Abstract Postmenopausal women often experience sexual dysfunction (e.g., vaginal dryness, dyspareunia) due to estrogen decline. While hormone replacement therapy (HRT) is effective, safety concerns have spurred interest in alternatives like soy isoflavones. This meta-analysis evaluated soy isoflavones’ efficacy for sexual function and menopausal symptoms. We systematically searched PubMed, Cochrane, Scopus, and Web of Science through May 2025 per PRISMA guidelines, identifying 13 RCTs ( n = 1325) comparing soy isoflavones (40–160 mg/day) with placebo/HRT. Outcomes included Menopause Rating Scale (MRS) scores. Risk of bias (Cochrane ROB-2) and heterogeneity (I²) were assessed. Soy isoflavones significantly improved vaginal dryness (SMD = − 1.88; 95% CI: −3.24 to −0.53; p = 0.006) and urogenital symptoms (SMD = − 0.33; 95% CI: −0.64 to −0.02; p = 0.04), with non-significant trends for vasomotor ( p = 0.08) and psychological symptoms ( p = 0.06). Effects were dose-dependent (optimal at 50–100 mg/day) and more pronounced in Asian populations. High heterogeneity (I² > 90%) reflected variability in study designs. Soy isoflavones appear safe and moderately effective for urogenital and sexual symptoms, though further standardized trials are needed to confirm long-term benefits.
KARAAHMET et al. (2026) studied this question.