Background: Improvements in both health and welfare in Indonesia have increased the life expectancy; thus, the number of women who experience menopause period would be increasing. Menopause symptoms resulting from estrogen deficiency often cause problems, such as menstrual cycle changes, hot flushes, dyspareunia, urethritis, incontinence, urgency, frequent micturition, insomnia, or sexual dysfunction. This symptom happened since perimenopause age. Phytoestrogens and their metabolites, equol, binds to estrogen receptors and induce biological effects resembling estrogen. The most important content of phytoestrogens is isoflavones. Isoflavones could be found in foods or drinks that contain soya (soybeans), such as tofu. Equol, a bacterial metabolite, and the only hormonally active daidzein metabolite is a good predictor to determine the degree of menopause symptoms. This was an experimental study with pre and post design. Aim: The aim of this study was to determine the effect of regular tofu consumption for three months on the symptoms of menopause and excreted human urinary equol level. Subjects were perimenopause women (n = 25) that were interviewed using questionnaire guidance of menopause rating scale (MRS). Urine samples were analyzed using high-performance liquid chromatography (HPLC). Results The result showed that regular tofu consumption significantly affected menopause symptoms and equol level (p value <0.05). Method: This was an experimental study with pre- and post- design. Subjects were perimenopause women (n = 25) that were interviewed using questionnaire guidance of menopause rating scale (MRS). Urine samples were analyzed using high performance liquid chromatography (HPLC). Conclusion: Research concluded there was a decrease in the degree of menopause symptoms and increased equol level in perimenopause women after consuming tofu regularly for 3 months. Clinical significance: Results can be an alternative choice besides hormonal drugs that we used regularly to decrease menopause symptoms.