For most women, the change of life is a scourge. And one set of symptoms is particularly troubling for women and their partners—vaginal dryness. Daily Health News has regularly given you insight about the best natural remedies for menopausal symptoms, including dryness…and here’s another to add to the list that will help you keep celebrating your sexuality. It’s an herb available in capsule or cream form that acts like natural estrogen to prevent and repair the damage done by estrogen depletion.

The herb is called Pueraria mirifica. Native to Thailand, it is a tuberous root rich in phytoestrogens, making it a good option for women who want relief but don’t want the risks of hormone-based remedies, says naturopathic doctor and sexual health expert Laurie Steelsmith, ND, LAc, coauthor of the book Great Sex, Naturally. And a recent experimental study bore this out. It tested a cream formulation of Pueraria mirifica in postmenopausal macaque monkeys and showed that the herb was just as effective as conjugated estrogen cream in repairing vaginal tissue that becomes thin and dry because of estrogen depletion. (The researchers used macaques because they naturally experience menopause and their reproductive organs and hormones are similar to those of humans.)


In this study, one group of macaques received a vaginal application of 0.1% Pueraria mirifica cream and another received a 1.0% application daily for one month. A third group received a daily application of conjugated equine estrogen cream, which is used in humans in oral and topical estrogen-based hormone therapy. Vaginal cells were collected from the macaques in a way similar to that of a Pap smear and studied on a weekly basis for three months that spanned pretreatment, treatment and posttreatment periods.

The results: Healthy cell growth lining the vaginal wall increased two-fold beginning at day seven of the treatment period for macaques treated with either 1.0% Pueraria mirifica cream or conjugated equine estrogen cream. (The weaker 0.1% cream also spurred cell growth but not as robustly, and it took a much longer time to kick in). Vaginal pH became more normalized, too. These restorative effects lasted as long as the macaques continued to receive treatment and reverted when treatment was stopped. The researchers also noted that the effects of the cream were comparable to the effects seen in other studies of capsule formulations of Pueraria mirifica.


Dr. Steelsmith, who was not involved in this study, told Daily Health News that she thought the study was well-done and provided reassurance for women who want a natural option to vaginal estrogen creams. However, although a cream formulation was experimentally used in macaques in the study, Dr. Steelsmith has concerns about over-the-counter cream formulations for vaginal use. They may be irritating or cause allergic reactions, she said. Rather than prescribing a marketed product, she said she would have a cream specially compounded if she were to prescribe it to a patient.

She prescribes Pueraria mirifica in capsule form at a dosage of 100 milligrams (mg) to 200 mg per day. The brand she prefers to prescribe is Nature’s Answer Pueraria mirifica Estro Balance with DIM. DIM, which stands for diindolylmethane, is a phytonutrient found in cruciferous vegetables such as broccoli, brussels sprouts, cauliflower, cabbage and kale. It promotes favorable estrogen metabolism in the liver, and so boosts Pueraria mirifica’s restorative effects.

The herb is not without potential side effects. For one, its estrogenic effects can cause breast enlargement in some women—which may or may not be an unwelcome effect. In fact, capsule and cream formulations are sold for that very purpose.

More importantly, women who have had or are at risk for estrogen-related cancers, including ovarian, endometrial and breast cancer, should not use Pueraria mirifica for the same reason they should not use other estrogenic supplements or drugs. “In addition, it’s definitely not for women who have chronic breast cysts, heavy menstrual bleeding, a history of chronic liver disease, diabetes, migraines, systemic lupus or a history of blood clots,” said Dr. Steelsmith. Herbal formulations of the herb can also interact with certain drugs, such as Luvox, Inderal and Clozaril to name a few.

Although formulations of Pueraria mirifica are available without prescription, Dr. Steelsmith stressed that it is wise to consult with a licensed naturopath first. Pueraria mirifica’s strong estrogenic effect in the right amount can be beneficial, but too much can contribute to disease, she said. In addition to assessing whether the herb is appropriate based on your symptoms and health needs, a naturopathic physician can also monitor care and troubleshoot any adverse effects that the herb may have on your body, she said.