Hormone replacement therapy was long the mainstay of treatment for menopausal symptoms. However, recent studies have shown that it presents significant risks, while providing fewer benefits than once thought. These findings have increased interest in alternative treatments for menopausal women suffering from hot flashes, vaginal dryness, and other problems.
Natural substances with mild estrogen-like properties, phytoestrogens , have been proposed as alternatives to hormone replacement therapy. Isoflavones from soy or red clover are the best known phyotestrogens. Lignans, found in abundance in flaxseed and sesame seed, also have phytoestrogenic properties. Furthermore, according to some but not all studies, the herb black cohosh may help reduce menopausal symptoms. (Contrary to popular belief, black cohosh is not a phytoestrogen.)
In November 2006, Italian researchers at the University of Naples published a study that found benefits with a combination of these substances. In this trial, eighty menopausal women were randomly assigned to receive either a mixture of isoflavones, lignans and black cohosh extract, or a calcium placebo. Over the course of three months, average menopausal symptoms (as rated by the standard Kupperman index) decreased to a greater extent in the treatment group than in the placebo group. The researchers note that isoflavones are absorbed and removed quickly, while lignans are absorbed and removed slowly. Therefore, they hypothesize that the combination provides more consistent benefits over a full twenty-four hours.