During perimenopause and menopause, up to 85% of patients experience vasomotor symptoms like hot flashes. Many will look to supplements for help. Be ready to discuss the options.
Most of the herbal therapies promoted for menopause are classified as phytoestrogens, with isoflavones being the most common. Explain to patients that soy isoflavones have effects in the body similar to selective estrogen receptor modulators (SERMs). And consuming soy protein 15-60 grams, providing 34-100 mg of isoflavones, daily seems to reduce hot flashes in some patients. Taking higher doses of isoflavones might be more beneficial. The most common side effects from soy are bloating, constipation, diarrhea, and nausea – but it’s usually well-tolerated.
Equol is one specific soy isoflavone to consider. Clinical research shows that taking equol 10-30 mg by mouth daily reduces hot flashes and improves mood during menopause. Equol can be taken as a supplement or consumed in the diet. When soy is eaten, certain bacteria in the gut change chemicals in soy into equol. But interestingly, this change only occurs in 20-60% of people – so these people might get more benefits when they eat soy.
Lastly, we can’t forget about black cohosh. There’s good evidence that using one specific product (Remifemin) might help with hot flashes, and it seems to be comparable to hormonal therapy. But it’s not clear if other black cohosh products help – the evidence is fairly mixed. This may be due to the way the black cohosh in these products is cultivated and processed. It seems to be well-tolerated by most patients, but there are concerns about liver damage based on case reports – consider monitoring liver function if patients want to give it a try.
Check out our Comparative Effectiveness Chart and interactive CE course on Complementary Therapies for Menopause to learn more.
The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2024 NatMed. Commercial distribution or reproduction prohibited. NatMed is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.
