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Dr. Tori Hudson, Portland, Oregon, Blog Healthline Blog

The purpose of this study was to evaluate the efficacy of a low dose of pycnogenol French maritime pine bark for any effect on perimenopause symptoms. This double-blind, placebo-controlled study was conducted in 170 perimenopausal women. They were given 30 mg of pycnogenol or placebo twice daily for 3 months. Perimenopause symptoms were evaluated using 2 very common research tools called the Women’s Health Questionnaire (WHQ) and the Kupperman Index (KI). Some sex hormones and routine blood chemistry tests were also performed.

Results: Compared to baseline pre-study, pycnogenol significantly improved all symptoms with the exception of itching sensation and abnormal perceptions. There was a significant overall placebo effect as well in the majority of the WHQ categories. But, pycnogenol was especially effective and significantly more effective than placebo for improving hot flashes and night sweats and insomnia/sleep problems. The total KI for the severity score of perimenopausal symptoms was decreased by 56% in the pycnogenol group and 39% in the placebo group, after 12 weeks, but it was already significantly better after 4 weeks of pycnogenol treatment.

Commentary: In a past study, pycnogenol was shown to improve perimenopause symptoms in all categories of the WHQ when compared to placebo. (Yang H, et al. Acta Obstet Gynecol Scand 2007;86:78-985) That study used a rather high dose of pycnogenol at 100 mg twice daily in perimenopausal Taiwanese women. Based on other research using pycnogenol at 60 mg/day for endometriosis and dysmenorrhea , the current authors theorized that a lower dose of pycnogenol could also help with menopausal symptoms, thus their choice of 60 mg/day versus duplicating the 200 mg/day dosing of the other study. However, the results of this current study do not duplicate the same level of efficacy as was seen in the Taiwanese study of 200 mg/day. Perhaps this could be explained by the lower dose. Another study was done in the past where 100 mg /day was used and showed benefit using a different questionnaire than the WHQ or the KI. In any case, the KI was statistically significant in the current study of 60 mg/day of pycnogenol. The mechanism of action of pycnogenol for this purpose remains unknown, but we do know from other research that pycnogenol helps to dilate the peripheral vascular system due to its effects on the endothelium of the vessels. Thermodysregulation is related to lowered estrogen levels at menopause- both in the blood and in the temperature regulating center of the hypothalamus, and estrogen treatment is very effective at eliminating hot flashes and night sweats. Perhaps the effect of pycnogenol on vasodilation helps the body to emit the excess heat; only a theory. In any case, pycnogenol should now be considered a reasonable option for hot flashes/night sweats, and given the increased risk of cardiovascular disease associated with postmenopause, and the improvement of pycnogenol on endothelial function, it becomes an option with more than one purpose and benefit.


Kohama T, Negami M. Effects of low-dose French maritime pine bark extract on climacteric syndrome in 170 perimenopausal women. J Reprod Med 2013;58:39-46

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