Pueraria mirifica (Kwao Krua)

Tier 3 — weak evidence · Menopause · Phytoestrogen · Women's health

A Thai traditional herb containing miroestrol, the most potent known phytoestrogen. A 2024 systematic review of 6 trials found it significantly reduced hot flashes, vaginal dryness, and menopausal symptoms compared to placebo. Potent oestrogenic activity means it is contraindicated in hormone-sensitive cancers, endometriosis, and fibroids. Must not be combined with HRT without medical supervision.

Dose: 25–50 mg/day standardised extract for menopausal symptoms; lower doses than most phytoestrogens due to high potency