St John's wort and menopause: what to know

Menopause symptoms can include hot flushes, night sweats, mood changes, vaginal dryness, and reduced sexual desire. St John's wort is a herbal product sometimes considered for mood-related symptoms, but products vary and its effects are not predictable for every person. It can change how the body handles other medicines, including some hormonal medicines, contraceptives, antidepressants, seizure medicines, and blood thinners.

Tell a doctor or pharmacist every medicine, supplement, and contraceptive you use before starting St John's wort. Do not stop prescribed treatment to replace it with a supplement without medical advice. Keep the product name and ingredient list available, because formulations differ. Ask about non-hormonal and hormonal options that fit your symptoms, medical history, and personal preferences.

Get medical advice promptly for a new rash, severe agitation, confusion, thoughts of self-harm, yellowing skin, unusual bleeding, or a suspected medicine interaction. Seek urgent help for breathing difficulty, facial swelling, collapse, or severe symptoms after taking it.

Ask whether St John's wort could alter any current treatment, how to manage your most troublesome symptom, and what to do if your mood, sleep, or bleeding changes.