Positives

• Equol-producing women on isoflavones described significant reductions in hot flashes and excessive sweating at 3 months, and reductions in weakness and palpitations at 6 months PubMed.
  
  
• Postmenopausal equol non-producers given 40 mg per day of S-equol described greater reduction in hot flash frequency than from soy isoflavones alone Journals.
  
  

Negatives

• Women in the equol-non-producing isoflavone group did not experience the same menopausal symptom reductions, suggesting equol supplementation may help only certain patients PubMed.
  
  
• Researchers caution that equol's estrogen-receptor activity has not been characterized for long-term safety in breast or endometrial tissue PMC.
  
  

Hurdles & Side Effects

• Only about 30 percent of Western women have the gut bacteria to convert daidzein to equol, making direct supplementation necessary for many Womensmentalhealth.
  
  
• Patients with hormone-sensitive cancers or on tamoxifen need clinician guidance before using equol because of estrogen-receptor binding PMC.