Menopause & perimenopause

Soy: a natural solution in menopause

When symptoms appear in menopause, many women look to the natural world for help. Of the many options available to women in perimenopause and menopause, we classify soy as a menopause “superfood.” Not only have we proven soy effective for reducing frequency and severity of hot flashes in thousands of cases at our clinic, but we have also seen that it is safe and easy to use for nearly everyone, especially as part of a combined approach using healthy lifestyle choices and gentle endocrine support.

So let’s review why soy is an especially healthy choice in menopause and touch on a few points you may not have heard about yet.

Soy isoflavones for menopause symptoms

The soybean (Glycine max) belongs to the legume family, whose members include peas, beans, and peanuts, as well as clovers and alders. Legumes feature phytonutrients that lend some unique benefits to women in menopause. The soybean in especially rich in isoflavones, the most widely studied class of phytonutrients. Of the three main types of soybean isoflavones, the ones found most effective for menopause symptoms relief are genistein and daidzein. Recently a third isoflavone, glycitein, is also being studied to determine its health benefits.

In addition to the healing power of isoflavones, soy is also high in antioxidants, omega-3’s, and protein. Plus, it’s low on the glycemic index. Talk about a superfood!

What can soy offer women in menopause?

Soy and soy isoflavones have been closely studied and found supportive for a wide range of perimenopause and menopause symptoms and concerns: improved insulin regulation; weight loss; bone health; improved nail, skin and hair health; heart health; and decreased frequency and severity of menopausal discomforts, particularly hot flashes and night sweats.

In fact, beyond the three fundamentals embodied in our Personal Program — core nutrition, stress reduction, and botanical endocrine support — soy is our next-best-step when it comes to hot flashes in menopause. But that doesn’t mean it works for every woman — the underlying reasons for hot flashes and night sweats can differ in menopause, and about 20% of the population report they do not tolerate the protein from soy well.

For some women, soy can also have a positive impact on symptoms of PMS. Premenstrual problems can worsen for many women as they enter perimenopause and monthly hormonal cycles take on a more erratic pattern. PMS symptoms that may increase in perimenopause include irritability and other mood changes, breast tenderness, and headaches.

Though controversial, there are also some promising benefits for the aging brain to be weighed with soy. The effects of soy isoflavones observed on mood and cognitive performance in post-menopausal women have been positive — particularly with verbal memory — and this may be of relevance to younger women experiencing memory lapses and foggy thinking in perimenopause, too. We expect more studies will help us understand these effects better, but women with hormonal imbalance report these symptoms almost universally — no matter what their age.

Women who eat foods rich in soy protein are also doing their hearts a big favor. According to a comprehensive review of the literature by the FDA in the late 1990’s, eating 25 g of soy protein daily is enough to gain soy’s heart-healthy benefits. A study on post-menopausal women released in the fall of 2006 also showed reduced markers for inflammation linked to risk of cardiovascular problems, including homocysteine and C-reactive protein. As we enter menopause, minimizing any risk factors that jeopardize our heart health — including inflammation — will support our chances for longer, healthier lives.

Not only is soy high in protein (38% of the bean) but it’s also low in carbohydrates, making it a low glycemic index (GI) food that can support us in keeping our weight at a healthy level. Choosing foods with a low GI helps your blood sugar and insulin levels remain stable over time, helping you feel fuller longer, with fewer hunger cravings and fewer calories being stored as fat.

Turning now to soy and cancer, results from studies on soy and cancer have been mixed. A well-designed study of over 650 women — premenopausal, perimenopausal, and post-menopausal — published in 2007 by the American Society of Clinical Oncology, showed a marked association between higher levels of all isoflavones in the blood and lower risk for breast cancer. The strongest evidence for a decrease in risk was seen for the isoflavone genistein, suggesting that this compound may be most protective against breast cancer development.

Even newer research lends mounting evidence to the observation that the protective effect of genistein is strongest when a woman’s diet is high in soy during the adolescence and childhood. So timing is vitally important — but because it’s very good for daughters or granddaughters is not to exclude soy’s potential benefits for mothers or grandmothers! There is just so much more we have to learn about the protective benefits of foods on all aspects of our health all our lives long.

In another recent development on the protective effects of soy against breast and ovarian cancers, glyceollins were compounds in soy found successful in suppressing cancer cell growth. An important note alongside this study is that soybeans treated with pesticides (or not organically grown) appear to have far less glyceollin content than those that are challenged by attacks from pests in the natural world — another reason to seek out organically grown, non-GMO soybeans.

Finally, we want to share with every woman in menopause the good news that soy isoflavones help promote better bone health and have a positive effect on bone density. During menopause, women can lose up to 20% of their bone density, so this is a particularly important time to consider adding soy to your diet.

Of the three main soy isoflavones, genistein is most closely linked with decreased bone turnover and increased markers associated with bone-formation activity. Whole bean soy (like that found in edamame, tofu and some soy supplements) provides the highest ratio of genistein, while also offering the synergistic benefits of isoflavone diversity.

What is so exciting for us is that new studies are being conducted and designed today to evaluate the effect of soy on function and well-being across all our systems as we age. All this new research is providing welcome confirmation for what we have experienced clinically for years in regard to the benefits of soy for women in menopause.

How soy works in the menopausal body

While we do have plenty of data that show soy’s health benefits and menopause symptoms relief, we know much less about how it works. We do know that phytoestrogens such as soy isoflavones are capable of binding to estrogen receptors (ER) to downgrade the effects of excess estrogen when levels are high, or to exert a weakly pro-estrogenic effect when levels are low. An interesting note in the research is that phytoestrogens do not seem to cause cells to proliferate as steroid estrogens can under certain circumstances.

Soy’s adaptogenic effect By weakly binding to estrogen receptors (represented in orange), soy isoflavones (such as daidzein, shown R) can block negative effects of excess estrogen; alternately, when levels decline, they can “stand in” for estrogen(estradiol molecule, shown L) to moderate negative effects of low estrogen. © 2008 Women to Women

This effect is illustrated at right, and is at least partly attributed to isoflavones’ higher affinity for estrogen receptor beta sites than estrogen receptor alpha sites in body tissues. The theory is that soy’s benefits are seen in the body tissues that are higher in estrogen receptor beta sites, like the bones and brain, but it does not cause unchecked cell growth in the tissues that are higher in estrogen receptor alpha tissues, such as the breasts and uterus. (See diagram.)

What forms and dosages of soy work best?

There are many ways you can add soy to your diet, but our first recommendation is always to start with whole foods. While every phytonutrient in our food carries with it the raw materials and information your body needs to run well on a day to day basis, whole foods have a synergistic quality that speaks volumes to your body’s ability to stay well over a long, long period of time. It is also important to seek out organic, non-GMO sources of whole soy wherever practical.

That may leave you wondering just how much soy is enough in menopause. Effective doses of individual soy isoflavones vary according to which soy foods and products you choose, but we recommend you target a range of 40–80 mg of isoflavones per day for adequate relief. This is the range most experts cite for symptomatic relief, and a level seen in healthy Asian diets. Women with severe menopause symptoms may see quicker results with a daily intake at the upper end of that range. Women supplementing their diets with soy products to treat troublesome and ongoing hot flashes and night sweats may want to consistently use this higher quantity to obtain good long-term results.

Most women find it is fairly easy to incorporate around 20 mg of soy from whole foods into their diet — that is the amount that can be found in a glass of high-quality soy milk, a handful of roasted soynuts, edamame or a tofu entrée. For those who feel the need to to augment their intake of soy through supplementation, there are many high-quality soy products on the market that can help here — look for bars, shake supplements and other “functional foods” made from whole bean soy that feature soy isoflavones on the supplement facts panel.

For women in menopause to get the most from soy, they need to be able to digest it! If this is a concern for you, you can use a digestive enzyme supplement such as Beano, to assist with the efficient break-down of soy sugars and proteins. If you experience digestive problems further down the gut, you may want to try a probiotic supplement, as intestinal bacteria are responsible for converting isoflavones into their most usable and effective forms for treating menopausal concerns.

Side effects/safety of soy

Studies abound on both the health benefits and the detrimental effects of soy, with somewhat conflicting results. Soy remains controversial — though as much as we’ve read about and used it at Women to Women, we’re not quite sure why soy seems to stir the passions of so many.

We’ve been following the soy controversy  for years, and from what we see in the research and at the clinic, the preponderance of evidence falls clearly on the beneficial side — especially as a safe alternative to conventional HRT-based menopausal treatments.

When it comes to soy, we’ve also observed that it works extremely well for some women and moderately well for others, while there is that segment of the population that does not metabolize or tolerate it well, and a smaller subset that reacts adversely to it. This should come as no surprise to us, though, since we all know from personal experience that different body types often react differently to different foods — and after all, soy is a bean!

We will often suggest that women experiencing menopausal symptoms add whole, non-GMO soy foods to their diet to see how well they tolerate them. Most of our patients have done very well by it, some women thrive on it, and for one reason or another, a very few choose to avoid it entirely. We are excited to offer our own delicious SoySational supplement, designed to bring women relief from symptoms like hot flashes and night sweats that are associated with menopause. So whether you’re pre-, peri- or post-menopausal, we recommend you give soy a try and see for yourself.

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