Herbs that may be helpful: Double-blind trials support the usefulness of black cohosh for women with hot flashes associated with menopause. A review of eight trials concluded black cohosh to be both safe and effective. Many doctors recommend 20 mg of a highly concentrated extract taken twice per day; 2–4 ml of tincture three times per day may also be used.

Warning: Reports from late 2001 have indicated that kava may be associated with liver damage. Until additional information clarifies the extent of the risk involved, it is strongly recommended that all individuals consult their physician before taking kava. In addition, based on the available information, it seems that people with liver disease and those taking medications that have the potential to damage the liver should not take kava.

A variety of herbs with weak estrogen-like actions similar to the effects of soy have traditionally been used for women with menopausal symptoms. These herbs include licorice, alfalfa, and red clover. In a double-blind trial, a formula containing tinctures of licorice, burdock, dong quai, wild yam, and motherwort (30 drops three times daily) was found to reduce symptoms of menopause. No effects on hormone levels were detected in this study. In a separate double-blind trial, supplementation with dong quai (4.5 grams three times daily in capsules) had no effect on menopausal symptoms or hormone levels.

A double-blind trial using a standardized extract of subterranean clover (Trifolium subterraneum), a relative of red clover, containing 40 mg isoflavones per tablet did not impact symptoms of menopause, such as hot flashes, though it did improve function of the arteries.

Sage may reduce excessive perspiration due to menopausal hot flashes during the day or at night.45 It is believed this is because sage directly decreases production of sweat. This is based on traditional herbal prescribing and has not been evaluated in clinical studies.

Blue vervain (Verbene hastata) is a traditional herb for menopause; however, there is no research to validate this use. Tincture has been recommended at an amount of 5–10 ml three times per day.