A new study published in Menopause evaluated the effect of isoflavone administration, either in conjunction with probiotic use or otherwise, on the symptoms of genitourinary syndrome of menopause, and compared its effects with those of hormone therapy. This was a randomized clinical trial conducted on 60 postmenopausal women aged 40-60 years, randomly assigned to receive oral isoflavone (150 mg dry extract of glycine max) alone or isoflavone plus probiotic (Lactobacillus acidophilus, Lactobacillus casei, Lactococcus lactis, Bifidobacterium bifidum, and Bifidobacterium lactis) or hormone therapy (1 mg estradiol and 0.5 mg norethisterone acetate). The urogenital symptom subscale of the Menopause Rating Scale and International Consultation on Incontinence Questionnaire-Short Form, were used to assess genitourinary symptoms. Vaginal maturation value, pH, vaginal health score, and vaginal flora were used to evaluate vaginal atrophy. Equol, equol intermediate, O-dimethylangolensin, and aglycones were measured. It was observed that after 16 weeks of treatment, urogenital symptoms, mainly vaginal dryness and sexual problems, improved significantly in the hormone therapy group. Meanwhile, there was a significant increase in the daidzein, glycitein, equol intermediate, and O-dimethylangolensin contents after 16 weeks in the isoflavone plus probiotic group. While maturation value, vaginal pH, and vaginal flora improved in the hormone therapy group. The vaginal health score increased in both, isoflavone and hormone therapy groups. Therefore, it was concluded that probiotics improve the metabolism of isoflavones after 16 weeks of treatment. However, the increase in contents of isoflavones and their metabolites fail to yield an estrogenic effect on the urogenital tract and relieve vulvovaginal symptoms.