Relief from Menopausal Symptoms by Non-hormonal Treatment with Pycnogenol® (French Maritime Pine Bark Extract)

Declining estrogen levels are connected to endothelial dysfunction and weakening of antioxidative defense. Endothelial dysfunction is linked to vasomotoric and sexual problems. Reduced synthesis of antioxidants as consequence of fading estrogen supply results in oxidative stress and promotes painful menstrual problems. In addition, psychosomatic symptoms as insomnia, depression and deficits in cognitive function are frequent. Compensation for loss of estrogen by hormone replacement therapy is problematic for some women because of adverse effects so that there is a need for a nonhormonal option for relief from menopausal symptoms. The ability of French maritime pine bark extract (Pycnogenol®) to alleviate climacteric symptoms was tested in clinical trials with perimenopausal women. The Woman’s Health Questionnaire was used in Taiwan and Japan in randomized, placebo-controlled, doubleblind studies with 155 and 156 women respectively. An Italian study compared symptoms by Menopause Symptoms Questionnaire in a Pycnogenol® group of 38 women with 32 controls. Climacteric symptoms decreased dependent on the length of treatment. The highest dose, 200 mg/day Pycnogenol® improved all symptoms relative to placebo, lower doses improved only some symptoms, suggesting a dose-dependent effect. Vasomotoric problems were ameliorated in all 3 studies, insomnia decreased with 200 mg and 60 mg Pycnogenol® daily. In addition, in the most informative study from Taiwan, a consistent improvement of psychosomatic symptoms was reported. A rationale for the attenuation of vasomotoric and sexual problems is proposed based on enhanced availability of nitric oxide (NO) via interaction of Pycnogenol® with endothelial nitric oxide synthase. Enhanced availability of NO is potentially also involved in the improvement of sleep, memory and psychic symptoms following Pycnogenol® intake. The relief from menstrual problems is connected with the anti-inflammatory properties of Pycnogenol®. By improving endothelial function and antioxidative status Pycnogenol® offers a versatile non-hormonal option for relief of climacteric symptoms.