Common Sense Health: Plant-based alternatives to HRT

By Diana Gifford-Jones on January 23, 2026.

Hot flashes, disrupted sleep, decreased sex drive, and irrational urges to kick your husband for no good reason. The menopausal transition can make life hard to manage! Many women find themselves weighing the pros and cons of hormone replacement therapy (HRT). But not everyone can take HRT, and not everyone wants to.

Interest is growing in plant-based options that offer symptom relief without synthetic hormones. One newer botanical, DT56a, marketed as Femarelle and available in more than 40 countries, has emerged as a promising option. It is a plant-based compound that behaves in some ways like pharmaceutical drugs and has been evaluated in clinical and laboratory studies.

Drugs such as raloxifene can mimic estrogen’s protective effect in some tissues, like bone, while blocking estrogen in others, such as the breast or uterus. The goal is to gain these benefits without stimulating cancer-sensitive organs. DT56a, a standardized soy-derived compound, is designed to interact with estrogen receptors in a tissue-selective way, only from a plant source.

Early studies are intriguing. In small clinical trials, women taking DT56a reported fewer and less intense hot flashes. The improvement was noticeable and meaningful for daily life. One study compared DT56a with low-dose estrogen, and both groups improved. Importantly, researchers did not observe changes in the uterine lining or mammograms in women taking DT56a. This suggests a reassuring safety profile for breast and uterine tissue. Laboratory and animal research adds to the optimism, showing that DT56a activates bone cells and may help them stay strong even under stressful metabolic conditions, meaning possible bone-protective effects.

Most studies have been small, following women for weeks or months rather than years. It’s not yet possible to say whether DT56a reduces fracture risk, protects the heart, or influences the risk of breast or uterine cancer. At the same time, no serious safety signals have emerged in trials.

How should women think about DT56a alongside more familiar options? Hormone therapy remains an option, especially for severe symptoms and for protecting bone health, but it is not safe or appropriate for everyone. Non-hormonal prescription drugs can also ease hot flashes. But DT56a is an option women should consider. It offers biologically active, hormone-free symptom relief rather than simply masking symptoms in the brain.

Women with bothersome but not overwhelming symptoms who want to avoid hormones may find it a welcome alternative. Those who prefer a plant-based approach may also be drawn to it. Women who cannot or choose not to use estrogen may find Femarelle particularly appealing. But for women with a history of breast or uterine cancer, or who are at high risk for estrogen-sensitive conditions, a doctor’s guidance is essential.

When you try Femarelle, do so with realistic expectations. It may take weeks to show an effect, and the improvement may be modest. Many women report gradual, steady improvement rather than a sudden change. Keep a journal of daily symptoms and any changes. It is not a cure, but it can meaningfully improve quality of life for some women.

The bottom line is that DT56a is an intriguing addition to menopause management. It represents a new generation of botanicals that are more refined than traditional natural remedies, and with enough early data to justify serious interest. It offers hope of relief, provided women approach it with eyes open, careful monitoring, and guidance from a healthcare provider.

Ladies, with menopause, don’t keep your symptoms to yourself, including the ones that are hard to discuss or seemingly hard to solve. There are treatments to help. Femarelle is one of them. But so too, vaginal moisturizers. And thermostats.

And gentlemen, remember, chocolates and flowers help too.

This column offers opinions on health and wellness, not personal medical advice. Visit http://www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

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