If you’re a woman going through menopause, you may be tempted to reach for a beer (or something stronger). Too bad that alcohol increases body heat and flushing and may trigger hot flashes in some women.

But there’s one ingredient in beer that actually may alleviate menopausal misery—hops. That’s according to two new studies.

Does it really work? Is it safe? If you try it, what’s the best form—and dose? Fortunately, there are many ways to get the menopausal symptom relief of hops without alcohol. Here’s how…

PUTTING AN ANCIENT REMEDY TO THE TEST

Besides giving beer its distinctive bitter flavor and aroma, hops—the flowers (also called seed cones or strobiles) of the hop plant (Humulus lupulus L.)—have a long history as a traditional remedy for indigestion, poor appetite, insomnia, anxiety…and for gynecological disorders.

One likely explanation is that hops contain one of the world’s most potent phytoestrogens. These are natural plant compounds that are similar to human estrogen. Given their historical gynecological use—and some earlier studies that have reported benefits for menopause symptoms but were not conclusive—Iranian researchers set out to find just how effective hops really are at mitigating menopausal symptoms, including hot flashes.

The researchers studied 120 women, between the ages of 40 and 60, who were in the early stages of menopause—they had had their final periods no less than one year and no more than five years earlier. The women were randomly divided into two groups.

One group received a daily tablet containing 500 mg of hops. The control group got a similar but inactive tablet (placebo).  The women rated their menopause symptoms on a standard 21-question survey beforehand and than at four weeks, eight weeks and at the end of the 12-week trial. The women also separately recorded the number of hot flashes they experienced.

Results: The hops takers had significantly fewer menopause symptoms than the control group—a 90% reduction by the end of the trial compared with a 4% reduction for the women taking a placebo. One of the benefits was a reduction in anxiety, which can go up with menopausal changes. That’s not too surprising, since hops have a folk reputation as a natural sedative—first discovered when it was noticed that hops pickers had a tendency to literally fall asleep on the job! (One study has even suggested that nonalcoholic beer, which contains hops but not alcohol, might be a good way to enhance calm and help you sleep soundly.) There was an improvement in sexual function for many of the women, too.

The most dramatic relief, though, was for hot flashes. Compared with the control group’s 0.8% improvement in these disturbing episodes, the women taking hops reduced their hot flashes by 95%. Their average number of hot flashes per week went from nearly 30 to a little more than one.

ARE HOPS SAFE?

To learn more about hops’ safe use, we spoke with Bottom Line’s medical contributing editor, naturopathic doctor Andrew Rubman, ND. He has plenty of clinical experience with hops—he has been prescribing them for his menopausal patients for 30 years. Dr. Rubman believes that hops are generally safe and effective when taken in appropriate doses (more about that in a moment), but it’s always a good idea to check with your own doctor first for a number of reasons. For example, because hops can act as a sedative and have antianxiety effects, their effect should be carefully weighed in people already being treated for anxiety or depression…and hops may increase the effects of anesthesia and other medications used before and during surgery.

One concern is whether hops’ estrogenic activity may pose an issue for women with estrogen-sensitive breast cancer. After all, if hops have estrogenic activity, women whose breast cancer is promoted by estrogen could theoretically be at increased risk from taking these supplements. Here, there’s encouraging news—it turns out that this plant estrogen–like compound acts differently from the body’s own estrogen. In a new test-tube study, researchers at University of Illinois at Chicago found that an enriched hops extract actually may help prevent breast cancer. One specific plant estrogen found in hops (6-prenylnaringenin) activated a metabolic pathway that has been shown to reduce the risk for breast cancer, they found. It’s preliminary research, to be sure, so if you have estrogen-sensitive breast cancer, it’s important to discuss with a specialist such as your oncologist whether hops are safe for you. (You may also be interested in a natural hot-flash supplement that doesn’t include plant estrogens.)

HOW-TO FOR HOPS USERS

If you want to try hops for menopausal symptoms, Dr. Rubman recommends working with a health-care professional who can prescribe the best product and dose for your particular situation. He prefers to prescribe hops for relief of symptoms as needed rather than on a regular, habitual basis. The key elements to look for in hops-based supplements are freshness and concentration of the naturally occurring compounds. “It’s important to know what to buy and what to avoid,” he said.

Here are his recommendations for hops formulations…

Tinctures. A tincture is an alcohol-based solvent combining ethyl alcohol, water and whatever active ingredients are being sought. Dr. Rubman often prescribes six to eight drops of hops tincture taken directly on the tongue or diluted to taste, every two or three hours to start and then tapering off as symptoms begin to diminish. (Note: He prefers tinctures over liquid extracts because tinctures preserve the active ingredients longer.) He recommends tinctures from HerbPharm, Eclectic and Wise Woman.

Pills. Dr. Rubman advises using capsules over tablets. The active ingredients in tablets are diluted with binders, making them less effective. Since capsules can also contain unwanted additives, choose freeze-dried hops powder that is 100% pure hops. Dr. Rubman most often prescribes freeze-dried hops in capsule form from Eclectic Institute. (These are sold in 200-mg capsules, to be taken one to three times a day). Again, talk to your health-care provider to determine how much to take—and take only as needed for symptoms, not as a daily supplement.

Tea. Some might like the strong, somewhat bitter flavor of hops tea, but if it’s a too hoppy for you, try adding chamomile or mint to tone it down. You can find dried hops online, either loose or in teabags. When making the tea, use just-boiled water (rather than boiling water, which will steam away some of the active ingredients), cover and steep for at least 10 to 12 minutes. “I might prescribe tea for a woman whose symptoms are occasional and not particularly bothersome,” says Dr. Rubman.

Caution: Hops are considered safe when used in reasonable amounts, but consistent, habitual use may lead to bleeding in some postmenopausal women, says Dr. Rubman. All in all, it’s really best to use hops under the direction of a physician.