Supporting oestrogen naturally (in perimenopause and beyond)

Perimenopause is a time when many women start to feel the sometimes subtle, but often dramatic, shifts in their hormonal landscape. Oestrogen levels no longer follow the predictable rhythm they once did. Instead, they rise and fall in irregular waves that can influence everything from mood and sleep to temperature regulation and menstrual patterns. As more women look for ways to support their bodies through these changes, interest in phytoestrogens, plant-derived compounds that can interact with oestrogen receptors,  has grown rapidly. In this blog, we explore what the research tells us about phytoestrogens, where they can be found in everyday foods, and how they may fit into a broader, holistic approach to midlife wellbeing. 

How phytoestrogens work

What makes phytoestrogens so compelling is their versatility. Because they bind to oestrogen receptors only weakly, they tend to have a gentle, modulating effect. In perimenopause, when oestrogen can swing from very high to very low, they may help soften the impact of those spikes by occupying receptor sites without delivering the same intensity as the body’s own oestrogen. This can reduce some of the negative effects associated with excess or fluctuating levels.

 In menopause, when oestrogen is consistently low, phytoestrogens can still activate those receptors to a mild degree, offering a subtle form of support even when the body produces very little oestrogen of its own. This dual action has placed them at the centre of conversations about natural approaches to hormonal balance during perimenopause and beyond. 

Phytoestrogen food sources

Although several plant foods contain some level of phytoestrogens, soya  has a high concentration and is the most frequently used in studies. Flaxseed (ground) is also a good source, along with herbs such as sage, red clover, hops and shatavari. 

Practical ideas

Here are some simple ways to include these foods in your diet:

• use frozen edamame beans instead of peas when cooking soups or stews

• add tofu to your stir fries

• add miso to soups or broths

• add ground flaxseed to your smoothies or granola (see the granola recipe of the month below!) 

• add sage leaves to meat dishes

What does the research say?

A review in 2021 (1) found an apparent reduction in menopausal hot flushes with phytoestrogen intake, although findings are mixed (2). There is also evidence for phytoestrogens supporting markers of cardiovascular risk (1) and bone health (3). 

A study based upon self-reports from 19,351 middle-aged women from 5 observational studies across Australia, UK, USA, and Japan concluded that soya products, but not soya milk, was associated with lower likelihood of reporting hot flushes and night sweats (4). This would suggest that choosing fermented soya may be more beneficial, for example tofu, tempeh and miso.  

Shatavari reduced hot flashes, night sweats, insomnia, anxiety, nervousness, vaginal dryness, and loss of libido in a trial involving 70 peri- and postmenopausal women (5), while sage significantly reduced the frequency of hot flashes in postmenopausal women according to a systematic review and meta-analysis of 4 independent studies (6).

Who may not benefit as much from phytoestrogens?

It is important to note that phytoestrogens have the potential to interact with hormone therapies, so do consult with a nutritional therapist if planning to use high concentrations (eg in supplement form). It is also uncertain if they are suitable for those with a high risk of breast cancer (7). Finally, there is individual variation in our responses to phytoestrogens, as they typically require specific gut bacteria to metabolise into their oestrogenic compounds, so not everyone will reap the same benefits as a result.

Take home message

As we learn more about the nuanced role of phytoestrogens, it appears they may form a  meaningful part of a broader nutritional strategy for navigating perimenopause and menopause with greater ease. Their gentle, adaptive interaction with oestrogen receptors makes them uniquely suited to the hormonal ebb and flow of midlife, and the research, while still evolving,  offers promising signs for symptom relief and long-term health. 

REFERENCES:

(1) Rowe, I. J., & Baber, R. J. (2021). The effects of phytoestrogens on postmenopausal health. Climacteric : The Journal of the International Menopause Society, 24(1), 57–63. https://doi.org/10.1080/13697137.2020.1863356

(2) Eden J. A. (2012). Phytoestrogens for menopausal symptoms: a review. Maturitas, 72(2), 157–159. https://doi.org/10.1016/j.maturitas.2012.03.006

(3) Jin, X., Sun, J., Yu, B., Wang, Y., Sun, W. J., Yang, J., Huang, S. H., & Xie, W. L. (2017). Daidzein stimulates osteogenesis facilitating proliferation, differentiation, and antiapoptosis in human osteoblast-like MG-63 cells via estrogen receptor-dependent MEK/ERK and PI3K/Akt activation. Nutrition Research (New York, N.Y.), 42, 20–30. https://doi.org/10.1016/j.nutres.2017.04.009

(4) Dunneram, Y., Chung, H. F., Cade, J. E., Greenwood, D. C., Dobson, A. J., Mitchell, E. S., Woods, N. F., Brunner, E. J., Yoshizawa, T., Anderson, D., & Mishra, G. D. (2019). Soy intake and vasomotor menopausal symptoms among midlife women: a pooled analysis of five studies from the InterLACE consortium. European Journal of Clinical Nutrition, 73(11), 1501–1511. https://doi.org/10.1038/s41430-019-0398-9

(5) 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, multicentre, randomized controlled trial. Cureus, 16(4), e57879. https://doi.org/10.7759/cureus.57879

(6) Moradi, M., Ghavami, V., Niazi, A., Seraj Shirvan, F., & Rasa, S. (2023). The effect of salvia officinalis on hot flashes in postmenopausal women: a systematic review and meta-analysis. International Journal of Community Based Nursing and Midwifery, 11(3), 169–178. https://doi.org/10.30476/IJCBNM.2023.97639.2198

(7) Paterni, I., Granchi, C., & Minutolo, F. (2017). Risks and benefits related to alimentary exposure to xenoestrogens. Critical Reviews in Food Science and Nutrition, 57(16), 3384–3404. https://doi.org/10.1080/10408398.2015.1126547