In the classic children’s story, “The Tale of Peter Rabbit,” the naïve young bunny eats himself sick in Mr. McGregor’s garden, then gets chased out at the wrong end of the angry farmer’s hoe. When Peter gets home, his mother serves him chamomile tea.

Peter’s mother was a wise herbalist. Since ancient times, both German/Hungarian chamomile (Matricaria chamomilla) and the Roman/English variety (Anthemis nobilis) have been used to soothe jangled nerves and treat indigestion. They still are. Good research shows that chamomile is a minor tranquilizer and stomach soother. That’s why it’s often included in teas recommended for inducing sleep, and for soothing anxiety and intestinal distress.

In addition, during the late 20th century, scientists discovered that chamomile contains compounds with action similar to the female sex hormone estrogen, or phytoestrogens, “phyto” meaning plant. During menopause, women’s natural estrogen production declines. This process causes hot flashes, night sweats, mood changes, psychological distress, and vulvo-vaginal atrophy (VVA), the thinning of vulvar and vaginal tissue. (The vagina is internal, the vulva, external.) VVA accounts for most of menopausal women’s sexual complaints. To relieve them, many postmenopausal women use estrogen creams to counter vulvo-vaginal atrophy and improve sexual function. A recent Iranian study shows that a topical gel containing 5 percent chamomile extract works just as well as estrogen.

The Study

The researchers asked 96 postmenopausal women to complete a standard survey of sexual function. Then they divided them into three demographically similar groups. One received a placebo cream; the second, a standard estrogen cream; and the third, a topical gel containing 5 percent chamomile extract. The women applied 1 gram of their creams (about a half-teaspoon) to their vulvas and vaginas nightly for two weeks and then twice a week for 10 weeks.

At the end of the 12-week study, the women completed the sexual-function survey again. All three groups reported significant benefits—more desire and self-lubrication, faster arousal, easier orgasms, and improved sexual satisfaction (p < 0.01). But compared with the placebo group, those who took estrogen or chamomile reported twice the improvement (p < 0.001). The estrogen and chamomile creams produced the same benefits. In other words, the chamomile gel worked as well as topical pharmaceutical estrogen.

Why Chamomile Helps

Around two-thirds of menopausal women suffer vulvo-vaginal atrophy and the physical and psychological symptoms associated with it. As estrogen production declines, blood flow to the vaginal lining decreases. This reduces self-lubrication and reduces the thickness of the vaginal lining, which causes vaginal dryness, itching, discomfort, emotional distress, and/or pain during genital play.

Because estrogen loss causes the discomforts of VVA, replacing estrogen usually clears symptoms. During the 1980s, doctors prescribed oral estrogen, known as “hormone replacement therapy” (HRT), to millions of women. Oral estrogen did, indeed, resolve vulvo-vaginal atrophy symptoms—but it also significantly increased the risk of heart disease and breast cancer. When estrogen's hazards became known, prescriptions plummeted.

Doctors switched to prescribing topical estrogen creams, which also largely relieve VVA symptoms without estrogen absorption in the gut and circulation through the bloodstream, the systemic absorption that raises risk of heart disease and breast cancer. But some women can’t use topical estrogen, and others don’t care to.

Meanwhile, since the 1970s, herbal medicine, a throwback to doctoring before today’s pharmaceutical medicines, has become increasingly popular. Many plants contain phytoestrogens, including soy, black cohosh, red clover, sage, fennel, and chamomile. Phytoestrogens bind to the same cell receptors as estrogen, and have similar effects.

Chamomile products, including gels, are available on the Internet. Unfortunately, no websites marketing topical chamomile products list their concentrations, so it may not be possible to be sure that you're purchasing a product with the 5-percent concentration used in this study. On the other hand, chamomile is safe ingested or applied topically, so you might experiment: Try different products. Follow package directions. If you gain no benefit, use more. Or apply them more frequently than directed. Or combine chamomile ointment with a low dose of prescription estrogen cream.

Iran: A Center of Herbal Medicine Research

It's worth noting that the chamomile gel study took place in Iran. Politically, Iran and the U.S. are enemies. The U.S. has imposed harsh economic sanctions, hoping to deter Iran’s nuclear weapons program. Independent of politics, though, Iranians have been prominent in the field of herbal medicine research for decades. U.S. sanctions have made it more difficult for Iran to purchase Western pharmaceuticals, spurring local efforts to replace them with more available herbal medicines—among them, chamomile.