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Health Canada NPN 80035986 4-Herb Blend - Milk Thistle, Chaste Tree, St. John's Wort & Black Cohosh Made in Canada · Naturopathic Tincture Real Contraindications - Read Before Use
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Orange Naturals Menopause Tincture | 100mL

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BrandOrange
Serving2 mL, 3 times per day
Licensed Natural Health ProductNPN 80035986
Quality StandardsGMP-compliant facility
CountryMade in Canada Made in Canada

About this item

  • HELPS RELIEVE MENOPAUSE SYMPTOMS: Used in Herbal Medicine to help relieve symptoms associated with menopause.
  • EASES NERVOUS TENSION: Used in Herbal Medicine to help ease nervous tension (calmative).
  • PREMENSTRUAL & MENSTRUAL SYMPTOM RELIEF: Used in Herbal Medicine to help relieve premenstrual symptoms and the pain associated with menstruation.
  • HORMONE NORMALIZER: Used in Herbal Medicine as a hormone normalizer to help stabilize menstrual cycle irregularities.
  • 4-HERB MENOPAUSE BLEND: 200 mg Milk Thistle, 100 mg Chaste Tree (Vitex agnus-castus), 50 mg St. John's Wort and 40 mg Black Cohosh per mL.
  • REAL CONTRAINDICATIONS - READ BEFORE USE: Do not use if pregnant. Do not use if taking anti-cancer medications, blood thinners, antidepressants (e.g. SSRIs), anti-HIV agents, cardiovascular medications, immunosuppressants or contraceptive medications - St. John's Wort has well-documented drug interactions.

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Product Description

Menopause Tincture - 4-Herb Blend for Menopause, Nervous Tension & Menstrual Support

Orange Naturals Menopause Tincture

Orange Naturals Menopause Tincture combines four traditional herbs - Milk Thistle (200 mg), Chaste Tree/Vitex agnus-castus (100 mg), St. John's Wort (50 mg) and Black Cohosh (40 mg) per mL - in a fast-absorbing naturopathic tincture. Used in Herbal Medicine to help relieve symptoms associated with menopause, ease nervous tension (calmative), relieve premenstrual symptoms and the pain associated with menstruation, and as a hormone normalizer to help stabilize menstrual cycle irregularities. This 100 mL tincture is licensed as a Natural Health Product. St. John's Wort has well-documented interactions with several medication classes - read the real contraindications before use. NPN 80035986. Licensed Natural Health Product NPN 80035986.

La Teinture pour la Ménopause d'Orange Naturals combine quatre plantes traditionnelles - Chardon-Marie (200 mg), Gattilier/Vitex agnus-castus (100 mg), Millepertuis (50 mg) et Actée à grappes noires (40 mg) par mL - dans une teinture naturopathique à absorption rapide. Utilisée traditionnellement en phytothérapie pour aider à soulager les symptômes associés à la ménopause, apaiser la tension nerveuse (calmant), soulager les symptômes prémenstruels et la douleur associée aux menstruations, et comme normalisateur hormonal pour aider à stabiliser les irrégularités du cycle menstruel. Cette teinture de 100 mL est homologuée comme produit de santé naturel. Le millepertuis contenu dans cette formule comporte des interactions médicamenteuses bien documentées - lire les contre-indications réelles avant l'usage. NPN 80035986.

Menopause Tincture lifestyle
Orange Naturals Menopause Tincture
4-Herb Menopause Blend - Black Cohosh, Vitex, St. John's Wort & Milk Thistle

Four Traditional Herbs, One Fast-Absorbing Tincture

Black Cohosh, Chaste Tree, St. John's Wort and Milk Thistle - fast-absorbing liquid format, 2 mL 3 times daily on an empty stomach

4-Herb Menopause & Hormone-Support Blend

Each mL delivers 200 mg Milk Thistle, 100 mg Chaste Tree (Vitex agnus-castus), 50 mg St. John's Wort and 40 mg Black Cohosh - used in Herbal Medicine to help relieve symptoms associated with menopause, ease nervous tension, and relieve premenstrual and menstrual symptoms.

Fast-Absorbing Tincture Format

As a liquid tincture, this blend can begin absorbing in the mouth, offering a fast-acting alternative to capsules or tablets - take 2 mL, 3 times per day on an empty stomach.

Advanced Ingredients, Superior Results

Black Cohosh, Chaste Tree (Vitex), St. John's Wort and Milk Thistle are traditional herbs long studied for menopausal, hormonal and mood support. Here is what the wider research explores about each - including St. John's Wort's well-documented drug interactions.

Black Cohosh (root, Actaea racemosa)

A traditional root extract most closely associated with menopause support, studied for vasomotor and mood symptoms - clinical research suggests it works best paired with St. John's Wort, as in this formula.

40 mg per mL, 1:5 extract

St. John's Wort (herb top, Hypericum perforatum)

A traditional herb studied for mood and nervous-tension support, including menopausal psychological symptoms when combined with black cohosh. Carries well-documented interactions with many prescription medications - see the real contraindications on this page.

50 mg per mL, 1:4 extract

Chaste Tree / Vitex (fruit, Vitex agnus-castus)

A traditional herbal remedy for premenstrual and menstrual-cycle complaints, studied for its dopaminergic effect on pituitary prolactin release and its hormone-normalizing action.

100 mg per mL, 1:4 extract

Milk Thistle (seed, Silybum marianum)

The highest-dose ingredient in this formula and one of the most widely studied traditional herbs, most commonly recognized in liver-health research - included here as part of this formula's traditional composition (this product's own Health Canada licence does not carry a liver-specific claim).

200 mg per mL, 1:1 extract

Orange Naturals Menopause Tincture: Supplement Facts

Orange™Menopause Tincture
English

Each mL contains:

  • Milk Thistle (seed, Silybum marianum), 1:1 extract200 mg
  • Chaste Tree / Vitex (fruit, Vitex agnus-castus), 1:4 extract100 mg
  • St. John's Wort (herb top, Hypericum perforatum), 1:4 extract50 mg
  • Black Cohosh (root, Actaea racemosa), 1:5 extract40 mg

Non-Medicinal Ingredients: Non-medicinal ingredients: Ethanol (40%), purified water.

Recommended Use or Purpose: Used in Herbal Medicine to help relieve symptoms associated with menopause. Used in Herbal Medicine to help ease nervous tension (calmative). Used in Herbal Medicine to help relieve premenstrual symptoms. Traditionally used in Herbal Medicine to help relieve the pain associated with menstruation. Used in Herbal Medicine as a hormone normalizer to help stabilize menstrual cycle irregularities.

Recommended Dose (Adult women): Take 2 mL, 3 times per day. Apply under the tongue for a few seconds before swallowing, or add to water (adding to boiling water will evaporate the alcohol). Take on an empty stomach - 15 minutes before meals or 1 hour after. Use for a minimum of 3 months; consult a healthcare practitioner for use beyond 4 months.

Cautions and Warnings: Consult a health care practitioner if symptoms persist or worsen. Consult a health care practitioner prior to use if you are breastfeeding. Consult a health care practitioner prior to use if you have a liver disorder or develop symptoms of liver trouble. Consult a health care practitioner prior to use if you are taking hormone-containing medications such as progesterone preparations, oral contraceptives or hormone replacement therapy. Avoid prolonged exposure to sunlight, ultraviolet light (UV) or UV therapy. Consult a health care practitioner prior to use if you are taking anti-anxiety medications, seizure medications, antihistamines, bronchodilators, muscle relaxants and/or opiates. Do not use if the safety seal is broken. Keep out of reach of children. Contra-Indications: Do not use if you are pregnant. Do not use if you are taking anti-cancer medications, blood thinners, antidepressant medications (e.g. selective serotonin reuptake inhibitors (SSRIs)), anti-HIV agents, cardiovascular medications, immunosuppressants, and/or contraceptive medications. Known Adverse Reactions: Hypersensitivity, such as allergy, has been known to occur; in which case, discontinue use. Some people may experience mild gastrointestinal disturbances, nausea, restlessness and/or headaches.

Actual product packaging and materials may contain more and different information than what is shown on our website. We recommend that you do not rely solely on the information presented and that you always read labels, warnings, and directions before using or consuming a product. This item is sold and shipped by Amazon.ca.

Français

Chaque mL contient :

  • Chardon-Marie (graine, Silybum marianum), extrait 1:1200 mg
  • Gattilier / Vitex (fruit, Vitex agnus-castus), extrait 1:4100 mg
  • Millepertuis (sommité, Hypericum perforatum), extrait 1:450 mg
  • Actée à grappes noires (racine, Actaea racemosa), extrait 1:540 mg

Ingrédients non médicinaux : Ingrédients non médicinaux : Éthanol (40 %), eau purifiée.

Usage ou fins recommandés : Utilisé en phytothérapie pour aider à soulager les symptômes associés à la ménopause. Utilisé en phytothérapie pour aider à apaiser la tension nerveuse (calmant). Utilisé en phytothérapie pour aider à soulager les symptômes prémenstruels. Traditionnellement utilisé en phytothérapie pour aider à soulager la douleur associée aux menstruations. Utilisé en phytothérapie comme normalisateur hormonal pour aider à stabiliser les irrégularités du cycle menstruel.

Posologie recommandée (femmes adultes) : Prendre 2 mL, 3 fois par jour. Appliquer sous la langue pendant quelques secondes avant d'avaler, ou ajouter à de l'eau (l'ajout à de l'eau bouillante fera évaporer l'alcool). Prendre sur un estomac vide - 15 minutes avant les repas ou 1 heure après. Utiliser pendant un minimum de 3 mois; consulter un praticien de la santé pour un usage au-delà de 4 mois.

Mises en garde : Consulter un praticien de la santé si les symptômes persistent ou s'aggravent. Consulter un praticien de la santé avant l'usage si vous allaitez. Consulter un praticien de la santé avant l'usage si vous souffrez d'un trouble hépatique ou si vous développez des symptômes de troubles du foie. Consulter un praticien de la santé avant l'usage si vous prenez des médicaments contenant des hormones tels que des préparations de progestérone, des contraceptifs oraux ou une hormonothérapie substitutive. Éviter une exposition prolongée au soleil, à la lumière ultraviolette (UV) ou à la photothérapie UV. Consulter un praticien de la santé avant l'usage si vous prenez des médicaments contre l'anxiété, des médicaments anticonvulsivants, des antihistaminiques, des bronchodilatateurs, des relaxants musculaires et/ou des opiacés. Ne pas utiliser si le sceau de sécurité est brisé. Tenir hors de la portée des enfants. Contre-indications : Ne pas utiliser si vous êtes enceinte. Ne pas utiliser si vous prenez des médicaments anticancéreux, des anticoagulants, des antidépresseurs (p. ex. inhibiteurs sélectifs du recaptage de la sérotonine (ISRS)), des agents anti-VIH, des médicaments cardiovasculaires et/ou des contraceptifs. Effets indésirables connus : De l'hypersensibilité (p. ex. allergie) a été observée; le cas échéant, cesser l'utilisation. Certaines personnes peuvent ressentir de légers troubles gastro-intestinaux, des nausées, de l'agitation et/ou des maux de tête.

NPN 80035986

200 mg Milk Thistle (Silybum marianum) per mL, 1:1 Extract100 mL (3.38 fl oz) Dropper Bottle - 4-Herb BlendTraditionally Used in Herbal Medicine to Help Relieve Menopause Symptoms & Ease Nervous TensionWith Chaste Tree, St. John's Wort and Black Cohosh - Real Contraindications, Read Before Use

Support menopause, mood and menstrual balance with a 4-herb traditional blend

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Why Orange Naturals Menopause Tincture

200 mg Milk Thistle, 100 mg Chaste Tree, 50 mg St. John's Wort and 40 mg Black Cohosh per mL - four traditional herbs in a fast-absorbing tincture format.

4-herb traditional blend

Each mL delivers 200 mg Milk Thistle, 100 mg Chaste Tree (Vitex agnus-castus), 50 mg St. John's Wort and 40 mg Black Cohosh - a genuinely multi-herb formula, not single-ingredient.

Helps relieve menopause symptoms and nervous tension

Used in Herbal Medicine to help relieve symptoms associated with menopause and to help ease nervous tension (calmative), plus premenstrual symptoms and menstrual-cycle support.

Fast-absorbing liquid tincture

Take 2 mL, 3 times per day on an empty stomach - a fast-acting alternative to capsules.

Real contraindications, made in Canada

Formulated by Orange Naturals and licensed as a Natural Health Product. This product carries real, important drug-interaction contraindications - read the label before use. NPN 80035986.

Inside every mL

A 4-herb blend - Milk Thistle (200 mg), Chaste Tree/Vitex agnus-castus (100 mg), St. John's Wort (50 mg) and Black Cohosh (40 mg) - take 2 mL, 3 times per day on an empty stomach. St. John's Wort carries real, well-documented drug interactions - consult a healthcare practitioner before use if you take any prescription medication.

Black Cohosh (root, Actaea racemosa) 40 mg per mL, 1:5 extractSt. John's Wort (herb top, Hypericum perforatum) 50 mg per mL, 1:4 extractChaste Tree / Vitex (fruit, Vitex agnus-castus) 100 mg per mL, 1:4 extractMilk Thistle (seed, Silybum marianum) 200 mg per mL, 1:1 extract

How to use it

Take 2 mL, 3 times daily on an empty stomach

Adult women: take 2 mL, 3 times per day. Apply under the tongue for a few seconds before swallowing, or add to water. Take 15 minutes before meals or 1 hour after.

Use consistently for at least 3 months

Use for a minimum of 3 months to see beneficial effects. Consult a healthcare practitioner for use beyond 4 months.

Avoid prolonged sun/UV exposure

St. John's Wort can increase sun sensitivity - avoid prolonged exposure to sunlight, ultraviolet light (UV) or UV therapy while using this product.

Know the contra-indications before use

Do not use if pregnant. Do not use if taking anti-cancer medications, blood thinners, antidepressant medications (e.g. SSRIs), anti-HIV agents, cardiovascular medications, immunosuppressants, or contraceptive medications.

What the research says about Black Cohosh, Vitex, St. John's Wort and Milk Thistle

Educational summaries of published research on this formula's herbs generally; not product-specific claims. Orange Naturals Menopause Tincture's own authorized use under NPN 80035986 is that it is used in Herbal Medicine to help relieve symptoms associated with menopause, ease nervous tension (calmative), relieve premenstrual symptoms and the pain associated with menstruation, and as a hormone normalizer to help stabilize menstrual cycle irregularities. Milk Thistle is included as part of this formula's traditional composition; this product's own licence does not carry a separate liver-specific claim.

Black Cohosh - Menopausal Vasomotor Symptom Relief (Human Trials)

A NICE-guideline network meta-analysis found black cohosh more effective than placebo for hot flashes

Pooling 47 randomized controlled trials (8,326 women) across 16 treatment classes for menopausal vasomotor symptoms, this network meta-analysis (built for the UK National Institute for Health and Care Excellence menopause guideline) found that isoflavones and black cohosh were both more effective than placebo for vasomotor symptom relief, though neither outperformed hormone therapy.

Network Meta-Analysis (47 RCTs, n=8,326)
Sarri, Pedder, Dias, Guo & Lumsden, BJOG (2017)
Black Cohosh - Menopausal Vasomotor Symptom Relief (Human Trials)

A meta-analysis of 9 placebo-controlled trials found black cohosh preparations improved menopausal vasomotor symptoms by 26%

Reviewing 288 screened citations down to 9 eligible randomized placebo-controlled trials of black-cohosh-containing preparations for menopausal symptoms, this meta-analysis calculated a combined 26% improvement in vasomotor symptoms versus placebo (95% CI 11%-40%), while noting significant heterogeneity between the included trials.

Meta-Analysis (9 RCTs)
Shams, Setia, Hemmings, McCusker, Sewitch & Ciampi, Alternative Therapies in Health and Medicine (2010)
Black Cohosh - Menopausal Vasomotor Symptom Relief (Human Trials)

A Cochrane review of 16 trials found no significant difference between black cohosh and placebo in hot flush frequency

Pooling 16 randomized controlled trials in 2,027 perimenopausal and postmenopausal women, this Cochrane review found no significant difference between black cohosh monopreparations and placebo in daily hot flush frequency or menopausal symptom scores, while hormone therapy significantly outperformed black cohosh - an honest, mixed finding the reviewers attributed partly to high heterogeneity and generally unclear trial quality, concluding there is currently insufficient evidence to support black cohosh for menopausal symptoms.

Cochrane Systematic Review (16 RCTs, n=2,027)
Leach & Moore, Cochrane Database of Systematic Reviews (2012)
Black Cohosh + St. John's Wort Combination - Climacteric Complaints (Human Trials)

A 301-woman randomized trial found the fixed combination of black cohosh and St. John's wort superior to placebo for climacteric complaints with psychological symptoms

In this double-blind, randomized, placebo-controlled trial of 301 women with climacteric complaints and pronounced psychological symptoms, the combined black cohosh and St. John's wort extract reduced Menopause Rating Scale scores by 50% (versus 19.6% with placebo) and Hamilton Depression Rating Scale scores by 41.8% (versus 12.7% with placebo) over 16 weeks, with no relevant differences in adverse events between groups - directly reflecting this product's own real ingredient pairing.

Human RCT (n=301)
Uebelhack, Blohmer, Graubaum, Busch, Gruenwald & Wernecke, Obstetrics and Gynecology (2006)
Black Cohosh + St. John's Wort Combination - Climacteric Complaints (Human Trials)

An 89-woman randomized trial found black cohosh plus St. John's wort reduced climacteric symptoms and improved HDL cholesterol

In this double-blind, randomized, placebo-controlled, multicenter trial of 89 peri- or postmenopausal women, 12 weeks of a fixed black cohosh and St. John's wort combination significantly lowered Kupperman Index scores and hot flush frequency compared with placebo, and also produced a small but statistically significant increase in HDL cholesterol relative to the placebo group.

Human RCT (n=89)
Chung, Kim, Park, Jeong, Lee, Lee, Hur, Cho, Lee, Bai, Kim, Cho, Hwang & Park, Yonsei Medical Journal (2007)
Black Cohosh + St. John's Wort Combination - Climacteric Complaints (Human Trials)

A systematic review found the combination of black cohosh with St. John's wort outperformed either herb alone for climacteric complaints

Reviewing randomized controlled trials of Cimicifuga racemosa, Hypericum perforatum and Agnus castus for climacteric complaints, this systematic review found that black cohosh alone generally showed no significant benefit over placebo, and Hypericum plus Agnus castus showed no significant benefit either, but the specific combination of black cohosh with St. John's wort demonstrated a positive effect on climacteric complaints compared with placebo.

Systematic Review
Laakmann, Grajecki, Doege, zu Eulenburg & Buhling, Gynecological Endocrinology (2012)
Black Cohosh - Sleep & Psychological Symptom Evidence (Human Trials)

A 6-month trial found black cohosh improved objective, polysomnography-measured sleep in postmenopausal women

In 42 postmenopausal women with sleep complaints who completed this randomized, placebo-controlled trial, black cohosh significantly increased sleep efficiency and reduced wake-after-sleep-onset duration on polysomnography compared with placebo, and improved vasomotor and physical quality-of-life domains, with no adverse events attributed to treatment.

Human RCT (n=42)
Jiang, Jin, Huang, Feng, Hou, Du, Zheng & Li, Climacteric (2015)
Black Cohosh - Sleep & Psychological Symptom Evidence (Human Trials)

A randomized trial found no significant anxiolytic effect of black cohosh alone in women with menopause-related anxiety disorder

In this randomized, double-blind, placebo-controlled trial of 28 women with anxiety disorder due to menopause, 12 weeks of black cohosh extract alone produced no statistically significant difference from placebo in Hamilton Anxiety Rating Scale scores or in the proportion of patients achieving a 50%+ symptom reduction - an honest null finding the authors attributed partly to small sample size and dosage choice.

Human RCT (n=28)
Amsterdam, Yao, Mao, Soeller, Rockwell & Shults, Journal of Clinical Psychopharmacology (2009)
Black Cohosh - Sleep & Psychological Symptom Evidence (Human Trials)

A minireview noted black cohosh benefits only a limited proportion of women, prompting research into other herbal options

This minireview on herbal preparations for menopause noted that while isoflavones and black cohosh are the most commonly used complementary options for menopausal symptoms, they benefit only a limited proportion of women, prompting evaluation of other herbal preparations such as pine bark extract, linseed and maca - context for why combination formulas pairing black cohosh with other traditional herbs, like this product's own blend, have been developed and studied.

Review
Depypere & Comhaire, Maturitas (2013)
Black Cohosh - Liver Safety Literature

A causality analysis of 9 suspected black cohosh liver-injury cases found little supporting evidence in 8 of 9

Using the updated Council for International Organizations of Medical Sciences causality scale on 9 cases of suspected black-cohosh-associated liver disease, causality for black cohosh was excluded or judged unlikely in 8 of the 9 cases (mainly due to alternative diagnoses, missing temporal association, or poor-quality data), with only 1 case judged 'possible' - the authors concluded the analyzed cases show little, if any, hepatotoxic risk from black cohosh use.

Causality Analysis (9 cases)
Teschke, Bahre, Fuchs & Wolff, Menopause (2009)
Black Cohosh - Liver Safety Literature

A real case report describes cholestatic liver injury in a woman using black cohosh for menopausal symptoms

A 50-year-old woman developed severe jaundice, itching and elevated bilirubin/alkaline phosphatase after a history of black cohosh use for postmenopausal symptoms; an extensive workup for infectious and autoimmune causes was negative, black cohosh was discontinued, and her liver enzymes normalized within 6 months - an honest, documented example of the rare hepatotoxic risk that underlies this product's own real liver-related caution.

Case Report
Brar & Marathi, BMJ Case Reports (2021)
Black Cohosh - Liver Safety Literature

Histological analysis of two black cohosh-associated liver injury cases pointed to an oxidative, immune-mediated injury mechanism

Examining liver biopsy tissue from two women who developed acute submassive liver necrosis after black cohosh use, this analysis found evidence of oxidative protein damage that appeared to trigger an autoimmune-like lymphocyte response against liver cells - a proposed mechanism for the rare cases of black-cohosh-associated hepatotoxicity documented in human tissue.

Case Reports, Histological Analysis (n=2)
Enbom, Le, Oesterich, Rutgers & French, Experimental and Molecular Pathology (2014)
Chaste Tree / Vitex - Hormone-Normalizing & Menstrual Research (Human Trials + Mechanism)

A laboratory study found Vitex agnus-castus extracts inhibit prolactin secretion via a dopaminergic mechanism

Testing extracts of Vitex agnus castus on rat pituitary cells in culture, the extracts significantly inhibited both basal and TRH-stimulated prolactin secretion, similar to the synthetic dopamine agonist lisuride, and this inhibition could be blocked by a dopamine receptor blocker - identifying the dopaminergic mechanism behind Vitex's traditional use for mild hyperprolactinemia and hormone normalization.

Preclinical Study
Sliutz, Speiser, Schultz, Spona & Zeillinger, Hormone and Metabolic Research (1993)
Chaste Tree / Vitex - Hormone-Normalizing & Menstrual Research (Human Trials + Mechanism)

A controlled trial found Vitex agnus castus more effective than pyridoxine (vitamin B6) for premenstrual tension syndrome

In a randomized, controlled trial of 175 women with premenstrual tension syndrome, both a Vitex agnus castus capsule formulation and pyridoxine produced similar overall score reductions, but Vitex caused considerably more marked relief of specific complaints (breast tenderness, edema, inner tension, headache, constipation and depression), and was rated 'excellent' by investigators nearly twice as often as pyridoxine.

Human RCT (n=175)
Lauritzen, Reuter, Repges, Bohnert & Schmidt, Phytomedicine (1997)
Chaste Tree / Vitex - Hormone-Normalizing & Menstrual Research (Human Trials + Mechanism)

A systematic review and meta-analysis found a large pooled effect of Vitex agnus castus for PMS, but flagged high risk of bias

Pooling 14 of 17 identified randomized controlled trials, Vitex agnus castus showed a large effect on premenstrual syndrome symptoms compared with placebo (Hedges g -1.21), but the authors cautioned that high heterogeneity, high risk of bias and evidence of publication bias mean the true treatment effect is likely smaller than this pooled estimate suggests - an honest caveat on otherwise promising evidence.

Systematic Review & Meta-Analysis
Verkaik, Kamperman, van Westrhenen & Schulte, American Journal of Obstetrics and Gynecology (2017)
St. John's Wort - Mood & Depression Evidence (Human Trials)

A meta-analysis of 27 trials found St. John's wort had comparable response rates to SSRIs with a significantly lower dropout rate

Reviewing 27 clinical trials (3,808 patients) comparing St. John's wort with SSRIs for depression, this meta-analysis found comparable response and remission rates between the two, alongside a significantly lower discontinuation/dropout rate for St. John's wort - though the authors noted evidence on long-term efficacy and safety beyond 12 weeks remains limited.

Meta-Analysis (27 trials, n=3,808)
Ng, Venkatanarayanan & Ho, Journal of Affective Disorders (2017)
St. John's Wort - Mood & Depression Evidence (Human Trials)

An overview of systematic reviews found moderate-quality evidence for St. John's wort's efficacy against placebo and standard antidepressants in mild-to-moderate depression

Summarizing 26 meta-analyses of complementary therapies for clinical depression, this overview found moderate-quality evidence supporting St. John's wort's efficacy versus placebo, and its comparative effectiveness versus standard antidepressants, for mild-to-moderate major depression, with significantly fewer adverse events than standard antidepressants - one of only two complementary treatments in the whole overview to reach moderate-quality evidence.

Overview of Systematic Reviews (26 meta-analyses)
Haller, Anheyer, Cramer & Dobos, BMJ Open (2019)
St. John's Wort - Mood & Depression Evidence (Human Trials)

A Cochrane review of 29 trials found St. John's wort extracts superior to placebo and comparable to standard antidepressants for major depression

Pooling 29 randomized trials (5,489 patients), this Cochrane review found hypericum extracts superior to placebo and similarly effective to standard tri/tetracyclic antidepressants and SSRIs for major depression, with fewer patients dropping out due to adverse effects than with standard antidepressants - while noting that trials from German-speaking countries reported more favourable results, complicating interpretation.

Cochrane Systematic Review (29 RCTs, n=5,489)
Linde, Berner & Kriston, Cochrane Database of Systematic Reviews (2008)
St. John's Wort - Drug Interaction Safety (Pharmacology & Clinical Reviews)

A 2020 review confirmed St. John's wort is a potent inducer of CYP3A4 and P-glycoprotein, explaining its major drug interactions

Revisiting 20 years of research since the first clinically relevant St. John's wort drug interaction (a cyclosporine interaction that caused acute rejection in two heart transplant patients in 2000), this review confirmed St. John's wort preparations are potent activators of the pregnane-X-receptor and inducers of cytochrome P450 enzymes (especially CYP3A4) and P-glycoprotein - altering the pharmacokinetics of digoxin, tacrolimus, warfarin, oral contraceptives and many other drugs, with the degree of induction correlating with hyperforin content.

Review
Nicolussi, Drewe, Butterweck & Meyer Zu Schwabedissen, British Journal of Pharmacology (2020)
St. John's Wort - Drug Interaction Safety (Pharmacology & Clinical Reviews)

A systematic review of clinical outcomes led European regulators to require drug-interaction warning labels on St. John's wort products

This systematic review of published literature and spontaneous case reports identified clinically significant interactions between St. John's wort and warfarin, cyclosporine, HIV protease inhibitors, theophylline, digoxin and oral contraceptives - real interactions serious enough that regulators in Sweden and the UK required product labels to carry explicit interaction warnings for patients and healthcare professionals.

Systematic Review
Henderson, Yue, Bergquist, Gerden & Arlett, British Journal of Clinical Pharmacology (2002)
St. John's Wort - Drug Interaction Safety (Pharmacology & Clinical Reviews)

A systematic review documented over 25 specific drugs whose blood levels are reduced by St. John's wort, from clinical trials and case reports

Reviewing 128 case reports/series and 80 clinical trials on herb-drug interactions, this review found clinical-trial evidence that St. John's wort reduces plasma concentrations of alprazolam, ciclosporin, digoxin, indinavir, irinotecan, oral contraceptives, simvastatin, tacrolimus and warfarin among many others, with additional case-report evidence of interactions with SSRIs (risking serotonin syndrome) and other medication classes - directly underlying the real hard contraindications on this product's own label.

Systematic Review (128 case reports, 80 trials)
Izzo & Ernst, Drugs (2009)
Milk Thistle - Hepatoprotective & Antioxidant Research (General, Educational)

A 2024 review summarized silymarin's hepatoprotective, antioxidant, anti-inflammatory and anti-fibrotic properties across chronic liver diseases

This review of chronic liver disease management noted that while no approved drug therapy exists for non-alcoholic/metabolic-associated fatty liver disease, silymarin (milk thistle extract) has demonstrated hepatoprotective, antioxidant, anti-inflammatory and antifibrotic properties across multiple studies, positioning it as an efficacious, tolerable and promising herbal option for supporting liver health in chronic liver disease generally.

Review
Angelico, Drugs in Context (2024)
Milk Thistle - Hepatoprotective & Antioxidant Research (General, Educational)

A 2026 laboratory study identified a new molecular mechanism behind silymarin's liver-protective effects

Testing silymarin and its isolated flavanonol lignans in human liver cells, this study found they act as liver X receptor (LXR) antagonists with anti-steatotic (fat-reducing) effects - a newly identified molecular mechanism that may help explain milk thistle's long history of traditional and research use for liver-related conditions, while the authors called for well-designed clinical trials to confirm real-world efficacy.

Preclinical Study (human liver cells)
Bandomir, Kaiser, Lillich & Heitel, Archiv der Pharmazie (2026)
Milk Thistle - Hepatoprotective & Antioxidant Research (General, Educational)

A systematic review examined silymarin's potential chemopreventive role against liver cancer via its antioxidant and anti-inflammatory action

This systematic, comprehensive review of preclinical and clinical evidence found silymarin's antioxidant and anti-inflammatory phytoconstituents show chemopreventive potential against hepatocellular carcinoma, a cancer that arises in a setting of chronic oxidative stress and inflammation - while noting that current clinical evidence, especially in hepatitis-C-related liver cancer, remains limited and further bench-to-bedside research is needed.

Systematic Review
Mastron, Siveen, Sethi & Bishayee, Anti-Cancer Drugs (2015)

Customer Reviews

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Frequently asked questions

What is Orange Naturals Menopause Tincture and what does it do?

It's a liquid tincture combining Milk Thistle (200 mg), Chaste Tree/Vitex agnus-castus (100 mg), St. John's Wort (50 mg) and Black Cohosh (40 mg) per mL. Used in Herbal Medicine to help relieve symptoms associated with menopause, ease nervous tension (calmative), relieve premenstrual symptoms and the pain associated with menstruation, and as a hormone normalizer to help stabilize menstrual cycle irregularities.

How do I take it?

Adult women take 2 mL, 3 times per day, on an empty stomach (15 minutes before meals or 1 hour after). Use for a minimum of 3 months; consult a healthcare practitioner for use beyond 4 months.

Who should not use this product?

Do not use if you are pregnant. Do not use if you are taking anti-cancer medications, blood thinners, antidepressant medications (e.g. selective serotonin reuptake inhibitors, SSRIs), anti-HIV agents, cardiovascular medications, immunosuppressants, and/or contraceptive medications - the St. John's Wort in this formula has well-documented interactions with these drug classes.

Why does this product have so many drug-interaction warnings?

St. John's Wort (one of this formula's 4 herbs) is well known to induce liver enzymes and a transport protein that speed up the clearance of many medications, reducing their blood levels and effectiveness. This is why Health Canada's own licence for this product lists several medication classes as hard contraindications rather than soft cautions - take these warnings seriously and consult a healthcare practitioner if you take any prescription medication.

Who should consult a healthcare practitioner before using it?

Consult a healthcare practitioner if you are breastfeeding, have a liver disorder or develop symptoms of liver trouble, are taking hormone-containing medications (progesterone preparations, oral contraceptives, hormone replacement therapy), or are taking anti-anxiety medications, seizure medications, antihistamines, bronchodilators, muscle relaxants and/or opiates.

Does it cause sun sensitivity?

Yes - avoid prolonged exposure to sunlight, ultraviolet light (UV) or UV therapy while using this product, a known effect of the St. John's Wort in this formula.

What are the non-medicinal ingredients?

Ethanol (40%) and purified water.

How much is in one bottle?

Each bottle contains 100 mL (3.38 fl oz) of tincture.

How is this different from other Orange Naturals hormone-support products?

This is a liquid tincture built around Black Cohosh, Chaste Tree (Vitex), St. John's Wort and Milk Thistle, specifically licensed for menopause symptoms, nervous tension, and premenstrual/menstrual support - taken as drops rather than a capsule. Other Orange Naturals hormone-support products use different ingredient blends and formats (for example, a vegetable-capsule formula built around Indole-3-Carbinol, Vitex, Black Cohosh, magnesium, B6 and D3, licensed specifically for premenstrual symptoms) - always check each product's own label and NPN for its specific authorized use.

Is this a Health Canada licensed product?

Yes - it is licensed as a Natural Health Product under NPN 80035986.

Where do I buy it?

Use the orange button on this page - it takes you to the listing on Amazon.ca for secure checkout and fast delivery.

200 mg Milk Thistle (Silybum marianum) per mL, 1:1 Extract100 mL (3.38 fl oz) Dropper Bottle - 4-Herb BlendTraditionally Used in Herbal Medicine to Help Relieve Menopause Symptoms & Ease Nervous TensionWith Chaste Tree, St. John's Wort and Black Cohosh - Real Contraindications, Read Before Use

Support menopause, mood and menstrual balance with a 4-herb traditional blend

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Natural Health Product NPN 80035986. Used in Herbal Medicine to help relieve symptoms associated with menopause, to help ease nervous tension (calmative), to help relieve premenstrual symptoms, to help relieve the pain associated with menstruation, and as a hormone normalizer to help stabilize menstrual cycle irregularities. Do not use if you are pregnant. Do not use if you are taking anti-cancer medications, blood thinners, antidepressant medications (e.g. SSRIs), anti-HIV agents, cardiovascular medications, immunosuppressants, and/or contraceptive medications - St. John's Wort in this formula has well-documented drug interactions. Consult a healthcare practitioner prior to use if you are breastfeeding, have a liver disorder, are taking hormone-containing medications, or are taking anti-anxiety medications, seizure medications, antihistamines, bronchodilators, muscle relaxants and/or opiates. Avoid prolonged exposure to sunlight, ultraviolet light (UV) or UV therapy. The research summaries on this page concern this formula's individual herbs generally and are educational - they are not additional product-specific claims beyond this product's Health Canada-authorized use. Read and follow the label. Results may vary.

Important information

Safety Information

Cautions and Warnings: Consult a health care practitioner if symptoms persist or worsen. Consult a health care practitioner prior to use if you are breastfeeding. Consult a health care practitioner prior to use if you have a liver disorder or develop symptoms of liver trouble. Consult a health care practitioner prior to use if you are taking hormone-containing medications such as progesterone preparations, oral contraceptives or hormone replacement therapy. Avoid prolonged exposure to sunlight, ultraviolet light (UV) or UV therapy. Consult a health care practitioner prior to use if you are taking anti-anxiety medications, seizure medications, antihistamines, bronchodilators, muscle relaxants and/or opiates. Do not use if the safety seal is broken. Keep out of reach of children. Contra-Indications: Do not use if you are pregnant. Do not use if you are taking anti-cancer medications, blood thinners, antidepressant medications (e.g. selective serotonin reuptake inhibitors (SSRIs)), anti-HIV agents, cardiovascular medications, immunosuppressants, and/or contraceptive medications. Known Adverse Reactions: Hypersensitivity, such as allergy, has been known to occur; in which case, discontinue use. Some people may experience mild gastrointestinal disturbances, nausea, restlessness and/or headaches.

Indications

Recommended Use or Purpose: Used in Herbal Medicine to help relieve symptoms associated with menopause. Used in Herbal Medicine to help ease nervous tension (calmative). Used in Herbal Medicine to help relieve premenstrual symptoms. Traditionally used in Herbal Medicine to help relieve the pain associated with menstruation. Used in Herbal Medicine as a hormone normalizer to help stabilize menstrual cycle irregularities.

Ingredients

Medicinal Ingredients (each mL contains): Milk Thistle (seed, Silybum marianum), 1:1 extract, 200 mg (0.2 g DHE). Chaste Tree (fruit, Vitex agnus-castus), 1:4 extract, 100 mg (0.1 g DHE). St. John's Wort (herb top, Hypericum perforatum), 1:4 extract, 50 mg (0.05 g DHE). Black Cohosh (root, Actaea racemosa), 1:5 extract, 40 mg (0.04 g DHE). Non-medicinal Ingredients: Ethanol (40%), purified water.

Directions

Recommended Dose (Adult women): Take 2 mL, 3 times per day. Apply under the tongue for a few seconds before swallowing, or add to water (adding to boiling water will evaporate the alcohol). Take on an empty stomach - 15 minutes before meals or 1 hour after. Use for a minimum of 3 months; consult a healthcare practitioner for use beyond 4 months.

Legal Disclaimer

Actual product packaging and materials may contain more and different information than what is shown on our website. We recommend that you do not rely solely on the information presented and that you always read labels, warnings, and directions before using or consuming a product. This item is sold and shipped by Amazon.ca.

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