Previously, we examined several herbal remedies that are commonly taken to relieve hormonal symptoms. Plants have been used since time immemorial for treating health conditions, and I have the utmost respect for plant-based medicine.
Except for three caveats: 1) botanical (plant-based) treatments can have side effects and drug interactions just like any other medicine; 2) their use, dosages, and efficacy in treating specific illnesses haven’t been rigorously studied; and 3) the manufacture of these products isn’t held to federal standards for safety or consistency.
So my general approach to botanical therapies has been to proceed with caution. Always tell your doctor what natural remedies you’re taking, buy products from reputable manufacturers, and pay attention to how they’re affecting you.
Except for soybean products. I withdraw most of my qualifiers for soy.
While soy has gotten a bad rap in some quarters, especially since most of the US-grown beans are from GMO seedstock, soy still comes close to being a superfood in my (and others’) playbook.
Another tick in the plus column is that soy has been subjected to numerous rigorous scientific studies. (Not to mention that it’s been consumed for millennia in Asian countries.)
Recently, new studies have shed light on how soy might work to relieve menopausal symptoms, such as hot flashes and even vaginal dryness. Its effects aren’t always straightforward, as in “eat more soy, have fewer hot flashes” (although sometimes, it is just that straightforward), but it does clarify how soy is broken down in our systems and under what circumstances it seems to be effective.
When we consume soy products, such as tofu, soy milk, tempeh, edimame, it’s metabolized in our gut into two main isoflavones: daidzein and genistein. These compounds have phytoestrogenic properties, meaning that they mimic estrogen in some ways. (However, seem to carry less risk than estrogen, related to estrogen, and in fact, some research suggests they may have some protective qualities.)
Some women (about 30-40 percent of North American and Europeans; significantly higher percentages of Asians) carry a gut bacteria that can metabolize daidzein into a substance called S-equol. And this, according to at least one recent study, is the bit that is strongly linked to relieving hot flashes and other good stuff.
Among the women who produce equol, those who ate the most soy and had the highest levels of daidzein, reported far fewer vasomotor symptoms (VMS--or hot flashes in common parlance) than equol producers who ate less soy. “Among equol producers, higher equol availability attributable to higher soy consumption contributes to decreased VMS,” the researchers concluded.
Among women who didn’t naturally produce equol, there was no link between higher levels of daidzein and fewer hot flashes. Either you could produce equol and reap the benefit of soy or you couldn’t. Until recently, the only way to find out, says North America Menopause Society executive director, Margery Gass, was to conduct your own personal experiment: Eat soy foods for 4 to 6 weeks, and if it didn’t help, you probably couldn’t metabolize equol.
You either had the right gut flora or you didn’t.
Recently, however, a Japanese pharmaceutical company, Otsuka (Pharmavite in the US) has developed an S-equol dietary supplement made from fermented soybean germ, so whether you are among equol-producing women or not, you have access to the same VMS-busting possibilities.
Studies are fragmentary and scattered, but the consensus seems to indicate that S-equol, either produced naturally or taken as a supplement, is a viable and safe way to reduce the frequency and severity of hot flashes. It also may have positive effects on skin health, including regeneration and thickening of vaginal tissues without the risks associated with hormonal supplements.
Theoretically, you can take 10-40 mg. of S-equol supplement per day for relief of hot flashes. Since it’s metabolized quickly, you should take it in several 10 mg. doses at different times. S-equol has no negative interactions with drugs or supplements, and its side effects are minimal, although research is contradictory, so women with a history of breast cancer are advised to avoid it.
So there you have it. No guarantees, but with very little risk or expense you can conduct your own naturopathic experiment in taming menopausal symptoms. Let us know how it goes.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.