Phytotherapy effective in menopausal dysphoric disorder (MMD)? In Response to 'Letter to the Editor'

As pointed out in the letter by Dr. Niederhofer, there is limited evidence from rigorous scientific studies for phytomedicines in the management of psychological symptoms specifically associated with menopause, referred to as menopausal dysphoric disorder. However, studies have been published supporting the role of several herbal extracts in this context, such as 'Hypericum perforatum' (St. John wort), the combination of 'Cimicifuga racemosa' (Black cohosh) with 'H. perforatum', 'Panax ginseng' (Korean ginseng), 'Pipermethysticum' (Kava), 'Tribulus terrestris', and a multicomponent herbal formulation.