Perimenopause and menopause symptoms are an individual experience for each woman. Some women experience symptoms that are few and short term and other women can experience significant and moderate to severe symptoms and for many years. Physical, emotional, and urogenital symptoms may be experienced, and some can have a significant impact on health and quality of life. Symptoms include hot flashes, night sweats, sleep disruption, fatigue, concentration problems, memory changes, frequent urination, depression, anxiety, mood swings, irritability, decrease in sexual desire and/or arousal, vulvovaginal dryness and discomfort, body aches, skin dryness, dry eyes, hair thinning, increase in facial hair, weight gain, and a few others, although that list is long enough. Other issues that more effect longevity and mortality include changes in lipids, increases in risk of cardiovascular diseases, decline in muscle mass and decline in bone density.
Treatment options include select lifestyle changes, botanicals, nutraceuticals, over the counter and prescription non-hormonal pharmaceuticals, and hormone therapy.
Research in this area of treatment options for menopause symptoms is robust and ongoing. The current study is the first published study on the effects of olive leaf extract (OLE) on postmenopause symptoms. The study also explored the effects of OLE on body composition, handgrip strength and blood lipid profile in postmenopausal woman.
This randomized, double-blinded parallel study design in which 60 healthy postmenopausal women aged 47-70 years, received either OLE 250 mg/day containing 100 mg of oleuropein per day or placebo (cellulose) for 12 weeks. Postmenopausal symptoms were assessed with common research tools including the Menopause-Specific Quality of Life Questionnaire (MENQoL), the Hot Flash Interference scale (HFI), and body composition and bone mineral density (BMD) with DXA scan and lipids with a serum lipid panel.
After six and twelve weeks of OLE supplementation, the overall MENQoL score significantly improved compared to placebo. The MENQoL is a 29-item questionnaire designed to measure four domains of menopausal symptoms (vasomotor, psychosocial, physical, and sexual) in the past month. Participants rate how bothersome each symptom is on a 7-point scale. Higher scores indicate more severe menopausal symptoms and a lower quality of life. Vasomotor, psychosocial, physical, and sexual domain scores when taken singularly were not significantly different between OLE and placebo groups. However, a trend towards benefit was seen in the OLE group in the physical domain and the overall MENQoL score was improved in the OLE group. There was no significant treatment effects recorded for HFI, fat mass, total body fat mass or fat free mass.
A significant improvement was observed in the BMD in the right arm in the OLE group compared to the placebo. Triglyceride concentrations were slightly decreased in the OLE group and slightly increased in the placebo group. There were not changes in body composition.
Commentary: Phytoestrogens are plant derived compounds that are similar in structure to the primary female sex hormone, 17-beta estradiol. Phytoestrogens can bind to estrogen receptors producing weak estrogenic effects in some tissues and anti-estrogenic effects in others. Oleuropein is the most abundant polyphenol, and a phytoestrogen, in olive tree leaves.
There are limitations of the current study. The design did not take into consideration including women experiencing moderate to severe vasomotor symptoms (hot flashes, nightsweats) and the study group ranged only from mild to moderate. It is less likely to observe an improvement in the HFI questionnaire in mild to moderate cases of VMS, which was true in this study. Another limitation was that they chose to measure body composition with DXA scan rather than more sensitive technologies for assessing body composition. The study was also quite small, with an evaluation for 30 in each group.
Overall, the treatment effects were less than compelling in my view, with OLE having a small improvement in the total collection of menopause symptoms, a small improvement in BMD and small decrease in serum triglycerides. Other than encouraging the increase dietary intake of olives and olive oil in the diet, I will likely wait for more research before adding olive leaf extract as a botanical supplement contender for menopausal women.
Reference: Imperatrice M, Lasfar A,. van Kalkeren C, Troost F. Olive leaf extract supplementation improves postmenopausal symptoms: a randomized, doub le-blind, placebo-controlled parallel study on postmenopausal women. Nutrients 2024; 16: 3879
