The perimenopause is a time of changing and fluctuating hormone levels which can cause a wide range of symptoms such as hot flushes, anxiety, mood swings, vaginal dryness, loss of libido, blood sugar imbalances, weight gain, and cognitive changes, including brain fog and memory issues. Many women look for alternative methods to support their health during this phase of life, often involving dietary and lifestyle changes, along with targeted nutrient support.[1]
What are Phytoestrogens?[2]
Oestrogen is a hormone in the body involved in multiple areas of health, including hormonal balance, reproduction, digestion, mood, metabolism, bone density, cardiovascular health, and cognition. Perimenopause is a time of significant fluctuations, later followed by a subsequent decline in oestrogen and other hormones. At this time, women may decide to opt for hormone replacement therapy (HRT) or look towards alternative options to manage their symptoms, such as phytoestrogens.
Phytoestrogens are polyphenolic non-steroid oestrogenic plant compounds that resemble the chemical structure of human oestrogen molecules. This means they can bind to the same oestrogen receptor sites and produce pro-oestrogenic and anti-oestrogenic effects in the body to help to reduce perimenopausal and menopausal symptoms.
Phytoestrogens can be classed into four main categories: Isoflavones, stilbenes, coumestrol, and lignans. Isoflavones are primarily found in soybeans and soy products, consisting of the compounds daidzein, glycitein, and genistein. Coumestrol is mainly present in legumes, clover, and alfalfa, while stilbenes, such as resveratrol, are found in grapes and peanuts. Lignans are primarily located in seeds like flaxseeds, as well as in whole grains and vegetables. Interestingly, gut bacteria play a role here by converting these lignans into their more bioavailable metabolites known as enterolignans, which exert oestrogenic activity. [3]
The benefits of phytoestrogens2
Phytoestrogens can be beneficial during perimenopause and menopause for managing symptoms and reducing the risk of certain conditions, such as cardiovascular disease and osteoporosis. Phytoestrogens are thought to exert a weaker effect than human oestrogen, whilst still having a beneficial impact on hormonal regulation by helping to modulate fluctuations and bring about balance, and can, therefore, support both high and low levels of oestrogen.
A great way to increase your phytoestrogen intake is through foods, including:
- Soya – tofu, edamame, tempeh
- Flaxseeds
- Alfalfa
- Legumes
- Nuts and seeds
- Fennel
- Lemon balm
- Sage
Soybeans are complete proteins, providing all twenty amino acids, making them a valuable food for women looking to increase their protein intake to support muscle preservation, build muscle, and lower the risk of sarcopenia.
What does the research say?
Phytoestrogen-rich foods have gained significant attention for their potential to help attenuate hormonal fluctuations and may even have a protective effect against longer-term health conditions. Various meta-analyses have found a protective and therapeutic role of phytoestrogens in perimenopause and beyond; however, their use in practice is often still debated due to some studies finding little or no effects. But what does the research say?
Soy Isoflavones
Low oestrogen levels are linked to an increase in LDL cholesterol and endothelial dysfunction, which can increase the risk of adverse cardiovascular events. However, research suggests that due to their antioxidant and anti-inflammatory effects, phytoestrogens may help to improve nitric oxide production and support a healthy endothelium.[4]
Geinstein, an isoflavone, accounts for around 60% of the isoflavones in soya beans and has been found to exert many beneficial biological effects. Research has shown that it can enhance glucose metabolism, exhibit anti-tumour activity, and influence the expression of genes involved in lipid metabolism, leading to improvements in markers such as total LDL, HDL, total cholesterol, and triglyceride levels. Symptomatically, for perimenopause and beyond, a reduction in hot flashes, sleep disturbances, appetite irregularities, stress, night sweats, low mood, and cognitive issues was also observed.[5]
A plant-based diet intervention study that included daily soy consumption found a significant reduction in hot flashes, along with improvements in weight management and libido. The study used 86g of soybeans, providing about 55-60mg of soy isoflavones, which is slightly higher than the amount typically consumed in Japan and China.[6] Both previous and subsequent studies have confirmed this effect while accounting for the placebo effect.[7],[8]
Epidemiological studies suggest that in Asian countries like Korea, China, and Indonesia, where soy consumption is estimated to be four to nine times higher than in Western countries, the reported incidence of hot flashes is much lower, ranging from 10–25%, compared to 60–90% of women in Western countries.2
Other phytoestrogens
Beyond soy isoflavones, lignans, like those found in flaxseed, have been shown to support mood through their impact on neurotransmission and neuroinflammation, as well as offering beneficial effects on the cardiovascular and metabolic systems. Flaxseeds are packed with omega-3, fibre, and phytoestrogens, which contribute to their anti-inflammatory and antioxidant benefits. [9]
Panax ginseng is a well-known adaptogenic herb that is used to support energy production, mental and physical performance, and blood glucose regulation. It also has oestrogen-like effects due to the presence of ginsenosides. Research has found that ginseng may have a beneficial effect on hot flushes and improve quality of life.[10]
Shatavari (asparagus racemosus) is an Ayurvedic herb with phytoestrogenic and adaptogenic properties that can help support hormonal balance during perimenopause. A randomised double-blind placebo-controlled study with menopausal women found that eight weeks of Shatavari supplementation led to significant reductions in insomnia, anxiety, nervousness, hot flushes, vaginal dryness, and low libido, alongside feeling overall improvements in their quality of life.1
Sage (salvia officinalis), a member of the Lamiaceae family, is a phytoestrogen that has been shown to modulate both GABA and serotonin, helping to support overall mood.[11] It also has been found to reduce the severity of night sweats and hot flushes, alongside improving fatigue, anxiety, and concentration.[12] In one three-month study with postmenopausal women, the intervention group supplementing with sage reported improvements in nighttime sweats, flushing, heart palpitations, muscle and joint pain, depression and anxiety, sleep disruptions, brain fog, mental exhaustion, and libido.[13]
Perimenopause may feel like a rollercoaster, but good nutrition, stress management, restful sleep, and the right supplements can all be valuable tools to help you navigate this transition.
The use of phytoestrogens has been a controversial topic, The British Menopause Society and other organisations recommend that those who have had breast cancer to avoid phytoestrogens at therapeutic doses[14] whilst much of the research reports no harmful effects[15] it is always best to talk to your practitioner who will take into account your individual health and help decide on the right course of action for you. We would not recommend the use of soy isoflavone supplements if taking HRT.
Key takeaways
- Perimenopause is a time of significant fluctuations followed by a subsequent decline in oestrogen and other hormones.
- Phytoestrogens are polyphenolic non-steroid oestrogenic plant compounds that resemble the chemical structure of human oestrogen molecules.
- Isolflavones are mainly found in soybeans and soy products and are composed of the compounds daidzein, glycitein, and genistein.
- Low oestrogen levels can cause an increase in endothelial dysfunction and LDL cholesterol, which can increase the risk of adverse cardiovascular events.
- Soya beans have been found to exert many beneficial biological effects, including improved glucose metabolism, anti-tumour activity, and alteration of the expression of genes related to lipid metabolism, including improvements in markers of total cholesterol, LDL, triglycerides, and HDL levels.
- Lignans, found in flaxseed, have been shown to help support mood via their effects on neurotransmission and neuro-inflammation, as well as having beneficial effects on the cardiovascular and metabolic systems.
- Other phytoestrogens include panax ginseng, shatavari, and sage and have been found to support perimenopause and beyond.
References
[1] Gudise, V. S., Dasari, M. P., & Kuricheti, S. S. K. (2024). Efficacy and Safety of Shatavari Root Extract for the Management of Menopausal Symptoms: A Double-Blind, Multicenter, Randomized Controlled Trial. Cureus, 16(4), e57879.
[2] Chen, L.-R. and Chen, K.-H. (2021). Utilization of Isoflavones in Soybeans for Women with Menopausal Syndrome: An Overview. International Journal of Molecular Sciences, 22(6), p.3212. doi:https://doi.org/10.3390/ijms22063212.
[3] Laveriano-Santos, E. P., Luque-Corredera, C., Trius-Soler, M., Lozano-Castellón, J., Dominguez-López, I., Castro-Barquero, S., … Pérez, M. (2024). Enterolignans: from natural origins to cardiometabolic significance, including chemistry, dietary sources, bioavailability, and activity. Critical Reviews in Food Science and Nutrition, 1–21. https://doi.org/10.1080/10408398.2024.2371939
[4] Yamagata K. Soy Isoflavones Inhibit Endothelial Cell Dysfunction and Prevent Cardiovascular Disease. J Cardiovasc Pharmacol. 2019 Sep;74(3):201-209. doi: 10.1097/FJC.0000000000000708. PMID: 31356541.
[5] Thangavel P, Puga-Olguín A, Rodríguez-Landa JF, Zepeda RC. Genistein as Potential Therapeutic Candidate for Menopausal Symptoms and Other Related Diseases. Molecules. 2019;24(21):3892. Published 2019 Oct 29. doi:10.3390/molecules24213892
[6] Barnard ND, Kahleova H, Holtz DN, et al. A dietary intervention for vasomotor symptoms of menopause: a randomized, controlled trial. Menopause. 2023;30(1):80-87. doi:10.1097/GME.0000000000002080
[7] Canivenc-Lavier MC, Bennetau-Pelissero C. Phytoestrogens and Health Effects. Nutrients. 2023;15(2):317. Published 2023 Jan 9. doi:10.3390/nu15020317
[8] Dunneram, Y., Chung, H-F., Cade, J., Greenwood, D., Dobson, A., Mitchell, E., Woods, N., Brunner, E., Yoshizawa, T., Anderson, D. and Mishra, G. (2019). Soy intake and vasomotor menopausal symptoms among midlife women: a pooled analysis of five studies from the InterLACE consortium – White Rose Research Online. Whiterose.ac.uk. [online] doi:https://eprints.whiterose.ac.uk/141153/1/Soy%20intake%20and%20vasomotor%20menopausal%20symptoms%20ACCEPTED.pdf.
[9] Jang WY, Kim MY, Cho JY. Antioxidant, Anti-Inflammatory, Anti-Menopausal, and Anti-Cancer Effects of Lignans and Their Metabolites. Int J Mol Sci. 2022;23(24):15482. Published 2022 Dec 7. doi:10.3390/ijms232415482
[10] Lee HW, Ang L, Lee MS. Using ginseng for menopausal women’s health care: A systematic review of randomized placebo-controlled trials. Complement Ther Clin Pract. 2022;48:101615. doi:10.1016/j.ctcp.2022.101615
[11] De Franciscis P, Colacurci N, Riemma G, et al. A Nutraceutical Approach to Menopausal Complaints. Medicina (Kaunas). 2019;55(9):544. Published 2019 Aug 28. doi:10.3390/medicina55090544
[12] Dadfar F, Bamdad K. The effect of Saliva officinalis extract on the menopausal symptoms in postmenopausal women: An RCT. Int J Reprod Biomed. 2019;17(4):287-292. Published 2019 May 28. doi:10.18502/ijrm.v17i4.455
[13] Zeidabadi A, Yazdanpanahi Z, Dabbaghmanesh MH, Sasani MR, Emamghoreishi M, Akbarzadeh M. The effect of Salvia officinalis extract on symptoms of flushing, night sweat, sleep disorders, and score of forgetfulness in postmenopausal women. J Family Med Prim Care. 2020;9(2):1086-1092. Published 2020 Feb 28. doi:10.4103/jfmpc.jfmpc_913_19
[14] 04-BMS-ConsensusStatement-Non-hormonal-based-treatments-SEPT2024-A.pdf
[15] Boutas I, Kontogeorgi A, Dimitrakakis C, Kalantaridou SN. Soy Isoflavones and Breast Cancer Risk: A Meta-analysis. In Vivo. 2022;36(2):556-562. doi:10.21873/invivo.12737
All of our blogs are written by our team of expert Nutritional Therapists. If you have questions regarding the topics that have been raised, or any other health matters, please do contact them using the details below:
nutrition@cytoplan.co.uk
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Last updated on 25th March 2025 by cytoffice
