Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health.

Arno Kroner, DAOM, LAc, is a board-certified acupuncturist, herbalist, and integrative medicine doctor practicing in Santa Monica, California.

Pueraria mirifica is a plant native to Thailand and Burma. The root of the plant contains phytoestrogens, compounds that have estrogen-like effects. Pueraria mirifica is sometimes used as an anti-aging supplement or as a natural remedy for menopausal symptoms such as hot flashes and vaginal dryness.

Pueraria mirifica is available in capsule, tablet, and softgel forms, as well as in serums and creams.

Pueraria mirifica should not be confused with other plants with "kwao krua" in their names, such as kwao krua dang (Butea superba) or black kwao krua (Mucuna collettii).

Alternative medicine practitioners contend that Pueraria mirifica is a powerful antioxidant able to neutralize free radicals that cause harm to cells. These antioxidant effects, along with its pro-estrogenic properties, are believed to be useful in treating women's health conditions, including:

Others claim that Pueraria mirifica can help soften skin, increase breast size, promote weight loss, and prevent heart disease, diabetes, and cancer.

Research on this remedy is fairly limited, but here is a look at what has been done.

Several smaller studies have found that the herb is beneficial in treating common menopausal symptoms.

A 24-week study published in the journal Menopause in 2007 investigated the use of Pueraria mirifica in doses ranging from 10 to 50 milligrams (mg) and concluded that P. mirifica at all doses was far more effective in reducing vaginal atrophy (wasting), vaginal dryness. and dyspareunia (pain during intercourse) than a placebo. The researchers did not specify whether any of the dosages were more or less effective than others.

The findings supported an earlier study in the Journal of the Medical Association of Thailand in which Pueraria mirifica improved vasomotor symptoms (such as hot flashes and night sweats) in 37 women experiencing menopause. After 24 weeks, women provided a daily 50-mg dose of Pueraria mirifica experienced the same level of relief as those given 100 mg per day.

More recently, a 2017 study published in Menopause reported that a vaginal gel containing Pueraria mirifica was nearly as effective as conjugated estrogen cream in preventing vaginal atrophy. The 12-week study involving 82 postmenopausal women also found that Pueraria mirifica cream was just as effective in relieving vaginal dryness and pain as estrogen cream.

Estrogen plays a key role in regulating bone turnover, the biological process in which old bone is broken down and replaced with new bone.

This is evidenced in part by a 2016 study in the Journal of Endocrinology in which bone loss was significantly slowed in postmenopausal monkeys with osteoporosis after they were given a diet supplemented with Pueraria mirifica powder for 16 weeks.

Similar results were achieved in baboons in a 2014 study in Phytomedicine. Further research is needed to see if the same benefits might be achieved in humans.

There is evidence, albeit weak, that Pueraria mirifica exerts positive influences on blood cholesterol levels. Most of the current evidence is based on a 2008 study from Japan in which 19 postmenopausal women were either given a Pueraria mirifica supplement or a placebo for two months.

At the end of the study period, the women provided Pueraria mirifica experienced a 17% drop in "bad" low-density lipoprotein (LDL) cholesterol and a 34% increase in "good" high-density lipoprotein (HDL) cholesterol. By comparison, people given the placebo experienced no change in either their LDL or HDL.

Pueraria mirifica appears to mimic the effects of estrogen in the body, increasing the rate by which carbohydrates and sugar are metabolized. In theory, this can lower cholesterol while promoting weight loss and controlling blood sugar. Further research is needed.

Little is known about the long-term safety of Pueraria mirifica. Due to the herb's estrogen-like effects, symptoms such as bloating, cramps, breast tenderness, headache, weight changes, and irregular periods are possible.

With that said, none of the above listed studies reported significant side effects, even with up to six months of daily use.

Because of its estrogen-like effects, Pueraria mirifica should not be used during pregnancy or breastfeeding. It should also be avoided in women with estrogen-sensitive conditions, such as breast cancer, ovarian cancer, endometriosis, and uterine fibroids.

A 2016 study in the journal Toxin reported that a 0.3% Pueraria mirifica solution significantly increased the risk of breast and endometrial cancer in female lab rats after 36 weeks.

Pueraria mirifica should be used with caution in people with liver disease since the herbal metabolites are broken down by the liver. Excessive use can place strain on the liver and potentially cause liver damage.

It is unknown if Pueraria mirifica can interact with other drugs.

Pueraria mirifica is sold almost exclusively in the United States as a dietary supplement. Oral formulations can be found in many health food stores in doses ranging from 100 mg to 1,000 mg. There are also topical products sold online and at cosmetic counters. Most of these serums and creams are intended for the face or breasts rather than the vagina.

At present, there are no guidelines for the appropriate use of Pueraria mirifica. Studies investigating its use in humans found that it was just as beneficial at 50 mg per day as it was at higher doses.

As a general rule, start with the lowest possible dose and increase gradually if needed. There is nothing in the current medical literature to suggest that higher doses of Pueraria mirifica are any more beneficial.

Dietary supplements are not strictly regulated in the United States. Because of this, supplements can vary in quality and/or contain ingredients not listed on the product label.

To ensure quality and safety, opt for brands that have been independently tested by a certifying body like the U.S. Pharmacopeia (USP), ConsumerLab, or NSF International. Although independent certification is lacking in the supplements industry, larger companies are starting to see the benefits of seeking it as consumers become increasingly aware of supplement safety.

It is relatively difficult to find organic Pueraria mirifica supplements in the United States since the active ingredient is typically grown in Thailand or Burma. In the absence of organic certification, some manufacturers will state that their products are "premium quality." This actually means nothing.

Always be sure to read the product label before making a supplement purchase. Many Pueraria mirifica supplements have added ingredients like folic acid, selenium, vitamin B12, and biotin. While additives like these may be beneficial, others may not. This includes wheat fillers of which you may have allergies or intolerance.

Try not to be swayed by health claims that may or may not be true. A number of Pueraria mirifica manufacturers have been known to market their products as "breast enlargement supplements," a claim that is patently false. Avoid any products that make such claims or promises cures of any sort.

Pueraria mirifica is an herb that's been used for more than 100 years in Thai folk medicine as a youth-enhancing, rejuvenating supplement. It contains phytoestrogens, substances that have estrogen-like effects, and has been researched as a therapy for menopause, cardiovascular disease, and bone health.

You can buy Pueraria mirifica in capsules, powder, and extracts where supplements are sold in health stores and online. You can buy Pueraria mirifica creams or gels online and in some cosmetic sections.

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Suwanvesh N, Manonai J, Sophonsritsuk A, Cherdshewasart W. Comparison of Pueraria mirifica gel and conjugated equine estrogen cream effects on vaginal health in postmenopausal women. Menopause. 2017 Feb;24(2):210-215. doi:10.1097/GME.0000000000000742

Okamura S, Sawada Y, Satoh T, et al. Pueraria mirifica phytoestrogens improve dyslipidemia in postmenopausal women probably by activating estrogen receptor subtypes. Tohoku J Exp Med. 2008 Dec;216(4):341-51. doi:10.1620/tjem.216.341

Kittivanichkul D, Charoenphandhu N, Khemawoot P, Malaivijitnond S. Pueraria mirifica alleviates cortical bone loss in naturally menopausal monkeys. J Endocrinol. 2016;231(2):121-33. doi:10.1530/JOE-16-0277

Manonai J, Chittacharoen A, Theppisai U, et al. Effect of Pueraria mirifica on vaginal health. Menopause. 2007 Sep-Oct;14(5):919-24. doi:10.1097/gme.0b013e3180399486

Lamlertkittikul S, Chandeying V. Efficacy and safety of Pueraria mirifica (Kwao Kruea Khao) for the treatment of vasomotor symptoms in perimenopausal women: Phase II Study. J Med Assoc Thai. 2004 Jan;87(1):33-40.PMID: 14971532

Tiyasatkulkovit W, Malaivijitnond S, Charoenphandhu N, Havill LM, Ford AL, Vandeberg JL. Pueraria mirifica extract and puerarin enhance proliferation and expression of alkaline phosphatase and type I collagen in primary baboon osteoblasts. Phytomedicine. 2014;21(12):1498-503. doi:10.1016/j.phymed.2014.06.019

Kakehashi A, Yoshida M, Tago Y. et al. Pueraria mirifica exerts estrogenic effects in the mammary gland and uterus and promotes mammary carcinogenesis in Donryu rats. Toxins (Basel). 2016 Nov;8(11):275. doi:10.3390/toxins8110275

Malaivijitnond S. Medical applications of phytoestrogens from the Thai herb Pueraria mirifica. Front Med. 2012;6(1):8-21. doi:10.1007/s11684-012-0184-8

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