Are Soy & Herbs Safe and Effective During Menopause?

green-eyed woman in red top against a red background eats a bowl of tofu with chopsticks

My patients know that their estrogen levels drop during menopause, and that dip in hormones can make it harder to sleep. They are having hot flashes, night sweats, and wake up with brain fog. They might be a little irritable. They are also concerned about their bone health as estrogen decreases, and so they are looking for safe, natural ways to replace that estrogen. 

Many women do not want to take Hormone Replacement Therapy (HRT), and are looking for alternatives. One that has been around for centuries is soy. There has been a steady increase in the interest in and availability of soy products since the 1960s. Many of you already have tried tofu, tempeh, edamame, roasted soy nuts, or soy milk. 

But the women I talk to have often done some online research, and they are worried about whether soy can cause an increased risk of breast cancer. This is because many years ago there was research that showed that soy did cause an increase in breast size…. in laboratory animals– but not in humans! When rodents were given really high levels of soy and isoflavones, which are the active ingredients in soy, they did show an increased breast size. So, people thought that this would be the case with humans. 

But further research was very reassuring, and the body of extensive research tells us that soy is a safe food for women to have in their diet and it does not increase the risk of breast cancer. In fact, there was a study on breast cancer survivors who were on various forms of chemotherapy from tamoxifen to aromatase inhibitors, and it was found that women who had one serving of soy per day in their diet after their breast cancer actually had a reduction in their recurrence rate. American Cancer Society says that women can safely have soy at all times of life, including during the midlife and menopause years.

Of course, if you still have concerns, or are a breast cancer survivor, do talk to your healthcare provider about your choices.

More About Soy and Supplements

Soy contains isoflavones, these are the active ingredients and have been shown to help alleviate the hot flashes and night sweats women often deal with during menopause. If you want to try a supplement, you should look for at least 50 milligrams of isoflavones. You can start with that, and then slowly increase. If you’re thinking about eating more foods with soy, it’s a little different. 1 cup of soy milk has approximately 25 milligrams of isoflavones and that’s a good place to start, because soy foods can cause a little gas. So, start with 1 cup and then gradually increase to 2 cups per day.

Be aware though, that studies have shown that many Caucasian women, particularly those of Northern European descent, do not have the genetic capability to metabolize soy into its natural and active metabolite. This active metabolite, known as S-Equol is what helps with the menopausal symptoms of hot flashes and night sweats. Many women just cannot convert soy to the active form for relief. But Japanese researchers finally came up with S-Equol in pill form that you can find online. Nature Made is a company that offers this under the name Equelle. I am not a spokesperson for this company, but I do have patients who are breast cancer survivors and others who cannot take estrogens because of migraines or a history of blood clots, who are finding relief, with Equelle. I also recommend it for my patients who are just not doing as well as we’d like with their hormonal treatment. They could be having bleeding or other problems, so to manage those symptoms, sometimes reducing the amount of bio-identical estrogen means more hot flashes and night sweats. In those cases, adding in a little Equelle seems to do the trick without adding more estrogen. 

Black Cohosh

Many of the soy or isoflavone supplements you see are combined with other herbs like black cohosh. Black cohosh has been shown in numerous randomized, placebo-controlled trials – which have the highest standard in proving effectiveness–to help some women with their hot flashes and night sweats. In fact, Black cohosh is one of the only herbs that’s been shown to be better than placebo when it comes to alleviating hot flashes and night sweats. If you do want to try it, I would recommend getting a product called Remifemin. Again, I don’t work for them, but I know that this formula contains pharmaceutical grade black cohosh and has rigorous quality control standards, so you know that you can trust that you are getting what the package says is inside. Also, it’s important to know that if black cohosh is going to work for you, you will start to see benefits within 6 – 8 weeks. But if you don’t see any benefit within that time frame, then most likely, you won’t see much improvement afterwards. We think that’s because some of us just don’t have the receptors for black cohosh. So, if it’s not working, save your money, and try something else.

Getting Phytoestrogens Through Your Skin

There are now lotions and creams available that can deliver phytoestrogen isoflavones to your skin. We know that the loss of estrogen does accelerate the aging of our skin, affecting its thickness, how it stays hydrated, its elasticity, wrinkling, and the amount of collagen it holds on to. There have been studies reported by the NIH that support phytoestrogens as effective in the treatment of aging skin by improving skin elasticity by preventing the loss of collagen. The noticeable affects will not be as great as with actual Hormone Replacement Therapy, and of course, sun protection and not smoking are still key to keeping your skin looking good!

Looking younger is one of the secret reasons many women use phytoestrogens and other estrogens. They’re not just for hot flashes!

Food First

You all know I’m all about food and nutrition first, because we absorb more of the nutrients from the whole food matrix. If you’re going to try introducing soy into your diet you might want to start with a half serving, as soy products can cause stomach upset and gas in some people, and then slowly increase your servings. Many women see menopausal symptoms reduced by about 30%, and that’s pretty good if you are suffering, right?

So, what is your tofu burger or edamame salad going to do for you beyond calming down your hot flashes? A few good things. Soy is a great source of plant-based protein. If you are trying to reduce your cholesterol and how much animal-based protein you are eating, soy is an excellent substitute and can reduce your risk of cardiovascular disease and atherosclerosis.  

To sum up, remember, soy contains a plant-based or phytoestrogen that is safe to have at all times of life, including menopause. Many studies show that soy helps to protect our bone health and reduce the risk of fracture. Unfortunately, soy is not a cure-all. It doesn’t help with vaginal dryness, pain with sex, or reducing any of the urinary tract issues. It is really much more effective for your whole body and to help control those hot flashes and sweats. 

How do you like your soy?  Please feel free to share your recipes.

Saving Calories & Time–Air Fryers & Instant Pots

instant pot with tomatoes and vegetables

Maybe you got one of these popular cooking devices for a holiday gift, or are considering giving one of them a try. Here’s some info on each, and a few recipes to try.

Low Fat Frying

Pretty much everybody loves the crispy crunch and moist insides of fried foods. But they do make the guilty pleasure list. At 294 calories and over 14 grams of fat, a battered deep fried chicken breast is definitely not health food. Frying in fat turns an innocent little baked potato (93 calories and 0 grams of fat) into French fries containing 

319 calories and 17 grams of fat. 

The air fryer to the rescue!  It works like a super-hot (around 400 F) convection oven to move air around your food, browning and creating a crispy exterior and keeping the inside soft. You can choose to toss the food in a bit of oil before cooking and try some of your deep-fried favorites.

A Few Drawbacks

There are various models available and a few complaints. Users say they are bulky and do take up a lot of counter space. A really big one is necessary to cook enough food for a larger family. And, noise is a factor. It takes a powerful fan to move the air around and that makes the fryer as loud as a vacuum cleaner or dishwasher. Also make sure you get a model made of BPA-free plastic.

Air Fryer Recipes

Cooking Light offers lots of air fryer recipes, see them here.

Try the Cauliflower Tots, Chicken Tenders, Avocado Wrapped Bacon, and Air Fryer Spicy Chicken Taquitos from Delish.

Not Your Mom’s Pressure Cooker

Another hot item is the Instant Pot cooker. The Instant Pot is the most well-known brand but there are other manufacturers, like Breville and Fagor. They have become very popular in the past couple of years. The appeal of this type of cooking is not necessarily to cut calories – but to save time. They also are multi-taskers, not only are they electric pressure cookers, but also slow cookers (like a crock pot), they sauté, steam rice, and some make yogurt. And unlike the old pressure cookers they now have safety features that prevent the explosions and burns that did happen back in the day. 

How They Work

The pressure cooker feature is the real time saver, especially for meats. It works by creating a very tight seal which raises the boiling temperature of liquids up to as much as 266 degrees. This higher temperature, and the pressure in the pot forces the hot steam into the ingredients, cooking them much faster. If you are cooking meats for bone broth, or a pork shoulder for pulled pork, this is a definite shortcut. It also cuts down the cooking time for dried beans.

Melissa Clark, of The New York Times Cooking, was not thrilled with what her Instant Pot did for a whole chicken, leaving it “flaccid and unappealing.” She also says it doesn’t do crispy or crunchy well, and makes vegetable limp, with the exception of beets and artichokes. Here’s her Instant Pot How To, and list of foods best cooked another way. 

Instant Pot Recipes

Corned beef for a Rueben sandwich in 2 hours? Oh yes, find the mustard!

Here’s the recipe.

And while we’re on sandwiches that usually take all day – here’s BBQ Pulled Pork, also in 2 hours. 

And in this video are 4 easy Instant Pot meals to try.

This year more people than ever are in the kitchen cooking and trying something new. Cooking at home is a way to eat a healthier diet, and sometimes new tools and methods can be inspiring and fun. 

Hurray for Fermentation!

three containers of kombucha

When we hear the word we often first think of wine, beer, and maybe sake – all made from turning fruits or grains into alcohol using the natural process of fermentation.  

But hey, it was not invented just so we could have happy hour. 

Fermentation is an ancient technique that humans have used for thousands of years to preserve food and enhance flavor. It refers to the chemical conversion of carbohydrates such as starches or sugars in food by beneficial bacteria, yeasts, or other microorganisms into alcohol, acids, or gases. It is the alcohol, acids and salt that provide protection from destructive bacteria and preserve the foods, while making a friendly environment for good bacteria. 

There Are Different Kinds

Here are the basics:

Alcoholic Fermentation

Wine, beer, spirits, vinegar and kombucha (a fermented tea drink) are produced by alcoholic fermentation using yeast. 

Lactic Bacteria Fermentation 

This is a type of acid that’s produced upon the breakdown of sugar in an oxygen-free environment. Examples of lacto-fermented foods include products like:

  • yogurt, kefir, sour cream, buttermilk 
  • cheese 
  • meats 
  • sourdough bread 
  • olives 
  • sauerkraut 
  • kimchi
  • other pickled vegetables 

Mold Fermentation

Two common mold ferments are:

  • Koji kin is a mold that is used to ferment rice or barley in Japanese foods such as sake, mirin and miso. (Miso is a seasoning made from fermented soybeans, often used in soup.)
  • Tempeh is a mold culture from Indonesia used to ferment soybeans turning them into a hearty, savory protein.  

Microbes to the Rescue

These foods are apparently very good for your health. Although more research is needed, many animal studies have shown wide ranging health benefits from eating fermented foods. One main reason could be that fermentation also promotes the growth of beneficial bacteria in the gut, known as probiotics.

Your Gut Biome

Researchers are learning a lot more about how essential the bacterial ecosystem in our gut is to our digestive health. Fermented foods are rich in beneficial probiotics and have been associated with a range of health benefits, starting with better digestion. To learn more about the benefits of probiotics and gut health read my blog Probiotics and the Gut Biome.

A 6-week study in 274 adults with Irritable Bowel Syndrome (IBS) found that consuming 4.4 ounces of yogurt-like fermented milk product daily improved IBS symptoms, including bloating and stool frequency. Fermented foods may also lessen the severity of diarrhea, bloating, gas, and constipation. 

It could be that fermentation helps make our food easier to digest by breaking it down before we eat it, making the nutrients more available for absorption. For example, those with lactose intolerance are usually okay eating fermented dairy like yogurt and kefir, because lactose, the sugar in milk, is broken down during fermentation into simpler sugars–glucose and galactose. 

More Possible Benefits

Mental Health: A few studies have linked the probiotic strains Lactobacillus helveticus and Bifidobacterium longum to a reduction in symptoms of anxiety and depression. This is because of the all-important brain gut connection. Both probiotics are found in fermented foods.

Heart Health: Fermented foods have been associated with a lower risk of heart disease. The process of fermentation can produce vitamins, anti-oxidants, and molecules that lower blood pressure and inflammation.

And They are Delicious

People have been happily eating these foods and drinking these beverages forever just because they taste good. Fermentation adds acid and usually salt which gives the food a special tang, and savory sourness. If you haven’t tried some of these foods, do give them a try. You may love them, and you’ll be doing your biome a big favor.