Kelly Anne Spratt, D.O., Director of Women's Cardiovascular Health at the University of Pennsylvania Presbyterian Medical Center, answers your questions.
Q. What foods naturally contain estrogen? I cannot take hormone replacement medication, so my doctor says I should eat a lot of estrogen-rich foods, such as yams. What other foods would be good for my diet?
A. Yams and soy are the two best sources of estrogen-like substances called phytoestrogens. These are literally "plant estrogens," which have been found to have benefits for hot flashes and some other uncomfortable effects of menopause. Large amounts need to be ingested, however (over 60 grams!), to get rid of these symptoms.
These foods are great options for women who cannot take hormone replacement therapy. On the other hand, the amount needed to prevent osteoporosis or to change cholesterol levels is unknown. If you cannot take HRT, and are at risk for osteoporosis, you may need to take a medication specifically for prevention or treatment of this disease, such as Fosamax. Since HRT lowers cholesterol, if you have high cholesterol you may need a medication specific for that condition such as Lipitor or Zocor.
Q. I have been taking Siberian ginseng, vitamin E, and Remifemin for hot flashes, but I still have them. Is there anything else I could try?
A. Various alternative supplements have been offered to women concerned about taking hormone replacement therapy (HRT). However, many of these have never been tested in a standardized way, so I'm not surprised you still have hot flashes.
Vitamins B and E are beneficial. Limit caffeine as much as possible and be sure to get lots of exercise.
Large doses of soy products are another option. The plant-estrogen compounds found in soybeans are called isoflavones. However, these are much weaker than human estrogen; at least 65 grams of soy per day is the amount that has been found to stop hot flashes.
Try using soy foods, not soy supplements, as an easy way to get soy into your diet. Soy milk, tofu, or even veggie burgers such as Boca Burgers or Garden Burgers all are good sources of soy, although the more processed the food, the less the amount of isoflavones. Excellent sources of recipes are The Soy of Cooking by Marie Oser (John Wiley, 1996) and The Vegetarian Way by Virginia Messina (Crown, 1996).