Phytoestrogens and (peri)menopause

As a female Gen Xer firmly in the middle of her (peri)menopausal transition, I realize just how much I don’t know about this part of my own life cycle. In my (peri)menopausal quest for knowledge, I’ve been digging for good research to learn what actually helps and what is bunk. This article delineates some of the benefits and caveats of phytoestrogens and how to incorporate them into our diet. Hint: soy is a good way to do that. More on that to come.

Side note: I label this time as (peri)menopause because the prefix leads right into the end result. The (peri) part can take ten years to get through and that is a significant chunk of our life experience. For the purpose of the information in this narrative, I'm lumping it all together.

My experience so far

In truth, my road through (peri)menopause thus far has been merciful. Despite an occasional flare of something slightly irregular and thankfully temporary, my symptoms have been quite mild. My cycles are still fairly regular, even though I’m starting to see signs of change. Temperature fluctuations are minimal; maybe I run warmer at night, but I haven’t experienced major hot flushes; this is now the preferred term in (peri)menopausal circles. I think my mood is mostly stable, but you may need to check with my husband on that one.

However, I definitely have memory issues, particularly with recall in the moment; words fail me more than I am comfortable admitting. Sleep disturbance is more regular when I’m stressed out. I also experience lots of joint creakiness and muscle stiffness; when I sit for any period of time and then stand up, I look like I’m 80 years old until I lubricate the joints for a bit. My hips and feet are particularly unhappy with that transition. I find myself wiggling often to try to lessen the “ouch factor.” 

I am very concerned with getting adequate rest and staying on top of my nutrition. I’ve written a bunch in My Weight Loss Journey posts, which really are more about weight management in general, and now they are squarely focused on this transition through middle age.

I consider myself an “eat to live” kind of gal who appreciates really delicious food. Fortunately, I am not a picky eater, I like most foods, and the “good for you” stuff doesn’t scare me away. Though sometimes I do indulge in the yummy stuff that doesn’t quite check all the good nutrition boxes (Ben and Jerry’s mmm), my daily food choices have my overall health in mind: does it provide my body with something that contributes to longevity?

My relationship with soy

In the last few years, I’ve incorporated soy more regularly in my diet. I use soy milk every day in my morning protein shake; I’ve cycled through the cow, almond, and oat varieties before landing on soy as my primary source. I love popping edamame out of their pods when we have sushi for dinner. I’m even starting to learn to cook with tofu once in a while to switch things up.

I’ve heard all sorts of things over the years about soy, much of it conflicting. As a result, I wanted to see what the experts are saying to help me parse out what foods I should be incorporating in my regular meal planning. Aside from the regular macros of carbs, protein, fat, fiber and plenty of hydration, and focusing on the Mediterranean-based diet rules, I want to dig a little deeper to see I might be able to do to help ease my transition into my older life and set myself up for the best possible health outcomes. One buzzword that has surfaced more and more is phytoestrogens.

First, let’s talk about estrogen

The word that is at the center of the (peri)menopausal experience is estrogen. The image above is an estradiol molecule and it’s the stuff of women. Because I’m a layperson who hasn’t studied this stuff, but who is squarely in the throes of losing it, I needed to clarify what exactly it does in the body and why losing it is so bad.

What does estrogen do?

According to John’s Hopkins Medicine, it’s the set of female hormones made mostly in the ovaries, but also in the adrenal glands and fat cells. Not only are they responsible for sexual and reproductive health, they also affect the urinary tract, the heart and blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles, and the brain. It seems to affect pretty much every system in a woman’s body. That’s why losing it wreaks havoc on our lives. 

Historically, (peri)menopausal treatment for waning estrogen and experiencing bad symptoms as a result has been about HRT (hormone replacement therapy). You go to your doctor, talk about what’s happening to you, and if appropriate, they prescribe something to pick up at the pharmacy. It is only more recently that more attention is being paid to how nutrition can play a part in managing your (peri)menopausal experience. In light of the fact that things aren’t too bad for me right now, I thought I’d look into trying to stave off or (hopefully) prevent some of the more difficult symptoms of (peri)menopause through healthy habits and nutrition.

A note from a Gen Xer in the transition

Maybe it’s the boss-ness of Gen X women (who are in the throes of the transition) who are demanding more well-researched information to make our lives a little easier as we go through this challenging phase of our lives. As one of those boss Gen Xers, I want to know how I can do some (or all) of this without pills or herbal “remedies.”

To be clear, I am not anti-medicine; if it is required or more effective than nutrition, I’m all for going to medical experts and doing what’s necessary to feel better. But If I’m otherwise healthy, I want to know what the experts know about how to mitigate this years-long phase through nutrition, exercise and generally healthy habits. If I can avoid the need to go to the doctor beyond my yearly checkups, I’d like to work every day to that end.

What’s in the research?

Some of the available (peri)menopause research is outdated. For example: for years, studies linked isoflavones to the risk of breast cancer. More recent studies on it prove the opposite, that soy foods can actually lower the risk of hormone-related cancers like breast, uterine and prostate, as well as reduce cancer recurrence and death. Thankfully, there seems to be more attention being paid now to the importance of proper diet in studies and articles are being updated.

My nutritionist sent me a Healthline article called Are Phytoestrogens Good for You? which covers information from 15 different studies on the topic. That article explained how phytoestrogens mimic the way natural estrogen works in our bodies and “accomplish some of the same things.” An interesting fact that I found when clicking into the sources for that article: When the estrogen level in your bloodstream is high, phytoestrogens have an antiestrogenic effect. When blood estrogen levels are now, the effect of phytoestrogens is more estrogenic. It makes sense that the benefits are highlighted for women during the (peri)menopausal transition.

Getting phytoestrogens into your diet

Aside from soy, I had little idea of what the best sources of phytoestrogens were. I’d much rather know that the foods I eat contain them, rather than mess around with herbal supplements that are questionably-sourced and not controlled in any way. The last thing I want is to throw away money on consuming something that is useless or worse, harmful. I was curious if what was already in my diet that was doing the trick. The following information was what I found. 

What makes a phytoestrogen?

The first place I looked was a review on over 30 studies published in 2019 in the National Library of Medicine called Phytoestrogens and Their Health Effect. This is a great source of information about what phytoestrogens are, foods that are good sources, what the benefits of consuming them from the waning estrogen perspective. This review was the springboard that led me down the rabbit hole of the information (some helpful, some not) that is currently out there.

To start, I learned that there are four compounds are classified as phytoestrogens:

How much soy do we need?

Going back to the 50 mg of isoflavones per day, I wondered what that looked like in terms of food servings. In the article Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature, they suggest:

Each gram of soy protein in soybeans and traditional soyfoods is associated with approximately 3.5 mg of isoflavones. Consequently, one serving of a traditional soyfood, such as 100 g of tofu or 250 mL soymilk, typically provides about 25 mg isoflavones.

100 grams is four ounces of tofu. 250 ml is a cup of soymilk. My morning shake has about a cup of soymilk, so I’m getting some in every day. A block of tofu is 14 ounces, so making it will create more than three servings.

There’s always caveats

Remembering that no one thing is a magic pill for our potential woes, there are always caveats to the things we discover are really great for us. The article also cautions that isoflavones should not be equated with the hormone estrogen, so just eating soy products won’t necessarily solve all of your lack of estrogen woes. It’s more complicated than that and beyond my pay grade to further interpret the words in the scientific studies that I don’t understand. A good thing is just that: a good thing. It should be used wisely and not be considered a be-all-end-all for (peri)menopausal health.

Another tidbit that I learned was that your body’s ability to use phytoestrogens from food is influenced by race. Apparently, people of Asian descent are far more capable of absorbing and metabolizing them than Western descendants. I’m guessing since Asians have consumed soy regularly for generations, their bodies have adapted to process it efficiently. The western world needs time to catch up.

Benefits of eating phytoestrogens

Since most of these high phytoestrogens foods are already largely in my diet, I wonder if my mild (peri)menopausal symptoms are attributable to my “eat to live” philosophy. Or maybe I’m lucky with good genetics. My mom had a hysterectomy before she hit menopause so I don’t really know how that plays a part. Questionable genetics aside, the things I can control now are my food choices and daily habits.

While the research suggests many more benefits than what I’ve listed here, I wanted to focus on these particular ones that I’ve been concerned with of late. The National Library of Medicine article presents a much bigger picture, but the following are a few of my personal target areas. 

Benefit: Weight loss

• Increasing lean muscle mass
• Reducing fat accumulation by inhibiting the life cycle of fat cells
• Their antioxidant properties help inhibit inflammation from obesity
• Appetite suppression, which is another effect of estrogen. Since the structure of phytoestrogens is very similar to the real thing, they act like estrogen at the cellular level.

Benefit: Bone health

While that event was caused by a significant impact, I know that bone building slows significantly after age 25. According to Johns Hopkins Medicine:

From about age 25 to age 50, bone density tends to stay stable with equal amounts of bone formation and bone breakdown. After age 50, bone breakdown (resorption) outpaces bone formation and bone loss often accelerates, particularly at the time of menopause.

John Hopkins Medicine

One study showed that combining phytoestrogens with Vitamin D can help reduce bone loss after menopause. They help to build more bone cells and reduce bone resorption (cells being reabsorbed into the bloodstream). This benefit happens over time when you regularly consume phytoestrogens for at least six months. I love my morning soy milk protein shake even more now. And after my broken foot saga, I never want to break a bone again.

Benefit: Skin Health

Looking at the research, I learned that phytoestrogens do all of the following from the inside out:

• Increase production of hyaluronic acid, collagen and extracellular protein matrix
• Increase vascularization
• Improve elasticity
• Prevents oxidative stress and apoptosis (cell death)

All of that equals anti-aging effects. While my mom always had great skin (yay genetics) and took care of it from the outside, I’m also trying to take care of it from the inside. I don’t need to roll my face with a cold stone. What does that even do?

Benefit: Cardiovascular Health

In addition to the benefits of regular exercise, soy has been shown to be protective against cardiovascular disease, and isoflavones seem to play a part in that protection. They can:

• reduce total cholesterol (replacing animal protein with 31-47 grams of soy protein can reduce high cholesterol levels 9%)
• lower LDL and triglyceride levels and raise HDL
• improve heart function

The National Library of Medicine article goes in-depth into all of the studies that link soy to cardiovascular health. In short, there are a lot of heart-healthy reasons that women should add some tofu or switch to soy lattes.

The research suggests that there are even more health benefits to incorporating phytoestrogens into the diet than what I’ve reflected here. While soy is just one of the available sources, it does have a high level of the isoflavones that are great for dealing with the waning estrogen of (peri)menopause. I’ve linked all the sources I’ve used, so if you’re curious and want to learn more, you might be inspired to do your own digging. This just scratches the surface of the information that’s out there, and more is coming out all the time. I’m happy to know that people much smarter than me are digging in as well.

Takeaways for the Gen X set

I will admit, even these few sources of information can feel like an overwhelming storm to someone who is just trying to make better health choices. I think these are things you can do to simplify the process:

1. Start reading the information for yourself. Digest what you can and put it away when your head starts to spin.
2. Look at the list of foods that contain phytoestrogens. See what you already like, and be mindful of keeping them in regular rotation.
3. Be careful adding new things to your diet that you’re not used to eating. If you have a bad reaction, it may not be for you.
4. Listen to podcasts that focus on (peri)menopause. I’m listening to one called Perimenopause WTF? that has great information and it features female experts talking all about the experience.

I suspect more attention will be paid moving forward on nutrition’s effects on (peri)menopause. We the women of Gen X, many of whom are squarely focused on living another 50+ years after our transition, want only to flourish in our second and third acts. The more we seek solid research, the better decisions we can learn to make for ourselves. For now, I feel comfortable with the direction I’m heading, and I think I have a solid foundation to build upon. 

Sources

Estrogen’s Effects on the Female Body Hopkinsmedicine.org (2023)

Are Phytoestrogens Good For You? Healthline.com (2021)

Soy Mount Sinai Health Library (2024)

Desmawati D, Sulastri D. Phytoestrogens and Their Health Effect. Open Access Maced J Med Sci. 2019 Feb 14;7(3):495-499. doi: 10.3889/oamjms.2019.044. PMID: 30834024; PMCID: PMC6390141.

M-n. Chen, C-c. Lin & C-f. Liu (2015) Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review, Climacteric, 18:2, 260-269, DOI: 10.3109/13697137.2014.966241

Osteoporosis: What You Need to Know as You Age Johnshopkinsmedicine.org (2024)