Written by Dr. Halima Phelps, DC, ND. This study demonstrated that Silybum marianum (milk thistle) significantly decreased the frequency and severity of hot flashes in the participating postmenopausal women.
As a normal part of aging, women enter into the menopausal phase of life after their final menstrual cycle. Signs and symptoms during this phase can include, but are not limited to, urogenital atrophy, psychological disturbances, weight changes and a decrease in bone density and estrogen levels 1, 2. Women are affected on varying levels with these conditions, but a common symptom than many experience are episodes of hot flushes, (also known as “hot flashes”) between the ranges of 1-20 years during menopause; four years being average1. These temperature fluctuations are often treated with hormonal therapy, as estrogen decline is thought to be a factor in the etiology, but the root of the problem is not fully understood 2. Estrogen combined with progesterone has also been utilized as a hormonal therapy 2. Though estrogen replacement is often very effective, a greater concern of activating the development of estrogen-based cancers in these women is of great concern 2. For this reason, nonhormonal therapy such as the use of phytoestrogens and other herbal compounds have also been sought out as treatment alternatives 2.
Silybum marianum (S. marianum), commonly known as milk thistle, is a medicinal herb often used in the treatment of hepatic ailments such as fatty liver disease. Sm has also historically shown effectiveness treatment of fever and kidney illness as well. In addition, a component of S. marianum, silymarin, is believed to have a positive effect on β estrogen receptors, as well as provide protection for the nervous system and decrease the potential of bone density loss—further potential menopausal complications. In this parallel randomized, double-blind study, the effects of Sm was studied for its effectiveness as a natural therapy for menopausal symptoms. Eighty postmenopausal women were provided with either oral gelatin capsules containing silymarin or a placebo oral gelatin capsule containing starch, with 40 women in each group of insignificant initial demographic differences. The women took the capsules at a frequency of two times per day for 8 weeks, and were required to manually document the occurrence of hot flushes along with the severity for those 8 weeks, plus an additional 4 weeks after. Every 4 weeks during the trial, the women were visited and evaluated for the same. A visual analogue scale was used to evaluate how strong the hot flashes were, with 0 being weakest to 10 being the strongest. The Green Climacteric Scale (GCS) was utilized to evaluate the severity as well, along with the Hot Flash Related Daily Interference Score (HFRDIS) questionnaire which assessed the interference with activities of daily living.
Study results found that the amount of hot flashes, along with the intensity of the hot flashes was significantly decreased with supplementation in the experimental group: the baseline frequency was 4.32 ± 0.20/day prior to intervention, and decreased to 2.05 ± 0.16/day by week four, and even further to 1.34 ± 0.17/day by week eight. At the four week assessment following the end of the trial, the frequency continued to decrease to a frequency of 1.31 ± 0.15/day: thereby, revealing a significant positive effect on minimizing the amount of hot flashes experienced by participants (p < .001). In the control group, however, there was an insignificant effect on the frequency of hot flashes, and in the weeks prior to intervention, week four, week 6, and the fourth week following intervention the frequency was 3.60 ± 0.21/day, 3.48 ± 0.17/day and 3.34 ± 0.17/day, and 4.05 ± 0.16/day respectively (p > .05). Severity of hot flashes followed a similar trend, showing a significant decrease in the experimental group and an insignificant effect in the placebo group. The values for the experimental group at baseline, the fourth week, eighth week, and 4th week following intervention were: 5.25 ± 0.22, 2.55 ± 0.95, 1.70 ± 0.09 and 1.62 ± 0.08, respectively (p<.001). For the same weeks, the control group values were 4.85 ± 0.11, 4.70 ± 0.19, 4.62 ± 0.20, and 5.60 ± 0.09: revealing an increase in symptomology following the treatment period. There was a significant distinction in effectiveness between these two categories in the test groups (p<.001).
The results of this study reveal that S. marianum should be considered as a treatment alternative to hormonal therapy for women in menopause who experience hot flushes, and it may decrease the concern of using direct hormonal therapy for some women. Another area of consideration for future studies would be to assess any side effects outside of gastric pain and bloating as some women in the study experienced, (i.e. reproductive effects), as well as the outcome on women with other underlying health conditions, as they were eliminated from this study. Potential effects of long term use should also be evaluated.
Source: Saberi Z, Gorji N, Memariani Z, Moeini R, Shirafkan H, Amiri M. Evaluation of the effect of Silybum marianum extract on menopausal symptoms: A randomized, double-blind placebo-controlled trial. Phytotherapy Research. 2020;1–8.
© 2020 John Wiley & Sons, Ltd.
Posted February 3, 2021.
References:
- Archer DF, Sturdee DW, Baber R, et al. Menopausal hot flushes and night sweats: where are we now? Climacteric. 2011;14(5):515-528.
- Fait T. Menopause hormone therapy: latest developments and clinical practice. Drugs in context. 2019;8:212551.
