Pueraria mirifica Airy Shaw & Suvat. is a tuberous leguminous herb native to northern Thailand and Myanmar. It has long been used in traditional Thai medicine for its purported rejuvenative properties and high phytoestrogen content (Airy Shaw & Suvatabandhu, 1952; Cherdshewasart et al., 2008). Modern research has sought to elucidate the active compounds, mechanisms of action, health benefits, and safety profile of P. mirifica, especially in relation to estrogen-deficiency states, bone metabolism, lipid regulation, and vascular function (Laupattarakasem et al., 2009; Turner et al., 2020). This review summarises key findings, discusses biological plausibility, and highlights unresolved issues.
Phytochemistry & Mechanisms of Action
P. mirifica contains a complex mixture of isoflavones, coumestans, and unique phytoestrogens such as miroestrol and deoxymiroestrol (Cherdshewasart et al., 2008). These compounds bind to estrogen receptors (ERα and ERβ) and may exert estrogen-like or modulatory effects on multiple tissues (Cherdshewasart et al., 2008). In vitro and animal studies indicate that P. mirifica extracts can modulate gene expression related to bone turnover, lipid metabolism, oxidative stress, and vascular endothelial function (Turner et al., 2020). However, human pharmacokinetic data remains very limited, and dose–response relationships are not well established.
Health Effects: Evidence Summary
Bone Metabolism
In a 24-week randomized, double-blind, placebo-controlled trial of healthy post-menopausal women (n = 71; doses 20–50 mg/day), P. mirifica significantly reduced bone-specific alkaline phosphatase compared to placebo, suggesting reduced bone turnover; endometrial and breast parameters showed no proliferative change (Muangman & Cherdshewasart, 2001; see Laupattarakasem et al., 2009).
Lipid and Vascular Effects
In a trial among post-menopausal women, daily P. mirifica supplementation increased HDL cholesterol by 34 % and reduced LDL by 17 % after two months (Healthline summary; Turner et al., 2020). Animal studies suggest improved arterial function (Turner et al., 2020).
Estrogen-Deficiency Symptoms & Reproductive Tissues
Early human pilot studies in menopausal women found improvement in vasomotor, skin, and urogenital symptoms using P. mirifica 50–100 mg/day (Restorative Medicine review; Saunders et al., 2011). Yet a systematic review concluded efficacy remains inconclusive due to methodological limitations (Efficacy & Safety review, 2018).
Safety and Adverse Effects
Although short-term trials report good tolerability, concerns remain. A case report described severe hypertriglyceridemia and necrotising pancreatitis associated with unsupervised P. mirifica use in a transgender individual (Tobolsky et al., 2023). High-dose and long-term estrogen-like activity may carry risks, and regulatory alerts exist (Nagoya Consumer Affairs Center, Japan; Turner et al., 2020).
Discussion
The available evidence indicates that P. mirifica has a plausible mechanistic basis for influencing endocrine, skeletal, lipid, and vascular systems. However, human data are limited in scale and duration; standardised extract formulations and long-term safety studies are lacking (Efficacy & Safety review, 2018). Clinicians and consumers should apply caution, especially in populations with hormone-sensitive conditions. Permissible use may be as a complementary agent within a broader lifestyle framework rather than a monotherapy.
Conclusion
Pueraria mirifica is a scientifically interesting botanical herb with demonstrated biological activity, but its clinical utility remains to be fully validated. Until larger, rigorous trials are available, usage should be approached conservatively with adequate monitoring and consideration of individual risk profiles.
References
Cherdshewasart, W., et al. (2008). Medical applications of phytoestrogens from the Thai herb Pueraria mirifica. Frontiers in Pharmacology, 4, Article 112. https://doi.org/10.3389/fphar.2012.00112
Laupattarakasem, P., Prachaney, P., Navasumrit, P., et al. (2009). Pueraria mirifica phytoestrogens improve dyslipidaemia in post-menopausal women probably by activating estrogen receptor subtypes. Clinical Interventions in Aging, 4, 543-552.
Muangman, Y., & Cherdshewasart, W. (2001). Clinical trial of the phytoestrogen-rich herb, Pueraria mirifica as a crude drug in the treatment of symptoms in menopausal women. Siriraj Medical Journal, 53(5).
Turner, J., et al. (2020). A comprehensive review on Pueraria: Insights on its chemistry and health-benefits. Fitoterapia, 147, 104799. https://doi.org/10.1016/j.fitote.2020.104799
Tobolsky, S., Hayes, F. J., & Lo, J. (2023). The aftermath of Pueraria mirifica: A case of hypertriglyceridemia and necrotizing pancreatitis in a non-binary individual with surreptitious use of oral estrogenic compounds. Journal of the Endocrine Society, 7(Supplement 1), bvad114.2072. https://doi.org/10.1210/jendso/bvad114.2072
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