uses to make sex hormones [ 2 ]
• Aralia quinquefolia: a plant used in homeopathic medicine [ 2 ]
• Avena sativa: a plant used in homeopathic medicine [ 2 ]
• L-arginine: an amino acid [ 2 ]
• Vitamin E: an antioxidant vitamin [ 2 ] Note that these supplements are part of a homeopathic preparation and their use in HRT should be discussed with a healthcare professional [ 2 ]

From the Research

Natural Supplements for HRT

Some natural supplements can be used as alternatives to Hormone Replacement Therapy (HRT) for menopausal symptoms, osteoporosis, and cardiovascular disease. These include:

• Phytoestrogens, such as isoflavones from soy and red clover, which may have antiosteoporotic effects and reduce menopausal symptoms 3, 4
• Calcium supplementation, which may delay osteoporosis 5
• Antioxidant dietary intake, which may protect against morbidity and mortality from cardiovascular disease 5
• Cimicifuga racemosa extracts, which may prevent climacteric complaints and have antiosteoporotic effects 3
• Botanical supplements, such as black cohosh, red clover, licorice, hops, dong gui, and ginger, which may modulate estrogen metabolism and have chemopreventive benefits 6

Dosages and Recommendations

The recommended dosages for these supplements vary:

• Isoflavones: 40-50mg per day, based on traditional Japanese diet intake 4
• Calcium: adequate intakes (AI) recommended, with caution not to exceed tolerable upper limits 5
• Antioxidants: no specific dosage recommended, but antioxidant-rich dietary intake may be beneficial 5
• Cimicifuga racemosa extracts: no specific dosage established, but may be effective in preventing climacteric complaints and osteoporosis 3
• Botanical supplements: no specific dosages established, but may have chemopreventive benefits when used in conjunction with other therapies 6

Safety and Efficacy

The safety and efficacy of these natural supplements are still being researched:

• Phytoestrogens: may have antiosteoporotic effects and reduce menopausal symptoms, but evidence is scarce and more research is needed 3
• Calcium supplementation: may delay osteoporosis, but high doses may pose health risks 5
• Antioxidant dietary intake: may protect against cardiovascular disease, but more research is needed to establish efficacy 5
• Cimicifuga racemosa extracts: may prevent climacteric complaints and have antiosteoporotic effects, but more research is needed to establish safety and efficacy 3
• Botanical supplements: may modulate estrogen metabolism and have chemopreventive benefits, but more research is needed to establish safety and efficacy 6