One of the major issues women struggle with during the menopause transition is insomnia. A recent randomized triple-blind study with 100 postmenopausal women showed a 30% increase in sleep quality in the group that used valerian. In this study, valerian extract 530 mg (standardized to 0.5% - 1% valerenic acids) was given twice a day for 4 weeks. No adverse effects were reported. Valerian root (Valeriana officinalis) is an herb commonly prescribed for insomnia and/or anxiety. Previous results of studies investigating its efficacy as a sleep aid have had mixed results. Usually valerian extract 400-600 mg is prescribed 1-2 hours before bedtime. The root of the plant is used and the concentration of valerenic acids should be about 0.8%. When valerian is used to treat anxiety it is usually given twice a day. Notice that in this insomnia study valerian was given twice daily instead of just bedtime. Of course anxiety can play a key role in insomnia so that may be why it was helpful. It is interesting that the participants did not experience any adverse effects from the day time dose. Most of the medications we use in conventional medicine to treat either insomnia or anxiety have significant side effects especially drowsiness or grogginess after waking. There are a couple of drawbacks to the use of valerian. First, it has a very distinct odor. It is best to take it in a pill form instead of a tea or tincture. Second, it can take 2-4 weeks to get the full benefits of its effects. Third, it is difficult to find a good quality supplement according to ConsumerLabs.com. Only 2 of the 9 products tested met their quality criteria!

 
A randomized trial explores the effect of mindfulness-based stress reduction (MBSR) training on coping with hot flashes and night sweats. A wait-list control design was used to study 110 women who were having at least 5 hot flashes a day during the perimenopausal period. As a result of the training, women experienced less bother from the hot flashes and improvement in quality of life, sleep quality, anxiety and perceived stress. These improvements continued 3 months after the training. Through MBSR training women were encouraged to recognize and discriminate between thoughts, feelings and sensations and to develop nonreactive awareness. MBSR programs have been shown to be helpful for women with a variety of psychological and physical issues (see meta-analysis).

Personal Note: I have studied MBSR among women with abnormal pap smears and found it reduced anxiety. The low income ethnically diverse women I studied incorporated concepts from MBSR into their lives and found it very beneficial. I discovered MBSR many years ago and still find it helps me in my daily life. I highly recommend taking the 8 week course. It is offered in many different sites including the Osher Center (check out the MBSR childbirth and parenting class) and Kaiser (open to non-members). You can see the creator of the MBSR program Jon Kabat-Zinn on YouTube. This is a talk he did at Google.

 If you are suffering from menopausal symptoms let me know, there are many different integrative therapies that can help you. I can see you at Osher 353-7700 (we take insurance) or at WHH.