Scientific Insights
Menopause is a natural stage in a woman’s life, during which significant changes occur both physically and emotionally[21].
Starting from perimenopause, the production of the hormones that regulate the reproductive system in fertile women – oestrogen and progesterone – gradually declines.
As a result, the menstrual cycle becomes irregular (periods may be skipped for a few months or come closer together) until they stop completely.
This gradual drop in oestrogen is the main reason for the common and often troublesome changes women experience during menopause[22].
To compensate for this gradual decline, people often turn to food supplements containing isoflavones, a group of natural compounds that can “mimic” the activity of oestrogen.
From Soy to Red Clover and Kudzu – more effective and easier for the body to absorb
First-generation menopause supplements offered isoflavones from Soy (Glycine max). However, their effect in easing menopause-related changes is quite limited[23].
Today, modern menopause supplements NO LONGER include soy, because it contains only two isoflavones (genistein and daidzein) in a glycosylated form, which prevents optimal and rapid absorption in the human body[24], making it largely ineffective.
Moreover, soy available on the market today is increasingly genetically modified.
In the natural and herbal products sector, there is growing attention to avoiding plant extracts from GM crops4.
For these reasons, second-generation menopause supplements have shifted to other plant-based active ingredients, particularly Red Clover (Trifolium pratense), which provides four isoflavones, most of which are already in an absorbable form, without the glycoside part, making them more easily assimilated and more bioavailable[25].
Red Clover is therefore better suited than soy to support women during menopause. In Pausanorm Forte, we have combined it with Kudzu (Pueraria lobata), a wild plant native to Japan.
In addition to providing six different types of isoflavones, Kudzu is particularly effective at helping to rebalance cardiovascular changes during menopause, such as blood pressure fluctuations, hypertension, and palpitations11.
The effectiveness of Kudzu extract is also due to one of its specific isoflavones, Puerarin11. Not only is it easily absorbed, but it also has very high bioavailability, excellent stability, and stays in the bloodstream longer than other types of isoflavones.
The innovation of Dioscorea villosa
Over time, isoflavones extracted from Red Clover and Kudzu have replaced those from soy. Their oestrogen-like action helps make up for the sudden drop in oestrogen levels in women during menopause.
But, as mentioned earlier, progesterone levels – another important hormone - also decline during this stage. How can it be supplemented?
By also including an extract of Dioscorea villosa, which provides a specific active compound (Diosgenin) with a natural “progestogenic” action, helping to support hormonal balance13.
Let’s now take a look at some detailed studies conducted on these active ingredients.
Experimental Phytotherapy
The Pausanorm Forte formulation contains Red Clover, Kudzu, Dioscorea villosa, Angelica sinensis, and Vervein.
Red Clover
- J Obstet Gynaecol. 2016;36(3):301-11. doi: 10.3109/01443615.2015.1049249. Epub 2015 Oct 15. Red clover for treatment of hot flashes and menopausal symptoms: A systematic review and meta-analysis. Ghazanfarpour M, Sadeghi R, Roudsari RL, Khorsand I, Khadivzadeh T, Muoio B
This study evaluated the effectiveness of Red Clover in relieving hot flushes and other menopause-related changes in peri- and postmenopausal women. The average frequency of hot flushes in the Red Clover groups was lower than in the control groups. In addition, both subjective symptoms, such as vaginal dryness, and objective signs, such as vaginal atrophy, showed significant improvement with a daily dose of 80 mg of Red Clover.
Kudzu
- Puerarin: a review of pharmacological effects. Zhou YX, Zhang H, Peng C. Phytother Res. 2014 Jul;28(7):961-75. doi: 10.1002/ptr.5083. Epub 2013 Dec 13. Review.
This study examined the beneficial effects of Puerarin on various physiological functions. These effects may be due to its wide range of properties, including vasodilation, heart protection, neuroprotection, antioxidant and anti-inflammatory action, pain relief, support for bone formation, inhibition of alcohol absorption, and reduction of insulin resistance.
- Br J Nutr. 2003 Jun;89 Suppl 1:S45-58. doi: 10.1079/BJN2002796. Bioavailability of phyto-oestrogens. Ian Rowland 1, Marian Faughnan, Leane Hoey, Kristiina Wähälä, Gary Williamson, Aedin Cassidy
This study focused on how well isoflavones are absorbed depending on the type used. Kudzu is among the most easily absorbed, which sets it apart from soy, the bioavailability odìf which is less reliable.
Dioscorea Villosa
- Am J Chin Med. 2009;37(1):159-67.doi: 10.1142/S0192415X09006746. Estrogen activities and the cellular effects of natural progesterone from wild yam extract in mcf-7 human breast cancer cells. Mi-Kyung Par, Hyeok-Yi Kwon, Woong-Shick Ahn, Sumi Bae, Mee-Ra Rhyu, Youngjoo Lee
According to this study, Dioscorea works by increasing the activity of progesterone receptors in cells that respond to this hormone, stimulating a physiological response even when progesterone levels are low. This makes it useful during menopause to help support hormonal balance.
Angelica Sinensis
- Estrogenic activity of standardized extract of Angelica sinensis. Circosta C, Pasquale RD, Palumbo DR, Samperi S, Occhiuto F. Phytother Res. 2006 Aug;20(8):665-9.
This study evaluated and confirmed the oestrogenic activity of a standardized extract from Angelica sinensis roots, used to help relieve menopause-related changes.
Vervein
- Novel neuroprotective effects of the aqueous extracts from Verbena officinalis Linn. Lai SW, Yu MS, Yuen WH, Chang RC. Neuropharmacology. 2006 May;50(6):641-50. Epub 2006 Jan 6.
In this study, researchers demonstrated the neuroprotective effects of Verbena officinalis, showing that these benefits are not just based on traditional beliefs, but can be confirmed using scientific methods.
Pausanorm Forte is a dietary supplement: please read the warnings on the label.
Supplements should not be considered a substitute for a varied and balanced diet and a healthy lifestyle.
The information provided here is for educational purposes only. It should not be interpreted as a diagnosis or treatment of any medical condition and is not intended to replace the advice of a doctor.
[1] Kim JE, Jeong H, Hur S, Lee J, Kwon O. Efficacy and Safety of Kudzu Flower-Mandarin Peel on Hot Flashes and Bone Markers in Women during the Menopausal Transition: A Randomized Controlled Trial. Nutrients. 2020;12(11):3237. Published 2020 Oct 22. doi:10.3390/nu12113237.
[2] Vitale DC, Piazza C, Melilli B, Drago F, Salomone S. Isoflavones: estrogenic activity, biological effect and bioavailability. Eur J Drug Metab Pharmacokinet. 2013;38(1):15-25. doi:10.1007/s13318-012-0112-y.
[3] Editoriale Domani – Politica – Mondo – L’Esperienza del Brasile – La soia è ovunque, anche dove non immagini. Ed è tutta ogm.
[4] Hadi THS, Santoso B, Hardianto G, Kurniawati EM. The effect of isoflavone on vaginal dryness and dyspareunia in postmenopausal symptoms: a systematic review and meta-analysis. Obstet Gynecol Sci. 2025;68(2):131-138. doi:10.5468/ogs.24282.
[5] Lipovac M, Chedraui P, Gruenhut C, Gocan A, Kurz C, Neuber B, Imhof M. Effect of Red Clover Isoflavones over Skin, Appendages, and Mucosal Status in Postmenopausal Women. Obstet Gynecol Int. 2011;2011:949302. doi: 10.1155/2011/949302. Epub 2011 Nov 1. PMID: 22135679; PMCID: PMC3206499.
[6] Wang S, Zhang S, Wang S, Gao P, Dai L. A comprehensive review on Pueraria: Insights on its chemistry and medicinal value. Biomed Pharmacother. 2020;131:110734. doi:10.1016/j.biopha.2020.110734.
[7] J Obstet Gynaecol. 2016;36(3):301-11. doi: 10.3109/01443615.2015.1049249. Epub 2015 Oct 15. Red clover for treatment of hot flashes and menopausal symptoms: A systematic review and meta-analysis. Ghazanfarpour M, Sadeghi R, Roudsari RL, Khorsand I, Khadivzadeh T, Muoio B.
[8] Goyal N, Chaudhary R, Aggarwal K, et al. Red Clover Supplementation Alleviates Neurological Deficits in Estrogen Deficient Rats Exposed to Chronic Unpredictable Mild Stress. Eur J Neurosci. 2025;61(12):e70164. doi:10.1111/ejn.70164.
[9] Bihlet AR, Byrjalsen I, Andersen JR, et al. The Efficacy and Safety of Multiple Dose Regimens of Kudzu (Pueraria lobata) Root Extract on Bone and Cartilage Turnover and Menopausal Symptoms. Front Pharmacol. 2021;12:760629. Published 2021 Oct 22. doi:10.3389/fphar.2021.760629
[10] Verma SK, Jain V, Singh DP. Effect of Pueraria tuberosa DC. (Indian Kudzu) on blood pressure, fibrinolysis and oxidative stress in patients with stage 1 hypertension. Pak J Biol Sci. 2012;15(15):742-747. doi:10.3923/pjbs.2012.742.747
[11] Chen R, Liu B, Wang X, et al. Effects of polysaccharide from Pueraria lobata on gut microbiota in mice. Int J Biol Macromol. Published online May 5, 2020. doi:10.1016/j.ijbiomac.2020.04.201
[12] Zhou YX, Zhang H, Peng C. Puerarin: a review of pharmacological effects. Phytother Res. 2014 Jul;28(7):961-75. doi: 10.1002/ptr.5083. Epub 2013 Dec 13. PMID: 24339367.
[13] Kim JE, Jeong H, Hur S, Lee J, Kwon O. Efficacy and Safety of Kudzu Flower-Mandarin Peel on Hot Flashes and Bone Markers in Women during the Menopausal Transition: A Randomized Controlled Trial. Nutrients. 2020;12(11):3237. Published 2020 Oct 22. doi:10.3390/nu12113237.
[14] Semwal P, Painuli S, Abu-Izneid T, et al. Diosgenin: An Updated Pharmacological Review and Therapeutic Perspectives. Oxid Med Cell Longev. 2022;2022:1035441. Published 2022 May 29. doi:10.1155/2022/1035441.
[15] Climacteric. 2011 Feb;14(1):132-9. doi: 10.3109/13697137.2010.498594. Epub 2010 Jul 23. The assessment of efficacy of Dioscorea alata for menopausal symptom. Hsu CC, Kuo HC, Chang SY, Wu TC, Huang KE.
[16] Circosta C, Pasquale RD, Palumbo DR, Samperi S, Occhiuto F. Estrogenic activity of standardized extract of Angelica sinensis. Phytother Res. 2006;20(8):665-669. doi:10.1002/ptr.1928.
[17] Xin YF, Zhou GL, Shen M, et al. Angelica sinensis: a novel adjunct to prevent doxorubicin-induced chronic cardiotoxicity. Basic Clin Pharmacol Toxicol. 2007;101(6):421-426. doi:10.1111/j.1742-7843.2007.00144.x.
[18] Chen SW, Min L, Li WJ, Kong WX, Li JF, Zhang YJ. The effects of angelica essential oil in three murine tests of anxiety. Pharmacol Biochem Behav. 2004;79(2):377-382. doi:10.1016/j.pbb.2004.08.017.
[19] Makino, Y., Kondo, S., Nishimura, Y. et al. Hastatoside and verbenalin are sleep-promoting components in Verbena officinalis. Sleep Biol. Rhythms 7, 211–217 (2009). https://doi.org/10.1111/j.1479-8425.2009.00405.x.
[20] Vicariotto F, Malfa P, Viciani E, et al. Efficacy of Lactiplantibacillus plantarum PBS067, Bifidobacterium animalis subsp. lactis BL050, and Lacticaseibacillus rhamnosus LRH020 in the Amelioration of Vaginal Microbiota in Post-Menopausal Women: A Prospective Observational Clinical Trial. Nutrients. 2024 Jan 30;16(3):402. doi: 10.3390/nu16030402. PMID: 38337685; PMCID: PMC10857347.
[21] Nature Menopause. S.R. Davis, I.Lambrinoudaki, M. Lumsden, G.D. Mishra, L. Pal, M. Rees, N. Santoro & T. Simoncini.
[22] Ministero della Salute - Salute della Donna – Menopausa.
[23] Levis S, Strickman-Stein N, Ganjei-Azar P, Xu P, Doerge DR, Krischer J. Soy Isoflavones in the Prevention of Menopausal Bone Loss and Menopausal Symptoms: A Randomized, Double-blind Trial. Arch Intern Med. 2011;171(15):1363–1369. doi:10.1001/archinternmed.2011.330.
[24] Br J Nutr. 2003 Jun;89 Suppl 1:S45-58. Bioavailability of phyto-oestrogens. Rowland I, Faughnan M, Hoey L, Wähälä K, Williamson G, Cassidy A..
[25] Maul R, Kulling SE. Absorption of red clover isoflavones in human subjects: results from a pilot study. Br J Nutr. 2010 Jun;103(11):1569-72. doi: 10.1017/S0007114509993564. Epub 2010 Jan 13. PMID: 20067656.
I nostri testi hanno scopo divulgativo, non vanno intesi come indicazione di diagnosi e cura di stati patologici e non vogliono sostituirsi in alcun modo al parere del Medico.