The Nine Best Herbs for Women

THE LATEST RESEARCH ON WHAT REALLY WORKS TO PREVENT PMS, HOT FLASHES, MIGRAINES, HEART DISEASE, AND MORE

NEWS FLASH: Women are not small men. We don't have prostates, rarely suffer from male-pattern baldness and (thankfully) never have to deal with jock itch. But that's not to say we don't have issues. Here's a short list: PMS, migraines, hot flashes, urinary tract infections. Lucky for us, there's a natural remedy for all of them. In many cases, more than one. In some cases, more than 10. To narrow the field, we scoured the medical journals and consulted top researchers and complementary-medicine specialists. The result: nine must-have female-friendly herbs to help you feel better, sleep more soundly, and maybe even live longer.
BLACK COHOSH (Cimicifuga racemosa) BEST FOR: Hot flashes and night sweats

"This herb is one of the best studied — and perhaps most popular — treatments for hot flashes," says Tieraona Low Bog, M,D., author of a review of botanical supplements for menopause published in the December 2005 issue of the American Journal of Medicine. In fact, most studies have found it to be effective in reducing the hot flashes and night sweats associated with menopause, according to the National Center for Complementary and Alternative Medicine (NCCAM), a division of the National Institutes of Health (NIH). Despite all the research, however, no one is quite sure how it works. One long-held theory asserted that black cohosh exerted a positive estrogenic effect. (Declining estrogen levels are principally responsible for menopausal symptoms.) But newer data suggest that it may actually decrease levels of other hormones (including luteinizing hormone) that cause hot flashes, according to a research review published in the journal American Family Physician. Black cohosh isn't effective at relieving other menopausal issues, such as vaginal dryness, however.

HOW TO TAKE IT The recommended dosage is 20 milligrams twice daily. It's available as a fresh or dried root or in pill form; Lane P. Johnson, M.D., M.P.H., author of The Pocket Guide to Herbal Remedies (Blackwell, 2001), recommends the brand Remifemin, a standardized extract that has been used in more than go studies.

SAFETY ISSUES "Anyone with any kind of liver disorder or on any type of hepatotoxic medication" should put the kibosh on black cohosh, cautions Johnson. Typically, black cohosh is used on a short-term basis; the long-term safety is unknown. It should not be taken during pregnancy or while breast-feeding.
CHASTE TREE BERRY (Vitex agnus castus) BEST FOR: Premenstrual syndrome

"There's very good data to suggest chaste tree berry as a general remedy for PMS," says Ellen Hughes, M.D., clinical professor of medicine at the University of California, San Francisco. A 2001 study of 170 women published in the British Medical Journal showed that 52 percent found relief from PMS-related irritability, mood changes, and headaches by taking this herb. It may also help regulate and normalize the menstrual cycle, according to Donielle Wilson, N.D., president of the New York Association of Naturopathic Physicians, who suggests it to patients suffering from amenorrhea (no period), too-frequent periods, and symptoms of perimenopause and menopause. Limited research suggests that chaste tree berry works by enhancing the luteal phase of the menstrual cycle (the period between ovulation and menstruation), says Low Dog.

HOW TO TAKE IT Wilson recommends one or two capsules of dried herb standardized to 0.6 percent acubin (the active ingredient). "Capsule is preferable," she says, "because you'd have to drink about 24 ounces of tea a day — and it's difficult to find a standardized tea preparation." Alternately, you can take chaste tree berry as a tincture of 40 to 80 drops daily.

SAFETY ISSUES Rarely, the herb can cause skin rash, and it should not be taken during pregnancy or while breast-feeding. Chaste tree berry may also interfere with drugs that inhibit the effect of dopamine in the brain, such as certain antidepressants.
CRANBERRY (Vaccinium macrocarpon) BEST FOR: Prevention of UTIs

For reasons that aren't well understood, women are more likely than men to develop a urinary tract infection (UTI). In fact, one in five women will get one in her lifetime, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Some women are more prone to UTIs than others — diaphragm users, for instance, are at a high risk — and almost 20 percent of women who develop one will eventually develop another. Most infections arise from an overgrowth of E. coli bacteria in the urethra (urethritis) and/or bladder (cystitis). Cranberry prevents bacteria from adhering to the walls of either organ, making it difficult for infection to take hold. It will not, however, kill the bacteria once they're established; in that case, only prescription antibiotics can provide relief.

HOW TO TAKE IT Johnson recommends drinking at least one eight-ounce glass of cranberry juice a day. Choose a high-quality juice with a large concentration of cranberry; Northland brand, for instance, contains up to 27 percent cranberry — the highest concentration in a commercially available sweetened juice. Pure unsweetened cranberry juice is available in health food and vitamin stores, but it's so tart that it's hard to drink. The recommended dosage is 15 to 30 milliliters per day; you can dilute it in water to improve the flavor. "You can also take cranberry capsules," says Johnson. "But studies show the effects aren't as strong."

SAFETY ISSUES There are no known medical precautions to consider when drinking cranberry juice, but if you suffer from gastroesophageal reflux disease or a peptic ulcer, the acidity may aggravate your symptoms.
DONG QUAI (Angelica sinensis) BEST FOR: General female wellness

Also known as angelica root or dang quai, this Chinese herb is often called the 'female ginseng' because of its usefulness in treating irregular periods, fatigue, and premenstrual irritability and anxiety, says Dana Price, D.O.M., LAc., Dipl.OM, founder of the Southwest Center for Oriental Medicine in Phoenix. Scientists aren't clear on how it works; dong quai may have a weak estrogenic effect, but this remains unconfirmed. In Traditional Chinese Medicine (TCM), dong quai is used in combination with other herbs to strengthen the blood of people with excess yin energy; females are generally more yin than yang, according to the ancient practice.

HOW TO TAKE IT TCM is highly individualized, so it's best to consult an accredited specialist for a correct herbal prescription, explains Price. Dong quai is always used in combination with other herbs and is an integral part of a common blood-toning formula called Si Wu Tang, says Price. If, however, you wish to take dong quai on its own: Steep 1 teaspoon crushed root in 8 ounces boiling water for 10 to 20 minutes, then drink as a tea. Or, as Price recommends, consume two to four milliliters of tincture daily. "Choose high-quality, American-made products for the best results," she explains.

SAFETY ISSUES Avoid dong quai if you're pregnant — it can stimulate uterine contractions, warns Price. "It may also cause diarrhea and/or abdominal distension," she says. If you're on a blood thinner such as warfarin, you shouldn't use this herb. Dong quai can increase your sensitivity to sunlight, so be sure to wear sunscreen.
FLAXSEED (Linum usitatissimum) BEST FOR: Heart health

Nearly twice as many American women die of heart disease and stroke as from all forms of cancer, including breast cancer, according to the American Heart Association (AHA). One reason: high cholesterol. In fact, women tend to have higher cholesterol levels than men from age 45 on, according to the AHA. Flaxseed, which is rich in the omega-3 fat alpha-linoleic acid, may help lower it.

A 2005 Italian study of 40 patients with cholesterol levels greater than 240 mg/dL found that consuming ground flaxseed (20 grams, or about 0.7 ounces, daily) could significantly lower levels of total and LDL cholesterol (the artery-clogging kind), while also improving the ratio of total cholesterol to HDL (Low levels of HDL may be a greater risk factor for women, according to the AHA.)

In a Harvard study of 76,763 women participating in the Nurses' Health Study presented at the 2004 American Heart Association's Scientific Session, researchers also noted that women consuming a diet rich in alpha-linoleic acid seem to have a lower risk of dying from heart disease and stroke, compared to women whose diets were lacking this fat. Although more research, including randomized, controlled clinical trials, is called for, the AHA recommends consuming foods rich in alpha-linoleic acid and other omega-3 fatty acids for heart health; a tablespoon of flaxseed contains eight grams. "Flaxseed also provides fiber," says Wilson. Two tablespoons of ground flaxseed have four grams of fiber — almost 20 percent of the 25 grams recommended by the U.S. Department of Agriculture. Lignans, which are a particular type of fiber found in flaxseed, may also be beneficial for preventing breast and prostate cancer, according to preliminary studies. "Lignans are not present in flaxseed oil, however," notes Low Dog.

HOW TO TAKE IT Low Dog recommends adding one to five tablespoons of ground flaxseed to your diet several days a week; sprinkle it on cereal or yogurt, or stir it into protein shakes. Flaxseed oil — which must be kept refrigerated to prevent rancidity — should be added to salads and not used for cooking.

SAFETY ISSUES Flaxseed and its oil are safe if consumed in normal amounts, although they can produce a laxative effect. "If you eat huge amounts of flaxseed meal, you could develop cyanide toxicity, but this hasn't, to my knowledge, ever occurred in humans," says Low Dog.
FEVERFEW (Tancetum parthenium) BEST FOR: Migraines

Nearly three times as many women as men experience migraines, according to the National Headache Foundation. Feverfew may help relieve the nausea and vomiting associated with these debilitating headaches and/or reduce the need for traditional prophylactic pharmaceuticals, according to Mark Blumenthal, executive director of the American Botanical Council in Austin, Texas. The active agent in feverfew is parthenolide, which may lessen the frequency of headaches in migraine sufferers by reducing inflammation and inhibiting vasoconstriction, according to the NIH; however, more research is needed.

HOW TO TAKE IT Blumenthal recommends 100 to 150 milligrams of dried leaves or 2½ fresh leaves daily (with food or after eating). A recent randomized double-blind placebo-controlled German study of 170 patients published in the European journal Cephalalgia found that a feverfew extract could help cut the frequency of migraines in half. Blumenthal notes, however, that more research is needed to confirm these findings. It may take four to six weeks to see an effect.

SAFETY ISSUES Blumenthal recommends that pregnant women and anyone taking a blood thinner steer clear of feverfew. If you're allergic to ragweed (a member of the feverfew family), marigolds, or chrysanthemums, it's also wise to stay away. (In the German study, some subjects reported mouth ulcerations as a side effect.) Finally, feverfew may also increase the risk of sun sensitivity caused by prescription medications like Retin A.
TURMERIC (Curcuma longa) BEST UP-AND-COMER

Curcuminoids, the active compounds that give the spice turmeric its bright-gold color, has long been known as an anti-inflammatory and antioxidant, says Bharat B. Aggarwal, Ph.D., the Ransom Home Jr. Distinguished Professor of Cancer Research at M.D. Anderson Cancer Center in Houston. For women with recurrent breast cancer, curcumin might prove especially useful, says Aggarwal. "We've shown in animal models that curcumin may help prevent metastasis, even after failed treatment with the drug tamoxifen," he says. In women with HER-2 receptor-positive cancer, curcuminoids also seem to behave much like the highly successful chemotherapy drug Herceptin, although research is highly preliminary.

HOW TO TAKE IT At this stage of the research, it's best to get your curcumin by using turmeric in curries and other foods. If you aren't a fan of Indian food, Aggarwal advises taking one 500-milligram capsule of curcumin — standardized to 95 percent curcuminoids, such as Sabinsa's CB Complex — each day.

SAFETY ISSUES Side effects are uncommon but include flatulence, diarrhea, and heartburn. Aggarwal suggests forgoing turmeric if you're taking blood thinners.
GREEN TEA (Camellia sinensis) BEST FOR: Cancer prevention

Although the Food and Drug Administration recently rejected a health claim for green tea, health professionals aren't so quick to ignore the growing body of research that suggests drinking this Asian staple may help ward off cancer. According to the American Cancer Society, many lab studies in cell cultures and animals have shown that green tea has chemopreventive properties. In 2005, two meta-analyses, one published in the journal Carcinogenesis and the other published in Integrated Cancer Therapies, found that green tea consumption may prevent the growth of breast cancer tumors, especially in the early stages. And the most recent laboratory study, conducted in China and published in the September 2006 issue of the journal Frontiers in Bioscience, found that the main constituent of green tea, an antioxidant called epigallocatechin gallate (EGCG), induced breast cancer cells to self-destruct.

EGCG may work by blocking the growth of blood vessels into tumors, thus starving them of nutrients. At the American Institute for Cancer Research (AICR) Winter 2006 Conference, researchers also noted that EGCG seems to bind to a specific protein that is present in every cell of the body and prevent it from passing on signals that start the cancer-development process. (Cancer cells tend to have higher levels of this protein than do other cells, according to AICR.)

HOW TO TAKE IT Drink 6 to 10 cups of organic green tea a day, suggests Christine Horner, M.D., author of Waking the Warrior Goddess: Dr. Christine Homer's Program to Protect Against and Fight Breast Cancer (Basic Health, 2005). Also, choose caffeinated, unless you are pregnant or must otherwise limit your intake of caffeine. (A cup of green tea contains 20 milligrams, about a quarter of the amount in coffee.) "Some research has found that removing the caffeine reduces the chemoprotective potential," says Horner.

SAFETY ISSUES If you are pregnant or breast-feeding, discuss caffeine-consumption limitations with your doctor. Otherwise, brew away.
GINGER (Zingiber officinale) BEST FOR: Nausea

Whether your queasy stomach is caused by PMS, pregnancy-related morning sickness, or an upcoming visit from the in-laws, ginger can most likely help. A 2005 review of six double-blind randomized controlled clinical trials published in the journal Obstetrics & Gynecology concluded that ginger was an effective treatment for nausea and vomiting during pregnancy. It may also treat nausea brought on by anesthesia, motion, and chemotherapy, but research is less conclusive, according to the NIH.

HOW TO TAKE IT Low Dog recommends taking dried ginger for the best effects. "Stick with 250 milligrams, four times a day." Cooking with the herb may also be helpful.

SAFETY ISSUES Few side effects are linked to normal ginger consumption, but powdered ginger may produce bloating or indigestion. Ginger may also exacerbate heart-burn in pregnant women.

PHOTO (COLOR): black cohosh

PHOTO (COLOR): cranberry

PHOTO (COLOR): chaste tree berry

PHOTO (COLOR): dong quai

PHOTO (COLOR): flaxseed

PHOTO (COLOR): feverfew

PHOTO (COLOR): turmeric

PHOTO (COLOR): green tea

PHOTO (COLOR): ginger

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By Lorie Parch

Photographs by Jack Miskell

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