Womens Health

Non-prescription Hormonal Replacement Therapy

A moderate amount of relief from menopausal symptoms is available with non prescription hormone therapy. Pharmeceutical grade progesterone cream has been shown to reduced hot flashes and there are non prescription progesterone creams that are about 1/4 as potent. The progesterone seems to be well absorbed through the skin. It is very likely that progesterone reduces hot flashes by being converted in the body to estrogen.


Phytoestrogens behave somewhat like "designer estrogens" (selective estrogen receptor modulators - SERMs). They have a positive effect on preventing osteoporosis and probably a positive heart disease prevention benefit based on animal studies. They are not very good at relieving vaginal dryness and do not seem to improve HDL ("good") lipid levels. Thus they are not equivalent in benefits to pharmeceutical estrogens which your doctor may prescribe.

On the other hand, diets high in phytoestrogens are associated with lower than expected incidences of breast cancer and no increase in uterine (endometrial cancer). There are not direct studies yet that prove it is the phytoestrogens alone that lower this incidence of breast cancer, i.e., it may be other dietary components. Up until recently products containing phytoestrogens were highly variable in the amount per pill and the amount in a given batch of pills. Now there are some measured amounts that are consistent. In this product above, the isoflavone class of phytoestrogen has a measured amount. If a woman has not had a hysterectomy, it is still recommended that progesterone is used to avoid the possibility that unopposed phytoestrogen could result in an endometrial cancer.


Unfortunately there are limitations in treating menopause with non prescription treatment. A woman would have to use daily 40 mg of isoflavones, 1/2-1 tsp of progesterone cream and probably a vaginal lubricant such as baby oil or a vaginal lubricant that has a bioadhesive component if she is having vaginal intercourse. Such a combination has not been studied at all scientifically so it is advisable to have the concurrence of your physician before using such a combination.

You may want to look at some of our other articles about hormonal therapy:

  • What is Natural About Natural Hormone Therapy?
  • Progesterone - Its Uses and Effects
  • Designer Estrogens - Are They for Me?
  • Hormones and Hip Fractures in Older Women
  • Plant Estrogens and Breast Cancer
  • Expected Bleeding from Continuous HRT

Literature findings:

  • topical progesterone cream (20 mg/ 1/4 tsp) applied daily does not improve bone density at all but it significantly reduce hot flashes 
  • isoflavones (40 mg/day) have a significant positive vascular effect like estrogens but they do not improve the lipid profile as do pharmaceutical estrogens
  • isoflavones do not lower blood pressure in hypertensive patients 
  • isoflavones significantly prevent bone loss or sometimes increase bone density but not to the extent that estrogen does
  • soy phytoestrogens do not positively effect the vaginal epithelium


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