Bee Pollen for Hot Flashes

Bee pollen has not been shown to ease hot flashes. The only trial of bee pollen itself enrolled 46 women with breast cancer taking tamoxifen or an aromatase inhibitor. Each took a tablespoon a day of a pollen-honey mixture and, in a separate phase, of pure honey, for 14 days each. About 71% reported an improvement in their menopausal symptoms on the pollen mix and 68% on honey, a difference that was not significant; the trial scored symptoms overall and did not report hot flashes separately, and only 31 women completed both phases [1].

Most of the research that turns up for "pollen for hot flashes" is about something else: purified pollen extracts sold under names such as Relizen, Sérélys, Femal and PureCyTonin. A review of the apitherapy literature pointed out that these trials did not test bee-collected pollen but extracts of pollen from wind-pollinated plants [2]. One 2005 placebo-controlled trial of such an extract reported fewer hot flushes [3], but a 2024 meta-analysis found the benefit was no longer significant when only controlled studies were pooled [4], and the North American Menopause Society does not recommend pollen extract for hot flashes [5].

Bee pollen is the flower pollen honeybees pack into pellets, so what it contains depends on the plants the bees visited. In one analysis every sample was rich in olive-family (Oleaceae) pollen [6]; the pollen behind a case of anaphylaxis came from Japanese hop, chrysanthemum, ragweed and dandelion [7].

No study has shown a mechanism by which bee pollen would reduce hot flashes. In the crossover trial, honey, which was meant to be the placebo, produced similar effects to the pollen mix [1], so the trial cannot attribute any improvement to the pollen.

The purified extracts are standardised blends: the one tested for drug interactions is 75% pollen/pistil extract and 25% pollen extract [8]. They do not act like oestrogen. Femal's extract contained only low, subeffective amounts of plant oestrogens (phytoestrogens), and a high dose of 500 mg/kg a day caused no uterine growth in immature rats [9].

Showing that the extract is non-oestrogenic does not show that it reduces hot flashes, and none of this laboratory work used bee pollen granules. The pooled clinical data suggest much of the improvement seen in uncontrolled extract studies may have been a placebo effect [4].

There is no evidence-based dose of bee pollen for hot flashes. The only trial gave a tablespoon a day of a pollen-honey mixture for 14 days [1]. A third of the women (15 of 46) did not finish both phases, and the main reason given was distaste for the pollen [1].

The extract trials used fixed commercial products: two Femal tablets each morning for 3 months [3], and in an open study 160 mg of the Sérélys extract twice a day with 5 mg of vitamin E for 3 months [10]. Bee pollen granules or capsules are a different product from these extracts [2], so the doses do not translate.

German researchers randomised 46 women with breast cancer on tamoxifen or an aromatase inhibitor, all with severe menopausal complaints, to a pollen-honey mixture or pure honey (as placebo) in a crossover trial. Each phase lasted 14 days, with at least 14 days between them, and symptoms were scored on the Menopause Rating Scale (MRS) questionnaire [1].

Improvement in menopausal symptoms was reported by 70.9% (22 of 31) on pollen and 68.3% (28 of 41) on honey, which was not a significant difference; the paper reports overall symptom scores, not a separate hot-flash count. Complaints fell on both, apart from honey on the psychological subscale, which narrowly missed significance (P = 0.052), and any improvement appeared within 3-4 days. The authors noted that both improvements exceeded the placebo effect of about 25% usually seen in this setting, but this trial had no inactive placebo, ran for only two weeks per phase and lost a third of its participants [1].

In a double-blind trial, 64 menopausal women were randomised to Femal or placebo for 3 months, and 54 completed it. 65% responded with fewer hot flushes on the extract compared with 38% on placebo (p < 0.006), and hot flushes recorded in diaries fell by 27% more than on placebo (p < 0.026) [3].

A 2024 double-blind trial in Italy randomised 39 breast cancer survivors (19 to PureCyTonin, 20 to placebo) for 3 months. The extract group had fewer hot flashes at 3 months than at the start (p = 0.02); the abstract does not report a between-group comparison for that count [11]. An open study of 104 women without a control group reported hot flashes 48.5% lower after 12 weeks [10].

A 2024 meta-analysis found five eligible studies of purified pollen extract (one randomised trial and four observational studies, 420 women). Pooled from baseline to 3 months, hot flashes improved (standardised mean difference -1.66, P < 0.00001), but when the controlled studies were pooled the results were no longer statistically significant. The authors concluded that improvements in uncontrolled studies may have been due to the placebo effect, and that the extract was not associated with significant adverse effects [4].

The North American Menopause Society's 2023 position statement reviewed the same trials and concluded that, based on expert opinion and limited research, pollen extract is not recommended for hot flashes (Level III) [5].

Hormone therapy remains the most effective treatment for hot flashes and should be considered by women within 10 years of their final period [5]. For women who cannot take it, for example after an oestrogen-dependent cancer, or who prefer not to, the society recommends cognitive behavioural therapy, clinical hypnosis, SSRIs or SNRIs, gabapentin and fezolinetant (Level I), and oxybutynin (Levels I-II) [5]. If you take tamoxifen, the society warns that some SSRIs, particularly paroxetine and fluoxetine, can inhibit CYP2D6, the enzyme that converts tamoxifen to its most active form, and lists venlafaxine, desvenlafaxine, escitalopram or citalopram as safer choices [5].

The hot flashes page compares the supplements studied for this symptom, and the menopause page covers the wider transition.

No trial has compared bee pollen granules with an inactive placebo, and the only bee pollen trial ran for 14 days per phase [1]. The controlled extract trials enrolled 39 to 64 women and lasted 3 months [3][11]. No trial has compared either product with an established hot-flash treatment, which a review of apitherapy for menopause called for [2].

Allergy is the main risk. A 40-year-old man with seasonal hay fever developed hives, facial swelling, breathlessness, vomiting and diarrhoea an hour after one tablespoon of bee pollen, and recovered after epinephrine [7]. In a skin-test study of 202 volunteers, people with airborne pollen allergy reacted strongly to bee pollen extracts while non-allergic people did not [6].

The menopause trial excluded anyone allergic to pollen or honey and reported minor complaints on pollen: prickling of the lips and mouth in three women (a complaint not seen on honey), exhaustion and increased aggressiveness in two each, and itching of the face and limbs, a hot flush on taking it, flatulence and dizziness in one each, among others [1]. It also excluded pregnant women [1]. For the purified extracts, the meta-analysis found no significant adverse effects [4], and the 2024 trial in breast cancer survivors described the extract as well tolerated [11].

The one documented interaction is with warfarin. A 71-year-old man's INR (a measure of how long blood takes to clot) rose to 7.1, against a target range of 2.0-3.0, a month after he began a teaspoon of bee pollen granules twice a day; the case was rated a probable interaction [12].

For women on tamoxifen, a laboratory test in human liver microsomes found that purified pollen extract did not inhibit CYP2D6, a liver enzyme that converts tamoxifen to its metabolites and that SSRIs strongly inhibit [8]. That test used the extract, not bee pollen, and was not done in patients.