Does Eating Tofu Ease Perimenopausal Symptoms?

My friend claims that she was able to minimize her symptoms during menopause and perimenopause by eating a pack of tofu every day. Is it possible that that amount of estrogen, consumed orally as food, would have any effect on symptoms such as hot flashes? If so, how might this choice be different from taking hormones (especially since it seems like self-medication by a non-medically-focused professional)?
—Tofu Milkshakes

Researchers and patients have been interested in soy — the main ingredient in tofu — as a treatment for the symptoms of perimenopause for quite a while. In the aftermath of the Women’s Health Initiative studies, women were desperate to find alternatives to estrogen to relieve their hot flushes and night sweats.

Our interest in soy is not unfounded. Soy (and many other foods) contains isoflavones — chemical compounds that bind to estrogen receptors in our cells and act like estrogen. Hot flushes and night sweats are caused by dropping estrogen levels. It makes sense that a compound that acts like estrogen in our cells might relieve those symptoms.

There have been numerous studies of soy for the treatment of menopause symptoms. They have included soy-containing foods and supplements containing soy extracts. The results are mixed.

Most of the studies are short — often only six weeks long — and difficult to compare because of the variability of the forms of soy used in the studies. The longest study showed no benefit of soy after 24 weeks of treatment. Importantly, in many of the studies, both the group receiving soy and the placebo group saw reductions in their symptoms by as much as 50% to 60%, suggesting a strong placebo effect.

Because the data is inconclusive, the North American Menopause Society does not recommend soy as a treatment for menopause symptoms. That said, tofu is not harmful; it just may not be that helpful.
The takeaway: There is mixed evidence as to whether your tofu milkshakes are treating your perimenopausal symptoms. If you like them, there is no need to stop drinking them. If you don’t like them, there is no compelling reason to choke them down.