Herbal Medicine for Hormonal Imbalance, PCOS & Menopause

Hormonal Conditions We Commonly Support

• Polycystic ovary syndrome (PCOS) — irregular periods, excess androgens, insulin resistance
• PMS and PMDD — mood swings, bloating, breast tenderness in the luteal phase
• Perimenopause and menopause — hot flushes, night sweats, mood changes, brain fog
• Endometriosis — pain management and anti-inflammatory support
• Irregular or painful periods
• Hormonal acne
• Low libido
• Thyroid dysfunction — as complementary support alongside conventional management

Key Herbs for Hormonal Balance

• Vitex Agnus-Castus (Chaste Tree Berry)The most widely studied herb for female hormonal conditions. Vitex works on the pituitary gland, increasing LH secretion relative to FSH to stimulate progesterone production. Multiple RCTs demonstrate efficacy for PMS — including both physical symptoms (breast tenderness) and psychological symptoms (irritability, mood).
• Black Cohosh (Actaea racemosa)The best-evidenced herbal treatment for menopausal symptoms. Acknowledged by the North American Menopause Society (NAMS) as a reasonable option for mild-to-moderate menopausal symptoms. Does not act via oestrogen receptors — relevant for women who cannot use HRT.
• Peony & Liquorice (Paeonia lactiflora + Glycyrrhiza glabra)The combination known as Shakuyaku-kanzo-to has clinical trial evidence for PCOS. It reduces testosterone levels and LH:FSH ratios, and in studies helped restore ovulation in women with anovulatory PCOS.
• Dong Quai (Angelica sinensis)A foundational herb in Chinese medicine for menstrual irregularity, amenorrhoea, and menopausal symptoms. Used to regulate the menstrual cycle and address “blood deficiency” patterns.
• Saw Palmetto (Serenoa repens)Used in PCOS and hormonal acne where there is elevated DHT. Saw palmetto inhibits 5-alpha reductase, reducing conversion of testosterone to DHT.
• Rhodiola & AshwagandhaAdaptogenic herbs that normalise cortisol output and support adrenal function — critical since adrenal cortisol production directly affects sex hormone regulation.

PCOS: A Closer Look

PCOS affects approximately 1 in 10 women of reproductive age in the UK. The underlying mechanism is heterogeneous — insulin resistance plays a central role in the majority of cases, driving elevated androgens, disrupted ovulation, and the characteristic polycystic ovarian morphology.

A herbal and nutritional approach to PCOS addresses insulin signalling (with herbs like berberine-containing plants and cinnamon), reduces androgen excess (with peony-liquorice, saw palmetto), supports ovulation (with vitex), and addresses the stress and adrenal burden that often underlies the condition.

Menopause: Evidence-Based Herbal Support

The evidence base for herbal medicine in menopause is substantial. Black cohosh is the most studied, but a combination approach — addressing vasomotor symptoms, mood, sleep, and bone health — often produces better results than any single herb. For women who cannot use HRT, or who prefer a complementary approach, herbal medicine offers a well-evidenced, individualised option.

What Your Consultation Involves

• Full menstrual or menopausal history
• Symptom timing and cyclical patterns
• Relevant blood work (oestrogen, progesterone, LH/FSH, testosterone, thyroid, insulin/HbA1c)
• Gut health — the gut microbiome plays a significant role in oestrogen recycling
• Adrenal function and stress load
• Current medications and contraceptives (for interaction screening)