Plant compounds during menopause

Phytoestrogens: Red Clover and Soy

Isoflavones are the most thoroughly researched phytoestrogens. A GRADE-rated meta-analysis published in 2024, comprising nine randomized studies, found a statistically significant reduction in hot flash frequency with a small to moderate effect for red clover. In addition to daidzein and genistein, red clover also contains formononetin and biochanin A, isoflavones not found in soy.

A 2024 meta-analysis also showed a small but significant benefit of soy isoflavonesfor menopausal symptoms. In practical terms, this means that isoflavones are not a miracle cure, but they are among the few plant-based options with robust, positive evidence, especially for hot flashes. The effect builds up over several weeks.

Black Cohosh (Cimicifuga)

Black cohosh is the classic among herbal menopausal remedies and is also available as an approved medicine in Germany. However, the evidence is inconsistent: a 2023 review indicated a possible benefit for hot flashes, while an older Cochrane analysis found no clear advantage over placebo. The mechanism of action is interesting, as Cimicifuga likely does not act via estrogen, but rather via neurotransmitters such as serotonin. This also makes it interesting for women who wish to avoid estrogens, but it should always be discussed with a doctor.

Sage, St. John's Wort, and Wild Yam

Sageis traditionally used for excessive sweating, and smaller studies suggest a benefit for hot flashes. St. John's wortcan help with mild depressive moods, which are more common during menopause. Important: St. John's wort has numerous interactions, including with the pill, blood thinners, and antidepressants, and should therefore be used under medical supervision. Wild yamis often marketed as natural progesterone, but the body cannot convert the contained substance diosgenin into progesterone, and the evidence is accordingly weak.

Are phytoestrogens the same as plant-based hormones?

No. Phytoestrogens are plant compounds that resemble estrogen and bind more weakly to its receptors, but they are not hormones. Bioidentical or prescription hormones are different and should be discussed with a doctor. When people look for plant-based hormones, they almost always mean phytoestrogens like isoflavones. You can find more about the overall nutrient situation in our overview of Nutrients in Menopause, and an overview of all symptoms is provided by the Typical Menopausal Symptoms.

What you can do in everyday life

Herbal remedies work best as part of a calm overall approach. A plant-based diet with natural sources of isoflavones such as soy products, flaxseed, and legumes provides phytoestrogens incidentally. Regular exercise, especially with strength training, good sleep, and stress reduction also help alleviate hot flashes and mood swings. And because herbal remedies require patience, it is worth giving a preparation a few weeks before you evaluate it.

If symptoms persist strongly, it is not a failure, but a signal. Then it is worth considering targeted plant compounds in tested dosages or a medical consultation about hormone therapy.

Conclusion

Herbal remedies can make menopause noticeably more pleasant, especially for mild to moderate symptoms. Isoflavones from red clover and soy have the best evidence, while black cohosh is worth a try, but its effects are inconsistent. All of them work gently and require patience. If symptoms remain severe, a hormone therapy discussed with a doctor is not a contradiction, but the next sensible option.