Menarche to menopause

The last menstrual period occurs on average at the age of 51. However, the body’s adjustment to the declining hormone levels begins several years before the menopause, and it can continue for several years afterwards. The most common menopausal symptoms include hot flushes and night sweats, which in turn contribute to sleep disturbances and daytime fatigue, as well as mood swings. Some women also complain of vaginal dryness and pain during intercourse, urinary discomfort or urge incontinence, anxiety and depression, sudden heart palpitations and tachycardia (racing heart), and skin dryness.

Many women want to avoid hormone therapy, which today can be used for very severe symptoms over a limited period of time depending on individual indications. They rely on »gentler« remedies. One of the best-studied plants in the field of menopausal complaints is the black cohosh (Cimicifuga racemosa). Pharmacological use is made of its rhizome, which contains various triterpene glycosides, phenolic carboxylic acid, fukinolic acid and cimicifugic acid. Hitherto, the exact mode of action of the ingredients is not clear. It is assumed that there are agonistic effects on the dopamine receptor, which could explain the effect against hot flushes.

The black cohosh is approved in Germany as a medicinal product for the relief of menopausal symptoms and can be recommended for hot flushes, sweating, sleep disturbances, nervousness and mood disorders. Women who have or have had breast cancer or liver disease should consult their doctor before taking it. Although it is now known that isoflavones, which have a phytoestrogenic effect, are not contained in the rootstock of black cohosh, it is still sometimes suspected that the plant has other oestrogen-like effects. Even if a hormone replacement therapy is being performed, women should consult a doctor before taking any additional preparations. The effect of the respective preparations only sets in after a few weeks; possible undesirable effects are stomach complaints, nausea, muscle and joint pain.