TODAY'S AJENDA #56

Let’s set soy straight. This legume has quite the rollercoaster reputation—it’s praised as a nutrient powerhouse one day, then scrutinized for potential health risks the next. 

So what’s the real story? Should we be adding tofu to our grocery lists or approaching it with caution? Here’s the truth—don’t soy I didn’t warn you (get it?!).  

The Science of Soy

Soy is a nutrient-rich legume packed with protein, fiber, and essential micronutrients like iron, calcium, and folate. But what makes it interesting—and sometimes controversial—is its biochemistry. 

Enter: Isoflavones. These plant-based compounds found in soy act as both estrogenic and anti-estrogenic substances in the body. In some tissues, isoflavones weakly mimic estrogen, but in others, they actually block estrogen’s effects. 

This dual nature is why soy has generated tons of debate and confusion. 

The Misconceptions of Soy 

A common myth about soy is that since it can boost estrogen in some tissues, it might increase the risk of breast or other hormonally responsive cancers. 

But here’s the thing: A cancer labeled as “estrogen receptor positive” (ER+) does not mean estrogen caused the cancer. It just means the cancer cell maintained its original receptor configuration as it transformed into a cancer cell—after all, all breast cells have receptors for estrogen. 

“What about progesterone?” Soy’s impact on progesterone (i.e., the pregnancy hormone) is more up in the air. Some studies suggest soy consumption may decrease progesterone levels, while others show no significant effect. 

The reason for this uncertainty is simple: Foods affect people differently. Soy’s impacts can vary dramatically based on whether it’s consumed by women or men, the type of soy, the amount consumed, etc. 

Until more research is done, we won’t have a crystal-clear picture of how soy affects women on a broad scale. That said, based on the studies we do have, here are some of its pros and cons: 

Pros of Soy  

1. Menopausal Symptom Relief:

Remember soy’s isoflavones? Because they can faintly mimic estrogen, they may alleviate menopause symptoms, such as night sweats and hot flashes. 

A 2012 meta-analysis reviewed 19 studies where women took soy isoflavone supplements to see if they help with hot flashes during or after menopause. The researchers found:

• A daily dose of about 54 mg reduced the frequency of hot flashes by 21% compared to a placebo. 

• The supplements also reduced how severe the hot flashes were by about 26% (Taku et al., 2012). 

A more recent study in 2021 found that a plant-based diet rich in soy, or just a half a cup of soybeans a day, reduced hot flashes by 84%—from nearly five hot flashes per day to fewer than one (Barnard et al., 2021). 

2. Bone Health Support:

Those same isoflavones that help with hot flashes may benefit your bones too, though the evidence is mixed. However, a promising meta-analysis found that women taking soy isoflavones showed significantly better spine density compared to those who didn’t (De-Fu et al., 2008). 

3. Cardiovascular Benefits:

Soy may help lower the risk of heart disease, especially in younger women and postmenopausal women not using hormone therapy. A study with over 200,000 participants found that eating at least one serving of tofu each week was linked to a reduced risk of heart disease (Le Ma et al., 2020). 

4. Cancer Prevention Myths Debunked:

Remember how we debunked those myths about soy and breast cancer? Well, research seems to confirm this. A meta-analysis found that soy consumption was actually associated with a reduced breast cancer risk, especially in Asian populations where soy is a childhood dietary staple (Truck et al., 2006).

Cons of Soy

1. Thyroid Health:

Soy has a…complicated relationship with your thyroid gland. If you have an underactive thyroid (hypothyroidism) or don’t get enough iodine in your diet, eating too much soy could interfere with how well your body absorbs thyroid medication.

The good news is that research shows that eating a moderate amount of soy foods is generally safe, even for those with thyroid issues—as long as you’re getting sufficient iodine (Messina, Nutrients, 2019). 

2. Processing Matters:

Not all soy is created equal. Highly processed soy products (e.g., soy protein isolate in snack bars) may not provide the same benefits as whole or fermented soy foods like edamame, tofu, tempeh, and miso.

Don’t Be Soy Afraid 

While I was getting my degree in nutrition, the general rule of thumb was you’d have to eat a lot of soy (and I mean a lot) for it to cause any harm.  

In moderation, soy isn’t just safe but also nutritious and potentially beneficial for women’s heart, bone, and hormonal health. Just be sure to choose whole or minimally processed sources of soy rather than highly processed soy isolates. 

Here’s to adding edamame and tofu to the grocery list! 🫛

If you’re one of the 60 million Americans who suffer from seasonal allergies (I’m right there with you), grab some eye drops and read on. 

We’re covering how to beat allergy season by getting ahead of symptoms before they start, rather than waiting until the sneezing, wheezing, and itching (So. Much. Itching.) kick in. 

Why Do We Get Allergies? 

Here’s the mini-med school on allergic rhinitis: 

When allergens such as pollen, ragweed, or dander enter the body and come into contact with our mucus membranes (eyes, nose, and throat), mast cells release histamine. 

Histamine means well. Its job is to increase blood vessel permeability and trigger inflammation, which helps your body get rid of those allergens. But this chemical also causes the symptoms you’re all too familiar with: 

• Sneezing

• Runny or stuffy nose

• Itchy eyes, nose, or throat

• Watery eyes

• Swelling in nasal passages or skin

That’s where antihistamines come in. These over-the-counter medications (Claritin, Zyrtec) block histamine receptors to reduce those pesky side effects, but they’re typically taken once the symptoms are already in full swing. 

But why wait for the misery of seasonal allergies? 

Tackle Allergies At Their Source 

Nasal steroid sprays like Nasacort or Flonase tackle allergies at their source by suppressing the immune cells (mast cells and eosinophils) that release histamine. 

The result is less swelling and mucus production, which in turn, eases congestion, sneezing, and runny nose. 

And when used consistently, these sprays can actually prevent inflammation from building up over time, making them effective for long-term allergy control, especially during allergy season. 

So ideally, you should start the steroid nasal spray 1-2 weeks before pollen counts soar (and your tissue consumption starts reaching deforestation levels). 

But medication isn’t your only defense. There are behavioral modifications that can make allergy season much more manageable too! 

1. Time Your Outdoor Exposure Wisely 

Pollen peaks in the early morning (5–10 a.m.) and on dry, windy days. Limit outdoor activities during these times or wear sunglasses and a mask (such as an N95) when venturing out. 

Unsure of the daily pollen forecast? The American Academy of Allergy, Asthma & Immunology (AAAAI) can help you check pollen levels so you can plan activities accordingly.

2. Shower and Change Clothes After Being Outdoors (And Before Bed!) 

Pollen clings to your skin, hair, and clothes. Showering and changing after being outside significantly reduces how much pollen you bring indoors—and this is especially important before bedtime. 

Why? Even brief outdoor trips collect pollen in your hair. Once you lie down on your pillowcase, you’re essentially spreading pollen all over, creating non-stop allergen exposure. 

Always shower before bed during allergy season! I cannot recommend this enough!

3. HEPA Filters and Ventilation

Time to whip out the air purifiers. High-efficiency particulate air (HEPA) filters in vacuum cleaners and air purifiers can significantly reduce indoor allergens. 

These devices can help with your sleep, too. A study found that purifier filters increased total time in bed for an average of 19 minutes per night relative to the placebo (Lamport et al., 2022). 

4. Nasal Irrigation

Rinsing nasal passages with a saline solution can be a game-changer for allergy sufferers. A 2012 meta-analysis in the American Journal of Rhinology & Allergy found that rinsing nasal passages with salt water for up to seven weeks can result in: 

• 62% reduction in allergy medication use 

• 31% faster mucus clearance 

• 28% improvement in nasal symptoms 

The best part? It’s well-tolerated, cheap, easy to use, and doesn’t have any concerning side effects. 

5. Diet and Probiotics

The science on this one is still developing, but emerging research suggests that your gut health may influence your allergic reactions. 

A 2022 review in the Journal of Asthma and Allergy found that specific probiotics (such as Lactobacillus paracasei) could reduce the severity of allergy symptoms. 

The Invisible Allergy Amplifier 

While antihistamines and nasal sprays are the classic allergy-fighting duo, they’re only half the battle. There’s another environmental factor that could be making your allergy symptoms worse—and it’s happening in your own home. 

The culprit? Dry air. When humidity drops below 40%,  your nasal passages become irritated and inflamed, making you hypersensitive to allergens. Even worse? The dry air makes pollen particles more potent and able to travel further. Ugh. 

I learned this the hard way after multiple seasons of allergies despite stocking up on the Zyrtec. It wasn’t until I found a quality humidifier that I felt that I checked every possible box in my anti-allergy arsenal.  

The humidifier in question? Canopy’s Bedside Humidifier.* This humidifier uses filtering technology that helps reduce the inhaling dust and larger particles–leading to cleaner, hydrated air that leaves your airways less irritated and your skin more dewy and fresh!  

I love using Canopy’s Bedside Humidifier during allergy season, but honestly, it’s great all year round (while using air conditioning OR heat). 

If you’re curious about tweaking the environment of your sleep den, towards a possible better night’s sleep, clearer skin, and less allergy symptoms, use the code DRJEN for 15% off! The code expires Sunday, April 20th and is exclusively for Ajenda subscribers.

“Just use more lubricant.” “It’s normal at your age.” Get used to it.” 

If you’ve heard any of these dismissive responses, I’m here to set the record straight: painful sex after menopause isn’t something you have to live with. 

There are ways to ease the pain and, even better, bring pleasure back into the picture. Here’s what you need to know: 

Why Sex Becomes More Painful As We Age

Why does sex become painful for some women as we get older? 

In a word: estrogen. During perimenopause or menopause, estrogen levels drop fast. This triggers a cascade of changes in your body since it has estrogen receptors in many tissues and organs (skin, brain, bones, and, you guessed it, genital tissues). 

In the lower genital tract, less estrogen means reduced blood flow, as well as lower collagen and moisture levels. That’s a perfect recipe for the tissue in and around the vagina to become thinner, drier, and way more fragile. 

Basically, it becomes the Vaginal Sahara Desert—and that leads, unsurprisingly, to painful sex. 

What You Can Do About It 

If sex is painful, there are solutions—and you don’t have to commit to systemic Hormone Replacement Therapy (HRT) to get relief. 

The first option that is generally recommended is vaginal estrogen. This prescription treatment, which comes in either a vaginal pill or cream form, is widely considered as safe and effective. That goes for women who’ve had breast cancer since it’s used locally and has little to no absorption into the rest of the body. 

• Zoom In:  If prescribed, your doctor would give you a generic estradiol cream 0.01%, along with instructions on how to use it—typically, every 2-3 nights using a small amount from a dosed applicator. 

While it may be a few weeks until you notice any improvements, the benefits can be significant. It not only reduces discomfort during sex, but it can also lower the risk of developing urinary tract infections and other urinary symptoms common during menopause. 

Now that we’ve tackled pain, let’s talk pleasure. 

From Discomfort to Pleasure 

I’ve heard from hundreds (if not thousands!) of women who weren’t sure they’ve ever had an orgasm. That’s not to say they didn’t enjoy sex. Many did. They just felt that The Big O had always been elusive. 

Turns out, they had a good reason to feel that way. Having an orgasm is not as simple as it sounds. A 2018 study published in the Journal of Sex and Marital Therapy found: 

That’s more than a third of women who need clitoral stimulation to orgasm!  

Why Women Feel Disconnected From Orgasm 

Here’s my theory: 

Men learn about sex in adolescence through a lens of physical currency. The goal is straightforward—find the target (the vagina), feel pleasure, orgasm. Simple. 

Women, on the other hand, learn about sex in adolescence through a lens of emotional currency. Sex is about love or being chosen—not so much as an activity that produces physical pleasure. (I’m generalizing here but stay with me.) 

In traditional heterosexual dynamics, the woman is largely dependent on the man to provide pleasure. And if her partner is focused only on penetration, the clitoris tends to be…forgotten.  Also, culturally, we tend to accept and encourage boys to self-pleasure, but don’t with girls. That should change! 

Considering a significant percentage of women can only orgasm with clitoral stimulation, they don’t even realize what they’re missing! 

You may think your sex life is on life support when in reality, you just need a new experience with your partner…or with yourself! 

Let’s Talk Vibrators 

That’s right: we’re talking vibrators. 

Because vibrators offer high-frequency, targeted stimulation for as long as you need (and you control the intensity), it can be a very effective way to show some much-needed love to the nerves and tissues in the genital area. 

They can also be helpful to women experiencing painful sex since you can choose the location and penetration, letting you explore at your own pace. 

Start solo or use the vibrator with your partner. While vibrators are not a one-size-fits-all (and require quite a bit of trial and error), I will say this: The Rolls Royce of clitoral vibrators is the Form 2 by Jimmy Jane.  

It’s designed specifically for external use, with a shape that stimulates both sides of the clitoris—making it a top-tier pick for discovering (or rediscovering) what feels good. 

Here’s to getting your groove back!

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ABOUT DR. JEN

In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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