The efficacy and safety of plant-based interventions in improving mental health outcomes among women during menopause – A systematic review

Background: Menopause is often accompanied by psychological disturbances such as Anxiety, Depression and Stress, which can adversely affect a woman’s quality of life. Plant based interventions are increasingly explored as alternatives to hormonal therapies due to their perceived safety and accessibility.

Objective: This study aims to examine the potential therapeutic benefits and safety of herbal interventions for menopause associated psychological symptoms such as Depression, Anxiety, Stress and Overall Quality of Life.

Methods: A systematic search was conducted in PubMed, Web of Science and Google Scholar for studies published between 2020 and 2025 using the keywords Menopause, Depression, Anxiety and Plant Medicine. PRISMA guidelines were followed. Of 1380 records screened, 25 studies met the inclusion criteria. All included studies were human clinical studies, with no in vivo (animal) or in vitro studies identified. Exclusion criteria included Insufficient Data, Irrelevance and Lack of Full Text Access.

Results: Eighteen plant-based interventions were identified, including Crocus sativus (Saffron), Rosa damascena (Damask Rose), Vitex agnus-castus (Chaste tree), Salivia officinalis (Sage), Lavandula angustifolia (Lavender), Matricaria chamomilla (Chamomile), Panax ginseng (Ginseng), Melissa officinalis (Lemon Balm), Nigella sativa (Black seed) and several polyherbal formulations. The human clinical evidence demonstrated reduction in Depression, Anxiety and Stress with improvements in quality of life. Crocus
sativus (Saffron) demonstrated the most consistent improvements in both Anxiety and Depression with favorable safety profiles. Conversely, Elaegnus angustifolia (Russian olive) and Rheum ribes (Rhubarb) showed no significant psychological benefits. Additional promising effects were reported for Cimicifuga racemosa (Black Cohosh), Trigonella foenum-graecum (Fenugreek), Humulus lupulus (Hops), Valeriana officinalis (Valerian), Passiflora species (Passion Flower) and Glycine max (Soy isoflavines) which improved mood and Anxiety symptoms with minimal adverse effects.

Conclusion: Evidence from human clinical studies suggests that several plant-based therapies may alleviate menopause related psychological symptoms, particularly Anxiety and Depression. However, interpretation of the findings is hindered by modest sample sizes and variability in methodological heterogeneity. More rigorous clinical trials are required to confirm efficacy, establish standardized dosages and ensure safe clinical use.