Leaves of the common garden sage.
Why it’s used: Traditionally used to help with hot flushes during the menopause.
Sage (Salvia officinalis) is the soft, grey-green herb many of us know from stuffing and roast dinners. A native of the Mediterranean, it has been grown in British kitchen gardens for centuries, and its Latin name comes from salvere, to be well, a hint at how highly it was regarded in early herbal practice.
Beyond the kitchen, sage leaf has a long history in European herbal tradition. It is traditionally used to help with hot flushes and excessive sweating during the menopause, and the European Medicines Agency recognises sage leaf preparations as traditional herbal products for this purpose. In supplements you will see it listed as sage leaf, sage leaf powder or sage leaf extract, sometimes made from fresh leaves, either on its own or in menopause blends with red clover, soy isoflavones or black cohosh.
Researchers have studied sage in small trials with women going through the menopause, and a meta-analysis of four studies reported fewer hot flushes compared with placebo. Sage naturally contains thujone, a compound that is harmful in large amounts, which is why good-quality extracts control or remove it and why concentrated sage essential oil is not suitable for taking by mouth.
3 findings behind this ingredient. Hover a card for the detail and the source.
Double-blind, randomised, placebo-controlled trial of 80 menopausal women aged 48–65 taking fresh sage extract tablets for 4 weeks. Menopause Rating Scale scores fell significantly versus placebo, and sleep quality and fatigue also improved.
Double-blind randomised controlled trial of 66 postmenopausal women taking three 100 mg sage extract tablets a day or placebo for 3 months. Flushing, palpitations, sleep, joint ache, depression and anxiety scores fell more than with placebo.
Open multicentre trial without placebo in 71 menopausal women with at least five flushes a day. Intensity-rated hot flush scores fell by 50% within 4 weeks and 64% within 8 weeks, and the tablet was very well tolerated.
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Sage is traditionally used to help with hot flushes and excessive sweating during the menopause. Small trials have reported fewer hot flushes than placebo, and EU regulators recognise this traditional use, but larger studies are still needed.
Thujone is a natural compound in sage, especially in its essential oil. In large amounts it can affect the nervous system, so the EU herbal monograph limits it to 6 mg a day from a product. Many sage extracts are prepared to keep thujone very low.
Not really. The amounts used in cooking are small and considered safe for most people. Supplements provide a more concentrated dose, which is why pregnancy, epilepsy and medicine cautions apply to them rather than to a sprinkle of sage on your dinner.
Information only, not medical advice. If you take medication, are pregnant or breastfeeding, speak to your GP or pharmacist first.
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