Hot flashes, night sweats, vaginal dryness, thinning of bones—millions of women suffer from these symptoms as they pass through the stages of menopause. Caused by a drop in estrogen and progesterone levels, these symptoms have until recently been routinely treated in mainstream medicine using hormone replacement therapy. The Office of Research on Women?s Health estimates that as of 1998 more than 17 million women were taking HRT to combat the biological effects of menopause.

In the last few years, however, the safety and efficacy of the synthetic and animal-derived hormones used in HRT have been called into question. Finding that HRT?s risks may outweigh its benefits, the National Institutes of Health halted a series of Women?s Health Initiative studies. The first, discontinued in July 2002, found that estrogen plus progestin (a synthetic form of progesterone) carried an increased risk of breast cancer, heart disease, stroke and blood clots. Less than a year later, the NIH ended the Women?s Health Initiative Memory Study, which found a heightened risk of dementia among women 65 and older taking estrogen and progestin. Most recently, in March 2004, the NIH announced that it was terminating the WHI ?estrogen-alone? study because of findings that estrogen therapy increased the risk of stroke.

These findings have prompted many women to either reduce their dosages of HRT or stop taking it altogether. Paul Berger, a physician at Boulder Community Hospital?s Holistic Medical Center, estimates that at least 90 percent of his patients have gone off HRT entirely. His patients are among the increasing number of women who are seeking safer, more natural alternatives to combat their menopausal woes.

Phytoestrogens may be their answer. Naturally occurring compounds found in many plants, phytoestrogens bind to estrogen receptors to provide an estrogenic effect when estrogen levels are too low, and block stronger estrogens when levels are too high. Phytoestrogens can be divided into two families: isoflavones and lignans. In their Encyclopedia of Natural Medicine (Prima Lifestyles, 1998), Michael Murray, N.D., and Joseph Pizzorno, N.D., say that ?[P]hytoestrogens can help decrease hot flashes, increase maturation of vaginal cells and inhibit osteoporosis.?

The following are just a few of the phytoestrogen-rich botanicals that science suggests do a good job of treating menopausal symptoms:

Manufacturers like Emerita, Novogen and Amerifit Nutrition are using these phytoestrogen-rich botanicals in their over-the-counter menopausal creams and supplements. Because such products offer a safe and effective alternative to conventional HRT, an increasing number of doctors are directing their menopausal patients to natural retailers to find them.

Emerita, based in Portland, Ore., manufactures a supplement that contains red clover, black cohosh and Siberian ginseng (Eleutherococcus senticosus). It Also markets a line of creams that are absorbed through the skin. Director of Research and Development Deborah Moskowitz, N.D., says that the bioidentical progesterone in the progesterone cream is good for perimenopausal women. ?Progesterone supplementation can help balance levels of estrogen, progesterone and testosterone to smooth the transition into menopause,? she says.

Novogen, based in Stanford, Conn., specializes in isoflavonoid technologies. Its products contain red clover and soy isoflavones. ?Clinical studies have proven that these products relieve hot flashes, maintain bone density and benefit cardiovascular health,? says Aaron Stryker, Novogen?s vice president of consumer business.

Amerifit Nutrition markets a family of products that contain the soy isoflavones daidzein and genistein, as well as black cohosh, calcium and other vitamins. Recently, the company began marketing an in-home urine test that can detect the elevated levels of follicle stimulating hormone that commonly indicate the early stages of menopause.

While many doctors continue to prescribe HRT to patients experiencing severe symptoms, an increasing number of them are advising their patients to try phytoestrogen supplementation first. Dan Lukaczer, N.D., the director of clinical research at the Functional Medicine Research Center in Gig Harbor, Wash., does prescribe HRT in some cases, but he says that phytoestrogens work well for many of his patients. ?For the treatment of hot flushes, I?ve seen some success using red clover, kudzu, flax lignans and soy isoflavones,? he says.

Lukaczer would like to see additional studies on the safety and efficacy of long-term phytoestrogen supplementation. That data may be forthcoming. The National Center for Complementary and Alternative Medicine is currently funding research on several botanicals including black cohosh, red clover, hops, dong quai, flaxseed and soy—all of which have shown promise for reducing menopausal symptoms.

In the meantime, the menopausal population is growing. The North American Menopause Society estimates that more than a million women began menopause in the year 2000. And that number continues to rise, generating increasing demand for natural menopausal remedies.

Kristen Lewis is a free-lance writer based in Arvada, Colo.

Natural Foods Merchandiser volume XXV/number 8/p. 28, 31