Can Phytoestrogens be as good as hormonal replacement for managing menopause related symptoms?

The primary source of Phytoestrogens (PhE) - soy and soy bean products - tofu, soy milk etc., which contain PhE in high concentration. Majority of plants contain PhE. , but in a small amount.  The similarities, at molecular level, of an estrogen and a phytoestrogen allow them to be helpful in early stages of menopause. They do this primarily by relieving hot flashes.   Unfortunately it is hard to standardize dose and frequency of consumption and does not consistently help everyone.

The good news is it is considered to be harmless.  It should not be taken by women with diagnosed cancer of the uterus or breast, mostly because of potential unconfirmed risk.   

Yet, it does not increase risk  for development of cancer and can be safely used to relieve menopausal hot flashes, but not other menopausal  symptoms. It appears that oriental women with a high rate of soy products consumption, suffer much less from hot flashes. So, we do recommend a glass of soy milk in the night time before starting Hormone replacement therapy.  If it meets a woman's expectations, she can safely stay with it for years. 

Similarly, Isoflavones [ red clover ] have mild estrogen like action, which unfortunately although harmless is ineffective. Numerous isoflavone and phytoestrogen based products, promising miraculous relief fall far from meeting most women’s expectations and cannot be seriously considered.

Before buying OTC ,  often expensive “ miracle “ supplements, focus on the active ingredient.   If this ingredient is based on Phytoestrogens or Isoflvones, do not expect dramatic results in managing menopausal symptoms.

Black Cohosh, is the only herb worthwhile to try before going to HRT.  It is not a Phytoestrogen and it does not elevate or mimics action of estrogens.   Black Cohosh appears to reduce hot flashes through Serotonin-like action on thermoregulating center of the brain and thus reducing hot flashes.

Black Cohosh is very safe, but once again, does not work for everybody or even every time.   It has to be tried twice daily, maximum 4 pills per day, it can be taken without detriment for years.

Dong Quai, also is not a Phytoestrogen, but appears to reduce level of circulating estrogens, contradictory recommendations make it unlikely candidate for relief of menopausal symptoms. It is less expensive and can be tried without detriment.

So to summarize - try PhE remedies for short period of time, purchase inexpensive formulation, use suficient quantities- there is very low risk of "overdosing" - it is unlikely to help or harm.  Make sure you  have had a GYN consult and screening mammogram less than a year prior.  If there are any signs of unexpected uterine spotting whilst using PhE, consult your GYN. If you notice an improvement of menopausal symptoms, continue using PhE as long as needed, it's safe!


The information contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Leon Nitkin, M.D. I offer a full range of GYN services and limited obstetric care. I specialize in the provision of services for gynecological plastic, including narrowing of vagina and labia reduction; Cervical Cancer Immunizations (HPV Immunizations - GARDASIL) and have extensive experience in treatment of Uterine Fibroids - therapeutic and surgical. Our primary focus is your comfort with a female physician assistant on staff and a Board Certified Anesthesiologist for procedures.

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