Navigating The Menopause With St. John’s Wort

Exploring alternative or complementary treatments is an excellent way to support your wellbeing and reduce unwanted symptoms in menopause. Native to Europe, St John’s wort is a flowering shrub whose botanical name is Hypericum Perforatum. This herb has long been used as an over-the-counter remedy to help mild-to-moderate depression, with strong scientific evidence outlining its efficacy.

In recent years, new research has discovered that St John’s wort may also reduce a few menopausal symptoms, namely hot flushes and night sweats. St John’s wort can also improve symptoms of anxiety, which commonly arise during the menopausal transition.

Here, we outline the benefits of using St John’s wort to help manage your emotional and physical health throughout menopause.

How Does St John’s Wort Operate In The Body?

St John’s wort is widely believed to function similarly to antidepressant medication in the body. Evidence shows that St John’s wort supports the activity of certain brain chemicals, like noradrenaline and serotonin, which are involved in regulating mood (1).

A recent meta-analysis of 27 clinical trials highlighted that St John’s wort exhibited similar levels of effectiveness as selective serotonin reuptake inhibitors (SSRIs) in supporting mild-to-moderate depression, where they further noted that St John’s wort had fewer side effects too (2).

Is St John’s Wort Good For Anxiety?

St John’s wort may also support the reduction of anxiety, which affects many women in menopause (3). The herb is believed to help the brain use chemical messengers such as dopamine, serotonin, norepinephrine, and gamma-Aminobutyric acid (GABA) more efficiently, which may produce a feel-good effect and alleviate symptoms of anxiety.

In 2019, a small study reported that St John’s wort helped participants respond more positively to negative stimuli, which is a promising discovery for those with anxiety-based disorders.4 However, further long-term human studies specifically related to anxiety need to be carried out to completely understand how St John’s wort may improve this mental health condition.

Does St John’s Wort Increase Oestrogen?

Some scientists believe that St John’s wort may also contain phytoestrogens, a powerful plant compound that imitates oestrogen in the body. Since oestrogen drops sharply in the perimenopause — often causing a host of challenging physical and psychological symptoms — increasing oestrogen through dietary sources, supplements, and herbal remedies may support many areas of your health in menopause.

Can St John’s Wort Help Hot Flushes?

Emerging evidence suggests St John’s wort may play a role in reducing hot flushes, which affects women throughout the menopausal transition.

In a double-blind study on 100 menopausal women who were experiencing moderate-to-severe hot flushes, researchers found that St John’s wort reduced the severity and duration of their episodes.5 The findings suggest that this herbal remedy could be used as an effective treatment for vasomotor symptoms, like hot flushes and night sweats, in perimenopause and postmenopause.

The lead researcher of the study concluded that these findings were due to the phytoestrogens present in St John’s wort. However, more research is needed to substantiate this theory.

Possible Interactions

While St John’s wort is a natural herb, it’s incredibly potent and may interact with the following medications:

  • Antidepressants: Taking antidepressants and St John’s wort can result in serotonin syndrome, in which levels of the neurotransmitter, serotonin, become gravely high in the body and, in severe cases, may prove fatal.
  • Contraceptive pills: St John’s wort may reduce the effectiveness of birth control.
  • Blood thinners, like Warfarin: St John’s wort is known to increase the risk of blood clots when taken alongside blood thinners.
  • Anti-anxiety medication, like Xanax: St John’s wort may decrease the effectiveness of anti-anxiety medication, like Xanax.

If you’re considering St John’s wort supplements during menopause, it’s always best to consult your GP before doing so.

Thanks to its role in emotional health and reducing symptoms like hot flushes, St John’s wort can be a helpful addition to your arsenal during menopause. To learn more about optimizing your wellbeing throughout this hormonal transition, please visit the rest of our dedicated Menopause hub.


  1. 2020. St. John’s Wort And Depression: In-Depth. Available online:
  2. Ng. QX, Venkatanarayanan. N, Ho. CY. Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. J Affect Disord. 2017;210:211-221.
  3. Kobak K. et al., St. John’s Wort in Generalized Anxiety Disorder: Three More Case Reports. Journal of Clinical Psychopharmacology. 2003;23(5):531-532.
  4. Warren. M, Cowen. P, Harmer. C. Subchronic treatment with St John’s wort produces a positive shift in emotional processing in healthy volunteers. Journal of Psychopharmacology. 2018;33(2):194-201.
  5. Abdali. K, Khajehei. M, Tabatabaee. HR. Effect of St John’s wort on severity, frequency, and duration of hot flashes in premenopausal, perimenopausal, and postmenopausal women: a randomized, double-blind, placebo-controlled study. Menopause. 2010;17(2):326-331.

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