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Menopause is a natural phase of life for women aged 45-55 years. Though, evolution devised it to protect ovaries from excess oestrogen, it comes with life-changing symptoms. Around 80% of women experience hot flushes and night sweats [1]. Mood swings are reported by 50% of women [2] and 40% have disturbed sleep [3]. Many of these menopause symptoms result from an imbalance of reproduction hormone, oestrogen and happy brain chemical, serotonin. For hot flushes, women are prescribed antidepressants, which may take 4-8 weeks to show effect [4]. These can have serious side effects and are ineffective for some women. This calls for a need for natural supplements for menopause that can safely and effectively improve symptoms.
Serotonin for a mood boost
Serotonin promotes positive mood and lowers stress. At night, it is converted to melatonin, the sleep chemical that promotes restful sleep [7]. Low serotonin levels are associated with low mood and depression [6]. The link between serotonin and menopause can help explain the symptoms experienced. Tryptophan, its building block, found in protein rich foods enters the brain and is converted to 5-HTP which is then converted to serotonin. This makes the direct precursor of serotonin, 5-HTP, an attractive option to directly increase serotonin levels, making it a good contender for the best natural treatment for menopause. Preliminary studies have also shown benefits for mood, sleep, and hot flushes.
Read about the smallest, nutrient-dense 5-HTP tablet providing 100mg of 5-TP here.
5-HTP- a happy pill?
A 13-studies review of 5-HTP supplementation among depressed individuals found that even small doses of 50mg/day had a beneficial effect in lowering depression and improving mood [8]. Another study found that 5-HTP was equally effective in managing depression in 2 weeks, compared to an antidepressant [9]
5-HTP has shown to help improve sleep troubles. 50mg 5-HTP supplementation improved sleep quality and lessened episodes of disturbed sleep [10]. Those supplemented with 100mg 5-HTP fell asleep almost 20 minutes faster [11].
24 women with hot flushes who were supplemented with 150mg of 5-HTP reported a decrease in the number of hot flushes episodes [12]. The small study size meant the evidence is weak and needs further research.
Can the promising pill fight menopause symptoms?
A few studies have shown favourable results about the benefits of 5-HTP for some menopause symptoms. To explore this further, a group of 10 menopausal women (9 women completed the study) volunteered to partake in a pre-clinical study conducted by Brain feed to explore the effects of 5-HTP on menopause symptoms. This study was designed to assess short term (5 days) and long term (30 days) intake. These participants took one 100mg tablet with food every morning. After 5 days and 30 days of intake, they filled a 12-item validated questionnaire reporting their symptoms and mindset. The questionnaire was designed for participants to scale their responses from -5 (Strongly disagree) to 5 (Strongly agree) with 0 being Neither agree not disagree.
Despite the small study size, the results were overall positive. Statistically significant results (those unlikely to occur by chance), were observed for decrease in feeling tense and improvement in sleep quality and libido.
Despite positive results, this study is insufficient to establish 5-HTP as a proven solution for menopause symptoms. Below are the results of this pre-clinical study. The results are a steppingstone towards bigger, higher quality research.
9 participants completed 30 days supplementation of 5-HTP. The collective results of all participants’ responses for the statements in the questionnaire are as follows:
- I am “calm, cool and collected”: There was a 3% increase over 5 days and a consequent 9% increase in feeling calm, cool and collected over 30 days.
- I am less irritated by things than I ever was: There was a 16% decrease in feeling irritated over short term with a 20% decrease in feeling irritated.
- I am less tense: There was a massive 20% decrease in feeling tense over short term of 5 days, which averaged on 9% decrease over the month.
- I take a positive attitude towards myself: There was a stable 11% increase in self-directed positive attitude over short and long term period.
- I have felt particularly excited or interested in something in the past few weeks: There was an initial 12% increase in feeling particularly excited over short term which stabilized to 3% increase long term.
- In general, I consider myself a very happy person: There was an initial decline of 3% over short term, which could be due to varied reasons, but an overall 7% increase in considering themselves a very happy person over 30 days
- I can sleep better than usual: There was a major 33% increase in 5 days of taking 5-HTP, which further bumped up to 38% increase in sleep quality over the month.
- I have no trouble falling asleep on most nights: There was a 12% increase in trouble falling asleep short term. This changed to an overall 1% improvement in falling asleep easily over 30 days
- I have uninterrupted sleep: There was a 15% increase in having uninterrupted sleep disruption over 5 days and this increased further to 19% in a month.
- I have noticed an decrease in the number of hot flushes: There was a 7% decrease over short term period with a stable 8% decrease in the number of hot flushes over 30 days
- I have noticed an decrease in the severity of hot flushes: There was a small 2% decrease in the severity over 5 days and a major 16% decrease in the severity of hot flushes over 30 days
- I have noticed a positive change in my libido: There was a positive 34% increase in libido over 5 days and a 27% improvement in the group’s libido over 30 days
A step towards the perfect solution.
This study is the first step towards producing a strong evidence base to possibly recommend 5-HTP for menopause symptoms. It shows promising results to become one of the supplements for hot flashes. There are many areas of improvement that can be implemented for a robust study. Brain feed strives for the best possible evidence to promote nutrient benefits. The recommendations for future research include:
- Bigger sample size for more reliable results. Involving a large sample in the study can help produce substantial results that can be applicable to the population.
- Using the gold standard research design of a randomized placebo-control trial, where 2 randomly allocated groups are provided either 5-HTP or a placebo (a replica capsule without 5-HTP) to assess the benefit on symptoms.
- Use of objective assessment methods along with validated questionnaires. Use of wearable devices to measure heart rate and temperature for 24 hours can help assess the frequency and intensity of hot flashes. Conducting the study in a sleep lab can provide stronger evidence for sleep quality and hot flashes at night.
- Assessment of dietary intake and physical activity levels of participants for a deeper analysis of all variables involved.
References
- NICE. (2022). Menopause.
- Health & Her. (2021). A fact-based focus on Perimenopause and Menopause issues faced by women. [online]
- Augoulea, A. et al. (2019). Psychosomatic and vasomotor symptom changes during transition to menopause. Przeglad Menopauzalny = Menopause Review, [online] 18(2), pp.110–115.
- Shams, T. et al. (2014). SSRIs for hot flashes: a systematic review and meta-analysis of randomized trials. Journal of general internal medicine, 29(1), 204–213.
- Wiśniewska, I. et al. (2016). The pharmacological and hormonal therapy of hot flushes in breast cancer survivors. Breast Cancer (Tokyo, Japan), [online] 23, pp.178–182.
- Freedman, R.R. et al. (2010). Treatment of menopausal hot flashes with 5-hydroxytryptophan. Maturitas, 65(4), pp.383–385.
- Poza, J.J., et al. (2020). Melatonin in sleep disorders. Neurología
- Javelle, F. et al. (2019). Effects of 5-hydroxytryptophan on distinct types of depression: a systematic review and meta-analysis. Nutrition Reviews.
- Jangid, P. et al. (2013). Comparative study of efficacy of l-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode. Asian Journal of Psychiatry, 6(1), pp.29–34.
- Meloni, M. et al. (2021). Preliminary finding of a randomized, double-blind, placebo-controlled, crossover study to evaluate the safety and efficacy of 5-hydroxytryptophan on REM sleep behavior disorder in Parkinson’s disease. Sleep and Breathing, 26(3), pp.1023–1031.
- Sutanto, C. et al. (2021). The Impact of 5-Hydroxytryptophan Supplementation on Sleep Quality of Older Adults in Singapore: A Randomized Controlled Trial. Current Developments in Nutrition, 5(Supplement_2), pp.372–372.
- Freedman, R.R. (2010). Treatment of menopausal hot flashes with 5-hydroxytryptophan. Maturitas, 65(4), pp.383–385.
