It’s all too common: Women seeking help for common concerns such as feeling tired are told it is just part of being a mom, or of working, or of aging...or one of countless other brush-offs. “Women face all sorts of health concerns, which, unfortunately, go misdiagnosed or unchecked by health professionals for far too long,” says Jessica Gitsham, Sales & Marketing Manager for Natracare. “We hear often of how women suffer from debilitating period pains and are told it’s perfectly normal, only to find out years later that they have very advanced endometriosis. Or women who experience stress incontinence and pee when they cough, sneeze or laugh. This is very treatable with pelvic focused physiotherapy, but again, it goes unchecked because of stigma around women’s health issues.”

Thankfully, more women are refusing to accept that they just have to deal with feeling less than their best, and instead seeking out more information and turning to natural products. A report from Grand View Research, published in February 2020, found that the global women’s health market is expected to hit a CAGR of 4.9% through 2027 for a market size of $47.8 billion (1).

John Peine, Founder of Friska, explains that this is in part due to education. "There is a growing awareness of the importance of gut health and its connection to immune support, overall health, and even emotional well-being."

And what education women may not have received, they are seeking out. “Women are asking more and better questions, and seeking out complete answers, more than they may have 20 years ago,” says Cheryl Myers, Chief of Scientific Affairs and Education at Terry Naturally/EuroPharma Inc. “I hope that they have begun to explore more natural options for their health, and how nutritional supplements can help them with specific and general concerns, whether that includes vaginal dryness, breast health, hormone and estrogen function, or any other challenge. I’m optimistic that we’re moving in the right direction.”
Health Tips by Decade
Dr. Josh Axe shares his strategies for healthy aging.

20s: “You want the health you have in your 20s to help catapult you into your 30s and beyond. That’s why it’s important to eat a healthy diet and to get regular exercise several days a week,” says Dr. Josh Axe, who also noted that at age 27 a significant score decline was first noted in the areas of mental speed, reasoning, and visual puzzle-solving ability. Collagen production, too, begins to decline in the mid-to-late 20s.

30s: Women in this decade “may notice a loss of muscle tone, decreased energy levels, and a sense that there just aren’t enough hours in a day to do everything you’re expected to do.” He adds that maintaining healthy bone mass begins during the 30s. His recommendations include eating healthy proteins as well as fruits and vegetables, as well as an exercise regimen involving weightlifting, resistance training, and aerobic activity.

40s: “For many women in their 40s, increased job responsibilities combine with complex family demands to create a decade that can determine their future health.” Women should eat wild-caught fish, flax seeds, fermented soy, and fresh vegetables and fruits, Dr. Axe recommends.

50s+: Dr. Axe’s advice here: “Women should select a diet rich in omega-3s, calcium, and vitamin D, and be sure to include weight-bearing exercises and stretching exercises in your health regimen to support heart health, bone health and hormonal health.” He also notes: “70% of women ages 51-70 and 90% of women over 70 don’t get enough vitamin D, so don’t skimp on vitamin D-packed foods. Digestion may also be sluggish, so eat foods rich in probiotics, enzymes, and fiber.”
Addressing Common Concerns
While heart health, cognitive health, and immune health are common across all genders, some concerns regularly raised by women include:

Tiredness: “A CDC survey from a few years ago pointed out that women ages 18 to over 75 were, overall, coming up short on energy at a rate of 15% vs. men who came in at 10%,” explained Dr. Josh Axe, D.N.M., C.N.S., D.C., Founder of Ancient Nutrition and DrAxe.com. “The rates for women were a bit higher for the age groups 18-44 and 45-64. In one survey, 41% of women in their 20s and 30s wished they didn’t look so tired. That doesn’t even include the estimated 20% of women of childbearing age who may have iron-deficiency anemia, leading to an energy shortfall, among other things. Getting enough iron and B vitamins is so important for energy levels.”

When considering energy levels, it’s important to look at iron: “According to WHO, iron deficiency anemia is the most common nutrient-related disorder, affecting 1.62 billion people, with women making up the greatest number of those affected,” says Tom Druke, Marketing Director at Balchem. Iron deficiency has many negative effects, he says. In addition to fatigue he lists chest pain, coldness in the extremities, difficulty concentrating, headache, irregular heartbeat, shortness of breath, and weakness (2). Druke also points to additional problems for pregnant women: “Studies have shown that pregnant women, without supplementation, deplete their iron stores and do not experience the increase in red cell mass seen in women receiving iron supplementation.” Albion’s Ferrochel, Druke says, has been shown to be highly bioavailable and devoid of gastric side effects, potential for drug interaction problems, and negative dietary interactions.

Emotional Wellness: Stress and anxiety are only rising in these troubled times, says Marita Schauch, N.D., Health Educator on behalf of Natural Factors. “Over the last few months I have seen more women deal with increased levels of stress, trying to juggle being a parent, teacher, chef, and entertainer—especially with young kids at home,” she explains. “They have experienced more anxiety and sleep disturbances as a result, and have felt the day-to-day effects on their wellbeing and overall health. The adrenal glands—our stress glands—are working in overdrive, and hormones like cortisol fluctuate more dramatically, contributing to anxiety, low mood, fatigue, sleep disturbances, worsening of menopausal symptoms, weight gain, digestive issues, and many more.” Natural Factors’ WomenSense AdrenaSense provides herbs to help balance cortisol levels and help women adapt to and cope with stress.

“Statistically, women are twice as likely as men to experience anxiety, depression, and insomnia,” says Jessica Mulligan, Founder of Winged CBD. “This is due to a myriad of reasons—and one important one is that we have different hormone responses, which is why it’s important to take products tailor-made for our bodies.” To this end, Winged CBD is unlike many other brands. “In Winged’s unique formulations, we take full-spectrum hemp extract one step further, adding nutrients that specifically support women, like evening primrose oil, black cohosh, chaste tree berry, and lemon balm.” Women looking for CBD—and tailored support—may find Winged to be a good fit.

Emotional wellness plays a role in physical health, too. Jing Struve, CEO and Executive Director at Farlong Pharmaceuticals, notes that “emotional and mental health are also vitally important. Since emotions and thoughts can affect your physical health, women need to make mental health a priority in order to achieve total wellness.”

The herb shatavari may be useful here, too, suggests David Winston, RH(AHG), President and Founder of Herbalist & Alchemist. His formula, Women’s Adapt, “combines adaptogenic herbs with nutritive tonics, developed for women who are fatigued and experiencing dryness, brain fog, and hormonal imbalances,” he says. “It contains the energizing adaptogens Shatavari and Red Ginseng to rejuvenate and support female libido as well as endocrine, immune and nervous system function. It also contains Processed Rehmannia, a restorative yin and blood tonic, as well as Ginseng and Shatavari to alleviate vaginal dryness and fragrant Rose petal for antidepressant and nervine activity.”
Spotlight on Pycnogenol
There are plenty of herbs out there that women may find helpful—black cohosh, chaste tree, shatavari—and another one that women may find supportive of overall health is Pycnogenol, a French maritime pine bark extract. Horphag Research’s Sébastien Bornet notes that Pycnogenol has been shown in studies to improve osteoarthritis symptoms, reduce oxidative stress, help alleviate symptoms associated with menopause transition, reduce cardiovascular disease risk markers, increase the efficacy of oral contraceptives in improving symptoms of endometriosis, reduce symptoms of menopause including hot flashes, act as an anti-inflammatory, promote natural generation of collagen and hyaluronic acid, and help reduce pain in women with dysmenorrhea.
Hormonal health: “It is important for women to understand the role hormones play in their lives and to have conversations about hormones with their friends and doctors,” opines Anju Sodhi, BAMS, ND, associated with Ayush Herbs. “Society often leaves us with a negative connotation of hormonal fluctuation, but it is simply our bodies doing their work. Sometimes our hormones just need a helping hand, or herbal guide, so that we can live our best lives.” Dr. Sodhi notes that hormones naturally fluctuate throughout the month, which can cause estrogen imbalance, painful periods, a bad mood, infertility, and early menopause. These problems can be exacerbated by an unhealthy diet, alcohol, or tobacco. Her suggestion: “Sitawari, also known as Shatavari. This wonderful herb has been used as a tonic for women’s health in Ayurvedic medicine for centuries. It balances hormones, especially estrogen, and guides the body into homeostasis. It is cooling and allows us to stay calm and collected throughout the month of hormonal changes.”

Struve also listed hormone health as a top concern for women. Her solution: “Farlong’s Hormone Balance is formulated with black cohosh extract, Dong Quai extract, and AstaBest astaxanthin. It is used to alleviate hot flashes, improve sleep, and reduce mood swings and anxiety. It also enhances estrogen production.”

And then, of course, there’s what Schauch calls the “foundation” of healthy hormonal balance: “I always recommend to my patients to focus on a healthy foundation of whole and nutritious foods, movement, and sleep. These key foundational tools can help minimize many other health concerns that women may have. I believe starting education in the early years about hormone disruptors in the environment, refined sugars, and a sedentary lifestyle—and how these impact our overall hormone health—needs to be a priority.”

PMS and Menopause: People who menstruate face the added physical and emotional struggles of premenstrual syndrome and peri-menopausal symptoms, points out Winston, which may call for more specialized supplement assists. “Women’s Calmpound is designed to restore emotional balance, especially with women suffering from PMS irritability or peri-menopausal anxiety,” Winston says. “This includes Chaste Tree, which in human studies has been found to reduce both PMS and peri-menopausal symptoms, particularly emotional ones, along with the anxiolytic herbs Motherwort, Skullcap, Blue Vervain and Pulsatilla. Motherwort, Blue Vervain and Pulsatilla together is a classic combination, dating back to the Eclectic Physicians who first noted that these herbs in combination are far more effective than either individually.”

A stressor that affects those who menstruate: access to menstrual care products. Rebecca Alvandi, Co-Founder of Maxim, says that to this end, “What motivates us as a company is the way we infuse our brand with a spirit of empowerment around being more socially responsible and making mindful lifestyle choices around giving. For example, we’ve supported menstrual health related bills that make menstrual care products more accessible in public restrooms, and we donated 280,000 tampons to help over 33,000 women in need.”

Turning to menopause, Winston notes that Black Cohosh is often touted as the menopause herb—but he maintains that this is a “myth.” “Black Cohosh offers some benefits for reducing the number and severity of hot flashes, but is not terribly effective as a standalone herb. If I had to pick a single most effective herb for hot flashes and night sweats it would be Chaste Tree, which works via the pituitary re-regulating FSH and LH levels. However, these two herbs in combination is far superior to either by itself.”

It’s also worth noting, according to Myers, that with black cohosh, “there is a less obvious corollary to dosage levels than to the quality of the plant material itself—concentration, extraction process, and much more indicate effectiveness. In fact, studies have shown that low doses of black cohosh can be more effective than high doses for menopause relief.” She also suggests rhodiola—“In a recent published clinical trial, our Menopause Relief PLUS was clinically tested against single-ingredient black cohosh products. It found that adding rhodiola reinforces the restorative power of black cohosh for menopause.”

Vaginal Health: Urinary tract and vaginal health is a major issue for many. Trisha Sugarek MacDonald, BS, MS, Sr. Director of R&D/National Educator at Bluebonnet Nutrition, tells WholeFoods that among the non-institutionalized geriatric population, UTIs are the second-most common infection, and are estimated to account for approximately 25% of all bacterial infections. Nearly 1 in 3 women will have had at least one episode of UTI requiring antimicrobial therapy by the age of 24. The urogenital tract, Sugarek MacDonald explains, is particularly susceptible to harmful bacteria, and it can be thrown out of balance by antibiotics, birth control, and other factors. Bluebonnet provides Urinary Tract Support capsules, formulated with D-mannose, cranberry fruit extract, and sustainably harvested or wildcrafted herbs and botanicals to help support a healthy urinary tract by flushing out undesirable microbes and providing an environment that allows healthy flora to thrive.

Neil E. Levin, CCN, DANLA, NOW Senior Nutrition Education Manager, goes into a little more detail regarding those healthy flora, noting that Lactobacilli—particularly Lactobacillus acidophilus and Lactobacillus casei—are major constituents of the normal flora of the vagina and urinary tract. “They provide protection against colonization by undesirable organisms via their production of bacteriocins, lactic acid, and hydrogen peroxide to regulate their environment,” he says. NOW sells a Women’s Probiotic specifically formulated to support vaginal health—as well as healthy immune function in pregnant and nursing women, and GI regularity.

When it comes to vaginal dryness, herbs can again step in to help out. Winston recommends his Replenish Compound, “a combination of nutritive and moistening herbs that correct vaginal dryness often accompanying the hormonal changes of menopause. It contains Fresh Milky Oat, which was used by the Eclectic Physicians (1830-1940s) to enhance sexual performance in women and men. It also has Shatavari; Licorice, which helps to re-regulate hormonal levels; and Dong Quai, which promotes pelvic circulation and cornification of vaginal tissue. The last ingredient is White Pond Lily, an old Thomsonian/Physiomedical remedy for atonic, irritated mucous membrane tissue. This combination of herbs gently improves the health and normal lubrication of vaginal mucous membranes.”

Another option: Omega-7, which Terry Naturally sells as a sea buckthorn supplement. “It is a rich source of the rare omega-7 fatty acid, as well as other beneficial plant nutrients and essential fatty acids,” says Myers. “The source of this amazing mix of nutrients is from the seed and berry of the sea buckthorn. This complete sea buckthorn extract promotes a healthy mucosal membrane in the vagina, and has been shown to reduce the burning, itching, and dryness of Sjögren’s syndrome.” She notes that researchers on one study concluded that it was the appropriate nutrient for postmenopausal women who can’t use estrogen for excessive vaginal dryness. “Given this, I think that Omega-7 should be used proactively to avoid the vaginal dryness that tends to increase with age.”

Also to consider with vaginal dryness: for some, it may begin with menstrual products. “Vaginal dryness and irritation is one of the main issues we set out to address when Maxim first launched,” Maxim’s Alvandi explained. “Minimizing exposure to dioxins released in the chlorine bleaching process was another important concern we had about conventional mainstream products. More recently, there is growing research and concern about possible hormone and endocrine disrupting agents found in plastic- and synthetic-based feminine hygiene products.” Maxim uses pure organic cotton, which is hypoallergenic, and grown without pesticides including glyphosate, which Alvandi says “has been linked to causing liver disease, birth defects, and reproductive problems in laboratory animals.”

Other things to avoid in menstrual products: perfumes and dyes, says Gitsham. “Probably the most common problem raised with regards to menstrual products is skin irritation when using certain brands. Itching, soreness, and some symptoms similar to thrush can make periods a dreaded moment in the month for some women. This all comes from a skin sensitivity to the ingredients in mainstream menstrual products.” Natracare products are made with organic cotton and wood pulp.

Another purveyor of natural menstrual products: The Honey Pot Company, which uses organic cotton and essential oils to provide a cooling effect. The company also sells post-partum herbal pads, vaginal washes, and cleansing wipes.

Sexual Function: “Sexuality is a complex process coordinated by the neurological, vascular, and endocrine systems,” says Sugarek MacDonald. “Because of this, many women can experience problems with sexual function—for various reasons—at some point in their life while some may have difficulties throughout their entire life. Female sexual dysfunction (FSD) can occur at any age and affects 40-45% of women worldwide. It is characterized by persistent, recurrent problems with sexual response, desire, orgasm, or pain, and distresses the individual. There are numerous types of sexual dysfunction for which women are seeking help, including low sexual desire, sexual arousal disorder, orgasmic disorder, and sexual pain disorder. The cause for each of these can be singular or a combination of physical, hormonal, psychological, or social factors.” Bluebonnet sells a line of Intimate Essentials, to support female libido, hormonal balance, and healthy sexual function.

Many who are sexually active may not be looking to get pregnant—they may take oral contraceptives to prevent this, not to mention the many women who take birth control in order to manage a health issue. However, Sébastien Bornet, VP Global Sales & Marketing at Horphag Research, notes that this comes with additional health problems, such as thrombosis, the forming of blood clots in blood vessels. As the blood clots can loosen, travel, and become lodged in the lungs, this can be serious (source). Fortunately, however, “A study from 2004 showed that Pycnogenol could have a preventative effect on thrombosis development in flight passengers,” Bornet says, which may be helpful for those taking oral contraceptives.
Support for a Healthy Pregnancy
Those who want to get pregnant should start early, according to Bluebonnet’s Sugarek MacDonald. She suggests physical activity, a good diet, and a prenatal vitamin—even prior to pregnancy. “Once you are pregnant, the baby is developing at an exponential rate,” she explains. “And having supplied your body with adequate nutrients ahead of time will help support the baby’s growth development. The U.S. daily values for some nutrients double during pregnancy; therefore, supplementation may be the only way to guarantee that mom’s nutrient needs are met.” Specifically, she notes, iron and B vitamins are vital. For one thing, she explains, approximately 28 days after conception, the neural tube begins to close, and it requires appropriate amounts of folic acid to seal.

Levin adds to that DHA: “It may not be in most prenatal vitamins, but the mother needs to get it from somewhere. If not fish oil, then an algae source is recommended to enhance development of the child’s brain and nerves. While DHA can also be manufactured in the body from some vegetable oils high in the omega-3 fatty acid ALA—such as walnuts, chia, and flax oils—that conversion relies on an enzyme that’s magnesium dependent, and so requires adequate magnesium intake.” NOW sells Prenatal Gels + DHA to help with this issue.

This information may be particularly useful and important for women of color, especially black women, who face enormous disparities in terms of risk factors for a difficult pregnancy, healthcare during and post-pregnancy, and difficulty accessing healthcare in the first place.

Once pregnant, Melinda Olson, Founder and CEO of Earth Mama, says that “everything changes”: “Mama is excited, she’s thrilled, maybe even a little scared. But simultaneously, she might be starting to deal with pregnancy symptoms. Let’s say she’s experiencing morning sickness, or heartburn. Or perhaps her skin tends toward eczema, or she has a sore throat. The question becomes: How can I safely address these discomforts?”

Olson’s suggestion: herbal care. “After all, childbirth has been supported by Mother Nature’s remedies for eons!” She explains: “This means formulations that steer clear of potentially harmful ingredients. It also means making a concerted effort to educate mamas about the importance of simply reading a product’s label. If, for example, a pregnant woman is making the effort to feed herself and her unborn baby organic food, free of things like GMOs, pesticides, and artificial dyes, she’ll want to address what’s in her personal care products, too. What’s in her deodorant matters, because it goes on her armpits—which are right next door to a group of lymph nodes.” Earth Mama sells deodorant, skincare products, teas, nipple cream—everything a pregnant woman or mother could need.

And then there’s the “taboo” topic that Olson says needs to be addressed: baby loss. “Not all pregnancies end in a baby,” she points out. “Alongside deep grief, a woman could be left engorged with breast milk, a cesarean scar, or a sore perineum, which is simply not fair. And oftentimes, the people around her don’t really know what to say or do—so they don’t say anything. We want these women to feel seen and heard, not invisible, and while Earth Mama has products that address those issues, we think it’s just as important to make baby loss a part of the pregnancy conversation. Because it’s crucial for women who’ve lost a baby to understand that yes, they are a mother. They’ll need to talk about it, or simply not feel alone; and it’s our job to listen, and lift her up as much as possible—even if it’s virtually right now.”
Digestive health: "Women are also looking for solutions to daily problems like bloating, gas, and other forms of gastric discomfort," says Friska's Peine. "The Friska Women's Daily product was formulated off of the USDA recommended women's diet, offering a best-in-class gut health formula with a clinically proven probiotic and proprietary blend of digestive enzymes. The probiotic offers a boost to the body's immune support and promotes overall digestive health. In addition, the digestive enzymes help your body break down the food that you eat and improve the bioavailability of the nutrients; they can help build muscle, convert carbs to energy, and eliminate toxins." The Women's Daily probiotic/enzyme blend also contains cranberry extract, biotin, and vitamin D to support urinary tract health, strong bones, and hair growth.

Bone density: Speaking of bone health, Myers says: “There’s no question that bone density is a big concern for women, especially as they get older—although, ideally, younger women could start supplementing to help build bone strength, too." Her suggestion: Silica. “First, it increases calcium absorption into the bones—by up to 50%. It also helps strengthen hair and nails, and keeps skin healthy because it has positive effects on collagen. So the right form of silica can stabilize bone growth and allow bones to retain calcium longer.” Terry Naturally’s Silica-20 uses silica from Spring Horsetail, which, after extraction, is blended with marine oil to enhance absorption.

Levin agrees. Along with silica, he recommends boron, magnesium, vitamins C and K, and protein—as well, of course, as calcium and vitamin D. “In addition to specific nutrients,” he says, “a diet which is alkaline-forming encourages the building of bone mass while diets that are acid-forming discourage bone mass. Whole plant foods, including fruits, are typically alkaline.”

 
Addressing Gender Inequality in Medicine
Women—and, indeed, anyone who doesn’t fit the precise vision of a male with XY chromosomes and certain levels of testosterone and estrogen who is a certain height and weight and body makeup—are very often at a disadvantage, in health spaces.

Bluebonnet’s Sugarek MacDonald explains that this starts with science. “Generally, men have higher body weights and BMIs than women. Women have more body fat than men do, while men have more lean mass. These differences in body composition have a significant impact on dietary needs. For example, a moderately active 125-pound women needs 2,000 calories a day; a 175-pound man with a similar exercise pattern needs 2,800 calories. However, most studies until recently only gauged intakes based on a 154-pound man.” Readers will note that this affects everyone who doesn’t fit that weight and body makeup, who is therefore subject to uncertainty in terms of their health. Retailers, for the sake of all non-men who come into their stores, should not stock products that have only been tested on men, and should request clarity regarding the range of human bodies represented in the literature backing a product.

Natracare’s Gitsham, too, pointed to this as a major problem. “There is an underlying gender inequality in medicine which impacts women’s health on a daily basis. Women are severely underrepresented in clinical trials, leading to a huge data gap in terms of how medicine can best support women. Furthermore, drug trials rarely take into account the impact of the menstrual cycle, despite evidence showing that heart medication and antibiotic treatments are affected by the hormone changes in our monthly cycle. To me, this is such a gaping hole in medical research which needs to be addressed.” She recommends Caroline Criado Perez’s Invisible Women, for those who want to learn more. And Natracare is taking steps—beyond just the products they sell—to support the health of their employees: The company became an endometriosis friendly employer this year, which Gitsham says “showcases how businesses can support the health needs of their staff through education and simple adjustments.” More information on that can be found at www.endometriosis-uk.org. WF
References
  1. Grand View Research, “Women’s Health Market Size, Share & Trends Analysis Report by Application, by Region, and Segment Forecasts, 2020-2027.” Published 2/2020. Accessed 8/1/2020. https://www.grandviewresearch.com/industry-analysis/womens-health-market
  2. “Iron-Deficiency Anemia,” National Institutes of Health. Accessed 8/1/2020. https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia