Context Perimenopause is the transitional period that precedes menopause; it is marked by hormonal fluctuations that disrupt regulatory and adaptive body systems, impacting quality of life. Cited presentations include vasomotor symptoms, mood and sleep disturbances, cognitive impairment, weight gain and joint pain. Conventional treatments, including hormone therapy and selective serotonin reuptake inhibitors, may be contraindicated, infrequently offered or insufficient alone, emphasising the need for alternative interventions.

Adaptogens modulate the body’s regulatory systems, enhancing resilience and systemic health. Withania somnifera (L.) Dunal (WS), or Ashwagandha, is a widely used adaptogenic herb with a longstanding history in Ayurveda. It is valued for its neuroprotective, anti-inflammatory, anxiolytic, sleep-enhancing and rejuvenating properties.

Aim and method This review explores the efficacy and safety of WS for perimenopausal symptoms, referencing 14 clinical trials from a broad literature search (2014–2024).

Results Findings indicate that WS can significantly improve vasomotor symptoms, psychological well-being, sleep quality, cognition, stress resilience, fatigue, and sexual function in perimenopausal women. A favourable impact on perimenopause hormonal profiles, including the reduction in follicle-stimulating hormone levels and increased oestradiol levels, was found in two studies despite variances in extraction methods and dosage. WS also improved immune function, reduced joint pain, supported weight management, hair and thyroid health in perimenopause-inclusive cohorts. Across all studies, WS was well tolerated, with only mild, transient side effects reported.

Conclusion In conclusion, WS is a promising therapeutic for perimenopause symptoms and disease-risk alleviation, with a strong safety profile. Future studies should seek to compare formulas, consider optimal perimenopause protocols and explore its longer-term effects.

Background As insomnia rates increase globally, there is growing interest in essential oils for stress reduction and sleep improvement.

Objective This pilot study aimed to explore the effects of essential oil blends on stress and sleep quality among working-age individuals.

Methods Ten healthy subjects underwent baseline assessments using the Pittsburgh Sleep Quality Index (PSQI), Mental Health Stress Scale Questionnaire (SPST-20), Stress Test Questionnaire (ST-5), and salivary cortisol levels. They received a blended oil containing ylang ylang, lavender, orange, and rosewood (in a ratio of 1:1:2:2) before sleep for four weeks, with biweekly monitoring. Subsequent assessments measured changes in sleep quality and stress levels using the same instruments.

Results The blended essential oil had a chemical composition containing D-Limonene (10.17%), α-Gurjunene (5.51%), Citronellol (1.96%), 3-Carene (1.55%), and Diethyl phthalate (1.72%) as the main compounds. The PSQI, SPST-20, and ST-5 scores significantly decreased after the intervention, while salivary cortisol levels increased within the reference range.

Conclusion This study offers preliminary evidence suggesting a potential correlation between the composition of a blended essential oil and improvements in sleep quality and stress levels. Further research is needed to elucidate the mechanisms underlying this relationship and validate these findings in larger, more diverse populations. Despite these limitations, the study contributes to our understanding of the therapeutic potential of aromatherapy in promoting sleep health.

Background Immersion baths at various temperatures have been used therapeutically worldwide. Hot water immersion has been recognised for its potential benefits to cardiovascular health. This pilot study aimed to assess the immediate effects of a 15-minute hot water immersion bath (HWIB) session on cardiovascular variables.

Methods Fourteen healthy male volunteers (average age  22.14 years +/- 4.9) were subjected to one session (15 minutes) of HWIB at a controlled temperature of 104°F (40°C). Cardiovascular variables were evaluated five minutes before and after to check for immediate changes. A non-invasive blood pressure monitoring system was used to measure beat-to-beat changes in cardiovascular variables, such as systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), heart rate (HR), stroke volume (SV), pulse interval (PI), cardiac output (CO), total peripheral resistance (TPR), and baroreflex sensitivity (BRS).

Results The results demonstrated a significant reduction in SBP, DBP, MAP, SV, PI (p<0.001), PP, TPR, and BRS following the 15-minute HWIB. There was a significant increase in the HR (p<0.001) post-intervention. Surprisingly, no significant difference was observed in CO after the intervention.

Conclusion The findings provide insights into acute cardiovascular responses to heat stress and physiological adaptations that occur during HWIB. HWIB appears safe and beneficial for cardiovascular health. Further research is warranted to explore the long-term effects and potential clinical implications of hot water immersion on cardiovascular health.

Traditional and complementary medicine (T&CM) plays a crucial role in Nepal’s healthcare system, with over 80% of the population relying on traditional practices. Naturopathy, a drugless system of medicine, integrates ancient healing traditions with modern research and is globally recognised by the World Health Organization (WHO). Despite its growing popularity, the status of naturopathic medicine in Nepal remains underexplored. This paper examines the current landscape of naturopathy in Nepal across four key domains: regulation, clinical practice, education, and research.

Regulation of naturopathy in Nepal falls under the Department of Ayurveda and Alternative Medicine, with no dedicated regulatory body or representation for naturopathic physicians, creating significant challenges. Clinical practice is primarily community-driven, with 12 community-based hospitals and 36 private centers, but no government-run naturopathy hospitals. Educational opportunities are limited to diploma-level courses, with no medical colleges offering a bachelor’s degree in naturopathy, compelling students to study in India. Research in naturopathy is minimal, with limited institutional support and funding.

Key challenges include inadequate regulatory frameworks, lack of integration within national healthcare policies, insufficient educational infrastructure, and limited research initiatives. Strengthening naturopathic medicine in Nepal requires the establishment of a dedicated regulatory council, inclusion in national healthcare policies, development of higher education programs and increased research support. Addressing these gaps would enable naturopathy to contribute more effectively to Nepal’s healthcare system, particularly in managing non-communicable diseases. This study aims to provide insights for policymakers to facilitate the integration and advancement of naturopathic medicine in Nepal.

These abstracts are brief summaries of articles in recent issues of medical journals. Articles selected are of a general nature for the information of practitioners of naturopathy and herbal medicine. A dominant theme is often present throughout the journals which will be reflected in the reviews.

These abstracts are brief summaries of articles which have appeared in recent issues of herbal medicine journals, some of which may be held in the NHAA library.

The AJHNM-based CPD questionnaire system is a voluntary system designed to assist members in the accumulation of NHAA CPD hours. Each question refers to an article in this issue of the Australian Journal of Herbal and Naturopathic Medicine. Hours accumulated through completion of these questions should be recorded in the NHAA CPD diary. The completion of answering each issue’s questions qualifies for four hours within the Formal Learning category. Your completed CPD diary should be returned with your membership renewal at the end of the financial year. For further information, please see the NHAA CPD Guide on the NHAA website: www.nhaa.org.au