African Journal of Biomedical Research · Jun 20, 2026
Efficacy and Safety of Soy Isoflavones in the Management of Menopausal Symptoms: A Narrative Review
By Tomaszek N, URBANIAK A, Chwesiuk K et al.
Background. Menopausal vasomotor, psychological, somatic, and urogenital symptoms markedly impair quality of life, and many women seek nonhormonal alternatives to menopausal hormone therapy. Soy isoflavones are widely used phytoestrogens, but clinical evidence for their benefit and safety remains inconsistent. Aim. To summarise recent evidence on the efficacy and safety of soy isoflavones for the management of menopausal symptoms. Material and methods. A narrative review was conducted using PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science (January 2021–December 2025), prioritising systematic reviews, meta-analyses, randomised controlled trials, and key observational studies of peri- and postmenopausal women assessing symptom and safety outcomes. Results. Soy isoflavones produced small but statistically significant improvements in overall menopausal symptom scores, with the most consistent benefits in psychological and global measures, particularly depressive and psychosocial complaints. Effects on vasomotor symptoms were heterogeneous, with several meta-analyses showing no significant reduction in hot flashes despite clinically meaningful reductions in some individual trials and multi-ingredient formulations. Urogenital symptoms showed little response to soy monotherapy at commonly used doses, whereas higher doses, aglycone-rich preparations, equol-producer status, and perimenopausal stage appeared to enhance responsiveness. Safety data were generally reassuring, showing no adverse effects on endometrial thickness, vaginal maturation, mammographic density, or breast cancer outcomes at food-comparable intakes, although long-term and high-dose data in women with hormone-sensitive malignancies remain limited. Conclusions. Soy isoflavones represent a reasonable nonhormonal option for women who are unable or unwilling to use menopausal hormone therapy, offering modest, symptom-specific benefits—particularly for mood and overall symptom burden—while requiring cautious use in settings of prolonged supplementation or hormone-sensitive disease.