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Easing
Menopausal
Symptoms With
Soy |
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As
the "baby boomer" generation eases into middle
age, millions of American women are entering menopause and
seeking ways to cope with its symptoms. Caused by declining
levels of estrogen, these symptoms vary from woman to woman,
but typically include mood swings, depression, insomnia,
forgetfulness, thinning of vaginal tissues, stress incontinence,
and severe "hot flashes." Post-menopausal women
are also at statistically higher risk for serious conditions
such as heart disease and osteoporosis.
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For the past several decades, millions of American women have
managed the symptoms of menopause with hormone replacement
therapy (HRT). Until very recently, many of them also thought
they were gaining protection against heart disease by taking
HRT. But last summer's widely reported findings of the Women's
Health Initiative combination-HRT study--which show a correlation
between use of an estrogen-progestin hormone supplement and
serious illnesses such as stroke, breast cancer, and heart
disease--has inspired many women to search for alternative
methods to cope with the symptoms of menopause.
Among various nutritional supplements and foodstuffs that
are touted as natural ways to manage menopause, soy is probably
the best known. Soy has gained special prominence in recent
years as a rich source of isoflavones--an estrogen-like substance
found in plants that produces, in a weaker form, many of the
same effects that human estrogen does. Many studies confirm
that regularly eating moderate amounts of soy-based food products
can help decrease menopausal symptoms--supporting soy's value
as a dietary approach to estrogen replacement.
However, a note of caution: Even natural products are not
risk-free, especially when taken in large amounts. Soy contains
variable amounts of chemicals known as "anti-nutrients"
that interfere with digestive processes and absorption of
other essential nutrients, such as zinc and calcium. Also,
the hormonal activity of soy isoflavones may, just like HRT,
stimulate estrogen-mediated diseases such as breast and ovarian
cancer and we do not know what impact that may have on risk
of those diseases, especially in certain high-risk subgroups
of women. So don't go overboard: Shoot for several servings
of soy a week, rather than multiple helpings each day. Some
other tips to keep in mind:
Soy products vary widely in the amount of processing they
have been subjected to. For general nutritional purposes and
cardiovascular benefits such as lowering blood cholesterol
levels, whole soy foods such as tofu, soy milk, and edamame
(young fresh or frozen soybeans) are preferable to more highly
processed varieties, such as textured vegetable protein. Fermented
soy foods such as miso and tempeh are especially nutritious
and easy to digest, as the fermenting process inactivates
many of the anti-nutrients.
If your main interest in incorporating soy into your diet
is the hormone-like effects of its isoflavones on menopause
symptoms or heart disease risk, it doesn't really matter how
you get them. The main point is to get a blood level of isoflavones
that works for you. "Smoothies" made with soy milk
and/or soy powder are an efficient way to ingest isoflavones.
Isoflavone supplements used in moderation are another way
to get isoflavones.
Because people react differently to soy, have varying family
risk factors, and may be taking it for different reasons,
no standard dosage has been identified that will work for
everyone. To decrease hot flushes, studies suggest that you
may need one to four servings of soy-based foods per day,
for a total of about 40 to 50 milligrams of soy isoflavones
per day. For heart benefits, the FDA suggests an intake of
25 grams of soy protein each day. Soy foods can cause gas
and intestinal discomfort, so add them to your diet slowly--try
one new type of soy food per week.
While soy on its own is quite bland, it absorbs the flavors
of other ingredients readily, making it easy to incorporate
into many dishes. Try using soy milk on cereals and in soups
and puddings; adding small cubes of tofu to soups, stews,
and pasta dishes; substituting silken tofu for ricotta or
cottage cheese in casserole recipes; using textured vegetable
protein as a substitute for ground beef or ground turkey in
chili, meat sauces, or meat loaf; or using soy flour to replace
part of the wheat flour called for when making cookies, muffins,
or bread.
Some menopausal women find that soy alone won't alleviate
certain symptoms--in particular, stubborn and severe hot flushes.
I typically recommend that patients who are troubled by such
symptoms use the lowest possible dose of prescription steroidal
estrogen that will control them. Often, incorporating soy
into the diet has the effect of complementing HRT and making
it possible for women to do well on a lower dose of the prescribed
estrogen.
To be most effective in easing the symptoms of menopause and
contributing to a longer and healthier life, adding soy to
your diet should be accompanied by other beneficial lifestyle
changes, such as eating a nutritious, high-fiber diet, limiting
alcohol intake, exercising daily, quitting smoking, and managing
stress.
The bottom line: We evolved as omnivores, and we're designed
to eat a little bit of a lot of different foods. Soy has a
helpful role to play in managing menopausal symptoms and maintaining
health--especially when used in moderation and within the
context of a healthy lifestyle and balanced diet.
www.dukehealth.org |
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Menopause