Mushrooms for Menopause: The Lion's Mane and Enoki Trials

Only one randomized trial has directly studied a mushroom in women with menopausal symptoms. That small four-week lion's mane study reported menopause, depression, sleep, and complaints scores. None of the overall measures differed significantly from placebo.

The separate enoki trial in men cannot show a benefit for menopause in women.

Only one randomized trial has directly tested a mushroom in women with menopause symptoms, and its result was weak. That small lion's mane trial reported four outcome measures: a menopause index, a depression scale, a sleep index and a complaints index. No overall outcome differed significantly between the lion's mane and placebo groups. The separate enoki study in men answers a different clinical question.

What can the two mushroom trials answer?

Lists of mushrooms for menopause usually name several species. The human research behind them comes down to two trials, and the people in those trials are very different.

Before reading the results, separate a result that is absent from a result that is negative or inconclusive. The 2010 lion's mane paper contains Kupperman Menopausal Index and Pittsburgh Sleep Quality Index results. Both failed to show a significant difference between groups.

The Kupperman Menopausal Index rolls several symptoms, including hot flashes, into one weighted score. The paper reported that composite score but no separate hot flash outcome, so a composite result is not a hot flash result. Neither trial tested whether a mushroom changes estrogen or progesterone in women. The enoki trial measured testosterone in men, which cannot show a hormone effect in women going through menopause.

Inside the Lion's Mane Cookie Trial

The 2010 lion's mane paper is that one randomized trial in women with menopause complaints. Reading its tables changes the conclusion, though it does not turn the study into positive evidence.

Researchers assigned thirty women to eat four cookies each day for four weeks. The treatment cookies held a total of 2 grams of lion's mane fruiting body powder per day, and the comparison cookies held no lion's mane. The researchers left four participants out of the analysis. So the reported results covered 12 women in the lion's mane group and 14 in the placebo group, and neither group reached 15 analyzed participants.

The paper reported results for every named instrument.

Each of those lines turns on the gap between a within-group change and a between-group difference. Lower scores after four weeks show that a group changed. They do not show that the ingredient caused the change when the placebo group also changed.

Single items within the Indefinite Complaints Index got their own comparison as well. Palpitations and an item translated as lack of motivation scored lower in the lion's mane group than in the placebo group. Three other items showed nonsignificant trends.

These item-level findings are exploratory, since they came from a 40-item instrument and a final sample of 26 people. Confirming them would take a larger trial built around a prespecified outcome.

• All four outcome measures were reported
• No overall measure differed significantly between groups
• The KMI result does not isolate hot flashes
• Two individual ICI items favored lion's mane
• The final analysis included 12 women on lion's mane and 14 on placebo

This study does not prove that lion's mane has no effect, because its size and four-week length leave wide uncertainty. It also gives no reliable evidence that lion's mane relieves hot flashes or menopausal symptoms. The broader lion's mane evidence belongs in its own review. On this question, the honest conclusion is narrower than the claims built from the paper.

The Enoki Trial in Men

The second randomized trial used the phrase male menopausal symptoms, but it enrolled men aged 40 and older. That label refers to age-related symptoms and possible late-onset hypogonadism, and it does not describe the menopause transition in women.

Fifty-five men finished the enoki extract trial, with 28 taking the extract and 27 taking placebo for 12 weeks. The main analysis found no significant difference in the total Aging Males' Symptoms score or in its psychological, physical, and sexual subscales across the full group.

Follow-up comparisons did show signals. The sexual subscale differed in a subgroup with borderline low free testosterone. In a cumulative responder comparison the extract came out ahead, and more men crossed a chosen threshold for increased total testosterone.

These findings may justify further study in men. They do not show an effect in women. Results in men do not transfer to women just because the word menopause appears in both labels.

The study material differs as well, since this trial used a processed extract standardized for adenosine. Eating enoki or taking an unspecified mushroom powder is a different thing.

What do the placebo figures mean?

Personal improvement can be real while its cause stays uncertain. The 2023 meta-analysis of paroxetine trials shows that problem by separating average responses in six placebo-controlled trials for hot flashes and night sweats.

The authors calculated how much of the average improvement in the treatment groups also appeared in the placebo groups. In their analysis, the drug-specific share was at most 21 percent for hot flash frequency and 32 percent for severity. Those percentages are ratios of group averages. They do not mean 79 percent of women improved because of placebo. They also cannot tell what would have happened to one particular person.

Nor can anyone copy them from paroxetine trials onto a mushroom supplement. What they offer here is a lesson in method. When symptoms improve in both treatment and placebo groups, your own before-and-after experience has no control to compare against. It cannot separate an ingredient effect from expectation, trial attention, symptom swings, or regression toward a more typical week.

• Expectation can change how symptoms are perceived and reported
• Regular recording changes what a participant notices
• People often begin a treatment during a particularly difficult period
• Symptoms and sleep can change during a trial for reasons unrelated to the product

Testimonials can describe an honest improvement. Without a comparison group, they cannot measure the difference the product made. The depression and complaints scores in the lion's mane trial raise a separate question. Mood and anxiety outcomes need their own evidence, and these scores do not support an anxiety treatment recommendation.

Short Personal Tests and Symptom Duration

Hot flashes and night sweats often last much longer than a supplement experiment. The Study of Women's Health Across the Nation followed 3,302 women and analyzed 1,449 who reported frequent hot flashes or night sweats.

These are group medians and not a forecast for an individual. The study also asked about symptoms over the previous two weeks at annual visits, so it may have missed some changes between visits.

The duration finding still changes the decision. Four weeks covers only a small part of a course that commonly lasts years. Sleep, stress, medication, temperature, and the symptoms themselves can all vary inside that window.

Short-term improvement cannot identify its own cause. Daily records can show how often symptoms come, how bad they are, and when. Without a control condition, they cannot show that a supplement produced the change.

Evidence-Based Menopause Care

Weak mushroom evidence does not mean effective care is out of reach. Clinical guidelines judge treatments on a much larger evidence base than the two mushroom trials.

The Menopause Society's 2023 position statement says hormone therapy remains the most effective treatment for vasomotor symptoms. It also lists nonhormonal options that have evidence behind them. It does not recommend supplements or herbal remedies for these symptoms, because their evidence remains thin or inconsistent.

That guidance does not pick a treatment for you. Several facts can shift the balance of benefits and risks. They include your age, time since your final period, whether you have a uterus, heart and cancer history, other conditions, and current medicines. Your clinician needs the whole history to match an option to you, and the mushroom studies cannot supply it.

• Which symptoms are present, how often they occur, and how much they disrupt sleep or work
• When the symptoms began in relation to the final menstrual period
• Personal and family medical history
• Every prescription, over-the-counter medicine, and supplement currently taken
• Which outcome would count as a meaningful improvement

Even a small benefit in a controlled drug trial differs from an untested product claim for that reason. Randomized comparisons estimate an added effect, and product testimonials do not.

What should you do with this evidence?

No mushroom has convincing clinical evidence for relieving hot flashes, night sweats, or the wider set of menopause symptoms in women.

If symptoms are affecting your sleep, work, or daily life, bring your record to a clinician and discuss evidence-based options. The record describes the problem and gives a baseline, and your clinical history shows which options fit and which do not.

If you already take a mushroom supplement and tolerate it, nothing in these two trials points to an emergency. The product still belongs on the medicine list you share with whoever manages your prescribed treatment. Some species carry documented side effects and interactions.

The study material counts here too. Lion's mane powder baked into cookies and a standardized enoki extract are different products. Neither trial tested an ordinary serving of mushrooms as treatment.