Dong Quai
Specifically for Menopause
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Why it works for Menopause:
Traditional use & putative mechanisms. In Traditional Chinese Medicine, dong quai is used in many “women’s health” formulas. Constituents such as ferulic acid and ligustilide have vasoactive, anti-inflammatory, and possible estrogen-like effects in preclinical models—reasons it’s marketed for hot flashes and other vasomotor symptoms. However, in humans the clinical signal for menopause is inconclusive. Memorial Sloan Kettering Cancer Center
Evidence summary from U.S. government sources. The U.S. National Center for Complementary and Integrative Health notes that very little research has tested dong quai for menopausal symptoms and no firm conclusions can be drawn. They also flag potential interactions with anticoagulants. NCCIH
Key randomized trial (monotherapy): no benefit. A double-blind, placebo-controlled RCT (71 postmenopausal women, 24 weeks, 4.5 g/day of root) found no improvement in hot flashes or other menopausal symptoms vs placebo and no estrogenic stimulation of the endometrium. This negative trial is frequently cited by regulators. FertStert
Combination products: mixed/low-certainty signals. Trials of multibotanical mixtures (which often include dong quai plus black cohosh, red clover, ginseng, etc.) have sometimes reported improvement, but better-designed NIH-funded work (HALT Study) showed no benefit for the multibotanical arm vs placebo on vasomotor outcomes. Because these mixes contain many herbs, any effect cannot be attributed to dong quai itself. world.30plus.co.nz
How to use for Menopause:
Regulatory monograph (Canada): For adults, typical oral quantities for traditional use are 4.5–15 g/day of dried root, prepared as powdered herb, decoction, tincture, fluid extract, or non-standardized water/ethanol extracts. The monograph advises seeking medical advice for use beyond 6 months. Health Canada
Formulations: Dong quai is sold as capsules/tablets of powdered root or extracts, liquid extracts/tinctures, and as dried root for teas/decoctions. (Again, these are forms—not endorsements for menopause efficacy.) Health Canada
Practical guidance if you still choose to try it (despite limited efficacy):
- Start at the low end of the traditional range (if using dried root) or follow the product’s standardized-extract instructions; do not exceed label directions. Health Canada
- Avoid sun exposure / use sun protection during use due to photosensitivity risk. Health Canada
- Check interactions (especially blood thinners, hormone therapy, and other CYP3A4 substrates) with a clinician or pharmacist before starting. Memorial Sloan Kettering Cancer Center
- Stop and seek care if you develop breast pain, abnormal bleeding, or cycle changes (if peri-menopausal), or if symptoms persist/worsen. Health Canada
Scientific Evidence for Menopause:
Monotherapy RCTs / human data
- Hirata et al., 1997 (Fertility & Sterility): 71 postmenopausal women; dong quai did not reduce vasomotor symptoms and showed no endometrial stimulation vs placebo. FertStert
- WHO monograph review: Summarizes the above RCT and states uses supported by clinical data: none for menopause. Keva Kaipo Industries
Combination products including dong quai
- HALT Study (NIH-funded): Randomized, double-blind, placebo-controlled trial comparing black cohosh alone, a multibotanical formula (black cohosh + alfalfa, chaste tree, dong quai, false unicorn, licorice, oats, pomegranate, Siberian ginseng, boron), and other arms; no improvement in hot flashes vs placebo. world.30plus.co.nz
- Other small combination-product trials (e.g., “Phyto-Female Complex”) report benefits but are limited by small size, short duration, and multiple active ingredients—so they cannot establish dong quai’s independent efficacy. Tel Aviv University
Authoritative secondary sources
- NCCIH (NIH): “Very little research… no conclusions” for menopause; warns of warfarin interaction. NCCIH
- Memorial Sloan Kettering (MSKCC) About Herbs: Summarizes inconclusive effectiveness for menopausal symptoms; details interactions (e.g., anticoagulants, possible CYP3A4 induction), photosensitivity, and case reports. Memorial Sloan Kettering Cancer Center
- Health Canada monograph (2024): Provides traditional dose ranges, duration limits, and safety language used on licensed products in Canada. Health Canada
Specific Warnings for Menopause:
Pregnancy & breastfeeding: Do not use. Risk of miscarriage and lack of safety data in lactation. Memorial Sloan Kettering Cancer Center
Bleeding risk / anticoagulants: May potentiate warfarin and increase bleeding; elevated PT/INR has been reported. Exercise caution with any blood thinners or antiplatelet therapy. Memorial Sloan Kettering Cancer Center
Photosensitivity: Increased sensitivity to sunlight; avoid sun exposure or use protection while taking. Health Canada
Hormone-sensitive conditions: Because some lab work suggests estrogenic or proliferative activity, avoid or use only under oncology/gynecology guidance if you have hormone-sensitive cancers (e.g., certain breast cancers). Memorial Sloan Kettering Cancer Center
Drug interactions (selected): Possible CYP3A4 induction with prolonged use (could lower levels of some meds); case-based concerns with clozapine; theoretical interactions with ACE inhibitors and dual antiplatelet therapy (animal data). Discuss all meds with a clinician before starting. Memorial Sloan Kettering Cancer Center
GI & skin effects: Bloating, appetite loss, diarrhea; photosensitive rashes reported. Memorial Sloan Kettering Cancer Center
Other contraindications noted by regulators: Heavy menstrual bleeding, diarrhea, or hemorrhagic disorders—avoid use. Seek medical advice if using >6 months. Health Canada
General Information (All Ailments)
What It Is
Dong Quai (pronounced “dong kwai”), also known as Angelica sinensis or “female ginseng,” is a traditional Chinese medicinal herb derived from the root of the Angelica plant, native to China, Japan, and Korea. It has been used for over a thousand years in Traditional Chinese Medicine (TCM), primarily to support women’s reproductive health. The root is typically dried and used in herbal teas, capsules, extracts, or powders.
Dong Quai contains several bioactive compounds such as ferulic acid, ligustilide, polysaccharides, and coumarins, which are believed to contribute to its therapeutic effects. In TCM, it is often prescribed in combination with other herbs rather than used alone, forming part of well-known formulas like Dang Gui Bu Xue Tang or Si Wu Tang.
How It Works
Dong Quai is thought to work through multiple mechanisms that influence blood, hormones, and inflammation:
- Blood Nourishment and Circulation – In TCM, Dong Quai is said to “nourish and invigorate the blood.” Modern research supports that it can improve blood flow, reduce clot formation, and may act as a mild vasodilator, thanks to compounds like ferulic acid.
- Hormonal Modulation – Although not a phytoestrogen in the strict sense, some studies suggest that Dong Quai may mimic or influence estrogenic activity in the body, helping balance hormone levels, particularly during menopause or menstrual irregularities.
- Anti-inflammatory and Antioxidant Effects – The herb contains antioxidants that combat oxidative stress and may reduce inflammation, which contributes to its use in easing menstrual cramps and menopausal discomforts.
- Smooth Muscle Relaxation – Ligustilide, one of its main compounds, can relax smooth muscles, particularly in the uterus, which may explain its reputation for alleviating menstrual pain or uterine tension.
Why It’s Important
Dong Quai holds importance both in traditional and modern herbal medicine for its broad range of health benefits, especially concerning female reproductive wellness:
- Menstrual Regulation – It’s commonly used to relieve menstrual cramps, regulate irregular cycles, and ease premenstrual syndrome (PMS) symptoms.
- Menopausal Support – Dong Quai may help reduce hot flashes, mood swings, and fatigue during menopause by supporting hormonal balance.
- Postpartum Recovery – Traditionally, it’s used to rebuild blood and restore vitality after childbirth.
- Circulatory and Cardiovascular Health – Due to its blood-improving effects, it may support heart health, reduce inflammation, and improve microcirculation.
- General Vitality – It’s sometimes used to enhance energy, reduce fatigue, and promote overall balance, earning it the name “female ginseng.”
Considerations
While Dong Quai is widely regarded as beneficial, several precautions and contraindications must be noted:
- Hormone-Sensitive Conditions – Because of its potential estrogen-like effects, it may not be safe for individuals with hormone-sensitive cancers (such as breast, ovarian, or uterine cancer) or endometriosis.
- Pregnancy and Breastfeeding – It is not recommended during pregnancy, as it may stimulate uterine contractions and increase the risk of miscarriage. Safety during breastfeeding is also not well established.
- Blood-Thinning Effects – Dong Quai can increase bleeding risk, especially when combined with anticoagulant or antiplatelet medications (e.g., warfarin, aspirin). It should be discontinued before surgery or dental procedures.
- Photosensitivity – Prolonged use may increase sensitivity to sunlight, leading to a higher risk of skin irritation or sunburn.
- Dosage and Quality – The dosage varies depending on the form and combination with other herbs. Because supplements can differ in potency and purity, it’s important to choose products from reputable sources and consult a qualified healthcare provider before use.
Helps with these conditions
Dong Quai is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Menopause
Traditional use & putative mechanisms. In Traditional Chinese Medicine, dong quai is used in many “women’s health” formulas. Constituents such as...
PMS
Traditional/TBM rationale (not proof): In Traditional Chinese Medicine (TCM), dong quai is used to “invigorate and tonify the blood” and is commonly i...
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