Menopause

Why it works: ER-β–selective “weak estrogen” action. The main soy isoflavones (genistein, daidzein, glycitein) are plant compounds that resemble estrogen and can bind estrogen receptors—especial...

Instructions: 1) Start with soy foods (typical target: ~50 mg/day isoflavones):. Examples that together land near ~40–60 mg/day isoflavones: 1–2 cups fortified soy milk, or 100–150 g firm tofu,...

Warnings: General safety (short-term): NIH/NCCIH notes soy protein has been used safely up to ~16 weeks and co...

Studies: JAMA 2016 (systematic review & meta-analysis, 62 studies...

Why it works: EPO is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid that the body converts to dihomo-γ-linolenic acid and then prostaglandin E1 (PGE1). PGE1 has anti-inflammatory/vaso...

Instructions: There’s no established, guideline-endorsed dose for menopausal symptoms because efficacy isn’t proven. If you decide to trial it after discussing with your clinician, the doses and...

Warnings: Authoritative health sources give precautions that matter if you consider EPO:. • Common side effect...

Studies: Systematic reviews/meta-analyses2024 Journal of Menopausal M...

Why it works: Traditional use & putative mechanisms. In Traditional Chinese Medicine, dong quai is used in many “women’s health” formulas. Constituents such as ferulic acid and ligustilide have...

Instructions: Regulatory monograph (Canada): For adults, typical oral quantities for traditional use are 4.5–15 g/day of dried root, prepared as powdered herb, decoction, tincture, fluid extract...

Warnings: Pregnancy & breastfeeding: Do not use. Risk of miscarriage and lack of safety data in lactation. Mem...

Studies: Monotherapy RCTs / human dataHirata et al., 1997 (Fertility...

Why it works: Possible estrogen-like activity (but weak/inconsistent in humans). Several lab studies suggest certain ginsenosides (e.g., Rb1, Rh1) can activate estrogen receptors or otherwise sh...

Instructions: Forms used in studies. • Korean red ginseng (KRG) root powder/extract totaling 3 g/day (≈60 mg ginsenosides) for 12 weeks. Europe PMC. • Ginseng capsules 250 mg, twice daily after...

Warnings: Interactions with medicines. Asian ginseng may interact with warfarin/antiplatelets, some calcium-ch...

Studies: Systematic reviewsMedicine (Open) 2016 SR of RCTs: Found imp...

Why it works: TCM rationale (kidney-yin deficiency): In traditional Chinese medicine, many menopausal symptoms (e.g., hot flashes, night sweats, dry mouth, insomnia) are interpreted as kidney yi...

Instructions: Formula & variants: LWDHW is a 6-herb base. For prominent hot flashes/night sweats, practitioners often select Zhi Bai Di Huang Wan (LWDHW + zhi mu, huang bai). Other classic varia...

Warnings: Drug–metabolism interactions: In healthy adults, LWDHW induced CYP1A2, suppressed CYP2A6, and suppre...

Studies: Direct evidence on LWDHW for menopause is limited.A register...

Why it works: Pattern match in TCM: Menopausal hot flashes, night sweats, thirst, dry/sore throat, irritability, and dark urine often map to Kidney Yin deficiency with Deficiency Heat.. Zhi Bai...

Instructions: Who it’s for (pattern): People diagnosed with Kidney Yin deficiency with heat/empty fire—classically: hot flashes/night sweats, tidal fever, dry mouth/throat, tinnitus, dark/scanty...

Warnings: Pattern mismatch: Avoid if you have cold/yang-deficiency presentations (aversion to cold, cold limbs...

Studies: Multicentre controlled clinical trial (UK & China):Jiang...

Why it works: Targets the classic TCM pattern behind vasomotor symptoms. In TCM, many menopausal complaints are attributed to a mix of Kidney yin & yang deficiency with empty heat. EXD combines...

Instructions: Classical decoction (boiled tea) — common clinic method. Typical raw-herb “adult” recipe (varies by clinic/patient):. • Xian Mao (Rhizoma Curculiginis) 6–12 g. • Yin Yang Huo / Xia...

Warnings: While EXD was well-tolerated in the 12-week RCT, safety depends on the individual, dose, duration, p...

Studies: Randomized controlled trial (Menopause, 2013): 108 perimenop...

Why it works: Evidence is mixed. Large evidence summaries conclude results are inconsistent, with several well-designed RCTs showing no benefit over placebo for hot flashes/night sweats, while s...

Instructions: Common studied regimens: Many clinical studies used standardized extracts in the range of 20–40 mg of dried extract once or twice daily (median 40 mg/day across trials; some trials...

Warnings: Liver injury (rare but serious): Multiple regulators have issued cautions due to case reports of hep...

Studies: Cochrane Review (2012): 16 RCTs (n=2,027). Conclusion: “Insu...

Why it works: Bone health after menopause: Falling estrogen accelerates bone loss and fracture risk. Vitamin D3 increases intestinal calcium absorption, helps maintain bone mineralization, and s...

Instructions: Who should consider it. • Adults 51–70 years generally need 600 IU (15 mcg) daily, and adults ≥71 years need 800 IU (20 mcg) from diet + supplements combined (U.S. National Academi...

Warnings: Not a substitute for evidence-based therapies for menopausal symptoms. For hot flashes/night sweats,...

Studies: Fractures/Bone outcomesWomen’s Health Initiative (WHI) CaD t...

Why it works: Vasomotor symptoms (hot flashes/night sweats): Vitamin E (α-tocopherol) is an antioxidant that can influence inflammatory pathways and nitric-oxide signaling, mechanisms that have...

Instructions: Oral for hot flashes (research use, not guideline-recommended):. • 400 IU α-tocopherol once daily for 4 weeks in a double-blind crossover RCT; produced small improvements versus pl...

Warnings: Bleeding risk / drug interactions: High-dose vitamin E can antagonize vitamin-K–dependent clotting a...

Studies: Hot flashes (oral): • Breast-cancer survivor RCT (n≈105): Cr...

Why it works: Menopause involves mood/sleep symptoms (anxiety, low mood, poor sleep) as well as vasomotor symptoms (hot flushes). Aromatherapy—in general, not geranium specifically—has shown mod...

Instructions: Inhalation (preferred for mood/sleep). • Diffuser: 3–6 drops in water, run intermittently (e.g., 30–60 min on, then off). Avoid continuous all-day diffusion; for direct/steam inhal...

Warnings: Skin sensitization/allergy: Geranium oil naturally contains geraniol, citronellol, linalool—recogniz...

Studies: Aromatherapy in menopause (mixed-oil evidence):Systematic re...

Why it works: Moisture retention + barrier support. HA is a glycosaminoglycan that binds and holds water in tissues, improving lubrication and elasticity. In the vagina, HA gels/inserts adhere t...

Instructions: General regimen (what guidelines and clinicians suggest):. • Frequency: Apply 2–3 times per week, regularly, for at least 4 weeks to judge benefit; ongoing maintenance is typical....

Warnings: Vaginal HA products are non-hormonal and generally well-tolerated, but keep these cautions in mind:....

Studies: Systematic reviews & guidanceSystematic review (2023) co...

Why it works: Phytoestrogenic activity. Shatavari roots contain steroidal saponins (notably the shatavarins) and flavonoids (e.g., rutin) that can bind to estrogen receptors—especially ER-α—show...

Instructions: Standardized extract in postmenopause (24 weeks).. • 250–500 mg/day of a standardized aqueous shatavari root extract taken daily improved menopause QoL scores and vascular/bone bio...

Warnings: Hormone-sensitive conditions. Because shatavari has phytoestrogenic activity, people with estrogen-s...

Studies: Postmenopausal RCT (2025; Journal of Menopausal Medicine).Ra...

Why it works: Mechanism (theory): DIM changes how estrogen is metabolised, tending to shift breakdown toward 2-hydroxy/2-methoxy pathways and away from 16α-hydroxy pathways. This “2:16 ratio” sh...

Instructions: Forms: Many studies used micro-encapsulated “BioResponse-DIM (BR-DIM)” to improve absorption. AACR Journals. Doses used in human research:. • 108 mg/day for 30 days in a pilot stud...

Warnings: Drug interactions (CYP & P-gp): DIM can affect drug-metabolizing enzymes/transporters (e.g., CYP1A2/...

Studies: Randomized, double-blind, placebo-controlled trial (n≈130, 1...

Why it works: Phytoestrogen & vascular effects: Resveratrol is a plant polyphenol that can act on estrogen receptors and up-regulate endothelial nitric-oxide synthase (eNOS), improving blood-flo...

Instructions: If you and your clinician decide to try it, model your approach on studied regimens:. • Form & dose used in RCTs: Trans-resveratrol 75 mg, twice daily (total 150 mg/day). This dose...

Warnings: Bleeding risk / surgery: Resveratrol has antiplatelet activity; stop before elective surgery (many h...

Studies: Cognition & brain blood flow12-month RCT (n=129): 75 mg...

Why it works: Red clover contains isoflavones (notably formononetin and biochanin A) that are demethylated in the body to daidzein/genistein. These compounds act as phytoestrogens with a prefere...

Instructions: Form/standardization: Most clinical trials used standardized red-clover isoflavone extracts (e.g., products standardized to total isoflavones). Teas or crude herb contain much less...

Warnings: Hormone-sensitive conditions: Because of estrogenic activity, avoid in those with estrogen-dependent...

Studies: Cochrane systematic review (phytoestrogens; 43 RCTs to 2013)...