Do oestrogen supplements work?
No supplement contains real oestrogen. Plant ones, like soy, may ease hot flushes a little. But if you’re 50 or over and past menopause, a pharmacy can sell you real oestrogen for vaginal dryness.
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Is there a supplement that contains oestrogen?
No. Real oestrogen is a medicine. It’s the main type of HRT (hormone replacement therapy), taken as tablets, patches, spray or gel.
Pills sold as natural oestrogen hold plant compounds instead. The best known come from soy and red clover. Soy’s isoflavones are shaped like oestrogen, but their effect is much weaker than the oestrogen your body makes.
Black cohosh is often sold next to them. It’s a herb, and it contains no oestrogen either.
| Option | What it is |
|---|---|
| Soy isoflavone supplements | Plant compounds, much weaker than oestrogen. 20.6% fewer flushes than a dummy pill in trials. |
| Red clover | Plant compounds. Five trials found no clear difference from a dummy pill. |
| Black cohosh | A herb. NICE says it may ease flushes. Linked to rare liver problems. |
| HRT | Real oestrogen. Tablets, patches, spray or gel on prescription. |
| Gina vaginal tablets | Real oestrogen for vaginal dryness. From a pharmacy if 50 or over, with no period for 1 year. |
So if a label says oestrogen, check what’s really in it. Then ask a pharmacist if it’s a licensed medicine.
Do natural oestrogen supplements work for hot flushes?
A little, maybe. Across 13 trials, soy isoflavone pills cut hot flushes by 20.6% more than a dummy pill. That’s at a typical dose of 54 mg a day, taken for 6 weeks to a year.
Picture it this way. If you started with 10 flushes a day, the soy pill would take away about 2 more than a dummy pill.
| Product | What trials found |
|---|---|
| Soy isoflavone pills | 20.6% fewer flushes than a dummy pill, across 13 trials. |
| Red clover (Promensil) | No clear difference from a dummy pill, across 5 trials. |
| Dummy pills | 1% to 59% fewer flushes, in most trials Cochrane looked at. |
| Soy compared with HRT | The BDA says soy isoflavones are less potent than HRT. |
That dummy pill line matters. Many people get fewer flushes on a pill with nothing in it.
A Cochrane review of 43 trials found no conclusive evidence that plant oestrogen supplements work. Many trials were small and at high risk of bias.
Want to try one anyway? Count your flushes for 2 weeks first, so you can tell if it helps. For herb by herb detail, see menopause supplements.
Are natural oestrogen supplements safe?
Nobody can say for sure. NICE says there are many products, their safety is uncertain and they can vary. Problems when mixed with other medicines have been reported.
Cochrane found no sign that plant oestrogens thickened the womb lining or caused other side effects in up to 2 years of use. But those trials left out women who’d had breast cancer.
Black cohosh carries a known risk. Advisers to the MHRA found it is linked to rare liver problems, and asked for a warning on every product.
On thyroid medicine? The BDA says soya may affect how well your body absorbs it. Ask your doctor first.
The NHS advice is simple: talk to a doctor before you take any herbal supplement. Never stop or change a prescribed medicine without your prescriber.
Can I buy oestrogen without a prescription?
Yes, but only one kind. That’s vaginal oestrogen, for dryness. The NHS says Gina tablets and Ovesse cream can be bought from a pharmacy.
It won’t help hot flushes, mood swings or sleep. Little of it gets into the rest of your body, so you don’t need a second hormone to protect your womb.
Getting Gina tablets from a pharmacy
- 1
Check you fit
50 or over, with no period for at least 1 year.
- 2
Talk to the pharmacist
They use a checklist to see if it suits you.
- 3
Use it
A tablet you put inside your vagina.
- 4
Give it time
It can take up to 3 months to work fully.
Under 50, or still having periods? Ask your GP instead. See vaginal dryness in menopause for the other options.
How do I get real oestrogen?
For hot flushes, sweats, sleep and mood, the real thing is HRT from your GP. If you still have a womb, you take a second hormone, progestogen, to protect it.
Under 60, with symptoms, and not at high risk of breast cancer or blood clots? The NHS says HRT’s benefits are likely to outweigh the risks.
Prefer to avoid hormones? See natural alternatives to HRT. Be wary of unlicensed “bioidentical” creams too. NICE says how well unregulated hormone products work, and how safe they are, is unknown. More in bioidentical HRT.
Before you try an oestrogen supplement
- Talk to a doctor before you take any herbal supplement.
- Tell your doctor or pharmacist every medicine you take.
- On thyroid medicine? Ask your doctor about soya first.
- Had breast cancer? Ask your specialist before any plant oestrogen.
- Read the liver warning on any black cohosh product.
- Count your flushes for 2 weeks first, so you can tell if it helps.
When to speak to a GP
Take any supplements with you, and tell the GP about them. Book an appointment if:
- You’re under 45 and think you have menopause symptoms. It may be early menopause.
- You want to know your options, including HRT.
- You have a fast heartbeat (palpitations).
- You still have periods, but you’re bleeding more, not less, than before.
- You’ve had no period for 12 months or more, then any vaginal bleeding, even a small amount or just once.
Bleeding after menopause is not usually serious. But it can be a sign of cancer, so always get it checked. For flush tips, see hot flushes in menopause.