Key Takeaways
Understanding herbal remedies for menopause requires balancing potential benefits with safety considerations, as these natural alternatives aren't regulated like conventional medicines.
• Look for THR certification marks when buying herbal remedies - these indicate products meet UK safety and quality standards from the MHRA.
• Sage and St John's wort show strongest evidence for menopause symptoms, while dong quai and evening primrose oil lack compelling research support.
• Start one herb at a time and track symptoms for 90 days to identify what works, as individual responses vary significantly.
• Consult your GP before starting any herbal remedy, especially if taking medications - St John's wort alone interacts with numerous drugs.
• Stop all herbal remedies 14 days before surgery as they can interfere with anesthesia, blood clotting, and increase bleeding risks.
While 40% of UK women use complementary therapies for menopause, remember that "natural" doesn't guarantee safety or effectiveness. The Menopause Society confirms no herbal supplements are considered definitively effective for menopause treatment, though some may provide modest symptom relief when used safely under professional guidance.
Herbal remedies for menopause have gained traction among UK women, with around 40% using complementary treatments for their symptoms32. Hormone replacement therapy differs from these herbs for menopause because they are not tested or regulated in the same way as conventional medicines. This raises questions about their safety and effectiveness2. Natural herbs menopause products, such as black cohosh and red clover, contain plant hormones that may help with hot flushes and other symptoms. Yet menopause herbal supplements remain unmonitored. This piece gets into the evidence, safety considerations and regulatory landscape surrounding herbal options available in the UK.
Understanding Herbal Remedies for Menopause in the UK
The terminology surrounding herbal remedies for menopause often creates confusion among women seeking HRT alternatives. Women can make informed choices about their menopause treatment options when they understand what these products are and how they're regulated.
What are herbal remedies and how do they differ from supplements
Products with active ingredients made from plant parts such as leaves, roots, or flowers are herbal remedies. An herbal substance has plants, algae, fungi, or lichen, defined by the botanical name and plant part used, either fresh or dried. These substances become herbal preparations when they undergo extraction, distillation, or concentration33.
The difference between menopause herbal supplements and herbal medicines lies in their intended purpose and permitted claims. Herbal medicines can make specific medicinal claims about treating conditions, while supplements are designed to complement a normal diet and deliver a benefit34. Food supplements cannot make medicinal claims in the UK. Otherwise they're viewed as medicines. A product containing black cohosh with THR registration can state it relieves symptoms of menopause such as hot flushes and night sweats, based on traditional use34.
Herbal remedies will affect the body. They can be harmful if not used correctly1. Being 'natural' doesn't mean they're safe. Health shops sell a variety of products, but they're not tested and regulated the same way as conventional HRT menopause treatments2.
UK regulation: THR marks and MHRA approval
The Medicines and Healthcare products Regulatory Agency grants Traditional Herbal Registration to products meeting specific standards. A THR is granted only if the medicine treats minor health conditions where medical supervision isn't required33. Products claiming to treat major health conditions require a marketing authorization.
Companies must submit scientific evidence relating to safety, quality, and traditional use. This has a technical dossier covering herbal ingredient quality, a safety review by a registered doctor, pharmacist, or scientifically qualified individual, and draft product characteristics33. The herbal medicinal product must have been used traditionally for a minimum of 30 years, with at least 15 years of use in the EU/EEA for UK or Northern Ireland products33.
The MHRA takes 210 days to review applications when all required documents are valid33. Products meeting these standards receive the THR Certification Mark on packaging and leaflets34.
The THR mark shows a product meets required standards for safety, quality, and patient information34. THR products are intended for self-medicated conditions, not serious health issues, while this provides some assurance. Claims made for THR products are based on traditional usage rather than evidence of effectiveness1. A THR mark doesn't mean the product is safe for everyone to take1.
Not all herbal remedies are regulated. Remedies specially prepared if you have specific needs don't need a license, and those manufactured outside the UK may not be subject to regulation1. Medical herbalists prescribe practitioner-grade medicines from their own dispensaries18.
Who should think over herbal remedies
Certain groups should be wary of taking herbs for menopause, especially when you have other health conditions. Taking a herbal medicine may not be suitable for:
- People taking other medicines and hormonal contraceptives
- People with serious health conditions such as liver or kidney disease
- People scheduled for surgery
- Pregnant or breastfeeding women
- Elderly people and children1
Women with breast cancer, liver problems, or high blood pressure shouldn't take black cohosh due to lack of research on how it affects them3. Some herbal medicines might interfere with anesthesia and medicines used during procedures1. Others may interfere with blood clotting and blood pressure, increasing bleeding risk during surgery.
Doctors may advise stopping herbal medicines during weeks leading up to operations1. Women should tell their GP about any complementary therapies they're taking, as they may make other medicines less effective or cause unexpected side effects1.
Prevalence of herbal remedy use among UK women
One in four postmenopausal women reported ever-use of complementary therapies for menopausal symptom relief, with 25.1% (22,206 out of 88,430) using one or more approaches35. Herbal remedies were most chosen among women using complementary therapies, with 43.8% (9,725 out of 22,206) selecting natural herbs menopause products35.
The prevalence across all responders showed 11.0% (9,725 out of 88,430) used herbal remedies35. Of women who discontinued hormone therapy, 70.4% of 5,060 women used plant remedies, with evening primrose oil at 48.6% and black cohosh at 30.3% being most used36.
Research indicates 80% of postmenopausal women in the United States and United Kingdom use herbal medicine, and 60% to 70% believe these menopause herbal supplements eliminate their problems and are safe without side effects37. Among women reporting complementary therapy use, 57.6% indicated they had used only one type of therapy, with herbal remedies being most selected (3,965)35.
Red clover and other phytoestrogens were used by 21.6% of women reporting complementary approaches35. The growing preference for NHS menopause services alongside herbal options reflects women's desire for multiple menopause treatment pathways during their life after menopause transition.
Top Herbal Remedies for Menopause Symptoms
Research into herbs for menopause reveals varying levels of scientific support. Some show promise while others lack compelling evidence. Women seeking HRT alternatives need to understand which menopause herbal supplements have showed benefit in clinical trials.
Black cohosh for hot flushes and mood
Black cohosh menopause research produces contradictory findings. Most studies indicate that extract of black cohosh (Actaea racemosa L.) improves menopause-related symptoms, though trials had methodologic shortcomings38. A meta-analysis with four randomized clinical trials found three of the four trials showed black cohosh helpful in treating menopausal symptoms. The extract proved effective for reducing hot flushes and night sweats39.
Black cohosh appears to work through serotonergic rather than estrogenic pathways. This makes it suitable for breast cancer patients taking tamoxifen39. A 2023 study found black cohosh extract improved menopause symptoms compared to placebo, but did not decrease anxiety or depression by much40. Adverse effects remain rare but include mild nausea, upset stomach and skin rashes40. Four case reports of possible hepatotoxicity have been published. Previous safety reviews suggest adverse events are rare when used the right way38.
Red clover for hot flushes and bone health
Red clover menopause supplements contain isoflavones that function like estrogen. Clinical data from five controlled trials assessing semipurified isoflavone red clover leaf extracts showed contradictory results for reducing hot flush frequency and severity38. The largest study showed no benefit for reducing symptoms for two different red clover isoflavone products compared with placebo38.
A 2022 study found fermented red clover reduced vascular inflammation compared to placebo40. A randomized placebo-controlled study with 60 healthy menopausal women found daily red clover extract containing isoflavones had positive effects on bone health41. The femoral neck T-score changed with a mean percentage change in the red clover group of 3.98%41. The red clover group showed a mean percentage change of -1.71% compared to -18.41% in the placebo group for lumbar spine41. No serious side effects have been reported, though mild symptoms like headache and nausea may occur40.
Sage for night sweats and hot flushes
Sage for menopause demonstrates strong evidence. An open, multicenter clinical trial with 71 patients treated with once-daily fresh sage tablets for eight weeks showed results. There was a decrease in total score of intensity-rated hot flushes by 50% within four weeks and by 64% within eight weeks42. The mean number of mild, moderate, severe and very severe flushes decreased by 46%, 62%, 79% and 100% over eight weeks42.
A 2023 review found sage associated with a decrease in hot flush number compared to placebo, though it did not reduce severity43. Sage contains phytoestrogens and has been used to treat sweating and menopausal complaints42. Some sage varieties contain thujone, which can cause vomiting, dizziness and tremors when consumed in excess43. Women should only use thujone-free products43.
St John's wort for mood and mild depression
Research suggests taking St John's wort alone or with black cohosh lessens menopause symptoms such as hot flashes14. Women took one St John's wort tablet three times daily for 12 weeks in a study. Over 75% of participants reported symptoms diminished or disappeared22. A 2008 review of 29 international studies suggested St John's wort may be as effective as different standard prescription antidepressants for major depression of mild to moderate severity44.
St John's wort does not cause side effects at recommended doses. Uncommon effects include anxiety, dry mouth, sensitivity to sunlight, dizziness, stomach upset, headache and fatigue44. The supplement interacts with many medicines and can cause serious side effects14. Combining St John's wort with certain antidepressants can lead to a life-threatening increase in serotonin levels44.
Valerian root for sleep and anxiety
Valerian root addresses sleep after menopause issues by interacting with GABA receptors in the brain22. A high quality study from 2011 examined 100 postmenopausal women experiencing insomnia. Those receiving 530 mg of valerian extract twice daily for four weeks had improved sleep quality compared with placebo45. More, 30% of women in the valerian group experienced sleep improvements, compared with just 4% in the placebo group45.
Research suggests valerian root may help ease anxious feelings that occur in response to stressful situations45. A 2018 study found taking 1,060 mg of valerian per day for two months reduced hot flashes in postmenopausal women45. Side effects remain mild but include digestive upset, headaches, uneasiness, excitability and insomnia40.
Dong quai and evening primrose oil: what the evidence says
Single clinical trials do not support the use of dong quai (Angelica sinensis L.) for improving menopausal symptoms38. Two separate studies using dong quai with other herbs for menopause, including red clover and black cohosh, found hot flashes and night sweats reduced40. Dong quai may have a blood-thinning effect, so its use is discouraged among people taking blood thinners40.
Evening primrose oil shows inconsistent results. A 2018 study found it reduced the severity of hot flashes in women, but a 2021 study found it had no effect on frequency or severity40. Single clinical trials do not support evening primrose seed oil for improving menopausal symptoms38. Short-term use is safe for most adults with mild reported side effects40.
Additional Herbs and Natural Supplements
Beyond the primary herbs for menopause already discussed, several other botanical options address specific symptoms of menopause. These complementary therapies offer targeted support for energy, libido, stress and sleep disturbances.
Ginseng for energy and fatigue
Ginseng research produces contradictory findings. One randomized controlled trial showed Korean red ginseng improved sexual arousal and global health by a lot compared with placebo46. Another trial reported Korean red ginseng's superiority for treating menopause symptoms, whilst a third failed to show any effect on hot flash frequency46. A 2022 study showed ginseng can reduce hot flushes and menopausal symptoms by a lot while improving quality of life47. Most trials suffer from high risk of bias and prevent firm conclusions46.
Maca root for libido and mood
Maca root, a Peruvian plant used for thousands of years, shows promise for menopausal women. Research found gelatinised maca influenced hormone levels by decreasing follicle stimulating hormone and increasing luteinising hormone, estrogen and progesterone6. Maca root may increase testosterone levels and restore sexual function in postmenopausal women with sexual dysfunction6. Some studies show maca doesn't affect hormone levels, yet preliminary research suggests improvement in sex drive compared to placebo48. One study found maca led to improvement in sexual functioning in postmenopausal women, with the herb being well tolerated48. Maca also improved depression symptoms and hot flushes in some postmenopausal women48.
Ashwagandha for stress and anxiety
This Ayurvedic adaptogen shows strong evidence for managing anxiety and menopause symptoms. Studies found ashwagandha reduced stress and anxiety levels, sleeplessness and serum cortisol levels by a lot compared with placebo49. Benefits appeared greater with doses of 500 to 600 mg daily than with lower doses49. Research indicates ashwagandha can improve sleep quality, efficiency and total sleep time49. Among 150 adults with sleep problems, 72% in the ashwagandha group reported improvements versus 29% in placebo49. Pregnant women, people with autoimmune diseases and those with thyroid disorders shouldn't use ashwagandha11.
Chasteberry for irregular periods
Chasteberry (Vitex agnus-castus) works by reducing prolactin production. A 2019 study found Vitex reduced total scores for menopause, anxiety, hot flushes and night sweats by a lot6. Chasteberry contains phytoestrogens and is unsuitable for anyone with hormone-sensitive conditions such as breast or ovarian cancer6.
Hops and passionflower for sleep support
Hops compounds boost GABA production and act as a natural sedative7. Hops contains phytoestrogens that help ease menopausal symptoms7. Passionflower supports sleep after menopause by reducing restlessness and anxiety through its effect on the central nervous system7.
Combination formulas available in UK
Menopause supplements combining multiple herbs offer synergistic benefits. Products like soy isoflavones with magnesium and hibiscus provide support across menopause treatment stages12. Combination formulas of hops, valerian and passionflower prove safe and work well for sleep onset and duration13. Women can take sage for menopause among other HRT alternatives if symptoms remain troublesome12.
Safety and Drug Interactions: What You Must Know
Just like conventional medicines, herbal remedies for menopause will have an effect on the body and can be harmful if not used the right way1. Women who are learning about HRT alternatives must understand what risks exist before starting any menopause herbal supplements.
Critical drug interactions with St John's wort
St John's wort interacts with many medications and makes it unsuitable for many women. The herb reduces the effectiveness of contraceptives and causes breakthrough bleeding or unplanned pregnancy14. It interferes with blood thinners like warfarin and antidepressants (risking serotonin syndrome). It also affects chemotherapy drugs, immunosuppressants, statins, digoxin and HIV medications144. Past Yellow Card reports identified interactions between St John's wort and other medicines5. Women who take prescription medications should consult their GP before using this complementary therapy.
Blood thinning concerns with red clover and dong quai
Red clover and dong quai contain coumarin-like substances that may interact with anticoagulants and cause bleeding15. Dong quai might slow blood clotting and increase the risk of bruising and bleeding16. Women who take blood thinners should avoid these herbs for menopause17.
Pre-surgery guidelines for herbal remedies
Stop taking natural herbs menopause products 14 days before surgery8. Herbal medicines might interfere with anesthesia, blood clotting and blood pressure. This increases bleeding risk during procedures15. CBD oil, Echinacea, Garlic, Ginkgo, Ginseng, St John's wort and Valerian should be discontinued at least seven days before surgery9.
Herbs to avoid with hormone-sensitive cancers
Dong quai may worsen hormone-sensitive cancers like breast or prostate cancer17. But current research suggests phytoestrogens may bind to beta receptors rather than alpha receptors and reduce breast cancer recurrence18.
Liver health and herbal safety
Black cohosh has been associated with liver reactions. The UK received 21 reports, and 14 cases support an association between black cohosh and hepatotoxicity. One case required liver transplantation19. Women should report suspected adverse reactions through the Yellow Card Scheme5.
Quality concerns and identifying safe products
Unlicensed herbal products manufactured outside the UK may contain illegal substances, toxic herbs and banned ingredients not listed on packaging2021. Women seeking NHS menopause services alongside menopause supplements should only purchase products with THR marks. Products used for slimming or sexual health have been found to contain dangerous unlisted ingredients5.
How to Use Herbal Remedies Safely and Effectively
Implementing herbal remedies for menopause requires a structured approach. Don't just select multiple products at random. [Menopause supplements](https://goldmanlaboratories.com/blogs/blog/menopause-supplements) work differently for each person based on genetics, health status, symptom severity, medical history and current medications22.
Starting one herb at a time
Women should introduce a single complementary therapy before adding others. This approach identifies which remedy addresses specific symptoms like hot flushes, night sweats or anxiety.
Recommended trial periods and dosages
Changes won't happen overnight. Women need to take [herbs for menopause](https://goldmanlaboratories.com/blogs/blog/HRT-[alternatives](https://goldmanlaboratories.com/fr/blogs/blog/natural-remedies-male-for-male-andropause-low-testosterone) for extended periods. Relief isn't like flicking a switch23. Symptoms and their easing remain general, and you'll need patience to notice gradual improvements23.
Keeping a symptom diary
A 90-day tracking journal helps identify patterns. You can understand how diet and lifestyle affect mood swings and sleep after menopause24. Daily journaling prepares women for appointments with doctors and nutritionists. This avoids wasteful menopause treatment attempts24.
Telling your GP what you're taking
Women should consult their GP or pharmacist before starting natural herbs menopause products2. Never rely on herbal remedies instead of proper medical care25.
Where to buy quality products in the UK
Purchase products with THR marks from pharmacies rather than unregulated sources. Quality, purity and ingredients can't always be guaranteed2, especially from overseas suppliers.
Herbal Remedies vs HRT: Making the Right Choice
Your choice between HRT menopause options and herbal remedies for menopause depends on individual health profiles and symptoms of menopause severity.
When herbal remedies may be appropriate
HRT alternatives suit women with breast cancer history, as doctors don't recommend HRT for those with hormone-sensitive conditions26. Women who experience mild hot flushes or prefer complementary therapies may choose natural herbs menopause products.
Realistic expectations and effectiveness
The Menopause Society's 2023 position statement confirms no dietary supplements or herbal remedies for menopause are considered to work for menopause treatment27. Placebo responses reduce hot flushes by 30%, even when measured with objective methods27. HRT has been shown to help ease mood swings during menopause and vasomotor symptoms in contrast28.
Cost comparison in the UK
HRT proves budget-friendly at £580 per QALY for women with intact uterus and £205 for hysterectomized women, falling far below UK thresholds29. Menopause herbal supplements vary in price without guaranteed effectiveness.
How to combine herbs with HRT safely
St John's wort may stop HRT tablets working as intended30. Most vitamins and minerals combine with HRT without issue, provided you follow safe dosages10. Women should consult NHS menopause services before they combine phytoestrogens menopause products with HRT, as excess estrogen may result31.
Conclusion
Herbal remedies for menopause offer UK women alternatives with varying levels of evidence behind them. Sage and St John's wort demonstrate the strongest research support. Others like dong quai and evening primrose oil show limited benefit. Women should prioritize safety by purchasing products with THR marks and consulting healthcare professionals before starting any complementary therapy. They must maintain realistic expectations about effectiveness. Natural doesn't mean safe or effective automatically. The right choice depends on individual health circumstances and careful thinking over what drug interactions mean. Women deserve evidence-based information to make informed decisions about their menopausal experience.
FAQs
Q1. Which herbal remedies are recommended by the NHS for menopause symptoms? The NHS acknowledges that health shops sell herbal products like evening primrose oil, black cohosh, angelica, and ginseng for menopausal symptoms. However, it's important to speak with your pharmacist or GP before trying any herbal remedies, as "natural" doesn't automatically mean a treatment is safe or effective. These products aren't tested and regulated in the same way as conventional medicines.
Q2. Is hormone replacement therapy (HRT) considered the safest menopause treatment? HRT is recognized as a safe and effective treatment for most women going through menopause and perimenopause. It works by using estrogen to replace your body's declining hormone levels. Your GP will discuss any individual risks with you to ensure it's appropriate for your specific health circumstances.
Q3. How long should I try a herbal remedy before expecting results? Herbal remedies require patience, as changes won't happen overnight. You should take them for extended periods to notice gradual improvements—relief isn't like flicking a switch. It's recommended to try one herb at a time for at least 90 days while keeping a symptom diary to track any changes.
Q4. Can I take herbal remedies alongside HRT safely? Most vitamins and minerals can be combined with HRT without issue when taken at safe dosages. However, St John's wort may interfere with HRT effectiveness, and combining phytoestrogen supplements with HRT could result in excess estrogen. Always consult your GP or NHS menopause services before combining treatments.
Q5. What safety precautions should I take when using herbal menopause remedies? Look for products with THR (Traditional Herbal Registration) marks, which indicate they meet UK safety standards. Stop all herbal remedies at least 14 days before any surgery, as they can interfere with anesthesia and increase bleeding risk. Always inform your GP about any herbal products you're taking, especially if you're on other medications, as serious drug interactions can occur.
References
[1] - https://www.nhs.uk/tests-and-treatments/herbal-medicines/
[2] - https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/alternatives-to-hormone-replacement-therapy-hrt/herbal-remedies-and-complementary-medicines-for-menopause-symptoms/
[3] - https://www.drlouisenewson.co.uk/knowledge/do-i-need-supplements-during-menopause
[4] - https://my.clevelandclinic.org/health/drugs/9304-st--johns-wort
[5] - https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/complementary-medicine/herbal-medicines/
[6] - https://www.forthwithlife.co.uk/blog/natural-remedies-for-the-menopause/
[7] - https://themenopauseco.com/blogs/learn/natural-menopause-sleep-aid?srsltid=AfmBOopXhrXecK3JmGNOlZZD1dYj3sd061J5w8MuWrvMmNrvH9TqAYie
[8] - https://www.avogel.co.uk/img-uk/information-download/menopause-booklet.pdf?m=1340794124&
[9] - https://utswmed.org/medblog/supplements-before-surgery-anesthesia/
[10] - https://arella-beauty.co.uk/blogs/menopause/can-you-take-menopause-supplements-with-hrt
[11] - https://drsarahbonza.medium.com/how-ashwagandha-can-help-your-symptoms-during-perimenopause-and-menopause-19dd3e59a248
[12] - https://www.avogel.co.uk/herbal-remedies/soy-isoflavones/
[13] - https://www.psychologytoday.com/gb/blog/rhythms-of-recovery/201707/how-the-3-sisters-of-sleep-can-help
[14] - https://www.mayoclinic.org/drugs-supplements-st-johns-wort/art-20362212
[15] - https://www.peacehealth.org/medical-topics/id/hn-10001008
[16] - https://www.webmd.com/vitamins/ai/ingredientmono-936/dong-quai
[17] - https://www.mskcc.org/cancer-care/integrative-medicine/herbs/dong-quai
[18] - https://menopauseandcancer.org/herbal-medicine-for-menopause-after-cancer-current-research/
[19] - https://assets.publishing.service.gov.uk/media/5df7610ce5274a08f78bca34/Black_cohosh_and_liver_injury.pdf
[20] - https://www.cancerresearchuk.org/about-cancer/treatment/complementary-alternative-therapies/individual-therapies/herbal-medicine
[21] - https://www.gov.uk/drug-safety-update/herbal-products-safety-update
[22] - https://www.menopausecare.co.uk/blog/herbal-remedies-for-menopause
[23] - https://hexi.ox.ac.uk/menopause/complementary-therapies-for-menopausal-symptoms
[24] - https://viridian-nutrition.com/products/the-menopause-journal
[25] - https://www.hollandandbarrett.com/the-health-hub/conditions/womens-health/menopause/best-natural-menopause-cures/
[26] - https://www.bbc.co.uk/programmes/articles/23S9Q66Jrl5lsJwtrnfycFL/are-there-natural-alternatives-to-hrt
[27] - https://www.health.harvard.edu/womens-health/menopause-supplements-effective-relief-or-empty-promises
[28] - https://pmc.ncbi.nlm.nih.gov/articles/PMC5783135/
[29] - https://www.researchgate.net/publication/24035292_Cost-effectiveness_of_hormone_replacement_therapy_for_menopausal_symptoms_in_the_UK
[30] - https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/continuous-combined-hormone-replacement-therapy-hrt-tablets-capsules-and-patches/taking-continuous-combined-hrt-with-other-medicines-and-herbal-supplements/
[31] - https://ie.kollohealth.com/blogs/news/can-i-take-menopause-supplements-with-hrt-essential-to-consider
[32] - https://dtb.bmj.com/content/47/1/2
[33] - https://www.gov.uk/guidance/apply-for-a-traditional-herbal-registration-thr
[34] - https://futureyouhealth.com/blogs/knowledge-centre/traditional-herbal-medicines
[35] - https://www.tandfonline.com/doi/full/10.1080/13697137.2017.1301919
[36] - https://www.sciencedirect.com/science/article/abs/pii/S0965229919300214
[37] - https://pmc.ncbi.nlm.nih.gov/articles/PMC7491766/
[38] - https://www.sciencedirect.com/science/article/pii/S0002934305009666
[39] - https://pmc.ncbi.nlm.nih.gov/articles/PMC11100637/
[40] - https://www.healthline.com/nutrition/menopause-herbs
[41] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4523657/
[42] - https://pubmed.ncbi.nlm.nih.gov/21630133/
[43] - https://www.healthline.com/health/sage-for-menopause
[44] - https://www.nccih.nih.gov/health/st-johns-wort-and-depression-in-depth
[45] - https://www.healthline.com/nutrition/valerian-root
[46] - https://pmc.ncbi.nlm.nih.gov/articles/PMC3659624/
[47] - https://www.sciencedirect.com/science/article/pii/S1744388122000834
[48] - https://www.texaschildrens.org/content/wellness/maca-root-viagra-for-menopausal-women
[49] - https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/
