Synopsis

Source of validity: Traditional
Rating (out of 5): 2

St. John's Wort (Hypericum perforatum) has a long history of traditional use, primarily for mood disorders such as mild to moderate depression. Its use for hot flashes, particularly those occurring during menopause, is less prominent in historical herbal medicine, but some traditional practices and modern herbalists have recommended it for this purpose, mainly due to its effects on mood and nervous system regulation.

Scientific evidence for St. John's Wort as a treatment specifically for hot flashes is limited. A few small clinical trials suggest that it may have a mild effect on reducing the frequency and severity of hot flashes, especially when combined with other herbs like black cohosh. For example, a 2009 double-blind, placebo-controlled trial found a modest reduction in hot flash severity among menopausal women taking St. John's Wort compared to placebo, but the study size was small and results have not been widely replicated.

The proposed mechanism is likely indirect: by improving mood and alleviating mild depression or anxiety, St. John's Wort might reduce the perception or impact of hot flashes rather than directly affecting the physiological mechanisms that cause them. Mainstream guidelines do not recommend St. John's Wort specifically for hot flashes due to insufficient evidence.

In summary, the use of St. John's Wort for hot flashes is rooted more in traditional and anecdotal reports than in robust scientific research. Its efficacy for this indication remains uncertain, and further high-quality studies are needed.

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