1. Introduction
Menopause represents a significant physiological transition in a woman’s life, typically occurring between the ages of 45 and 55, characterized by the permanent cessation of menstruation due to declining ovarian function and reduced oestrogen production. The hormonal shifts accompanying menopause—particularly the decline in estradiol (E2)—can precipitate a constellation of symptoms including hot flushes, night sweats, mood disturbances, vaginal dryness, sleep disruption, and increased risk of osteoporosis and cardiovascular disease. While conventional hormone replacement therapy (HRT) and non-steroidal anti-inflammatory drugs (NSAIDs) remain standard treatment options, their associated side effects—including gastrointestinal distress, nephrotoxicity, hepatotoxicity, and potential long-term risks—have driven growing interest in alternative and complementary therapies.
In Nigeria, traditional medicine remains deeply embedded in healthcare practices, offering accessible, affordable, and culturally acceptable alternatives for managing menopausal symptoms. This review synthesizes available literature on Nigerian medicinal plants utilized for menopausal management, their modes of administration, and adjunctive therapeutic approaches that may enhance symptom relief and overall well-being.
2. Nigerian Herbs in Menopausal Management: Evidence and Traditional Use
Several Nigerian plants have demonstrated either traditional application or scientific evidence supporting their use in managing menopausal symptoms. The therapeutic potential of these herbs primarily stems from their phytoestrogenic, antioxidant, and oesteogenic properties.
2.1. Eastern Nigeria Mistletoe (Loranthus micranthus Linn.)
Traditional Context and Application
Eastern Nigerian mistletoe, a hemiparasitic plant harvested from various host trees including Kola acuminata, Citrus species, and Garcinia kola, holds significant ethnopharmacological importance. The plant is traditionally prepared as aqueous decoctions or alcoholic extracts and administered orally. Beyond its use for post-menopausal syndrome, it has folklore claims for managing diabetes, hypertension, epilepsy, infertility, rheumatism, and conditions requiring immune modulation.
Scientific Evidence
The traditional use of L. micranthus for post-menopausal syndrome has received scientific validation through systematic investigation. Research evaluating methanolic extracts from mistletoe harvested from three different host trees demonstrated significant oesteogenic activity—the ability to promote bone formation—a critical property for preventing postmenopausal osteoporosis.
Key findings from this research include:
- Osteoblast differentiation: Increased alkaline phosphatase (ALP) activity at lower concentrations (0.2–0.8 μg/ml)
- Cytotoxicity: None observed at tested concentrations
- Osteogenic gene expression: Upregulation of BMP2 and RUNX2
- Key compounds: Lupeol derivatives (7β,15α-dihydroxylupeol palmitate), 3,4,5-trimethoxy gallate
- Uterine estrogenicity: Extract from Kola acuminata host did not show uterine estrogenic effects
Notably, the researchers isolated compounds including lupeol derivatives and gallic acid derivatives that demonstrated excellent oesteogenic properties in vitro. The absence of uterine oestrogenicity in some extracts suggests that these compounds may promote bone health through mechanisms distinct from classical oestrogen receptor activation, potentially offering a safer alternative to HRT for bone protection.
2.2. Combination Therapy: Sorghum bicolor, Spondias mombin, Xylopia aethiopica, and Related Species
A comprehensive study investigating five Nigerian medicinal plants traditionally used for menstrual disorders revealed promising applications for menopausal hormonal management. The plants examined—Aristolochia littoralis, Picralima nitida, Sorghum bicolor, Spondias mombin, and Xylopia aethiopica—were subjected to rigorous antioxidant and hormonal assays.
Phytochemical Profile and Bioactivity
Phytochemical screening confirmed the presence of bioactive compounds including flavonoids, alkaloids, tannins, phenolic acids, and saponins at varying concentrations. The research demonstrated significant antioxidant activities:
| Plant | Key Activity | Notable Parameter |
| S. bicolor | DPPH inhibition | 69.55 ± 6.96% at 1,000 μg/mL |
| X. aethiopica | Ferric reducing capacity | 4.71 ± 0.14 mg/mL (FRAP assay) |
| P. nitida | Nitric oxide scavenging | 186.88 ± 0.78 μM |
| S. mombin | Glutathione (GSH) concentration | Highest (0.190 ± 0.034 mM) |
Hormonal Effects
The most clinically relevant finding for menopause management was that all examined plant extracts significantly increased estradiol levels compared to untreated groups. Additionally, lipid profile analysis revealed improved cardiovascular markers:
- A. littoralis demonstrated the highest HDL/LDL ratio (1.394 ± 0.014)
- X. aethiopica showed the lowest total cholesterol levels (2.276 ± 0.129 mmol/L)
The combined antioxidant, oestrogen-modulating, and cardioprotective activities of these plants provide strong pharmacological support for their traditional use and suggest potential applications in menopausal symptom management.
Traditional Administration
While specific dosage information requires further clinical validation, these plants are traditionally prepared as:
- Decoctions (boiling plant material in water)
- Infusions (steeping in hot water)
- Powdered forms taken with food or liquids
The choice of preparation method influences the extraction of bioactive compounds and should be guided by traditional knowledge and healthcare provider recommendations.
2.3. Mountain Thistle (Acanthus montanus)
Traditional Application
Acanthus montanus, despite its challenging physical characteristics (sharp spines), has been a mainstay in Nigerian traditional medicine for centuries. Herbalists employ the dried leaf powder mixed with pap (a fermented cereal porridge) for managing “internal heat” and menopausal discomforts.
Specific Uses
The plant is traditionally indicated for:
- Lower abdominal heat sensations
- Night sweats
- Sleep disruption
- Other menopausal discomfort
Administration: One teaspoon of dried leaf powder taken twice daily, typically consumed with pap or other food vehicles. While empirical evidence on this specific plant remains limited, its traditional use aligns with the broader pattern of employing antioxidant-rich herbs for menopausal symptom relief.
2.4. Carapa Species (African Mahogany)
Traditional Context
Carapa species are trees widely distributed across tropical Africa, recognized for their socio-cultural and medicinal importance. In Senegal and other West African regions, including Nigeria, Carapa oil is traditionally extracted by menopausal women.
Therapeutic Applications
The oil, along with leaves, bark, and roots, is used for:
- Treatment of various illnesses
- Cosmetic applications
- Menopausal symptom management
The traditional involvement of menopausal women in oil extraction highlights the cultural significance and intergenerational transfer of knowledge regarding this plant’s therapeutic applications.
2.5. Ficus umbellata (Fig Species)
Traditional Context
While primarily documented in Cameroon, Ficus umbellata is used traditionally to treat amenorrhea and menopausal-related physiological disorders. The plant has been scientifically evaluated for its estrogenic properties.
Scientific Evidence
Research findings include:
- Estrogen receptor activation: Both aqueous and methanol extracts significantly activated ERα and ERβ in cell-based assays
- Uterotropic effects: Increased uterine and vaginal epithelial thickness in ovariectomized rats (dose-dependent)
- Hot flush relief: Both extracts at 100 mg/kg BW significantly reduced total number, average duration, and frequency of hot flushes
- Major compound: 7-methylumbelliferone (coumarin) identified
The researchers concluded that F. umbellata extracts demonstrate estrogen-like effects and may alleviate menopausal problems including vaginal dryness and hot flushes. The identification of coumarins as key bioactive compounds suggests mechanisms worthy of further investigation for Nigerian variants of similar fig species.
2.6. Millettia macrophylla
Traditional Context
This Cameroonian medicinal plant (with likely Nigerian distribution) is traditionally used to alleviate menopausal problems. Scientific evaluation has confirmed estrogen-like properties.
Scientific Validation
- ER transactivation: Methanol extract significantly transactivated both ERα and ERβ
- Mechanism: Oestrogen-like effects inhibited by pure ER antagonist ICI 182,780 (confirming ER-mediated action)
- Uterine effects: Increased uterine and vaginal epithelial heights (3-day treatment)
- Cardiometabolic benefits: Methanol extract significantly decreased fasting serum triglycerides, total cholesterol, and atherogenic risk
These findings support the traditional use of this plant for menopausal management and demonstrate additional cardiovascular benefits that are particularly relevant given increased cardiovascular risk following menopause.
3. Comparison of Nigerian Herbs for Menopausal Management
| Herb (Scientific Name) | Traditional Use in Nigeria | Key Scientific Evidence | Primary Mechanism | Preparation Method |
| Loranthus micranthus | Post-menopausal syndrome, bone pain, diabetes | Osteogenic activity, BMP2/RUNX2 upregulation, no uterine estrogenicity | Bone formation promotion, immune modulation | Decoctions, alcoholic extracts |
| Sorghum bicolor | Menstrual disorders | Significant DPPH inhibition (69.55%), increased estradiol | Antioxidant, hormonal modulation | Decoctions, powders |
| Spondias mombin | Menstrual disorders | Highest GSH concentration, increased estradiol | Antioxidant defense, hormonal modulation | Decoctions |
| Xylopia aethiopica | Menstrual disorders | Strong FRAP reducing capacity, lowest total cholesterol | Antioxidant, cardioprotective | Decoctions, powders |
| Aristolochia littoralis | Menstrual disorders | Highest HDL/LDL ratio, increased estradiol | Hormonal modulation, cardioprotective | Decoctions |
| Acanthus montanus | Internal heat, night sweats, sleep disruption | Traditional use documented; empirical data limited | Cooling, symptom relief | Dried leaf powder with pap |
| Carapa species | Menopausal symptoms, general health | Oil extracted by menopausal women traditionally | Cosmetic, symptomatic relief | Oil extraction |
| Ficus umbellata | Amenorrhea, menopausal disorders | ERα/ERβ activation, hot flush reduction, uterotrophic effects | Phytoestrogenic | Aqueous/methanol extracts |
4. Adjunctive Therapies for Menopausal Symptom Management
Beyond herbal interventions, a comprehensive approach to menopausal management includes nutritional supplementation, lifestyle modifications, and support systems.
4.1. Evening Primrose Oil (EPO)
Overview
Evening Primrose Oil, rich in Gamma-Linolenic Acid (GLA) , has recently gained attention in Nigeria following its market introduction. Clinical studies support its use for improving skin condition, reducing premenstrual discomfort, and addressing symptoms related to hormonal changes.
Mechanisms and Benefits
The essential fatty acids in EPO may:
- Support skin hydration and elasticity
- Modulate inflammatory responses
- Alleviate premenstrual and perimenopausal symptoms
Integration into Nigerian Healthcare
At the 2026 Continuing Education Conference of the Association of Community Pharmacists of Nigeria (ACPN), healthcare professionals emphasized the importance of evidence-based wellness products for menopausal support. Pharmacists play a critical role in distinguishing clinically supported supplements from unverified alternatives, ensuring women receive credible recommendations.
4.2. Curcumin and Antioxidant Support
Emerging research on curcumin (from turmeric) suggests potential benefits for postmenopausal health. While short-term intake showed limited cardiometabolic effects, long-term interventions with bioavailable formulations demonstrated improvements in:
- Serum fasting glucose
- Fasting insulin
- HOMA-IR (insulin resistance marker)
- Lipid parameters
These findings align with the antioxidant mechanisms identified in Nigerian herbs, suggesting that polyherbal and nutraceutical approaches combining multiple antioxidant sources may offer synergistic benefits.
4.3. Lifestyle and Dietary Interventions
Nutritional Support
The Nigerian diet, rich in vegetables, legumes, and fermented foods, provides foundational nutritional support for menopausal women. Health professionals advocate shifting from symptomatic treatment to preventive care and internal health management.
Traditional Rituals and Coping Mechanisms
Research on Urhobo women from the Niger Delta region documented the integration of traditional practices, herbal remedies, and rituals as coping mechanisms during menopause. These cultural approaches complement biomedical interventions and contribute to positive adaptation.
Healthcare Communication and Education
A significant barrier to effective menopausal management in Nigeria is the cultural stigma and limited evidence-based information surrounding this natural transition. Increased awareness, education, and open dialogue—as advocated by public figures like Kate Henshaw—are essential for empowering women to make informed choices about their health.
5. Safety Considerations and Recommendations
Important Cautions
- Herbal medicines, while natural, are not inherently safe and may interact with prescription medications
- Dosage standardization remains a challenge; traditional preparations vary in potency
- Host plant variation (as with mistletoe) can significantly affect bioactivity
- Long-term safety data for many Nigerian herbs used in menopause require further research
- Pregnancy and breastfeeding: Many herbs with estrogenic activity should be avoided during these periods
Recommendations for Safe Use
- Consult qualified healthcare practitioners before initiating any herbal regimen
- Seek guidance from trained pharmacists who can evaluate product quality and potential interactions
- Document symptoms and treatment responses to facilitate informed adjustments
- Combine herbal therapies with lifestyle modifications for comprehensive management
- Consider host and source when using mistletoe products, as efficacy varies significantly
6. Research Gaps and Future Directions
The current literature reveals several areas requiring further investigation:
- Human clinical trials: Most evidence comes from animal models (Wistar rats); human studies are needed to validate efficacy and safety profiles
- Dose optimization: Standardized dosing protocols for Nigerian herbs remain undefined
- Long-term outcomes: The chronic effects of herbal therapies on menopausal health, bone density, and cardiovascular risk need longitudinal study
- Phytochemical characterization: Active compounds and their mechanisms warrant deeper investigation
- Combination therapies: Synergistic effects of polyherbal formulations require systematic evaluation
- Cultural preservation: Documenting and preserving traditional knowledge of plant harvesting, preparation, and administration is essential for sustainability
7. Conclusion
Nigerian medicinal herbs offer promising alternatives for managing menopausal symptoms, grounded in both traditional wisdom and emerging scientific evidence. Eastern Nigerian mistletoe shows particular potential for bone health through its oesteogenic properties, while combinations including Sorghum bicolor, Spondias mombin, and Xylopia aethiopica demonstrate antioxidant, hormonal-modulating, and cardioprotective effects. Traditional preparations such as decoctions, powders, and oils remain the primary modes of administration, though standardization efforts would enhance safety and efficacy.
A holistic approach integrating herbal therapies with nutritional supplements like evening primrose oil, dietary optimization, and culturally sensitive healthcare communication offers the most comprehensive framework for menopausal management. As Nigerian healthcare systems continue to evolve, bridging traditional knowledge with evidence-based practice—and ensuring appropriate professional guidance—will be essential for optimizing health outcomes in menopausal women.
References
- Ige AB, Ogunlakin AD, Sonibare MA. Antioxidant and ameliorative effects of selected Nigerian plants on hormonal imbalance associated with dysmenorrhea in albino rats. Frontiers in Nutrition. 2025;12:1635080.
- Omeje EO, Khan MP, Osadebe PO, et al. Analysis of constituents of the eastern Nigeria mistletoe, Loranthus micranthus linn revealed presence of new classes of osteogenic compounds. Journal of Ethnopharmacology. 2014;151(1):643-651.
- Zingue S, Njamen D, Tchoumtchoua J, et al. Effects of Millettia macrophylla (Fabaceae) extracts on estrogen target organs of female wistar rat. Journal of Ethnopharmacology. 2013;123(2):120-131.
- Zingue S, Njamen D, Tchoumtchoua J, et al. Estrogenic effects of Ficus umbellata Vahl. (Moraceae) extracts and their ability to alleviate some menopausal symptoms induced by ovariectomy in Wistar rats. Journal of Ethnopharmacology. 2016;179:332-340.
- New Heights Pharmaceuticals. Menopause: Experts advocate internal wellness as Efamol EPO debuts in Nigeria. Vanguard News. March 2026.
- The Sun Nigeria. The soothing secrets of mountain thistle. 2025.
- Punch Newspapers. Nollywood veteran Kate Henshaw advocates menopause awareness. March 2026.
- CORE. The Lived Experiences of Urhobo Women from the Niger Delta Region of Nigeria During the Menopausal Transition. 2024.