Pomegranate seeds have been used traditionally in Mediterranean countries and in ancient Ayurveda for a variety of disorders including infertility, insufficient breast milk, hypermenorrhea, and genital pain. Pomegranate seed oil (PSO) mainly contains unsaturated fatty acids such as γ-linoleic acid (Gamma linolenic acid, or GLA) and linolenic acid and phytoestrogens (campesterol, stigmasterol and beta-sitosterol). These phytoestrogens have led some to assert that it could be an effective option for menopause symptoms such as hot flushes, night sweats, sleep problems, libido and mood. A 2012 study demonstrated that PSO was similar to placebo regarding relief of hot flushes; however, the researchers noted significant improvement in women who were also experiencing difficulty with sleep.1
A 2017 study2 used PSO sourced from Turkey, with 500 mg/capsule of pure PSO at a dose of 1 capsule twice per day (1,000 mg) for 8 weeks. A total of 78 women from two German sites participated in the study. There was one month of no treatment and then two months of treatment with PSO. Women were 45-55 and had menopause symptoms for more than 3 months but a mean duration of 46 months.
The primary outcome was the intensity of sweating and hot flushes as indicated on the German version of the menopausal rating scale (MRS). A secondary issue was to measure the 17-beta estradiol after 8 weeks of treatment and compare it to baseline.
The MRS was scored at baseline, after 4 weeks without treatment, after 4 weeks of treatment and post treatment. Most MRS symptoms were significantly reduced with the greatest improvements seen in hot flushes, sleeping problems, depression, exhaustion and irritability. Hot flushes changed from a score of 2.32 before treatment to 1.41 after. Surprisingly, symptoms of vaginal dryness also improved significantly from 1.32 down to 0.85. No significant changes were seen for joint and muscle complaints, anxiety or urinary symptoms. The levels of 17-beta estradiol were measured at the second baseline and post-intervention. While there was only complete data for 37 women, it was concluded that estrogen levels were not significantly affected by the PSO.
Pomegranate seed oil has been on the market for some time but it has not been typically used clinically for menopause symptoms. While the potential of PSO for common menopause symptoms such as hot flushes, night sweats, sleep problems, fatigue and mood changes is important, I find that the added value of this study is in the improvement of vaginal dryness. There are very few oral botanical options for vaginal dryness and those have only limited clinical evidence of efficacy. More compelling solutions have been vaginal delivery of estrogen products, with a small amount of data on hops vaginal gel, fennel cream, vitamin E suppositories and a few others. Oral PSO may be a new solution for integrative practitioners to consider for this common problem that menopausal women face.
Dr. Tori Hudson directs the curriculum for post-graduate training in women's health at the Institute of Women's Health and Integrative Medicine, and is the director of product research and education for VITANICA. For more information on Dr. Hudson visit http://drtorihudson.com/.
