Hi, I’m Nurse Barb. I’m a women’s health nurse practitioner, and this is your Daily Dose on menopause information. Today, we’ll take a deeper dive into soy and whether or not it’s beneficial and safe in menopause. Well, as you know, in menopause, your estrogen levels start to decline. And many women find that they’re having hot flashes and night sweats.

They’re not able to sleep. They wake up with brain fog. They might be a little irritable. They also worry about their bone health as estrogen level decreases. And they’re looking for natural and safe ways to replace some of that estrogen. Some women don’t want to use hormone replacement therapy and they’re looking for other alternatives.

And one thing that has been shown to work for centuries really is using soy. And you may not have grown up drinking soy milk, but chances are, you’ve been exposed to some soy in the last few years, maybe through tofu, edamame, roasted soy nuts, or even soy milk. But many of my patients really are worried because they’ve done some online research and they worry about whether or not soy can cause an increased risk of breast cancer.

And that’s because many years ago, there were some studies that showed that there was an increase in breast size, but not in humans. It was shown in laboratory animals and specifically rodents. That when rodents were given really high levels of soy and isoflavones, which are the active ingredient in soy, they did develop an increase in breast size.

So people thought, well, maybe that would translate to humans, but the research is really reassuring and it tells us that soy is a safe food for women to take. It does not increase the risk of breast cancer. In fact, there was a study on 3,000 breast cancer survivors who were on various forms of chemotherapy from Tamoxifen to aromatase inhibitors.

And it was found that the women who had one serving of soy per day in their diet, after their breast cancer, actually had a reduction in their recurrence rate. So the American Cancer Society says that women can safely have soy during the menopause. And of course, if it’s something that you’re concerned about, or if you’re a breast cancer survivor, do talk to your healthcare provider about that.

But let’s get back to soy for a moment. Soy contains isoflavones and those are the substances that seem to help widen our thermostat when we’re in menopause. So it seems to help us have less likelihood of having sweating or feeling really hot at night or shivering. So what, what should you look for if you’re looking for a supplement?

You want to look for at least 50 milligrams and you can start with that. And then slowly increase. Many of the soy supplements are also combined with other herbs like black cohosh and black cohosh has been shown in numerous randomized control trials. And that’s kind of like the highest evidence we have for effectiveness.

Black cohosh has been shown to be very effective for some women to help them with their hot flashes and night sweats. So, there’s products on the market that combined soy isoflavones with black cohosh. And so that might be something. Something that you might think about for me, I’m all about food first, and we know that people absorb the nutrients from the whole food matrix. So if you’re going to try soy, you might try one to two servings a day, but start off with like a half a serving because soy can cause so much stomach upset and gas. So go low and slow if you’re going to use soy. So what does soy do for you when you’re in menopause?

Well, there’s a lot of helpful benefits beyond reducing hot flashes and night sweats. And we think that women might see about a 30% reduction. So that’s about a third and that’s not bad if you’re really suffering and you can’t really do anything else. But soy also has another important aspect and that is it’s great source plant-based protein.

And so if you’re trying to reduce your cholesterol or reduce how much animal protein you’re eating. Eating soy is a great substitute and it’s been shown to help reduce the risk of cardiovascular disease and atherosclerosis. So that’s something you might think about now, a lot of women try soy in it.

It really doesn’t work for them. And there’s been some studies that have shown that. White women, Caucasian women, especially women of Northern European descent-many of them do not have the genetic ability to metabolize soy into its natural metabolite. What does that mean? Well, when you metabolize soy, the women who seem to do better and have fewer hot flashes and night sweats, they’re able to metabolize soy into its metabolite, which is known as S -equol..

At qual or S dash E Q U O L. Now as air quality for years, it was super hard to try to make that in the laboratory and to be able to take the soy molecule and get the metabolites. That women could absorb through their body, but over time, a group of researchers from Japan were able to do that. And now that’s available on the market.

So you can search online for S-equol supplements. I know nature made is making them, they marketed under the name Equelle, and I don’t work with them. I don’t  have any conflict of interest, so I’m not promoting that. But I have many breast cancer survivors, many patients. Who have migraines who cannot use hormones, but are looking for some relief.

And I’m recommending for them. I also use it for my patients who are not doing very well with their hormone treatment and they’re having bleeding and other issues. So to reduce the amount of estrogen that I’m giving them with bio-identical hormones. Sometimes what I do is add in a little Equelle for them, and that seems to do the trick without giving them more estrogen.

So remember soy contains a plant-based or phytoestrogen that can be safe to use in menopause. And it’s been shown in some studies to help. Women retain more of their bone mineral density and reduce the risk of fracture. We don’t think that soy does much to help with vaginal dryness or any kind of sexual side effects that happen during menopause or any of the urinary tract issues.

So it’s really bad. Much more effective for your whole body and to help reduce those hot flashes and night sweats. Now I touched a little bit earlier on black cohosh. Black cohosh is an herb that’s been shown. In many studies to work really well to reduce hot flashes and night sweats by about 30%, if you’re going to use black cohosh, my recommendation is to get Remifemin.

Remifemin has a pharmaceutical grade of black cohosh. So if you go to any other store, you just really don’t know how much black cohosh is in any given tablet or in any given bottle of black cohosh. But Remifemin has very high standards. And again, I don’t work for them and I have no conflict of interest in telling you about this.

So, when you look for black cohosh, though, it will. Or will not work for you, and you will be able to tell within six weeks, if you’re going to get any benefit after about six weeks, if you don’t have the receptors for black cohosh, it’s not going to work. So, so if it’s working for you before then terrific fine keep using it. But if it’s not working, don’t keep trying, because it’s not going to work in three or six months after that. So I’m trying to think about any other concerns you might have with soy. I personally like it, I can only tolerate a little bit because of the gas and the GI disturbances, and I do recommend it for my patients.

I hope you found this helpful as you’re thinking about how to manage your menopausal symptoms. And as always, you can go to my blog, NurseBarb.com for more information about menopause and all things pertaining to women’s health. Take care and be well. And I hope you’ll click, subscribe and check out all my other videos.

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