Phytoestrogens and the menopause – do they really help?

Summary Studies have recently questioned the safety of hormone replacement therapy (HRT) during the menopause with regard to an increased risk of breast cancer and heart disease. Most notably the US Women's Health Initiative and British Million Women Study resulted in a considerable media furore which has prompted women, who may previously have been happy to take HRT, to explore alternative approaches to the menopause. It is widely accepted that diet and lifestyle play a large part in symptom relief and evidence is strengthening for the role of phytoestrogens in the relief of hot flushes. It is estimated that three‐quarters of women in the UK experience one or more symptoms of the menopause, and that for one third these symptoms are severe. This article distinguishes the fact from the fiction and provides an overview of the practicalities of a diet and lifestyle to relieve menopausal symptoms.