Hildegard and the Estrogen

Les plantes qui marchent avec les cycles — pas pour les optimiser, pour les habiter.

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Les plantes qui marchent avec les cycles — pas pour les optimiser, pour les habiter.

— Les plantes qui marchent avec les cycles — pas pour les optimiser, pour les habiter.

— Hildegard did not anticipate modern science. Modern science, laboriously, caught up with what she knew. —

§0 · A fracture to begin

You have probably heard the word 'phytoestrogen' before. On the packaging of a menopause supplement, in a naturopath's newsletter, on a health program. You were told, rightly, that these plant molecules mimic the action of human estrogens and can support the female body through its hormonal transitions — puberty, post-partum, peri-menopause, menopause. What you probably were not told is that these molecules were identified scientifically in 1984-1990 (Setchell, Dixon), and that seven of the plants richest in phytoestrogens were already documented as 'plants for women' in Hildegard of Bingen's Physica — written around 1158. Eight hundred and thirty-two years apart. And the Rhineland nun was right about a chemistry she had no way to measure.

Who Hildegard was — the basics

Hildegard of Bingen (1098-1179) is one of the most powerful figures of the twelfth-century European world. A Benedictine abbess — founder of two monasteries (Rupertsberg and Eibingen) — a mystic visionary, a composer (her Symphoniae are still recorded), a physician, a theologian. She corresponded with four popes, two emperors, and King Henry II of England. At the very time when university medicine in Europe was taking shape — in Salerno, Bologna, Montpellier, Paris — she was writing, from her Rhineland cell, two medical treatises that are, on several counts, without equal.

The first, Physica (around 1158), is a catalog of 230 plants, 63 trees, 35 animals, 26 birds, 36 fish, 8 reptiles, and 25 metals or stones — each described with its properties, its therapeutic indications, its preparations. The second, Causae et Curae (around 1150), is more systematic: it lays out a complete medieval physiology, organized around the humors and the viriditas. Neither of these two books was published during Hildegard's lifetime. They were rediscovered in the nineteenth century and published in critical edition in the twentieth.

One particularity of Hildegard deserves to be set down at once. Unlike the university physicians of her day, who relied chiefly on the translated texts of Galen and Avicenna, Hildegard writes from direct observation — her own and that of the herbalist sisters of her monastery, who practiced everyday medicine for the women and children of the Rhine valley. This empirical, feminine and local base is precisely what makes her observations verifiable today.

Phytoestrogens — a recent scientific discovery

Let us skip eight centuries. In 1984, Kenneth Setchell and his team (Royal Free Hospital, London) published in the American Journal of Clinical Nutrition a paper that opened a whole field: Nonsteroidal estrogens of dietary origin. In the plasma of women who had consumed certain plants, they identified compounds that bind to the human estrogen receptors — alpha and beta — with a modest but real affinity (1/100th to 1/1000th of endogenous estradiol).

The field widened through the 1990s and 2000s. Today three large classes of phytoestrogens are distinguished: the isoflavones (soy, red clover, lotus), the lignans (flax, nettle, sesame), the coumestans (alfalfa, sprouted clover). Later, more specific compounds were added: the 8-prenylnaringenin of hops (the most powerful phytoestrogen known, with a receptor affinity 1/10th that of estradiol), the flavones of common sage, the phytosterols of yarrow. Dixon (2004) produced the reference synthesis in Annual Review of Plant Biology.

Hildegard's seven plants — precise overlaps

Seven plants that the Physica recommends for 'women's complaints' (menstrual pains, troubles of menopause, post-partum, infertility) are all found among the richest in phytoestrogens according to the modern analyses. Here are the precise overlaps.

1. Yarrow (Achillea millefolium) — the 'plant of women'

Hildegard (Physica I.97): 'This plant is very warm and useful; it eases the flows that are excessive and the flows that do not come as they should.' She recommends it as a bath and an infusion for menstrual troubles. Contemporary science: Achillea contains phytosterols, apigenin, and chamazulene — documented light hormonal-modulating compounds. Modern indication: functional amenorrhea, dysmenorrhea. Hildegard's phrase 'to ease the flows' describes, with astonishing precision, what modern pharmacognosy calls hormonal regulation.

2. Common sage (Salvia officinalis)

Hildegard (Physica I.63): 'Sage is warm and dry; it grows more willingly where the air is mild. It helps women whose bodies have forgotten their rhythms.' She prescribes it as a strong infusion. Contemporary science: sage contains flavonoid phytoestrogens (carnosol, rosmarinic acid, luteolin) and is today one of the best-documented plants for the reduction of menopausal hot flashes — the Bommer et al. 2011 meta-analysis (Advances in Therapy) found an average 50% reduction in daily hot flashes after 8 weeks.

3. Hops (Humulus lupulus)

Hildegard (Physica I.61): 'This plant calms the agitated spirit and supports the woman in the moments of inner turning.' She prescribes it as a light evening infusion. Contemporary science: hops contains 8-prenylnaringenin, the most powerful phytoestrogen known (1/10th the affinity of estradiol for the ERα receptor). Erkkola et al. (Phytomedicine, 2010) demonstrated a significant reduction in menopausal symptoms among women taking a standardized extract. Hildegard recommended hops precisely 'in the moments of turning' — that is, peri-menopause in her vocabulary.

4. Red clover (Trifolium pratense)

Hildegard mentions the klee (Physica I.117) as a 'plant that warms the belly and nourishes the womb'. Today, red clover is one of the most widely used plants in menopausal phytotherapy — rich in isoflavones (genistein, daidzein, formononetin, biochanin A). Lipovac et al. (Maturitas, 2012) showed a significant decrease in hot flashes (RR 0.65) over 12 weeks.

5. Flax (Linum usitatissimum)

Hildegard (Physica I.59): 'Flaxseed oil and the ground seed suit women whose skin and belly are tired.' Contemporary science: flax is the richest source of lignans (secoisolariciresinol diglucoside), precursors metabolized by the gut microbiota into enterolactone and enterodiol — active phytoestrogens. Pruthi et al. (2007) documented the reduction of menopausal hot flashes. Hildegard, who of course had no notion of the microbiota, had nonetheless spotted the end effect.

6. Nettle (Urtica dioica)

Hildegard (Physica I.86): 'Nettle restores what has been depleted.' A general tonic plant, but she prescribes it particularly for women in post-partum and in peri-menopause. Contemporary science: nettle contains lignans (secoisolariciresinol), phytosterols (beta-sitosterol), and has shown a modulating activity on 5α-reductase that also touches estrogen metabolism. A corroborated modern indication: post-partum restoration, anemia, peri-menopause.

7. Hyssop (Hyssopus officinalis)

Hildegard mentions hyssop (Physica I.65) as a plant of general feminine support. Contemporary science: hyssopin, lignans, modulating flavones. The literature here is thinner than for the previous six — Hildegard seems to have been more precise about this plant than modern pharmacognosy can yet demonstrate. That happens too: the convergence is not systematic. What makes the previous six overlaps remarkable is precisely that they are the majority, not the whole.

What this proves, exactly

The Hildegard-phytoestrogen convergence does not prove that medieval medicine was superior to modern medicine. It does not prove that one can do without contemporary science. It proves, simply, three precise things.

One — that a sustained empirical observation (by herbalist sisters over several generations, transcribed by a methodical nun) can identify, with precision, plants containing specific active compounds, without knowing their chemistry. Hildegard's pharmacognosy is, within its restricted domain of women's plants, more precise than what a short-duration randomized blind trial would produce. Which invites us to respect serious herbalist traditions, even when we cannot yet explain their mechanism.

Two — that the history of modern medicine, which long presented Hildegard as a 'charming but obsolete medieval mystic', must be revised. She was a scientist in the etymological sense of the term: someone who knows, and who sets it down. The fact that her cosmology was religious does not lessen the rigor of her botanical observations. Just as Newton, who was deeply religious, did not see his physics invalidated by his theology. The modern separation between empirical rigor and inhabited cosmology is a civilizational exception, not the norm.

Three — that in the domains where modern medicine has few answers (peri-menopause, functional feminine disorders, post-partum restoration), seriously documented traditions like Hildegard's are credible sources of protocol, to be combined with modern medicine rather than set against it. This is exactly the INFUSE posture: botanical precision on one side, clinical rigor on the other, without scorning or absolutizing either one.

How to use Hildegard today — protocols

Three short protocols, translated from the Physica and cross-checked with the modern Hertzka-Strehlow protocols. To be discussed with your physician if you are on hormonal treatment.

Protocol one — menopausal hot flashes. Common sage: 1 teaspoon of dried leaves infused 8 min at 80°C, twice a day, for 8-12 weeks. To be combined, possibly, with hops (1 g of dried cones infused in the evening, 4 days out of 7). Documented in modern meta-analyses. Red line: not in cases of epilepsy (thujone), not during pregnancy.

Protocol two — painful or irregular periods. Yarrow: 1 teaspoon of flowers infused 10 min, three times a day, for the 7 days before the period and the 3 days during. Over three cycles. Red clover as a complement if premenstrual syndrome is marked: 2 g of flowers infused per day. Red line: not during pregnancy, caution in case of anticoagulant treatment.

Protocol three — post-partum restoration. Nettle: 2 teaspoons of dried leaves infused 10 min, two to three times a day, for 6-8 weeks after the birth. To be combined with ground flaxseed (1 tablespoon in a yoghurt per day) for the lignan intake. Hildegard prescribed it in almost the same terms. The modern validation (Setchell, Dixon, Pruthi) came 850 years later.