Got Hot Flashes? Get Phytoestrogens in Your Diet
Yesterday, I wrote about new evidence that hormone replacement therapy (HRT) is now linked to a significantly greater risk of ovarian cancer. HRT is a common treatment regimen for menopause symptoms, such as hot flashes. It relies on synthetic estrogen replacement.
It was popular for decades, at least up until about a decade ago, when evidence emerged that it could dramatically boost one’s risk of developing breast cancer and heart disease. Use of HRT plummeted, by about 80%. But some experts still prescribe it for their patients who suffer from intolerable hot flashes and night sweats.
Maybe there’s a better alternative to higher disease risk from synthetic hormones for relief of menopausal misery. Maybe we should turn our attention to the East, where Asian women who consume large amounts of soy experience menopause dramatically differently than Western women. In fact, up to 80% of menopausal women in the West complain of “vasomotor symptoms.” That’s medical-speak for hot flashes and night sweats, which are obviously unpleasant and capable of diminishing one’s quality of life.
But in Asia, only about 10% to 20% of women ever complain about these symptoms. What gives? Are Asian women simply more stoic? Are Western women simply more inclined to complain? While it’s possible that something along those lines may be at play, scientists think it’s far more likely that diet has something to do with these striking differences.
Specifically, they think it may have to do with consumption of phytoestrogens. As you might have guessed, phytoestrogens are plant compounds that act somewhat like estrogen in the human body. Several plants produce these chemicals; including black cohosh, red clover, and soy.
Soy is perhaps the most important dietary source. The situation is slightly complicated by the fact that to become active in the body, these compounds must interact with bacteria in the gut first. To date, it remains unclear if taking supplements intended to boost one’s phytoestrogen levels really works to reduce hot flashes. Some studies say yes, definitely. Others do not. To some extent, it may depend on the makeup of your gut microbiome—which in turns depends on your general diet, and use—or not—of antibiotics.
The situation is further complicated by the fact that endocrine disruptors—chemicals with the ability to mimic natural estrogens and bind with estrogen receptors—are widespread in the home and environment. Most of these synthetic chemicals—such as BPA, which is added to plastics—are believed to interfere with normal reproduction. Sadly, there’s virtually no escaping them. Research indicates that the vast majority of us have these chemicals circulating in our bodies, regardless of our reliance on BPA-laced plastics. They’re simply everywhere now in the environment—the ultimate environmental pollutants.
Nevertheless, the fact remains that Asian women consume lots of soy—and tend to suffer less during menopause. This suggests that something about their diet—which tends to feature more vegetables and less meat than the typical Western diet—is particularly beneficial for menopausal women.
So. To soy or not to soy? That remains the question, I’m afraid.
What about you? Have you ever taken a dietary supplement, such as black cohosh, red clover, or soy isoflavones, to control menopause symptoms? Did it help? I’d love to hear your feedback about your experiences.
Patisaul HB, Jefferson W. The pros and cons of phytoestrogens. Frontiers in neuroendocrinology 2010;31(4):400-419. doi:10.1016/j.yfrne.2010.03.003.