Menopausal symptoms, such as hot flushes and night sweats, significantly impact the quality of life for women. These, also called, vasomotor symptoms (VMS) are a consequence of the natural decline and dysregulation of the body’s own oestrogen. While hormone therapy is the standard treatment for VMS, it is associated with an increased risk of cancers. Isoflavones, phytoestrogens that selectively interact with human oestrogen receptors, offer a potential alternative. The selective nature of isoflavones, like those from Red Clover (RC), can provide beneficial effects while minimizing cancer risks. These extracts have shown an even greater efficacy if isoflavones undergo fermentation processes. While recent clinical trials of RC for VMS have shown promising results, some of the challenges around research into VMS have been that they are primarily based on subjective experiences. Hence this study also employed hot flush analysis technology to generate objective data, besides blood samples, blood pressure readings, and subjective questionnaires. This randomised, double-blind, placebo control trial assessed the effect of bioavailable RC-derived isoflavones and probiotics in peri-menopausal women experiencing daily VMS. The participants received twice-daily 34 mg/d isoflavones and probiotics or a placebo for 12 weeks. The data from 59 participants was analysed for the results. This indicated that moderate doses of isoflavones from RC and probiotics, effectively reduce both physiological and reported menopausal symptoms. The authors observed discrepancies between physiological and reported measures, which may have been due to reporting biases and missing data in self-reports. Interestingly, both the placebo and treatment groups showed improved symptoms, highlighting the prevalence of the placebo effect in menopausal women and underscoring the challenges associated with self-report measures in menopausal research. Their isoflavones did not exhibit any effect on lowering blood pressure, which confirmed previous research that dietary isoflavones may only impact hypertensive people but not those with normal blood pressure. Isoflavones also did not impact blood lipids. The study highlights the importance of developing and implementing objective assessment methods for interventions targeting menopausal VMS, acknowledging the influence of the prevalent placebo effect. And further demonstrated that well-formulated probiotic isoflavone compounds can be a helpful tool in reducing VMS, with minimal side effects.