Pairing up two commonly used herbal medicines is “very effective” for easing physical and psychological symptoms of menopause, German researchers report.

St. John’s wort is widely used to treat mild to moderate depression, while women have traditionally taken black cohosh for menopausal complaints, Dr. Joerg Gruenwald of Analyze & Realize, a Berlin-based botanical consulting company, and colleagues write in the February issue of Obstetrics & Gynecology.

To see if a fixed combination of the herbal medicines could offer an alternative to hormone replacement therapy, the researchers studied 301 women who had been experiencing menopausal symptoms for at least three months, along with depressed mood. Half took the St. John’s wort and black cohosh combo, while the other half took placebo pills.

In each tablet, the black cohosh contained 1 milligram of the substances that are believed to be responsible for the herb’s activity, triterpene glycosides, while the St. John’s wort component contained 0.25 milligrams of the active ingredient hypericine.

Study participants took the two tablets twice a day for the first eight weeks of the study, and once daily thereafter.

After 16 weeks, women who took the two-herb combination showed a 50 percent reduction in symptoms such as hot flashes and sweating, compared to 19.6 percent for those on placebo. Scores measuring depression fell by 41.8 percent among women on the herbal medicines, compared to 12.7 percent for those on placebo.

Among patients on the herbal medicines, 62.2 percent rated the treatment as “good” or “very good” at the end of the study, compared to 25.6 percent of patients on placebo. There was no significant difference between the groups in the number of adverse events or side effects seen from the medicine.

The improvement in menopausal symptoms was similar to that seen among women taking hormone therapy for three months, Gruenwald and his team point out. They conclude that the treatment is safe and effective for easing both depression and menopausal complaints.

SOURCE: Obstetrics & Gynecology, February 2006.