Hop Extract Versus Soy Isoflavone Extract for Menopausal Symptoms (HOPES) (HOPES)

Efficacy of a Full Spectrum Hop (Humulus Lupulus L.) Extract Versus a Soy Extract in Women With Menopausal Symptoms: A Randomized, Double-Blind, Active-Controlled Nutritional Intervention Study (HOPES: Hops On Psychological and Estrogenic Symptoms in Menopause)

HOPES (Hops On Psychological and Estrogenic Symptoms in Menopause) is a randomized, double-blind, active-controlled nutritional intervention study in 120 peri- and postmenopausal women aged 45 to 60 years with moderate to severe menopausal symptoms. For 12 weeks, participants take one capsule per day of either a full spectrum hop (Humulus lupulus L.) extract or a soy isoflavone extract. Both products are marketed dietary supplements, and there is no placebo arm.

The main question is whether the hop extract, which combines prenylated flavonoids with bitter acids, improves the psychological symptoms of menopause (depressive mood, irritability, anxiety, and physical and mental exhaustion) more than the soy extract. The main outcome is the change in the psychological subscale of the Menopause Rating Scale (MRS) from baseline to week 12.

Secondary outcomes include the other MRS domains, anxiety, depressive symptoms, menopause-related quality of life, body composition, and safety.

Study Overview

• Status: Recruiting
• Conditions: Menopause; Postmenopause; Perimenopause
• Intervention / Treatment: Dietary supplement: Full Spectrum hop extract (MENODUO FullSpectrum); Dietary supplement: Soy isoflavone extract

Detailed Description

Rationale

Many women cannot or do not wish to use menopausal hormone therapy (MHT) and turn to plant-based supplements. Soy isoflavones act mainly through estrogenic mechanisms and have shown a modest effect on vasomotor symptoms, while the evidence for psychological symptoms and sleep is more limited and less consistent. Hop extract has a dual profile: prenylated flavonoids, linked to estrogenic activity, and bitter acids, described in relation to GABAergic neurotransmission and vagal signalling. No direct comparison of the two extracts is available. HOPES tests whether this profile gives the hop extract a differential effect on the psychological domain of menopausal symptoms.

Design

Candidates complete a secure online screening (visit 0). Eligible women attend a baseline visit (visit 1) at the coordinating center, where eligibility is confirmed, assessments and a blood sample are taken, and participants are randomized 1:1 (computer-generated permuted blocks of variable size, stratified by center and menopausal status: perimenopause or postmenopause). Follow-up includes a visit at week 6 (visit 2, in person or remote) and a final visit at week 12 (visit 3).

Capsules and bottles are identical and coded by the sponsor. Participants, the research team and the statistician remain masked until database lock, and an emergency unblinding procedure is available. Adherence is assessed with a capsule diary and a count of returned product, and dietary intake with a 3-day food record at visits 1 and 3.

Assessments

Menopause Rating Scale (MRS), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Cervantes-31 quality of life scale, and 0-10 visual analogue scales (VAS) for hot flashes, sleep quality and mood; body composition by bioimpedance; and blood tests (liver profile, lipid profile, estradiol and follicle-stimulating hormone) at baseline and week 12.

Analysis

The primary outcome is analyzed in the intention-to-treat population with a mixed model for repeated measures. With 60 participants per arm, the study has 80% power, at a two-sided significance level of 5%, to detect a standardized effect size of about 0.52. Secondary outcomes are tested hierarchically.

A between-group difference of at least 0.5 standard deviations in the change of the MRS psychological subscale is prespecified as clinically relevant.

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Esmeralda Josa; Phone Number: +34 914 324 499; Email: esmeralda.josa@menoclinica.com

Study Locations

• Spain
  • Madrid
    • Madrid, Madrid, Spain, 28009
      • Recruiting
      • Menoclínica by Palacios

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years to 60 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Woman aged 45 to 60 years (both inclusive).
• Perimenopausal or postmenopausal status according to the Stages of Reproductive Aging Workshop +10 (STRAW+10) criteria.
• Moderate to severe menopausal symptoms, defined as a total Menopause Rating Scale (MRS) score of 15 or higher at the baseline assessment prior to randomization.
• Not receiving menopausal hormone therapy (MHT) and not having received it in the previous 3 months.
• Ability to understand and complete the study questionnaires autonomously.
• Written informed consent.

Exclusion Criteria:

• Known allergy or hypersensitivity to soy or any of its derivatives.
• Known allergy or hypersensitivity to hops or to other species of the Cannabaceae family.
• Personal history of breast cancer, endometrial cancer or any other hormone-dependent tumor.
• Genital bleeding of undiagnosed cause.
• Current use, or use in the previous 3 months, of MHT, tibolone, selective estrogen receptor modulators, or dietary supplements or products specifically intended for menopausal symptoms or with a relevant phytoestrogen content, or anticipated need to start any of them during the study.
• Current treatment with antidepressants, anxiolytics, hypnotics, gabapentin or pregabalin.
• Known liver disease or abnormal baseline liver profile (transaminases more than twice the upper limit of normal).
• Moderate or severe renal insufficiency.
• History of venous thromboembolic disease.
• Oral anticoagulant treatment.
• Body mass index (BMI) of 35 kg/m2 or higher.
• Pacemaker or any other implantable electronic device (contraindication for bioimpedance).
• Unstabilized major psychiatric disorder.
• Risky alcohol consumption or substance dependence.
• Simultaneous participation in another clinical trial or intervention study, or participation in one within the previous 30 days.
• Pregnancy or lactation.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Hop extract; One capsule per day for 12 weeks of MENODUO FullSpectrum, a dry hop (Humulus lupulus L.) strobilus extract, 100 mg/day, providing 10 mg/day of bitter acids and derivatives, 3.5 mg/day of prenylated flavonoids and 2.5 mg/day of xanthohumol.	Dietary supplement: Full Spectrum hop extract (MENODUO FullSpectrum); 100 mg/day orally, one capsule per day for 12 weeks. Provides 10 mg/day of bitter acids and derivatives, 3.5 mg/day of prenylated flavonoids and 2.5 mg/day of xanthohumol.; Other Names: MENODUO FullSpectrum
Active Comparator: Soy extract; One capsule per day for 12 weeks of a dry soy (Glycine max (L.) Merr.) seed extract, 100 mg/day, standardized to at least 40% total isoflavones (at least 40 mg/day) and selected to provide at least 20 mg/day of genistein.	Dietary supplement: Soy isoflavone extract; Description: 100 mg/day orally, one capsule per day for 12 weeks. Standardized to at least 40% total isoflavones (at least 40 mg/day) and at least 20% genistein (at least 20 mg/day).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in the psychological subscale score of the Menopause Rating Scale (MRS)	The MRS psychological subscale is the sum of items 4 to 7 (depressive mood, irritability, anxiety, and physical and mental exhaustion), each rated from 0 (none) to 4 (very severe). Score range 0 to 16; higher scores indicate greater symptom severity. Change is the week 12 score minus the baseline score.	Baseline (visit 1) and week 12 (visit 3)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in total MRS score	Sum of the 11 MRS items, each rated 0 to 4. Score range 0 to 44; higher scores indicate greater severity.	Baseline, week 6 and week 12
Change in MRS somatic-vegetative subscale score	Sum of items 1, 2, 3 and 11. Score range 0 to 16; higher scores indicate greater severity.	Baseline, week 6 and week 12
Change in MRS urogenital subscale score	Sum of items 8, 9 and 10. Score range 0 to 12; higher scores indicate greater severity.	Baseline, week 6 and week 12
Change in Generalized Anxiety Disorder-7 (GAD-7) score	Seven items rated 0 to 3. Score range 0 to 21; higher scores indicate more anxiety symptoms.	Baseline and week 12 (optional at week 6)
Change in Patient Health Questionnaire-9 (PHQ-9) score	Nine items rated 0 to 3. Score range 0 to 27; higher scores indicate more depressive symptoms.	Baseline and week 12 (optional at week 6)
Change in the Cervantes Scale global score	The Cervantes Scale is a 31-item, menopause-specific health-related quality of life questionnaire. Each item is rated from 0 to 5. The global score ranges from 0 to 155; higher scores indicate worse health-related quality of life. Change is the week 12 score minus the baseline score.	Baseline and week 12
Change in the Cervantes Scale sexuality domain score	The sexuality domain of the Cervantes Scale (31-item, menopause-specific health-related quality of life questionnaire) comprises 4 items on sexual function, each rated from 0 to 5. The domain score ranges from 0 to 20; higher scores indicate worse sexual function. Change is the week 12 score minus the baseline score.	Baseline and week 12
Change in body fat percentage	Body fat percentage measured by bioimpedance.	Baseline and week 12
Change in estimated visceral fat	Visceral fat estimate measured by bioimpedance.	Baseline and week 12
Change in hot flash intensity (visual analogue scale)	0-10 scale; 0 = no hot flashes, 10 = maximum imaginable intensity.	Baseline, week 6 and week 12
Change in sleep quality (visual analogue scale)	0-10 scale; 0 = very poor sleep quality, 10 = excellent sleep quality.	Baseline, week 6 and week 12
Change in mood (visual analogue scale)	0-10 scale; 0 = very poor mood, 10 = excellent mood.	Baseline, week 6 and week 12
Number of participants with adverse events	Incidence, nature, severity, duration and relationship to the intervention, including events that lead to interruption of the intervention or withdrawal.	From baseline to week 12
Change in liver profile	Aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase and bilirubin.	Baseline and week 12
Change in lean mass	Lean mass in kilograms measured by bioimpedance.	Baseline and week 12

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in lipid profile	Total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides.	Baseline and week 12
Change in serum estradiol	Serum estradiol concentration.	Baseline and week 12
Change in serum follicle-stimulating hormone (FSH)	Serum FSH concentration.	Baseline and week 12

Collaborators and Investigators

• Sponsor: Menoclinica by Palacios
• Investigators: Principal Investigator: Silvia Pilar González Rodríguez, Menoclínica by Palacios

Publications and helpful links

General Publications

• Heinemann K, Ruebig A, Potthoff P, Schneider HP, Strelow F, Heinemann LA, Do MT. The Menopause Rating Scale (MRS) scale: a methodological review. Health Qual Life Outcomes. 2004 Sep 2;2:45. doi: 10.1186/1477-7525-2-45.
• Palacios S, Ferrer-Barriendos J, Parrilla JJ, Castelo-Branco C, Manubens M, Alberich X, Marti A; Grupo Cervantes. [Health-related quality of life in the Spanish women through and beyond menopause. Development and validation of the Cervantes Scale]. Med Clin (Barc). 2004 Feb 21;122(6):205-11. doi: 10.1016/s0025-7753(04)74198-6. Spanish.
• Morimoto-Kobayashi Y, Ohara K, Ashigai H, Kanaya T, Koizumi K, Manabe F, Kaneko Y, Taniguchi Y, Katayama M, Kowatari Y, Kondo S. Matured hop extract reduces body fat in healthy overweight humans: a randomized, double-blind, placebo-controlled parallel group study. Nutr J. 2016 Mar 9;15:25. doi: 10.1186/s12937-016-0144-2.
• Keiler AM, Zierau O, Kretzschmar G. Hop extracts and hop substances in treatment of menopausal complaints. Planta Med. 2013 May;79(7):576-9. doi: 10.1055/s-0032-1328330. Epub 2013 Mar 19.

Study record dates

Study Major Dates

• Study Start (Actual): October 26, 2026
• Primary Completion (Estimated): February 5, 2027
• Study Completion (Estimated): April 1, 2028

Study Registration Dates

• First Submitted: October 23, 2026
• First Submitted That Met QC Criteria: October 23, 2026
• First Posted (Actual): October 29, 2026

Study Record Updates

• Last Update Posted (Actual): November 5, 2026
• Last Update Submitted That Met QC Criteria: November 4, 2026
• Last Verified: October 1, 2026

More Information

Terms related to this study

• Keywords: dietary supplement; Humulus lupulus; phytoestrogens; hops; soy isoflavones; Menopause Rating Scale; psychological symptoms
• Additional Relevant MeSH Terms: Amino Acids, Peptides, and Proteins; Proteins; Food; Diet, Food, and Nutrition; Physiological Phenomena; Food and Beverages; Plant Proteins, Dietary; Dietary Proteins; Plant Proteins; Soy Foods; Vegetable Products; Vegetables; Soybean Proteins
• Other Study ID Numbers: HOPES-2026-01; 6554 (Other Identifier: Research Ethics Committee (CEIm), Hospital Universitario de La Princesa)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

IPD Plan Description

Individual participant data will not be shared at this stage. Aggregate results will be published in a peer-reviewed journal.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No