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Monograph Library

Fémance Menopause (VitexCombo)

What is Fémance Menopause?

As its name indicates, the herbs in this formula specifically address the symptoms of this significant and far-reaching change in a woman’s life. Three out of every four menopausal women, for example, experience hot flashes.[1] Other manifestations of menopause include vaginal dryness, anxiety, insomnia, and fatigue. One mainstream approach to the problems of menopause has involved hormone replacement therapy (HRT), but research has called its use into question. The Women's Health Initiative Study drew attention to the increased risk of breast cancer, stroke, and heart attack associated with HRT.[2] Randomized, controlled clinical trials (RCTs) since then have further demonstrated increased risks. A 2010 trial, for example, showed that HRT-treated women were over twice as likely to experience coronary heart disease in the first few years after starting therapy than those not using the treatments.[3] Hormonal medications also wreak havoc with women’s libido. Research in Germany concluded that women using hormonal contraceptives had significantly lower sexual function scores.[4]

A formula hinged on Black Cohosh

A plant native to the heavy woods and rich soils of eastern North America, black cohosh was used by native peoples extensively for rheumatic conditions[5]—a use adopted by the Eclectics, botanically oriented physicians of the 19thand early 20thcenturies who also valued this herb for neuralgia and as a gynecological therapy for painful menstruation and childbirth.[6] In 2010, the Canadian authors of a meta-analysis of clinical trials assessing black cohosh for menopausal symptoms confirmed the findings of previous reviews, which point to the benefit of black cohosh in reducing the frequency of vasomotor symptoms (i.e. hot flashes and night sweats).[7] At least one subsequent clinical study corroborates this assessment.[8] Even though research shows that black cohosh is not estrogenic[9] and does not bind to estrogen receptors, it has been found to reduce menopausal problems as effectively as conjugated estrogens.[10] It seems that black cohosh works on the endocrine regulatory system[11], and its effectiveness is likely attributable to its neurotransmitter-mimetic nature, which is characterized by demonstrable dopaminergic, noradrenergic, serotoninergic and GABAergic effects.[12] Also, it is considered to have phytoestrogenic qualities.[13]

Gynecological stalwarts: Dong Quai, Chastetree, and Motherwort

Dong quai contains bioactive compounds such as polysaccharides, ligustilide, and ferulic acid and has been called “female ginseng.”[14] A classic herb in TCM, dong quai is highly regarded as a blood tonic and a tonic for female issues like menopause and dysmenorrhea.[15],[16]

Besides being markedly anti-inflammatory[17], Dong quai clearly plays a role in balancing estrogenic/antiestrogenic activities to good effect in menopause, but the mechanism of action has not been clearly established.[18]

Chastetree has been used for women’s health from classical antiquity,[19] and in modern times the German Commission E has approved its well-attested use to alleviate the symptoms of PMS, as well as mastodynia and irregularities of the menstrual cycle.[20] Chastetree works through the pituitary gland and acts as a hormone normalizer,[21] even while acting as a SERM, i.e. a Selective Estrogen Receptor Modulator.[22]

As for motherwort, it is a perennial herb indigenous to temperate areas of Europe and Asia. This plant comes by its common name honestly, since it was used for female reproductive disorders by both indigenous peoples and the Eclectics.[23],[24] One of its alkaloids, leonurine, is uterotonic, and another, stacydrine, is thought to stimulate the release of oxytocin. It is also speculated that motherwort’s alkaloids produce its myocardial actions, which have traditionally benefited nervous heart conditions.[25]

Green leaves on top of each other in a group

Sage and Rhodiola: Neuroprotective and more

A clinical study of sage conducted in 2008 found that it significantly enhanced secondary memory performance in 20 volunteers with an average age of 73.[26] This finding has been corroborated by a comprehensive review of sage’s cognitive-enhancing effects.[27] Meanwhile, a clinical trial of this same herb published in 2011 confirmed a significant decrease in the intensity and frequency of hot flashes.[28]

Rhodiola, a classic adaptogenic herb native to wild regions of the northern hemisphere, not only increases physical endurance, but acts as a natural selective estrogen receptor modulator (SERM), which is to say that it is an estrogen receptor ligand that exhibits estrogen agonistic and antagonistic activity in a tissue-specific fashion. A recent study suggests that rhodiola alleviates the cognitive, cardiovascular, psychological, and osteoporotic problems that can arise in menopause more safely and with fewer side effects than synthetic SERMs.[29]  

The anti-inflammatory contribution of Burdock

With excellent anti-inflammatory and free radical scavenging properties[30],[31],[32], Burdock root rounds out this formula, having been shown in a recent clinical study to produce improvement, for example, in patients with knee osteoarthritis.[33] Burdock helps with the digestion and metabolism of fats and oils. This makes it a useful endocrine and reproductive remedy, since sex hormones require lipids for their makeup and transmission.[34]

Active Ingredients (per ml): 

  • 18 ml of dong quai(Angelica sinensis,root) tincture 1:4 (QCE 45 mg)
  • 17 ml of black cohosh(Actaea racemosa,root and rhizome)tincture 1:5 (QCE 34 mg)
  • 17 ml of chastetree(Vitex agnus-castus,fruit) tincture 1:4 (QCE 42.5 mg)
  • 15 ml of burdock(Arctium lappa, root) tincture 1:1 (QCE 150 mg fresh) OR 1:4 (QCE 37.5 mg dry)
  • 14 ml of sage(Salvia officinalis, leaf) tincture 1:4 (QCE 35 mg)
  • 11 ml of motherwort(Leonurus cardiaca, herb top) tincture 1:4 (QCE 27.5 mg)
  • 08 ml of rhodiola(Rhodiola rosea, root) tincture 1:4 (QCE 20 mg)

Non-Medicinal Ingredients: Alcohol, Distilled water


Adult women:Take 1.5-2 ml (45-60 drops) 3 times daily in a little water on an empty stomach. Not to be taken immediately before bedtime.

Duration of Use:

Consult a health care practitioner for use beyond 6 weeks.

Health Canada Approved Use Claims

Used in Herbal Medicine to help relieve: (1) symptoms associated with menopause; (2) premenstrual symptoms; (3) pain associated with menstruation; (4) muscle and joint pain associated with rheumatic conditions (such as rheumatoid arthritis, osteoarthritis and/or fibrositis), as well as pain associated with neuralgia (such as sciatica); (5) nervous tension (calmative).

Cautions and Warnings

Consult a health care practitioner before use: if you are taking antidepressants, blood thinners/anticoagulants or hormone-containing medications such as progesterone preparations, oral contraceptives or hormone replacement therapy; if you suffer from diabetes; if you have a liver disorder or develop symptoms of liver trouble. Discontinue use and consult a health care practitioner: if menstruation is delayed or absent; if you experience increased menstrual bleeding time; if you experience breast pain, discomfort and/or tenderness. Consult a health care practitioner if symptoms worsen or persist.


Do not use: if pregnant or breastfeeding; if you are allergic to plants of the Asteraceae/Compositae/Daisy or Apiaceae/Umbelliferae family; if you have bipolar disorder or bipolar spectrum disorder, profuse menstrual flow/heavy periods, diarrhea or haemorrhagic diseases; if you have a seizure disorder (e.g. epilepsy).

Known Adverse Reactions

Hypersensitivity/allergy is known to occur, including irritability and insomnia; in which case, discontinue use.

Quality Summary

Our products are all third party tested to ensure the absence of pesticides, microbes, and heavy metals and to confirm purity and stability.

For more information on woman health check out our Castor Oil monograph and how it is Transdermal Healing and Beyond, A versatile and Effective Oil.

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Who is it for

  • Women suffering from the symptoms of menopause (e.g. hot flashes) who want to avoid HRT
  • Also women prone to premenstrual symptoms and menstrual pain
  • Those with rheumatic muscle and joint pain, as well as neuralgia or nervous tension

How it helps

  • Hinged on nonestrogenic black cohosh, which reduces menopausal problems 
  • With dong quai, often called “female ginseng,” hormonenormalizing chastetree, and anti-inflammatory burdock, which also has endocrine and reproductive properties
  • Also includes 
    • Neuroprotective sage 
    • Rhodiola, an adaptogen that acts as a natural selective estrogen receptor modulator (SERM)


[1] - “Introduction to Menopause,” accessed online from Johns Hopkins Medicine at:

[2] - JE Rossouw et al, “Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial,” JAMA2002; 288(3): 321-333.

[3] - S Toh et al, “Coronary heart disease in postmenopausal recipients of estrogen plus progestin therapy: does the increased risk ever disappear? A randomized trial,” Annals of Internal Medicine 2010; 152(4): 211-7.

[4] - CW Wallwiener et al, “Prevalence of sexual dysfunction and impact of contraception in female German medical students,” Journal of Sexual Medicine2010; 7(6): 2139-48.

[5] - DE Moerman, Native American Ethnobotany, Cambridge, UK: Timber Press; 1998, pp. 162-3.

[6] - HW Felter, JU Lloyd, King’s American Dispensatory, Vol. 1,Portland, Oregon: Eclectic Medical Publications; 1983. Reprint of Eighteenth Edition of 1898, pp. 528-533.

[7] - T Shams et al, “Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis,” Alternative Therapies in Health and Medicine2010; 16(1): 36-44.

[8] - SM Ross, “Menopause: a standardized isopropanolic black cohosh extract (remifemin) is found to be safe and effective for menopausal symptoms,” Holistic Nursing Practice2012; 26(1): 58-61.

[9] - Birgit M Dietz et al, “Botanicals and Their Bioactive Phytochemicals for Women’s Health,” Pharmacological Reviews2016; 68: 1026-1073.

[10] - Wolfgang Wuttke et al, “The non-estrogenic alternative for the treatment of climacteric complaints: Black cohosh (Cimifuga or Actaea racemose),” Journal of Steroid Biochemistry and Molecular Biology2014; 139: 302-310.

[11] - Mark Blumenthal et al, eds., “Black Cohosh Root,” Herbal Medicine: Expanded Commission E Monographs, Austin, TX: American Botanical Council; 2000, pp. 22-26.

[12] - Wolfgang Wuttke et alop. cit.

[13] - D Seidlova-Wuttke et al, “Plant derived alternatives for hormone replacement therapy (HRT),” Hormone Molecular Biology and Clinical Investigation2013 December; 16(1): 35-45.

[14] - WL Wei et al, “Angelica sinensis in China—A review of botanical profile, ethnopharmacology, phytochemistry and chemical analysis,” Journal of Ethnopharmacology

[15] - Heather Boon and Michael Smith, The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs, Toronto: Robert Rose, 2004, p. 85.

[16] - Pharmacopoeia of the People’s Republic of China, Vol. 1, English Edition, Beijing: Chemical Industry Press, 2000, p. 158.

[17] - JR Villanueva et al, “Solving the puzzle: What is behind our forefathers’ anti-inflammatory remedies?” Journal of Intercultural Ethnopharmacology2016; 6(1): 128-43.

[18] - Birgit M Dietz, op.cit., pp. 1047-8.

[19] - W Wuttke et al, “Chaste tree (Vitex agnus-castus)—pharmacology and clinical indications,” Phytomedicine 2003 ; 10 : 348-357.

[20] - Mark Blumenthal et al, eds., “Chaste Tree Fruit,” Herbal Medicine: Expanded Commission E Monographs, Austin, TX: American Botanical Council; 2000, pp. 62-64.

[21] - Eric Yarnell et al, Clinical Botanical Medicine, Second Edition Revised and Expanded, New Rochelle, NY: Mary Ann Liebert, 2009, p. 308.

[22] - Birgit M Dietz, op.cit, p. 1045.

[23] - D E Moerman, Native American Ethnobotany, Portland, OR: Timber Press, 1998.

[24] - F Ellingwood, American Materia Medica, Therapeutics and Pharmacognosy, Portland, OR: Eclectic Medical Publications [reprint of 1919 original].

[25] - Mark Blumenthal et al, eds., “Motherwort Herb,” Herbal Medicine: Expanded Commission E Monographs, Austin, TX: American Botanical Council; 2000, pp. 267-69.

[26] - AB Scholey et al, “An extract of Salvia (sage) with anticholinesterase properties improves memory and attention in healthy older volunteers,” Psychopharmacology2008; 198(1): 127-39.

[27] - Adrian L Lopresti, “Salvia (Sage): A Review of its Potential Cognitive-Enhancing and Protective Effects,” Drugs in R & D2017 March; 17(1): 53-64.

[28] - S Bommer et al, “First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes,” Advances in Therapy2011 June; 28(6): 490-500.

[29] - Patricia L Gerbarg and Richard P Brown, “Pause menopause with Rhodiola rosea, a natural selective estrogen receptor modulator,” Phytomedicine2016 June; 23(7): 763-9.

[30] - Fabricia S Predes et al, “Antioxidative and in vitroantiproliferative activity of Arctium lapparoot extracts,” BMC Complementary and Alternative Medicine2010; 11: 25

[31] - YS Chan et al, “A review of the pharmacological effects of Arctium lappa (burdock)” Inflammopharmacology2011; 19(5): 245-54.

[32] - CC Lin et al, “Anti-inflammatory and radical scavenge effects of Arctium lappa,” American Journal of Chinese Medicine1996; 24(2): 127-37.

[33] - L Maghsoumi-Norouzabad et al, “Effects of Arctium lappa L. (Burdock) root tea on inflammatory status and oxidative stress in patients with knee osteoarthritis,” International Journal of Rheumatic Diseases2016; 19(3): 255-61.

[34] - Matthew Wood, “Arctium lappa (Burdock),”The Practice of Traditional Western Herbalism, Berkeley, CA: North Atlantic Books, 2004, pp. 224-227.

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