The Effect of Herbal Medicines on Treatment of Hot Flashes in Postmenopausal Women: A Systematic Review and Meta-Analysis

Document Type : Review Article


1 Assistant professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 M.Sc. of Midwifery, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Assistant professor, Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


Introduction: Vasomotor symptoms during menopause occur on average in 75% of women. Hot flashes are the most common of these symptoms. Hormonal drugs  are the most effective method of treatment. Due to the known risks of hormone therapy, many researchers have investigated the effect of herbal medicines to improve vasomotor symptoms, especially hot flashes. This study was performed with aim to investigate the clinical trial studies conducted on the effectiveness of various herbal medicines on hot flashes.
 Methods: In this study, to find the related articles, databases of Google scholar, Scopus, PubMed, Web of science, Science direct and national databases such as (MagIran), (SID), (IranDoc) and (IranMedex) were searched from the beginning of January 2005 to January 2020. Data were combined using STATA software (version 12.2) and using meta-analysis method, random effects model.
Results: In the present study, 11 clinical trials were included in the meta-analysis according to the inclusion criteria.In the medicinal plants group, mean reduction in the number of hot flushes was 2.41 times (95% CI: -1.56 to -3.27%) less than the control group, which was statistically significant (p<0.05).In addition, in the medicinal plants group, the intensity of hot flashes was 20.28 degrees (95% CI: -71.70 to -22.87) compared to the control group, and this difference was statistically significant (p<0.05).
Conclusion: Medicinal plants containing phytoestrogens have good effects on reducing the frequency and intensity of hot flashes in menopausal women and can be a suitable treatment for hot flashes in menopausal women.


  1. Aidelsburger P, Schauer S, Grabein K, Wasem J. Alternative methods for the treatment of post-menopausal troubles. GMS health technology assessment 2012; 8.
  2. Ziaei S, Kazemnejad A, Zareai M. The effect of vitamin E on hot flashes in menopausal women. Gynecologic and obstetric investigation 2007; 64(4):204-7.
  3. Gold EB, Block G, Crawford S, Lachance L, FitzGerald G, Miracle H, et al. Lifestyle and demographic factors in relation to vasomotor symptoms: baseline results from the Study of Women’s Health Across the Nation. American journal of epidemiology 2004; 159(12):1189-99.
  4. Speroff L, Fritz MA, editors. Clinical gynecologic endocrinology and infertility. lippincott Williams & wilkins; 2005.
  5. Penotti M, Fabio E, Modena AB, Rinaldi M, Omodei U, Viganó P. Effect of soy-derived isoflavones on hot flushes, endometrial thickness, and the pulsatility index of the uterine and cerebral arteries. Fertility and sterility 2003; 79(5):1112-7.
  6. Moghadam R, Ozgoli G, Molayi B, Majid H, Soori H, Ghanati K. Effect of omega3 on vasomotor disorders in menopausal women. Journal of Arak University of Medical Sciences 2012; 15(1):116-26.
  7. Menati L, Khaleghinezhad K, Tadayon M, Siahpoosh A. Evaluation of contextual and demographic factors on licorice effects on reducing hot flashes in postmenopause women. Health care for women international 2014; 35(1):87-99.
  8. Reed SD, Ludman EJ, Newton KM, Grothaus LC, LaCroix AZ, Nekhlyudov L, et al. Depressive symptoms and menopausal burden in the midlife. Maturitas 2009; 62(3):306-10.
  9. Stahl SM. Vasomotor symptoms and depression in women, part I. Role of vasomotor symptoms in signaling the onset or relapse of a major depressive episode. J Clin Psychiatry 2009; 70(1):11-2.
  10. Dalal S, Zhukovsky DS. Pathophysiology and management of hot flashes. The journal of supportive oncology 2006; 4(7):315-20.
  11. Stearns V, Ullmer L, Lopez JF, Smith Y, Isaacs C, Hayes DF. Hot flushes. The Lancet 2002; 360(9348):1851-61.
  12. Taghizadeh Z, Rezaeipour A, Kazemnejad A, Mirsaeidi Z. The study of the effect of vitex agnus-castus on the early menopausal complications in menopaused women. Hayat 2006; 12(1):67-76.
  13. Albertazzi P. Noradrenergic and serotonergic modulation to treat vasomotor symptoms. British Menopause Society Journal 2006; 12(1):7-11.
  14. Guttuso Jr T, Kurlan R, McDermott MP, Kieburtz K. Gabapentin’s effects on hot flashes in postmenopausal women: a randomized controlled trial. Obstetrics & Gynecology 2003; 101(2):337-45.
  15. Elkind-Hirsch K. Cooling off hot flashes: uncoupling of the circadian pattern of core body temperature and hot flash frequency in breast cancer survivors. Menopause 2004; 11(4):369-71.
  16. Newton KM, Reed SD, LaCroix AZ, Grothaus LC, Ehrlich K, Guiltinan J. Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Annals of internal medicine 2006; 145(12):869-79.
  17. Andrikoula M, Prelevic G. Menopausal hot flushes revisited. Climacteric 2009; 12(1):3-15.
  18. Mirabi P, Mojab F. The effects of valerian root on hot flashes in menopausal women. Iranian journal of pharmaceutical research 2013; 12(1):217.
  19. Nahidi F, Kariman N, Simbar M, Mojab F. The study on the effects of Pimpinella anisum on relief and recurrence of menopausal hot flashes. Iranian journal of pharmaceutical research 2012; 11(4):1079.
  20. Shahnazi M, Nahaee J, Mohammad-Alizadeh-Charandabi S, Bayatipayan S. Effect of black cohosh (cimicifuga racemosa) on vasomotor symptoms in postmenopausal women: a randomized clinical trial. Journal of caring sciences 2013; 2(2):105.
  21. da Silva Andrade DC, Carmona F, Angelucci MA, Martinez EZ, Pereira AM. Efficacy of a Homeopathic medicine of capsicum frutescens L.(Solanaceae) in the treatment of hot flashes in menopausal women: A phase-2 randomized controlled trial. Homeopathy 2019; 108(02):102-7.
  22. Nahidi F, Zare E, Mojab F, Alavi-Majd H. Effects of licorice on relief and recurrence of menopausal hot flashes. Iranian journal of pharmaceutical research: IJPR 2012; 11(2):541.
  23. Motaghi Dastenaei B, Safdari F, Jafarzadeh L, Raisi Dehkordi Z, Taghizadeh M, Nikzad M. The effect of Evening Primrose on hot flashes in menopausal women. Iran J Obstet Gynecol Infertil 2017; 20(10):62-8.
  24. Nahidi F, Zare E, Mojab F, Alavi MH. The effect of Licorice root extract on hot flashes in menopause. Pejouhandeh: Bimonthly Research Journal 2011; 16(1):11-17
  25. Abdolahi F, Azadbakht M, Shabankhani B, Rezaie Abhari F, Moslemizadeh N. Effect of aqueous Glycyrrhza globra extract on menopausal symptoms. Journal of Mazandaran University of Medical Sciences 2007; 16(56):75-82.
  26. Nahidi F, Taherpour M, Mojab F. Effects of Anise abstract on menopausal hot flashes. Pajoohandeh Journal 2008; 13(3):167-73.
  27. Baghdari N, Akbari A, Ayati S, Emami A, Esmaeili H. Effect of powder of flaxseed on hot flashes in women at the climacteric. Iran J Obstet, Gynecol Infertil 2011;14(1):37-47.
  28. Sekhavat L, Dehghani Firouzabadi R. Effect of soya protein on symptoms of hot flash in menopausal women in Yazd, Iran. Iran J Obstet, Gynecol Infertil 2012; 15(6):10-15.
  29. Menati L, Siyahposh A, Tadayon M. Clinical evaluation of the effect of liquorice plant Brgrgrftgy postmenopausal women in a randomized, double-blind comparison with hormone therapy. Medical Journal of medical university of ahvaz 2011; 9(2):157-67.
  30. Kazemian A, Banaian S, Parvin N, Delaram M. The effect of valerian on hot flash in menopausal women. Journal of Shahrekord Uuniversity of Medical Sciences. 2006; 8(2):35-40.
  31. Taghizadeh Z, Rezaeipur A, Kazemnejad A, Mirsaeidi Z. Effect of Vitex agnus on Premature Menopause Symptoms. Hayat: J Facult Nurs Midwif Tehran Univ Med Sci 2006; 12(1):67-76.
  32. Boroomandfar KH, Kazemiyan A, Safdari F, Delaram M, Nooriyan K. Effect of Vitex on hot flash of menopausal women referred to health center of Isfahan. Journal of Birjand University of Medical Sciences 2007; 14(03).
  33. Jenabi E, Shobeiri F, Hazavehei SM, Roshanaei G. The effect of Valerian on the severity and frequency of hot flashes: a triple-blind randomized clinical trial. Women & health 2018; 58(3):297-304.
  34. Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database of Systematic Reviews 2012(9).
  35. Kleijnen J. Evening primrose oil. BMJ 1994; 309(6958):824-5.
  36. Brzezinski A, Adlercreutz H, Shaoul R, Rosier A, Shmueli A, Tanos V, Schenker JG. Short-term effects of phytoestrogen-rich diet on postmenopausal women. Menopause 1997; 4(2):89-94.
  37. Brooks JD, Ward WE, Lewis JE, Hilditch J, Nickell L, Wong E, et al. Supplementation with flaxseed alters estrogen metabolism in postmenopausal women to a greater extent than does supplementation with an equal amount of soy. The American journal of clinical nutrition 2004; 79(2):318-25.
  38. Abdnezhad R, Simbar M. A review of the effective herbal medicines on hot flashes in menopausal women. Iran J Obstet Gynecol Infertil 2020; 23(8):107-19.
  39. Ghazanfarpour M, Sadeghi R, Abdolahian S, Roudsari RL. The efficacy of Iranian herbal medicines in alleviating hot flashes: A systematic review. International Journal of Reproductive BioMedicine 2016; 14(3):155.
  40. Heydari L, Suhrabi Z, Sayehmiri F, Sayehmiri K. Effect of herbaceous medicines effective in hot flashes of menopause women: a systematic review and meta-analysis in Iran. Iran J Obstet Gynecol Infertil 2014; 17(109):16-25.
  41. Ernst E. The efficacy of herbal medicine–an overview. Fundamental & clinical pharmacology 2005; 19(4):405-9.
  42. Hamilton JL, Roemheld-Hamm B, Young DM, Jalba M, DiCicco-Bloom B. Complementary and alternative medicine in US family medicine practices: a pilot qualitative study. Alternative Therapies in Health & Medicine 2008; 14(3).
  43. Steiner M. Postnatal depression: a few simple questions. Family Practice 2002; 19(5):469-70.
  44. Verhagen AP, De Vet HC, De Bie RA, Kessels AG, Boers M, Bouter LM, et al. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. Journal of clinical epidemiology 1998; 51(12):1235-41.