phytoestrogens and Hot-Flashes

Based on their nutrient composition, soybeans and related foods have been considered to be nutritious and healthy for humans. Particularly, the biological activity and subsequent benefits of soy products may be associated with the presence of isoflavone in soybeans. As an alternative treatment for menopause-related symptoms, isoflavone has gained much popularity for postmenopausal women who have concerns related to undergoing hormone replacement therapy. However, current research has still not reached a consensus on the effects of isoflavone on humans. This overview is a summary of the current literature about the processing of soybeans and isoflavone types (daidzein, genistein, and S-equol) and supplements and their extraction and analysis as well as information about the utilization of isoflavones in soybeans. The processes of preparation (cleaning, drying, crushing and dehulling) and extraction of soybeans are implemented to produce refined soy oil, soy lecithin, free fatty acids, glycerol and soybean meal. The remaining components consist of inorganic constituents (minerals) and the minor components of biologically interesting small molecules. Regarding the preventive effects on diseases or cancers, a higher intake of isoflavones is associated with a moderately lower risk of developing coronary heart disease. It may also reduce the risks of breast and colorectal cancer as well as the incidence of breast cancer recurrence. Consumption of isoflavones or soy foods is associated with reduced risks of endometrial and bladder cancer. Regarding the therapeutic effects on menopausal syndrome or other diseases, isoflavones have been found to alleviate vasomotor syndromes even after considering placebo effects, reduce bone loss in the spine and ameliorate hypertension and in vitro glycemic control. They may also alleviate depressive symptoms during pregnancy. On the other hand, isoflavones have not shown definitive effects regarding improving cognition and urogenital symptoms. Because of lacking standardization in the study designs, such as the ingredients and doses of isoflavones and the durations and outcomes of trials, it currently remains difficult to draw overall conclusions for all aspects of isoflavones. These limitations warrant further investigations of isoflavone use for women's health.

Topics: Animals; Chemical Fractionation; Dietary Supplements; Drug Evaluation, Preclinical; Glycine max; Hot Flashes; Humans; Isoflavones; Menopause; Metabolic Networks and Pathways; Phytoestrogens; Plant Extracts; Spectrum Analysis; Structure-Activity Relationship; Syndrome

The menopausal transition, or perimenopause, is characterized by menstrual irregularities, vasomotor symptoms, sleep disturbances, mood symptoms, and urogenital tract atrophy. These changes can also affect the quality of life and one's self-esteem. Hormone replacement therapy (HRT) is considered the best option to achieve therapeutic relief of different menopausal symptoms but is usually restricted to moderate or severe symptoms. Moreover, many women refuse HRT for a variety of reasons concerning the fear of cancer and other adverse effects. According to these considerations, new topics are emerging: Dissatisfaction with drug costs and conventional healthcare, desire for personalized medicines, and the public perception that "natural is good". In this context, nonhormonal therapies are mostly evolving, and it is not unusual that women often request a "natural" approach for their symptoms. The aim of this study is to investigate nonhormonal therapies that have been identified to reduce the menopausal symptoms.

Topics: Contraindications, Drug; Dietary Supplements; Hormone Replacement Therapy; Hot Flashes; Humans; Menopause; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy; Sleep Wake Disorders; Vitamins

Serotonin reuptake inhibitors, clonidine, gabapentin and pregabalin have shown moderate efficacy in menopausal disorders. The effect of phytoestrogens is reported to be modest, but the side effects are not well known.

Topics: Acupuncture Therapy; Clonidine; Complementary Therapies; Female; Gabapentin; Hot Flashes; Humans; Hypertension; Menopause; Panax; Phytoestrogens; Pregabalin; Selective Serotonin Reuptake Inhibitors; Vasomotor System

Phytoestrogens have recently been claimed to positively influence menopausal discomforts, including hot flashes. However, little is known about the influence of phytoestrogens on core body temperature during oestrogen fluctuation at menopause.. Previously published findings showed that phytoestrogens could relieve menopausal complaints, thus, the present review was aimed at assessing the effects of phytoestrogens on thermoregulatory mechanism during menopausal transition.. The molecular mechanisms underlying hot flashes are complex. Oestrogen fluctuations cause hypothalamic thermoregulatory centre dysfunction, which leads to hot flashes during menopause. The phytoestrogens of interest, in relation to human health, include isoflavones, lignans, coumestans, and stilbenes, which are widely distributed in nature. The phytoestrogens are capable of reducing hot flashes via their oestrogen-like hormone actions. The potential effects of phytoestrogens on hot flashes and their molecular mechanisms of action on thermoregulatory centre are discussed in this review.. The effects of phytoestrogens on these mechanisms may help explain their beneficial effects in alleviating hot flashes and other menopausal discomforts.

Topics: Body Temperature Regulation; Female; Hot Flashes; Humans; Menopause; Phytoestrogens

Soy isoflavones may benefit some, but not all, menopausal women, and the ability of the women to produce equol may be the major determinant of effectiveness. We assessed the efficacy of soy isoflavones and equol for alleviating menopausal symptoms, especially vasomotor symptoms, in postmenopausal women who were equol producers and nonproducers by using systematic review and meta-analysis of randomized clinical trials (RCTs). We searched 12 English, Korean, and Chinese language scientific and medical databases. We selected all available RCTs that assessed the effect of equol, either equol itself or soy isoflavone in equol producers, on menopausal symptoms in peri- or postmenopausal women. The primary outcome was the effect on hot flashes. The severity of hot flashes was determined by the scores, and sensitivity and risk of bias analyses were conducted. Other outcomes of the review, but not meta-analysis, included depression and adverse events. Six studies (779 total subjects) met all criteria for the systematic review, 5 of those could be included in the meta-analysis (728 total subjects). Two studies included in the meta-analysis reported no statistically significant benefits of equol; the other three did report significant benefits of equol. Meta-analysis revealed a significant benefit of equol for lowering hot flash scores and revealed a generally low risk of bias. In conclusion, this study found that supplementing equol to equol nonproducers significantly lowered the incidence and/or severity of hot flashes in menopausal women.

Topics: Adult; Aged; Dietary Supplements; Equol; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Phytotherapy; Plant Extracts; Postmenopause

This systematic review and meta-analysis aimed to critically evaluate the effectiveness of phytoestrogens on sexual disorders and severity of dyspareunia.. Relevant studies were identified through a systematic search of major databases such as PubMed, Cochrane Library, ISI Web of Science, and Scopus up to 29 September 2017, without any time limit. Two independent reviewers screened all abstracts and full-text articles. The final version of Jadad scale was used for evaluating the quality of trials.. Soy did not have an effect on sexual function (standardized mean difference [SMD] = 1.099 [95% CI: -3.033 to 0.835, p = 0.265]; heterogeneity I. Phytoestrogens have various effects on sexual function. Published reports show that maritime pine bark, T. foenum-graecum L., and F. vulgare could be considered as agents to overcome sexual dysfunctions while soy, red clover, genistein, and flaxseed had no promising effects on these conditions.

Topics: Dyspareunia; Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Plant Preparations; Plants, Medicinal; Randomized Controlled Trials as Topic; Sexual Dysfunction, Physiological

Complementary and alternative medicine (CAM) treatments have been used for thousands of years around the world. There has been increased interest in utilizing CAM for menopausal symptoms since the release of results of the Women's Health Initiative elucidated long-term adverse effects associated with hormone therapy. Women looking for more natural or safer means to treat hot flushes, night sweats, and other menopausal symptoms often turn to CAM such as yoga, phytoestrogens, or black cohosh. Yet there have been few well-conducted studies looking at the efficacy of these treatments. This review examines randomized clinical trials, systematic reviews, and meta-analyses evaluating the effectiveness of commonly used CAM for the treatment of menopausal symptoms.

Topics: Cimicifuga; Complementary Therapies; Exercise Movement Techniques; Female; Hot Flashes; Humans; Menopause; Phytoestrogens; Phytotherapy; Plant Extracts; Yoga

The pharmacodynamics of phytoestrogens representing nonsteroidal compounds of plant origin with variable affinity to estrogen receptor subtypes has been studied. Clinical and experimental data on the mechanisms of action of phytoestrogens of the isoflavone and lignan classes are presented and their effects ca- pable of reducing the risk of cardiovascular disease development in women with climacteric syndrome and in experimental hypoestrogenemia are considered.

Topics: Cardiovascular Diseases; Endothelium, Vascular; Female; Gene Expression; Hemorheology; Hot Flashes; Humans; Isoflavones; Lignans; Middle Aged; Phytoestrogens; Postmenopause; Receptors, Estrogen

Menopause is for many females associated with an occurrence of a variety of health complaints and a decrease in quality in life. Hot flashes, sleep disturbances and a variety of other symptoms result in a strong psychological strain. Hormone replacement therapy for treatment of climacteric complaints is discussed controversially regarding associated side effects. This is a major reason to propose treatment with plant derived extracts and compounds as an alternative. Such compounds are available either as drugs but mostly as nutritional supplements. Here we have to distinguish between so-called phytoestrogens which are postulated to act via estrogen receptors such as hop extracts, soy extracts, pomegranate extracts and red clover extracts. A second group of compounds addresses postmenopausal complaints independent of estrogen receptors. This group includes yams, actaea racemosa, agnus castus, rhei radix extracts and spinach extracts. For none of the mentioned substances and extracts could a clear proven effectiveness for the treatment of postmenopausal complaints be demonstrated. In contrast, for some of the mentioned substances, for example isoflavones, there are concerns regarding side effects and safety. The free availability of such nutritional supplements results in an uncontrolled consumption. Different products were combined and consumed in doses far higher than recommend by the manufacturers.

Topics: Administration, Oral; Dietary Supplements; Evidence-Based Medicine; Female; Hot Flashes; Humans; Menopause; Phytoestrogens; Risk Assessment; Sleep Wake Disorders; Treatment Outcome

Isoflavones (IFs) from soy and other legumes have weak estrogenic properties. Isolated IFs are available as dietary supplements and advertised to alleviate symptoms of menopause. The present chapter provides an overview of the occurrence, the chemical structure of IFs and their metabolites, the market situation and reviews the current evidence on the efficacy and safety of IF-containing dietary supplements.The biological effectiveness of IFs is attributable to the activation of the estrogen receptor (ER). Studies on the influence of IFs on endogenous estrogen levels in women show inconsistent results. So far, the European Food Safety Authority (EFSA) has rejected all submitted health claims for IFs due to insufficient scientific evidence for any of the postulated health effects. Based on the results of their recent risk assessment, the EFSA concluded that the available human studies did not support the hypothesis of adverse effects of isolated IFs on the human mammary gland, uterus or thyroid in healthy postmenopausal women. However, the assessment does not allow a general statement on the safety of IF-containing dietary supplements. Studies in animal models are often not comparable with the complex interactions in humans due to differences in the metabolism of IFs, in the developmental stage at time of consumption and in the temporarily restricted uptake of IFs during certain stages of life.. So far, for none of the advertised functions is unequivocal scientific evidence available. On the basis of available data, potential unwanted side effects cannot be fully excluded. This holds particularly true for women with undiagnosed diseases, especially for those with undetected precancerous lesions in the mammary gland.

Topics: Dietary Supplements; Evidence-Based Medicine; Female; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Treatment Outcome

Menopause is a critical stage in every woman's life. It can cause a distressing time for women by creating various vasomotor symptoms (VMS). Phytoestrogens can potentially exert various favourable effects and alleviate VMS in postmenopausal women. The hop (Humulus lupulus L.) contains 8-prenylnaringenin (8-PN), the most potent phytoestrogen known to date. The hop is eight times stronger than any other herbal oestrogens. This study aims to conduct a comprehensive systematic review and a meta-analysis survey of the effects of hop in the management of VMS in postmenopausal women.. Only randomised controlled clinical trials, with cluster randomisation and crossover, blinded and non-blinded designs, conducted between 2000 and 2015, will be included in this review. Quasi-experimental and observational studies as well as case reports will be excluded. The studies will be selected if their participants were aged 40-60 years, had elevated follicle-stimulating hormone (FSH) levels and/or menstrual irregularities, and experienced discomforting VMS (at least hot flashes or night sweats). The primary outcome will be the rate of response to treatment, such as changes in frequency and intensity of symptoms in the intervention and placebo groups. 'Hop', 'Humulus', 'menopause', 'vasomotor', 'hot flashes', 'phytoestrogen' and 'night sweats' will be used as search key words. Prior to their inclusion in the review, the selected papers will be assessed by two independent reviewers for methodological validity. Any disagreements will be resolved through a third reviewer. The risk of bias will be independently determined using the Cochrane Risk of Bias Tool. The quality of the papers will be assessed based on the CONSORT checklist.. Results will be disseminated through traditional academic literature. Dissemination of results will occur by peer-reviewed publications. The results of our project can help reproductive health researchers when evaluating the discomforts of research procedures described in study protocols or when designing a study. Information on experiences of menopausal women involved in previous studies may also help in future research. The expected dissemination actions are effective treatment in designing strategies that aim to develop women's health and healthcare providers when offering treatment for women with vasomotor symptoms.

Topics: Adult; Clinical Protocols; Female; Flavanones; Hot Flashes; Humans; Humulus; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Plant Extracts; Research Design; Sweating; Systematic Reviews as Topic

Between 40% and 50% of women in Western countries use complementary therapies to manage menopausal symptoms.. To determine the association of plant-based therapies with menopausal symptoms, including hot flashes, night sweats, and vaginal dryness.. The electronic databases Ovid MEDLINE, EMBASE, and Cochrane Central were systematically searched to identify eligible studies published before March 27, 2016. Reference lists of the included studies were searched for further identification of relevant studies.. Randomized clinical trials that assessed plant-based therapies and the presence of hot flashes, night sweats, and vaginal dryness.. Data were extracted by 2 independent reviewers using a predesigned data collection form.. Hot flashes, night sweats, and vaginal dryness.. In total, 62 studies were identified, including 6653 individual women. Use of phytoestrogens was associated with a decrease in the number of daily hot flashes (pooled mean difference of changes, -1.31 [95% CI, -2.02 to -0.61]) and vaginal dryness score (pooled mean difference of changes, -0.31 [95% CI, -0.52 to -0.10]) between the treatment groups but not in the number of night sweats (pooled mean difference of changes, -2.14 [95% CI, -5.57 to 1.29]). Individual phytoestrogen interventions such as dietary and supplemental soy isoflavones were associated with improvement in daily hot flashes (pooled mean difference of changes, -0.79 [-1.35 to -0.23]) and vaginal dryness score (pooled mean difference of changes, -0.26 [-0.48 to -0.04]). Several herbal remedies, but not Chinese medicinal herbs, were associated with an overall decrease in the frequency of vasomotor symptoms. There was substantial heterogeneity in quality across the available studies, and 46 (74%) of the included randomized clinical trials demonstrated a high risk of bias within 3 or more areas of study quality.. This meta-analysis of clinical trials suggests that composite and specific phytoestrogen supplementations were associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats. However, because of general suboptimal quality and the heterogeneous nature of the current evidence, further rigorous studies are needed to determine the association of plant-based and natural therapies with menopausal health.

Topics: Complementary Therapies; Female; Hot Flashes; Humans; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Plant Preparations; Sweating; Vaginal Diseases

To perform a meta-analysis examining the efficacy of phytoestrogens for the relief of menopausal symptoms.. Medline, Cochrane, EMBASE, and Google Scholar databases were searched until September 30, 2013 using the following key words: vasomotor symptoms, menopausal symptoms, phytoestrogens, isoflavones, coumestrol, soy, red clover. Inclusion criteria were (1) randomized controlled trial (RCT), (2) perimenopausal or postmenopausal women experiencing menopausal symptoms, (3) intervention with an oral phytoestrogen. Outcome measures included Kupperman index (KI) changes, daily hot flush frequency, and the likelihood of side-effects.. Of 543 potentially relevant studies identified, 15 RCTs meeting the inclusion criteria were included. The mean age of the subjects ranged from 49 to 58.3 and 48 to 60.1 years, respectively, in the placebo and phytoestrogen groups. The number of participants ranged from 30 to 252, and the intervention periods ranged from 3 to 12 months. Meta-analysis of the seven studies that reported KI data indicated no significant treatment effect of phytoestrogen as compared to placebo (pooled mean difference = 6.44, p = 0.110). Meta-analysis of the ten studies that reported hot flush data indicated that phytoestrogens result in a significantly greater reduction in hot flush frequency compared to placebo (pooled mean difference = 0.89, p < 0.005). Meta-analysis of the five studies that reported side-effect data showed no significant difference between the two groups (p = 0.175).. Phytoestrogens appear to reduce the frequency of hot flushes in menopausal women, without serious side-effects.

Topics: Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Placebos; Randomized Controlled Trials as Topic; Treatment Outcome

Worldwide, breast cancer is the most common malignant neoplasm and the second most common cause of cancer death in women. This malignancy is recognized to be estrogen-dependent and due to this feature, hormone replacement therapy is regarded as potentially dangerous in breast cancer survivors who seek relief of their menopausal symptoms. Whereas hot flashes are detected in nearly half of postmenopausal women with a relatively high frequency and severity, botanic sources of estrogens have been proposed as an alternative treatment. Nevertheless, estrogenic properties of these compounds suggest possibility of stimulating cancer recurrence or worsening prognosis in survivors. As well, effects in improving vasomotor climacteric changes is controversial. Many studies have considered the subject, some focusing on efficacy of phytoestrogens for control of menopausal symptoms, and others discussing effects of these compounds on breast cancer outcome in terms of survival or recurrence. The present article is a concise review of the effects of consumption of phytoestrogens on menopausal symptoms, namely hot flashes, and breast cancer recurrence and mortality in survivors of the disease. Overall, the major part of the current existing literature is in favor of positive effects of phytoestrogens on breast cancer prognosis, but the efficacy on menopausal symptoms is probably minimal at the best.

Topics: Breast Neoplasms; Female; Hot Flashes; Humans; Menopause; Phytoestrogens

In postmenopausal women estrogens in combination with progestins have beneficial effects on climacteric complaints and on osteoporosis but this hormone replacement therapy (HRT) bears the risk of increased mammary carcinomas and cardiovascular diseases. Phytoestrogens at low doses have little or no effects on climacteric complaints, at high doses they mimic the effects of estrogens. Therefore other plant derived substances are currently intensively investigated. Extracts of the rhizome of black cohosh (Cimicifuga racemosa=CR) did not bind to estrogen receptors and were shown to be devoid of estrogenic effects on mammary cancer cells in vitro and on mammary gland and uterine histology in ovariectomized rats. In addition in this rat model the special extract CR BNO 1055 inhibited the occurrence of hot flushes and development of osteoporosis. In postmenopausal women CR BNO 1055 reduced major climacteric complaints as effectively as conjugated estrogens and significantly more than placebo. Similar data were published for other European CR preparations whereas 2 US American preparations were ineffective. This was most likely due to the too high doses or due to the adulteration with Asian Cimicifuga preparations. In all European studies neither effects in the uterus nor in mammary glands were observed. The effective compounds in CR are most likely neurotransmitter-mimetic in nature: dopaminergic, noradrenergic, serotoninergic and GABAergic effects were demonstrated and some have been structurally identified. We conclude that CR extracts at low doses are effective to ameliorate climacteric complaints but are devoid of adverse estrogenic effects. These finding strengthens the role of CR extracts as substitutes for HRT. This article is part of a special issue entitled: Special Issue on Phytoestrogens.

Topics: Animals; Cimicifuga; Clinical Trials as Topic; Endometrium; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Mammary Glands, Human; Phytoestrogens; Plant Extracts; Postmenopause

Review controlled clinical trials of isoflavones and amino acid preparation effects on hot flashes and at least one other symptom including mood, sleep, pain, and cognitive function that women report during the menopausal transition and early postmenopause.. An experienced reference librarian searched PubMed/Medline, CINAHL Plus, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, AMED, and Alt-Health Watch for English-language randomized controlled trials between 2004 and July 2011. Seventeen trials of isoflavones and amino acid effects on hot flashes and one additional symptom were identified.. In five trials of soy isoflavone preparations, two (6g soy germ extract and 25 g soy protein in soy nuts) significantly decreased hot flashes, but no other symptoms. In the seven trials of other isoflavones, six significantly reduced hot flashes; in addition, red clover (80 mg) significantly reduced mood symptoms; Rexflavone (350 mg) for women with Kupperman Index>20 significantly reduced sleep symptoms; two trials had significant reductions for pain: isoflavone powder (90 mg) and red clover (80 mg). The only trial in this systematic review that significantly reduced cognitive symptoms was red clover (80 mg). In one trial, red clover isoflavone (80 mg/day) significantly relieved hot flashes, mood, pain, and cognitive symptoms. Amino acids yielded no significant results. Equol supplements of 30 mg/day for non-Equol producing women significantly reduced mood symptoms in one trial. The magnolia bark extract combination significantly reduced hot flashes, mood, and sleep symptoms.. Isoflavone trials yielded significant reductions on hot flashes and co-occurring symptoms during the menopausal transition and postmenopause, but studies require replication with larger sample sizes and attention to measurement of outcomes.

Topics: Affect; Amino Acids; Cognition Disorders; Female; Hot Flashes; Humans; Isoflavones; Menopause; Pain; Phytoestrogens; Postmenopause; Sleep Wake Disorders

Women have always looked for non-hormonal options to alleviate menopausal vasomotor symptoms and prevent menopausal bone loss. The use of complementary and alternative medicine for these purposes has particularly increased after the publication of the Women's Health Initiative's results suggesting that there might be more risks than benefits with hormone replacement. Phytoestrogens are plant-derived estrogens that, although less potent than estradiol, bind to the estrogen receptor and can function as estrogen agonists or antagonists. Soy isoflavones extracted from soy are the phytoestrogens most commonly used by menopausal women. Because typical Western diets are low in phytoestrogens and taking into account the general difficulty in changing dietary habits, most clinical trials in Western women have used isoflavone-fortified foods or isoflavone tablets. Although some women might experience a reduction in the frequency or severity of hot flashes, most studies point towards the lack of effectiveness of isoflavones derived from soy or red clover, even in large doses, in the prevention of hot flashes and menopausal bone loss. This article is part of a Special Issue entitled 'Phytoestrogens'.

Topics: Animals; Diet; Estrogen Replacement Therapy; Female; Guidelines as Topic; Hot Flashes; Humans; Isoflavones; Osteoporosis, Postmenopausal; Phytoestrogens; Randomized Controlled Trials as Topic; Soy Foods

Concerns pertaining to the risk of estrogen exposure through HT have prompted an increase in the use of natural alternatives. Phytoestrogens may provide postmenopausal women with a practical alternative and many women have already begun to utilize phytoestrogen supplements. However, research regarding the efficacy of phytoestrogens as a hormone therapy alternative has been previously pessimistic or questionable at best. This review scrutinizes the most current research regarding the efficacy of three types of phytoestrogens, isoflavones, lignans and coumestans, and their specific effect on the reduction of climacteric symptoms, specifically vasomotor symptoms, vaginal atrophy, insomnia and osteoporosis. A discussion of the research pertaining to the relative safety of each phytoestrogen in terms of breast and endometrial health is also included. Overall, current research demonstrates that phytoestrogens are effective in reducing the intensity of hot flushes, and some phytoestrogen combinations result in a decreased frequency. Certain phytoestrogens have also been shown to decrease vaginal atrophy, improve sleep and cognition, and positively affect bone health. Even though initial research was generally unconvincing, the more recent evidence reviewed here is rather positive. In terms of safety and reports of adverse reactions, trials have not shown an increase in breast cancer risk or increase in endometrial hyperplasia following phytoestrogen use, but trials explicitly designed to find neoplasia have not been reported. Moreover, unlike hormone therapy, lignans may not increase clotting risk in postmenopausal women, thus supplements may serve as a treatment option for patients who have contraindications to hormone therapy. Phytoestrogens may provide a safe and partially effective alternative to HT. However, because research regarding phytoestrogens is relatively new, pharmaco-vigilence is still required, as these products are not yet FDA-approved. This article is part of a Special Issue entitled 'Phytoestrogens'.

Topics: Atrophy; Coumarins; Estrogen Receptor Modulators; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Phytoestrogens; Postmenopause; Vagina; Vasomotor System

Menopausal women suffer from a variety of symptoms, including hot flashes and night sweats, which can affect quality of life. Although it has been the treatment of choice for relieving these symptoms, hormone therapy has been associated with increased breast cancer risk leading many women to search for natural, efficacious, and safe alternatives such as botanical supplements. Data from clinical trials suggesting that botanicals have efficacy for menopausal symptom relief have been controversial, and several mechanisms of action have been proposed including estrogenic, progestogenic, and serotonergic pathways. Plant extracts with potential estrogenic activities include soy, red clover, kudzu, hops, licorice, rhubarb, yam, and chasteberry. Botanicals with reported progestogenic activities are red clover, hops, yam, and chasteberry. Serotonergic mechanisms have also been proposed since women taking antidepressants often report a reduction in hot flashes and night sweats. Black cohosh, kudzu, kava, licorice, and dong quai all either have reported 5-hydroxytryptamine receptor 7 ligands or inhibit serotonin reuptake, therefore have potential serotonergic activities. Understanding the mechanisms of action of these natural remedies used for women's health could lead to more efficacious formulations and to the isolation of active components which have the potential of becoming effective medications in the future.

Topics: Female; Hot Flashes; Humans; Ligands; Magnoliopsida; Menopause; Phytoestrogens; Phytotherapy; Plant Extracts; Plants, Medicinal; Progestins; Receptors, Serotonin; Selective Serotonin Reuptake Inhibitors; Serotonin Receptor Agonists; Sweating; Women's Health

Hop extract is a long used medicinal product and, regarding hormonal activities, in 1999 a number of prenylflavanones have been identified as its major constituents with 8-prenylnaringenin (8-PN) being the main active estrogenic compound. There have been several in vivo studies performed that demonstrate the potential of hop extract and the single compound 8-PN to alleviate climacteric symptoms like osteoporosis, vasomotoric complaints, and sexual motivation. On the other hand, only a few clinical studies have been performed so far, and these mainly focused on menopausal discomforts, especially hot flushes, yielding rather inconclusive results. Despite preferentially activating estrogen receptor α, 8-PN is only slightly uterotrophic, but it also elucidates estrogenic effects on the mammary gland. In conclusion, although hop extract and especially 8-PN are promising candidates as a relief for climacteric symptoms, data on the safety and efficacy is still scarce.

Topics: Estrogen Receptor alpha; Female; Flavanones; Hot Flashes; Humans; Humulus; Mammary Glands, Human; Menopause; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy; Plant Extracts; Sexual Dysfunctions, Psychological; Uterus

Vasomotor symptoms, such as hot flushes and night sweats, are very common during the menopausal transition. Hormone therapy has traditionally been used as a highly effective treatment, but concerns about increased risk of some chronic diseases have markedly increased the interest of women in alternative treatments. Some of the most popular of these treatments are foods or supplements enriched with phytoestrogens-plant-derived chemicals that have estrogenic action.. To assess the efficacy, safety and acceptability of food products, extracts and dietary supplements containing high levels of phytoestrogens when compared with no treatment, placebo or hormone therapy for the amelioration of vasomotor menopausal symptoms (such as hot flushes and night sweats) in perimenopausal and postmenopausal women.. Searches targeted the following electronic databases: the Cochrane Menstrual Disorders and Subfertility Group Specialised Register of randomised trials (29 July 2013), the Cochrane Register of Controlled Trials (CENTRAL; 29 July 2013), MEDLINE (inception to 29 July 2013), EMBASE (inception to 29 July 2013), AMED (1985 to 29 July 2013), PsycINFO (inception to 29 July 2013) and CINAHL (inception to 29 July 2013). Attempts were made to access grey literature by sending letters to pharmaceutical companies and performing searches of ongoing trial registers. Reference lists of included trials were also searched.. Studies were included if they were randomised, included perimenopausal or postmenopausal participants with vasomotor symptoms (hot flushes or night sweats), lasted at least 12 weeks and provided interventions such as foods or supplements with high levels of phytoestrogens (not combined with other herbal treatments). Trials that included women who had breast cancer or a history of breast cancer were excluded.. Selection of trials, extraction of data and assessment of quality were undertaken by at least two review authors. Most trials were too dissimilar for their results to be combined in a meta-analysis, so these findings are provided in narrative 'Summary of results' tables. Studies were grouped into broad categories: dietary soy, soy extracts, red clover extracts, genistein extracts and other types of phytoestrogens. Five trials used Promensil, a red clover extract; results of these trials were combined in a meta-analysis, and summary effect measures were calculated.. A total of 43 randomised controlled trials (4,364 participants) were included in this review. Very few trials provided data suitable for inclusion in a meta-analysis. Among the five trials that yielded data assessing the daily frequency of hot flushes suitable for pooling, no significant difference overall was noted in the incidence of hot flushes between participants taking Promensil (a red clover extract) and those given placebo (mean difference (MD) -0.93, 95% confidence interval (CI) -1.95 to 0.10, I(2) = 31%). No evidence indicated a difference in percentage reduction in hot flushes in two trials between Promensil and placebo (MD 20.15, 95% CI -12.08 to 52.38, I(2) = 82%). Four trials that were not combined in meta-analyses suggested that extracts with high (> 30 mg/d) levels of genistein consistently reduced the frequency of hot flushes. Individual results from the remaining trials were compared in broad subgroups such as dietary soy, soy extracts and other types of phytoestrogens that could not be combined. Some of these trials found that phytoestrogen treatments alleviated the frequency and severity of hot flushes and night sweats when compared with placebo, but many trials were small and were determined to be at high risk of bias. A strong placebo effect was noted in most trials, with a reduction in frequency ranging from 1% to 59% with placebo. No indication suggested that discrepant results were due to the amount of isoflavone in the active treatment arm, the severity of vasomotor symptoms or trial quality factors. Also, no evidence indicated that these treatments caused oestrogenic stimulation of the endometrium or the vagina or other adverse effects when used for up to two years.. No conclusive evidence shows that phytoestrogen supplements effectively reduce the frequency or severity of hot flushes and night sweats in perimenopausal or postmenopausal women, although benefits derived from concentrates of genistein should be further investigated.

Topics: Female; Glycine max; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Randomized Controlled Trials as Topic; Sweating; Trifolium

Non-hormonal treatment for menopausal vasomotor symptoms (VMS) is needed in women in whom there are medical or personal concerns on the use of hormone therapy. This paper reviews conventional and phytochemical therapies available for the relief of VMS, on their mechanisms of action, their efficacy and safety concerns.. Medline was searched through Pubmed on the names of the diverse therapies analyzed, up to June 2011. The Cochrane Controlled Clinical Trials Register Database was searched for relevant trials that provided data on treatment of menopausal hot flushes.. All non-estrogen treatments for VMS are less efficacious than estrogen treatment. Randomized trials with neuroendocrine agents show globally modest to moderate reduction of VMS and frequent bothersome adverse events. The variability of effects makes it possible to undergo treatment in search for individual response where estrogen treatment is contraindicated. The antidepressants that interact with cytochrome P450, inhibiting tamoxifen metabolism to endoxifen, interfere with tamoxifen therapy in breast cancer patients. Otherwise, botanical products containing isoflavones from soy bean or red clover have great variability in bioavailability, have a broader spectrum of action than estradiol, and have predominant estrogen receptor-b activity. The efficacy of phytoestrogens on VMS is similar to placebo. They should be avoided in women with breast cancer and, in particular, in women being treated with tamoxifen or aromatase inhibitors due to possible antagonism. Cimicifuga racemosa is not a phytoestrogen, has partial serotonin agonist action and has a modest effect on VMS.. There are safe non-hormonal conventional treatments for menopausal VMS, although they are less efficacious than estrogens. The indication of phytochemicals is for women who make this choice on personal beliefs; long-term studies of larger groups of patients are needed to assess safety.

Topics: Adrenergic alpha-2 Receptor Agonists; Amines; Anticonvulsants; Cimicifuga; Clonidine; Cyclohexanecarboxylic Acids; Female; Gabapentin; gamma-Aminobutyric Acid; Hot Flashes; Humans; Menopause; Phytoestrogens; Phytotherapy; Plant Extracts; Pregabalin; Selective Serotonin Reuptake Inhibitors; Sweating; Vasomotor System

Despite a re-evaluation of risks in recent years, hormone replacement therapy is still surrounded by controversy. Almost 30% of women in a recent survey sought a natural approach to combat climacteric symptoms. Nevertheless, a large proportion of patients felt that they wanted a good safety profile and strong evidence base for treatment. This article seeks to review the evidence supporting non-hormonal approaches to treatment. There is only conflicting evidence at best to support alpha-2 agonists, e.g. clonidine and limited evidence for dihydroepiandrosterone and natural progesterones. There is limited randomized controlled trial data for gabapentin, selective norepinephrine re-uptake inhibitors (SNRIs) and selective serotonin re-uptake inhibitors (SSRIs), many of these studies being related to breast cancer patients. Of the herbal medicinal products, the largest evidence base rests with phytoestrogens. A Cochrane Database review looking at all types of phytoestrogens, e.g. red clover extracts, dietary soya and soya extracts concluded that there was no evidence to support improvement in climacteric symptoms and the meta-analysis of a 178 studies on soy products was inconsistent. Nevertheless, other studies disagree. Mammographic density is not affected by soy or phytoestrogen products and recent in vitro work shows only a weakly proliferative effect of soy isoflavone on breast cancer cells and evidence that soy isoflavone blocks the proliferative effect of estradiol on these cells. There are no studies looking at clinical outcome measures for cardiovascular disease but a number of studies looking at biochemical markers including arterial wall stiffness and apolipo protein B. Recent studies have also looked at the effects of red clover isoflavone on mood and depression, using specific depression rating scales. Finally, it is important to note that herbal medicinal products should not be used without caution. Some may produce quite marked side-effects in high doses and others can interact with pre-existing medication. A strategy for which patients are suitable for herbal medicinal products is reviewed.

Topics: Complementary Therapies; Female; Hot Flashes; Humans; Menopause; Phytoestrogens; Phytotherapy; Plant Preparations

To review the evidence that isoflavones are effective treatments for menopausal symptoms and to present the safety data.. The databases Scopus, ScienceDirect and Primo Central Index were searched and preference was given to systematic reviews and meta-analyses.. The available evidence suggests that isoflavones do not relieve menopausal vasomotor symptoms any better than placebo. Long-term safety studies suggest that women who consume a diet high in isoflavones may have a lower risk of endometrial and ovarian cancer.. Isoflavones cannot be recommended for the relief of hot flushes.

Topics: Breast Neoplasms; Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Risk Factors

The increased risk of breast cancer recently observed with some specific estro-progestin associations has raised concerns about the harmful effects of menopausal hormone replacement therapy (HRT). It has been proposed that phytoestrogens (PEs), which have a similar chemical structure to estrogens, could be used as HRT. The main selling points of these preparations concern the management of hot flashes and their potential beneficial effects on breast tissue. In this review, we will address the effects of PE on hot flashes and breast cancer risk as well as the questions raised on a chemical point of view. We conclude that the efficacy of a PE rich diet or nutritional supplements is not clearly established. The use of PE as an alternative for HRT cannot be advocated for now, due to insufficient and conflicting data on efficacy and safety. Moreover, due to the hormone dependence of breast cancer, PE use must be contraindicated in breast cancer survivors.

Topics: Breast Neoplasms; Contraindications; Diet; Female; Hot Flashes; Humans; Phytoestrogens; Phytotherapy; Plant Extracts; Plants; Risk

To review and summarise current evidence on the efficacy and safety of herbal medicinal products for the relief of hot flushes in women with previous breast cancer.. A literature search was conducted in the databases of Medline, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), PSYCHINFO, AMED (Allied and Complementary Medicine), NCCAM (The National Centre for Complementary and Alternative Medicine).. Black cohosh and phytoestrogens have received the most research attention but there is currently insufficient evidence to recommend either for relief of flushes. Black cohosh use appears safe in women with previous breast cancer. Opposing advice has been given regarding the safety of dietary phytoestrogen use for women with previous breast cancer, but there is emerging data that soyfood phytoestrogen intake may have a beneficial effect on tumour recurrence.. The majority of studies, regarding the efficacy of herbal treatments for hot flushes, have not been conducted in women with breast cancer and many are of short duration. Increased pharmacovigilance practices for herbal medicines are required with initiatives to stimulate reporting of suspected adverse reactions.

Topics: Actaea; Animals; Breast Neoplasms; Cimicifuga; Diet; Female; Glycine max; Herb-Drug Interactions; Hot Flashes; Humans; Phytoestrogens; Phytotherapy; Plant Preparations

Hot flushes are the most common indication for the prescription of hormone replacement therapy (HRT) since it is effective in over 80% of cases. In 1995, 37% of American women took HRT, principally for this purpose. However, over the last five years, publications such as those from the Women's Health Initiative (WHI) have caused concern among women since they perceive that the risks outweigh the benefits. Following this publication, half of the women taking HRT in the UK, USA and New Zealand discontinued HRT. With the discontinuation of estrogen many women re-developed hot flushes; however only a small number (18%) of women report restarting hormone therapy. The majority of these (76%) for the recurrence of severe hot flushes or night sweats. Alternatives are available, but limited knowledge on aetiology and mechanisms of hot flushing represents a major obstacle for the development of new, targeted, non-hormonal treatments, and no current alternatives are as effective as estrogen.

Topics: Acupuncture Therapy; Amines; Cimicifuga; Clonidine; Cyclohexanecarboxylic Acids; Estrogen Replacement Therapy; Exercise; Female; Gabapentin; gamma-Aminobutyric Acid; Hot Flashes; Humans; Menopause; New Zealand; Norpregnenes; Phytoestrogens; Progesterone; Selective Serotonin Reuptake Inhibitors; Skin; United Kingdom; United States; Vitamin E

Vasomotor symptoms (VMS) are recognized to adversely affect the quality of life. The prevalence and the magnitude of VMS may vary across populations. Although a natural regression of VMS may be expected over a period of time, it remains the most common of symptoms for which women seek help. Menopausal hormone therapy (MHT) is currently the only treatment approved by the Food and Drug Administration that has shown uniform benefit in the management of VMS. In clinical situations when estrogen is or may be contraindicated, a finite number of alternative options, including use of neuroactive agents (SSRIs, SSNRs, and gabapentin), lifestyle changes, and nonprescription remedies such as phytoestrogens and black cohosh have been shown to provide relief, albeit with mixed results and questionable safety. Existing data identify an ethnic variation in the degree and frequency of VMS of aging; in this latter context, the Asian woman's perspective is dominantly conveyed from the perspective of Chinese and Japanese ethnicities, whereas data regarding the magnitude of burden of VMS in the postmenopausal women from other Asian ethnicities and races are sparse. This article reviews the symptoms and relates that VMS are of significant concern for the aging Asian women.

Topics: Aging; Amines; Antihypertensive Agents; Asian People; Complementary Therapies; Cyclohexanecarboxylic Acids; Estrogen Receptor beta; Estrogen Receptor Modulators; Estrogen Replacement Therapy; Female; Gabapentin; gamma-Aminobutyric Acid; Hormone Replacement Therapy; Hot Flashes; Humans; India; Life Style; Menopause; Mind-Body Therapies; Nonprescription Drugs; Phytoestrogens; Prevalence; Progesterone; Vasomotor System

Side effects and contraindications connected with hormonal replacement therapy in climacterium resulted in search for new methods of softening menopausal symptoms. The aim of the following study was to evaluate, based on literature analysis, the effectiveness of phytohormonal therapy as an alternative method of relieving the symptoms of menopausal period and preventing the diseases connected with deficiency of estrogens after menopause. Phytoestrogens therapy reduces the number and strength of the vasomotor symptoms and improves serum lipid profile. Moreover phytoestrogens show beneficial effects on bone tissue metabolism, skin and mucous membranes condition and are applicable in chemoprevention. This therapy is an effective method, allowing to avoid further changes in blood and urogenital systems, which result from estrogen stimulation deficiency. Phytoestrogens administration is an efficient method of relieving postmenopausal symptoms, facilitating the difficult menopausal period and keeping good health condition.

Topics: Breast Neoplasms; Cardiovascular Diseases; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Isoflavones; Middle Aged; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy; Postmenopause; Women's Health

Vasomotor symptoms are generally recognized as one of the most common symptoms, or signs, of the menopause, together with menstrual cycle changes. The etiology of hot flushes is unknown, although several mechanisms have been implicated. The reduction in hot flushes with estrogen replacement therapy suggests a hormonal etiology. However, the levels of estrogens do not appear to correlate with hot flushes. It seems more likely that the rate of change of plasma estrogen concentrations influences the thermoregulatory system via the hypothalamus. During the past few decades, remedies for the treatment of hot flushes have advanced from simple sedatives and purgatives to the use of ovarian extracts and, finally, to pharmacological estrogen preparations. In view of the contraindications and side-effects of estrogens and progestogens in postmenopausal women, however, there is a need to consider treatments other than hormone replacement for the relief of hot flushes.

Topics: Acupuncture Therapy; Adult; Alcohol Drinking; Amines; Caffeine; Cyclohexanecarboxylic Acids; Estrogen Replacement Therapy; Estrogens; Exercise; Female; Gabapentin; gamma-Aminobutyric Acid; Hot Flashes; Humans; Menopause; Middle Aged; Phytoestrogens; Smoking

Phytoestrogens (plant oestrogens) have become popular alternatives to conventional oestrogen products, and various preparations are marketed as effective in the treatment of menopausal symptoms. A number of clinical trials have been conducted, but it is still difficult to assess the effectiveness of plant oestrogen treatment. If treatment is started, the same precautions should be taken as with conventional oestrogen treatment.

Topics: Evidence-Based Medicine; Female; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Plant Extracts

Since conventional hormone replacement therapy has fallen out of favour, alternatives are being sought by many women. These therapies include herbal preparations such as black cohosh (Cimicifuga racemosa). The purpose of this update of a previous systematic review is to evaluate the clinical evidence for or against the efficacy of black cohosh in alleviating menopausal symptoms. Five computerized databases (Medline, Embase, Amed, Phytobase and Cochrane Library) were searched to identify all clinical data that provided evidence on the efficacy of C. racemosa. Bibliographies of the articles thus located were scanned for further relevant publications. Only double blind, randomized, clinical trials (RCTs) were included in the evaluation of efficacy. No language restrictions were imposed. Trials were excluded if they did not focus on menopausal problems, they included women suffering medically induced menopause, they did not use black cohosh monopreparations, or they did not use placebo or a standard drug treatment for the control group. Six studies with a total of 1112 peri- and post-menopausal women met our inclusion criteria. The evidence from these RCTs does not consistently demonstrate an effect of black cohosh on menopausal symptoms; a beneficial effect of black cohosh on peri-menopausal women cannot be excluded. The efficacy of black cohosh as a treatment for menopausal symptoms is uncertain and further rigorous trials seem warranted.

Topics: Cimicifuga; Clinical Trials as Topic; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Menopause; Phytoestrogens; Phytotherapy; Plant Preparations

Traditional soyfoods have been consumed for centuries throughout much of East Asia and, recently, these foods have also become popular in the West. Soyfoods and specific soybean components, such as the protein and isoflavones, have attracted attention for their possible health benefits. Isoflavones are classified as phytoestrogens and have been postulated to be natural alternatives to hormone therapy for menopausal women. To provide guidance on optimal soy intake, this article evaluates Asian soy consumption and both clinical and Asian epidemiologic studies that examined the relationship between soy intake and a variety of health outcomes. On the basis of these data and the standard principles of dietary practice the author suggests that optimal soy protein and isoflavone intakes are 15-20 g/day and 50-90 mg/day, respectively. In addition, an intake of 25 g/day soy protein can be specifically used as the recommendation for cholesterol reduction.

Topics: Dietary Supplements; Dose-Response Relationship, Drug; Female; Health Promotion; Hot Flashes; Humans; Isoflavones; Nutritional Physiological Phenomena; Osteoporosis, Postmenopausal; Phytoestrogens; Soybean Proteins; United States; United States Food and Drug Administration; Women's Health

Although the hot flush is generally recognised by women and the medical profession as the most characteristic and often a very distressing symptom of the climacteric, it remains an enigma. The physiological changes associated with the hot flush are different from any other flushing condition, with an increased peripheral blood flow, increased heart rate and in particular a decrease in galvanic skin resistance, which is unique to the flush. Flushing occurs as a result of disturbance of the temperature regulating mechanism situated in the hypothalamus, and probably a reduction in the thermoneutral zone, within which fluctuations of basal body temperature do not provoke compensatory vascular responses. Many factors have been implicated, including hormone releasing factors, gonadotrophins and neurohumorals. However, the role of oestrogen is critical and the clinical value of oestrogen therapy is well established and has been confirmed by a Cochrane review. Nevertheless, the precise mechanism by which reduced circulating levels of oestrogen are involved in causing the flush has not yet been established. Priming with oestrogen seems to be an essential pre-requisite for flushing, as young women with ovarian dysgenesis and very low circulating levels of oestrogen never have hot flushes unless they are given oestrogen replacement therapy, which is later discontinued. Oestrogen antagonist activity by selective oestrogen receptor modulators such as tamoxifen and raloxifene can also cause flushing. A link with gonadotrophins is demonstrated by a temporal association of flushes with the pulsatile release of luteinising hormone (LH). However, if LH pulses are eliminated by GnRH analogue, the frequency of flushing is not altered, which confirms that LH is merely associated with the flush rather than being causative. It is probable that the flush is initiated by a supra-pituitary mechanism which is influenced by the hypothalamic factors responsible for pulsatile LH release. A variety of chemical pathways have been proposed involving serotonin, noradrenalin and dopamine. Trials of drugs that selectively inhibit the re-uptake of serotonin and noradrenalin have shown some beneficial effects, as also has gabapentin, but often the results have been disappointing, and certainly less than the response seen with oestrogen or tibolone. The prevalence of hot flushes varies considerably around the world and is less in the Far East than in the west. Differences in diet and in partic

Topics: Estrogen Replacement Therapy; Estrogens; Female; Hot Flashes; Humans; Hypothalamus; Luteinizing Hormone; Menopause; Middle Aged; Phytoestrogens

Interest in non-hormonal therapies for the treatment of menopausal symptoms has increased since the publication of adverse effects of estrogen replacement therapy.. To provide information on the efficacy of non-hormonal therapies for menopausal vasomotor symptoms based on evidence from published randomised controlled studies.. The Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Alternative Therapies in Health and Medicine database (ATHMD) and Allied and Complementary Medicine database (AMED) were searched for randomised controlled trials in the English language reporting data on treatment of menopausal vasomotor symptoms. Trials including cancer breast patients were included.. Our search identified 58 randomised controlled trials of which 11 involved the use of clonidine, six for SSRIs, four for gabapentin, seven for black cohosh, seven for red clover, 18 for phytoestrogens, two for ginseng, one for evening primrose, one for dong quai and one for vitamin E. Most trials had methodological deficiencies.. There is evidence that clonidine, paroxetine, venlafaxine, gabapentin and black cohosh may be beneficial in the treatment of menopausal vasomotor symptoms in some women. Current evidence does not support the use of fluoxetine, red clover, phytoestrogens, Ginseng, evening primrose, dong quai and vitamin E. The side effects profile of these therapies should be considered.

Topics: Amines; Cimicifuga; Clonidine; Cyclohexanecarboxylic Acids; Female; Gabapentin; gamma-Aminobutyric Acid; Hot Flashes; Humans; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Plants, Medicinal; Randomized Controlled Trials as Topic; Trifolium

Vasomotor symptoms, such as hot flushes and night sweats, are very common during the menopausal transition. Hormone replacement therapy has traditionally been used as a very effective treatment but concerns over increased risks of some chronic diseases have markedly increased the interest of women in alternatives. Some of the most popular of these are treatments based on foods or supplements enriched with phytoestrogens, plant-derived chemicals that have oestrogenic action.. To assess the efficacy, safety and acceptability of foods and supplements based on high levels of phytoestrogens for reducing hot flushes and night sweats in postmenopausal women.. Searches were undertaken of the following electronic databases: the Cochrane Menstrual Disorders and Subfertility Group Specialised Register of randomised trials, Cochrane Register of Controlled Trials (CENTRAL) (March 2007), MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007), AMED (1985 to March 2007), PsycINFO (1986 to March 2007) and CINAHL (1982 to March 2007). Attempts were made to access grey literature by letters to pharmaceutical companies and searches of ongoing trial registers. Reference lists of included trials were also searched.. Studies were included if they were randomised, had peri- or postmenopausal participants with vasomotor symptoms, a duration of at least 12 weeks and where the intervention was a food or supplement with high levels of phytoestrogens (and not combined with other herbal treatments). Trials of women who had breast cancer or a history of breast cancer were excluded.. Selection of trials, data extraction and quality assessment were undertaken by at least two authors. Most of the trials were too dissimilar to combine in meta-analysis and their results are provided in table format. Studies were grouped into broad categories: dietary soy, soy extracts, red clover extracts and other types of phytoestrogen. Five trials used Promensil, a red clover extract; these trials were combined in a meta-analysis and summary effect measures were calculated.. Thirty trials comparing phytoestrogens with control met the inclusion criteria. Very few trials had data suitable for combining in meta-analysis. Of the five trials with data suitable for pooling that assessed daily frequency of hot flushes, there was no significant difference overall in the frequency of hot flushes between Promensil (a red clover extract) and placebo (WMD=-0.6, 95% CI -1.8 to 0.6). There was no evidence of a difference in percentage reduction in hot flushes in two trials between Promensil and placebo (WMD=20.2, 95% CI -12.1 to 52.4). Individual results from the remaining trials were compared. Some of the trials found that phytoestrogen treatments alleviated the frequency and severity of hot flushes and night sweats when compared to placebo but many of the trials were of low quality and were underpowered. There was a strong placebo effect in most trials with a reduction in frequency ranging from 1% to 59% with placebo. There was no indication that the discrepant results were due to the amount of isoflavone in the active treatment arm, the severity of vasomotor symptoms or trial quality factors. There was also no evidence that the treatments caused oestrogenic stimulation of the endometrium (an adverse effect) when used for up to two years.. There is no evidence of effectiveness in the alleviation of menopausal symptoms with the use of phytoestrogen treatments.

Topics: Female; Glycine max; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Randomized Controlled Trials as Topic; Sweating; Trifolium

Vasomotor symptoms are the most common menopausal symptom experienced by women and the leading reason menopausal women seek health care advice. The recent shift towards a more conservative use of hormone therapy (HT) during menopause has prompted the need for treatment regimens to be individualized according to symptom severity. Our objective was to develop a new algorithm that enables practitioners to customize treatment regimens according to symptom severity. In order to develop a comprehensive treatment algorithm, we conducted a literature review and considered the findings from recently published treatment guidelines from around the world. We also evaluated the results of systematic reviews investigating the efficacy and safety of complementary and alternative medicines. We found a growing trend away from prescription HT in women with mild to moderate symptoms and an increasing trend toward lifestyle modification and the use of complementary and alternative medicines. On the basis of these findings, we have developed an algorithm that accounts for symptom severity. The algorithm presented here provides treatment options based on symptom severity and a comprehensive approach for integrating lifestyle modifications and complementary therapies with prescription treatment regimens.

Topics: Algorithms; Cimicifuga; Decision Trees; Estrogen Replacement Therapy; Female; Glycine max; Hot Flashes; Humans; Phytoestrogens; Phytotherapy; Plants, Medicinal; Randomized Controlled Trials as Topic; Severity of Illness Index; Trifolium

Review on complementary and alternative therapies for climacteric symptoms.. Search for publications about complementary or alternative treatments for climacteric symptoms based on Cochrane Library and Medline (1966-2006) including the references from the identified clinical trials and reviews.. Cimicifuga may influence climacteric symptoms, especially hot flushes. Results for phytoestrogens, hop and Salvia seem promising but are less convincing. St. John's wort is an option for the treatment of moderate depressive symptoms. Phytoestrogens seem to have some potential for the prevention of osteoporosis and cardiovascular diseases. Results for the influence of lifestyle on hot flushes are conflicting, but interventions have demonstrated their use for the prevention of osteoporosis and cardiovascular diseases.. Lifestyle modifications, Cimicifuga and phytoestrogens may relieve climacteric symptoms. Phytoestrogens and Cimicifuga should not be given to breast cancer survivors.

Topics: Acupuncture; Adult; Aged; Aromatherapy; Breast Neoplasms; Cardiovascular Diseases; Case-Control Studies; Cimicifuga; Climacteric; Cohort Studies; Complementary Therapies; Contraindications; Depression; Diet; Dioscorea; Exercise; Female; Homeopathy; Hot Flashes; Humans; Humulus; Hydrotherapy; Hypericum; Life Style; Longitudinal Studies; MEDLINE; Middle Aged; Osteoporosis; Phytoestrogens; Phytotherapy; Plant Extracts; Postmenopause; Prospective Studies; Randomized Controlled Trials as Topic; Relaxation Therapy; Salvia; Stress, Physiological; Surveys and Questionnaires; Survivors; Trifolium

With the increasing numbers of breast cancers survivors, menopause, its symptoms, and its physical complications are becoming more prevalent problems in this patient population. Hormonal replacement, which has been the cornerstone therapy of menopausal related symptoms for decades, recently has been shown to increase breast cancer incidence as well as risk of recurrence and no longer should be recommended. Menopausal symptoms and complications such as hot flashes, vaginal dryness, dyspareunia, and osteoporosis leading to fractures have a negative impact on the quality of life of both breast cancer survivors and the general postmenopausal population. The purpose of this review is to discuss the evidence for the use of alternative therapies for menopausal symptoms, thus providing guidance and recommendations that should facilitate therapeutic decisions in the daily practice of medical oncologists and primary care physicians.

Topics: Breast Neoplasms; Cardiovascular Diseases; Complementary Therapies; Estrogens; Female; Genitalia, Female; Hot Flashes; Humans; Menopause; Menopause, Premature; Osteoporosis; Phytoestrogens; Quality of Life; Survivors; Vasomotor System

In the discussion of the risk-benefit relation of the hormone replacement therapy (HRT) for elder women phytochemicals with estrogenic activity received a great deal of attention. Phytoestrogens are naturally occurring compounds with structural similarity to 17beta-estradiol. Especially genistein, an isoflavone most abundant in soy, possess a high and selective binding-affinity to the mammalian estrogen receptors. It has been found, that genistein exert in humans both: weak estrogenic and anti-estrogenic effects, similar to the SERMs. Consequently, it was concluded, that genistein might provide an alternative to prevent postmenopausal bone-loss and ameliorate menopausal symptoms without side-effects similar to HRT. Pre-clinical experiments and results from clinical pilot studies with pure genistein confirmed its efficacy in these indications. Nevertheless, currently some open issues still exist to recommend its intake thoughtlessly. Bonistein, pure synthetic genistein developed by DSM Nutritional Products, was tested extensively in appropriate models for bone health. A battery of toxicological studies was conducted to determine safe intake levels. In the early clinical development pharmacokinetic studies were performed in healthy volunteers and in postmenopausal women. Now large-scale studies are in preparation to investigate Bonistein's efficacy in postmenopausal bone-loss and climacteric syndrome.

Topics: Animals; Dietary Supplements; Female; Genistein; Hot Flashes; Humans; Menopause; Osteoporosis, Postmenopausal; Phytoestrogens

Topics: Drug Therapy, Combination; Estrogens; Female; Hot Flashes; Humans; Menopause; Norpregnenes; Phytoestrogens; Progestins

Approximately two thirds of women who reach menopause develop menopausal symptoms, primarily hot flashes. Hormone therapy long was considered the first-line treatment for vasomotor symptoms. However, given the results of the Women's Health Initiative (WHI), many women are reluctant to use exogenous hormones for symptomatic treatment and are turning to botanicals and dietary supplement (BDS) products for relief. Despite the fact that there is limited scientific evidence describing efficacy and long-term safety of such products, many women find these natural treatments appealing. Perimenopausal and postmenopausal women are among the highest users of these products, but 70% of women do not tell their healthcare providers about their use. Compounding this issue is the fact that few clinicians ask their patients about use of BDS, largely because they have not been exposed to alternative medical practices in their training and are unfamiliar with these products.. This paper reviews the botanicals and dietary supplements commonly used in menopause (such as black cohosh, red clover, and soy products) as well as the available data on efficacy and safety. We searched the MEDLINE database from 1966 to December 2004 using terms related to BDS and menopausal symptoms for perimenopausal or postmenopausal women. Abstracts from relevant meetings as well as reference books and websites on herbal supplements were also searched. Randomized, controlled trials (RCTs) were used if available; open trials and comparison group studies were used when RCTs were not available.. The evidence to date suggests that black cohosh is safe and effective for reducing menopausal symptoms, primarily hot flashes and possibly mood disorders. Phytoestrogen extracts, including soy foods and red clover, appear to have at best only minimal effect on menopausal symptoms but have positive health effects on plasma lipid concentrations and may reduce heart disease. St. John's wort has been shown to improve mild to moderate depression in the general population and appears to show efficacy for mood disorders related to the menopausal transition. Other commonly used botanicals have limited evidence to demonstrate safety and efficacy for relief of symptoms related to menopause.

Topics: Diet; Estrogens, Non-Steroidal; Female; Health Knowledge, Attitudes, Practice; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Phytotherapy; Plant Preparations; Plants, Medicinal; Randomized Controlled Trials as Topic; Soybean Proteins; United States; Women's Health

Menopausal symptoms such as hot flushes and night sweats can be very disrupting. While hormone replacement therapy is an effective therapy, concerns about side effects and breast cancer risk have stimulated interest into alternative therapies such as phytoestrogens. These are oestrogen-like compounds made by plants. Two major sources of phytoestrogens are soy and red clover. Data on randomised controlled trials of red clover for the control of menopausal symptoms are presented. The conflicting data are encouraging and suggest that phytoestrogens are a treatment modality that needs pursuing.

Topics: Female; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Phytotherapy; Plant Preparations; Randomized Controlled Trials as Topic; Trifolium

Some of the important health issues for postmenopausal women include cardiovascular disease, osteoporosis, breast cancer, and relief of menopausal symptoms. Ovariectomized cynomolgus monkeys (Macaca fascicularis) have many strengths as models for research in this area including a close phylogenetic relationship to humans, similarities in lipid/lipoprotein metabolism and coronary artery anatomy, similar skeletal anatomical and morphological characteristics, mammary glands with similar pathophysiological characteristics, and a 28-day menstrual cycle with similar hormonal fluctuations. Monkeys (macaques) also experience declining ovarian function and irregular menstrual cycles (natural menopause) when they approach 24 to 29 yr of age. However, because of their very short life span after natural menopause, ovariectomized macaques are used to model postmenopausal women. The cynomolgus monkey model has been useful in defining the potential cardiovascular benefits of soy foods and soy supplements; however, it remains unclear whether the observations are generalizable to all women or only to those who, like cynomolgus monkeys, convert the soy isoflavone daidzein to the metabolite equol. Particularly important has been the use of the cynomolgus monkey model to understand the effects of soy on breast health. There is evidence from a cynomolgus monkey trial to suggest that soy/soy phytoestrogens have no estrogen agonist effects for breast. Finally, soy/soy phytoestrogens do not appear to be an adequate alternative to postmenopausal hormone therapy. Nevertheless, important attributes of soy have been identified, and it may have potential as a complementary component to hormone therapy.

Topics: Animals; Arteries; Bone and Bones; Breast Neoplasms; Cardiovascular Diseases; Female; Hot Flashes; Humans; Isoflavones; Lipids; Lipoproteins; Macaca fascicularis; Models, Animal; Phytoestrogens; Plant Preparations; Postmenopause; Soy Foods

Although alternatives exist, hormone therapy remains the most effective treatment for menopausal symptoms such as hot flashes, and it is the only treatment approved by the US Food and Drug Administration (FDA) for this indication. The FDA recommends using the lowest effective dose of hormones. New low-dose preparations and new dosage forms of hormone therapy are available.

Topics: Drug Approval; Drug Delivery Systems; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Plant Preparations; Women's Health

To assess the efficacy and tolerability of phytoestrogens for treatment of menopausal symptoms.. We searched the Cochrane Library and MEDLINE from 1966 to March 2004, using a detailed list of terms related to phytoestrogens and menopausal symptoms and also hand-searched abstracts from relevant meetings.. Randomized trials were eligible if they involved symptomatic perimenopausal or postmenopausal women, compared phytoestrogen with placebo or control, reported hot flush frequency or menopausal symptom scores, and were at least 4 weeks in duration.. Data were extracted onto standardized forms using a prospectively developed protocol. Twenty-five trials involving 2,348 participants met criteria. At baseline, the mean age was 53.1 years, mean duration of menopause was 4.3 years, and mean daily hot flush frequency was 7.1. Mean study duration was 17 weeks. Trials were grouped into categories according to type of phytoestrogen: soy foods, beverages, or powders (n = 11); soy extracts (n = 9); and red clover extracts (n = 5). Of the 8 soy food trials reporting hot flush frequency outcomes, 7 were negative. Five trials of soy foods provided information to calculate effect sizes; these were in the small-to-medium range, favoring placebo in 3 trials and soy in 2. Of the 5 soy extract trials reporting hot flush frequency, 3 (including the 2 largest trials) were negative. Effect sizes were calculated for 2 soy extract trials: one favored placebo with small effect size and the other favored soy with moderate effect size. Red clover trials showed no improvement in hot flush frequency (weighted mean difference -0.60, 95% confidence interval -1.71 to 0.51). Adverse effects were primarily gastrointestinal and taste intolerance in the soy food and beverage trials.. The available evidence suggests that phytoestrogens available as soy foods, soy extracts, and red clover extracts do not improve hot flushes or other menopausal symptoms.

Topics: Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Plant Preparations; Plants, Medicinal; Prospective Studies; Randomized Controlled Trials as Topic

The data concerning post-menopausal hormone replacement therapy (HRT) were recently completely modified. The aim of this review is to present the last studies about post-menopausal HRT and to describe new alternatives to this treatment.. In May 2002, the women's health initiative (WHI) trial of post-menopausal HRT was interrupted earlier than expected. The studied hormonal formulation in this arm of the WHI trial was the association of conjugated equine estrogens and medroxyprogesterone. The reason for termination was an increased risk of breast cancer and myocardial infarction in the hormone-therapy group. Later, reports confirmed that this type of HRT could not be used any more for the primary prevention of coronary heart disease even if the absolute risk remained low. There is an increased risk for venous thromboembolism with post-menopausal estroprogestative replacement. This risk does not seem to exist with transdermal estrogens. The other WHI findings concerned the lack of protection against dementia and cognitive decline. On the contrary, osteoporotic hip fractures and colorectal cancers were reduced in the treated group. In April 2004, the estrogen only arm of the same WHI study was also prematurely interrupted because of an increase in the incidence of stroke. The risk of breast cancer was on the contrary not increased after 6.8 years, raising the question of the eventual role of progestins.. The impact of the WHI trial on clinical practice was very important since then. The "Agence Francaise de sécurité sanitaire des produits de santé" (AFSSAPS) edited in May 2004 a public recommendation limiting indication for HRT to patients with severe climacteric symptoms. The treatment must now be prescribed for the shortest time and at the minimal dose. The patient has to be precisely informed about the risks with HRT and the practitioner has to re-evaluate his prescription annually. Hormonal or non-hormonal alternatives have also to be considered as phytoestrogens and tibolone for hot flashes, and raloxifene and diphosphonates for osteoporosis prevention. In any case, a healthy diet, exercise and smoking cessation should be encouraged.

Topics: Breast Neoplasms; Clinical Trials as Topic; Equilin; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Life Style; Medroxyprogesterone; Menopause; Myocardial Infarction; Phytoestrogens; Risk Assessment; Thromboembolism; Treatment Outcome

Topics: Clonidine; Estrogens; Female; Hot Flashes; Humans; Menopause; Norpregnenes; Phytoestrogens; Progestins

Perimenopausal period is associated with the reduction of endogenous estrogens which might lead to many disorders of general health in women. Traditional hormone replacement therapy (HRT) is effective for controlling vasomotor symptoms and reducing the risk of cardiovascular disease and osteoporosis in postmenopausal women. However, according to the latest studies, many women are reluctant to initiate this therapy because of concerns regarding the benefits and risks considering contraindications and side effects of it. Therefore, a lot of studies were carried out to find the influence of phytoestrogens on menopausal symptoms. Phytoestrogens are defined as naturally occurring compounds, found in plants; they have a variety of activities: estrogenic and antiestrogenic. Could phytoestrogens be used as an alternative to hormonal therapies for the management of menopausal symptoms?

Topics: Breast Neoplasms; Cardiovascular Diseases; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Isoflavones; Menopause; Osteoporosis, Postmenopausal; Phytoestrogens; Poland; Women's Health

This review presents findings with clear statements from the literature as well as own results of effects of soy, red clover and their isoflavones as well as of the Cimicifuga racemosa extract BNO 1055. Experimental and clinical effects on climacteric complaints, osteoprotective effects, activity in the urogenital tract, and risks concerning cardiovascular diseases and mammary and endometrial tissue will be compared, also in comparison to classical hormone preparations. The question whether soy and red clover products and/or Cimicifuga racemosa (CR) preparations are endocrine disrupters or may fulfill the criteria of the so-called phyto-SERMs will be discussed.. Review of selected publications since 1980 and summary of unpublished own results of the authors.. Experimental and clinical evidences suggest that soy/red clover and their isoflavones do not fulfill the criteria of an ideal SERM. They appear to have mild osteoprotective effects but do not improve climacteric complaints. Furthermore, they seem to stimulate uterine growth and mammary epithelial proliferation. In ovariectomized rats, the CR extract BNO 1055 showed many of the beneficial effects of 17beta-estradiol, including effects in the brain/hypothalamus to reduce serum LH levels, effects in the bone to prevent osteoporosis and estrogenic effects in the urinary bladder. The CR extract BNO 1055 had no uterotrophic effect.. If clinical studies confirm these results, the Cimicifuga racemosa preparation BNO 1055 would appear as an ideal SERM and may therefore be an alternative to hormone replacement therapy.

Topics: Animals; Bone and Bones; Breast; Cimicifuga; Disease Models, Animal; Endocrine System; Endometrium; Estrogen Replacement Therapy; Estrogens, Non-Steroidal; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Phytotherapy; Plant Extracts; Plant Preparations; Rats; Selective Estrogen Receptor Modulators; Trifolium; Urinary Bladder; Uterus

Topics: Acetates; Amines; Cimicifuga; Clonidine; Contraindications; Cyclohexanecarboxylic Acids; Estrogens, Non-Steroidal; Evidence-Based Medicine; Exercise; Female; Gabapentin; gamma-Aminobutyric Acid; Hormone Replacement Therapy; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Phytotherapy; Plant Preparations; Postmenopause; Practice Guidelines as Topic; Selective Serotonin Reuptake Inhibitors; Soybean Proteins

The indications for hormone therapy (HT) have changed markedly since the 1980s; they now include the treatment of menopausal symptoms and the prevention and treatment of osteoporosis in the short term. Long-term therapy is discouraged because of the small increase in risk of breast cancer after 5 years of therapy. Careful assessment of the midlife woman allows for individualized risk-benefit analysis with the formulation of a specific health management plan. Lifestyle advice and modification form the cornerstone of management-followed by therapeutic options if appropriate indications exist. In some industrialized countries alternative therapies are preferred despite little scientific evidence of their efficacy. The choices of hormonal products have increased, with the introduction of new formulations and routes of administration allowing for more optimal treatment of the menopause, especially in the presence of concurrent medical conditions, for example, diabetes, breast cancer or fibroids.

Topics: Complementary Therapies; Estrogen Replacement Therapy; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Life Style; Menopause; Mood Disorders; Osteoporosis, Postmenopausal; Phytoestrogens; Plant Preparations

Hot flashes are a common experience for menopausal women, with an 85-percent incidence in the West. With the increased knowledge of side effects attributable to conventional treatment options, more women are exploring natural alternatives. Although more definitive research is necessary, several natural therapies show promise in treating hot flashes without the risks associated with conventional therapies. Soy and other phytoestrogens, black cohosh, evening primrose oil, vitamin E, the bioflavonoid hesperidin with vitamin C, ferulic acid, acupuncture treatment, and regular aerobic exercise have been shown effective in treating hot flashes in menopausal women.

Topics: Female; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Phytotherapy; Plant Preparations

Phytoestrogens are a diverse group of plant-derived compounds that structurally or functionally mimic mammalian estrogens and show potential benefits for human health. The number of articles published on phytoestrogens has risen dramatically in the past couple decades. Further research continues to demonstrate the biological complexity of phytoestrogens, which belong to several different chemical classes and act through diverse mechanisms. This paper discusses the classification of phytoestrogens, methods of identification, their proposed mechanisms of action and botanical sources for phytoestrogens. The effects of phytoestrogens on breast and prostate cancers, cardiovascular disease, menopausal symptoms and osteoporosis will also be examined including research on benefits and risks.

Topics: Hot Flashes; Humans; Isoflavones; Osteoporosis; Phytoestrogens; Phytotherapy; Plant Preparations; Plants, Medicinal; Receptors, Estrogen; Research Design

For many years, women have sought alternative therapies for menopausal symptoms and for general health overall. The highly publicized findings from the Women's Health Initiative have led to an increased pressure on the medical community to find safe and alternative medications for female health. This article reviews the challenges and problems with the use of alternative medicines, and the clinical trials that prove their efficacy, and discusses the safety issues that may occur with these types of products.

Topics: Acetates; Acupuncture Therapy; Adrenergic alpha-Agonists; Amines; Antidepressive Agents, Second-Generation; Antioxidants; Behavior Therapy; Belladonna Alkaloids; Cimicifuga; Cyclohexanecarboxylic Acids; Dietary Supplements; Drug Combinations; Ergotamines; Estrogen Replacement Therapy; Female; Gabapentin; gamma-Aminobutyric Acid; Hot Flashes; Humans; Isoflavones; Menopause; Methysergide; Phenobarbital; Phytoestrogens; Plant Preparations; Selective Serotonin Reuptake Inhibitors; Sulpiride; United States; Vitamin E; Women's Health

Many women use alternative therapies to treat hot flushes and other menopausal symptoms. The purpose of this review is to summarize current information on the efficacy and safety of phytoestrogens and the herbal medicine black cohosh. A preponderance of evidence indicates that phytoestrogens are ineffective in treating hot flushes. Trials of black cohosh, many of which are small, of limited duration and of poor methodological quality, provide conflicting results, and at present it is unclear whether black cohosh is more effective than placebo. Although phytoestrogens and black cohosh appear to be safe when used for short periods of time, much larger and longer studies are needed to detect infrequent but potentially serious adverse events. Women who do not wish to take hormone therapy to treat menopausal symptoms should be encouraged to consider using selective serotonin reuptake inhibitors and other conventional therapeutic options.

Topics: Cimicifuga; Clinical Trials as Topic; Female; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Phytotherapy; Plant Preparations

Topics: Clonidine; Estrogens; Female; Hot Flashes; Humans; Menopause; Norpregnenes; Phytoestrogens; Progestins

The female life period in which hormonal share begins to drop and the first menopausal clinical symptoms occur, is called perimenopausal period. During this female life phase, frequently, time of regular function and time of ovarian dysfunctions occur, with a limited luteal phase and an estrogen production fall. So, perimenopausal clinical symptoms begin: hot flushes, tiredness and libido decrease; to these problems, others can be connected to inadequate luteal phase, as breast pain, nervousness and body increase. Therefore, it's possible to affirm that the perimenopause is a particularly delicate period, either because it represents a transient moment to climateric phase, or because it's possible to detect a great hormonal instability, fundamental step for clinical problems. In our investigation we discuss this problem, explain the causes and the possible remedies to delay the onset of symptoms or to treat hormonal perimenopausal modifications.

Topics: Contraceptives, Oral; Drug Combinations; Estrogen Replacement Therapy; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Libido; Menstruation Disturbances; Middle Aged; Phytoestrogens; Plant Preparations; Premenopause; Progestins

Cimicifuga racemosa has long been advocated as an alternative to hormone-replacement therapy. However, recent experimental studies and a clinical trial have raised some questions on its utility. The aim of this systematic review is principally to summarise the trial evidence regarding the efficacy of C. racemosa in the treatment of menopausal symptoms. In addition, we also explore the evidence relating to the mechanism of action of this herbal medicine.. Searches of seven computerised databases were performed to identify all randomised clinical trials (RCTs) on C. racemosa as well as animal and in vitro experiments. No language restrictions were imposed. Data were extracted by both authors according to predefined criteria and are summarised in narrative form.. Four RCTs of C. racemosa as a treatment of menopausal symptoms were included. They yielded no compelling evidence for the efficacy of C. racemosa on menopausal symptoms. The small beneficial effects observed in some studies could be explained by a central activity, and an oestrogenic activity cannot be completely excluded.. In spite of plausible mechanisms of action of C. racemosa, its clinical efficacy for the treatment of menopausal symptoms has not been convincingly demonstrated through rigorous clinical trials. Additional rigorous RCTs and biochemical and chemical investigations are warranted.

Topics: Animals; Cimicifuga; Clinical Trials as Topic; Estrogen Replacement Therapy; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Phytotherapy; Plant Preparations

Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms. Randomized, controlled trials have evaluated the efficacy and short-term safety of these therapies.. To review randomized, controlled trials of CAM therapies for menopausal symptoms in order to better inform practice and guide future research.. Searches of MEDLINE for articles published from January 1966 through March 2002, of the Alternative and Complementary Database (AMED) of the British Library for articles published from January 1985 through December 2000, and of the authors' own extensive files. Search terms were hot flash/flush, menopause, and climacteric, combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine (TCM ), Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch.. 29 randomized, controlled clinical trials of CAM therapies for hot flashes and other menopausal symptoms were identified; of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies.. Each author extracted information from half of the studies on the number of patients, study design, outcome measures, and results; the other author then checked these results.. Soy seems to have modest benefit for hot flashes, but studies are not conclusive. Isoflavone preparations seem to be less effective than soy foods. Black cohosh may be effective for menopausal symptoms, especially hot flashes, but the lack of adequate long-term safety data (mainly on estrogenic stimulation of the breast or endometrium) precludes recommending long-term use. Single clinical trials have found that dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flashes; two trials have shown that red clover has no benefit for treating hot flashes.. Black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms. Clinical trials do not support the use of other herbs or CAM therapies. Long-term safety data on individual isoflavones or isoflavone concentrates are not available.

Topics: Acupuncture Therapy; Behavior Therapy; Complementary Therapies; Diet; Estrogens, Non-Steroidal; Hot Flashes; Humans; Isoflavones; Menopause; Ointments; Phytoestrogens; Plant Preparations; Progesterone; Randomized Controlled Trials as Topic; Soybean Proteins; Vitamin E

Topics: Cyclohexanols; Estrogens; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Placebos; Plant Preparations; Selective Serotonin Reuptake Inhibitors; Venlafaxine Hydrochloride

Women frequently chose alternatives to hormone replacement therapy (HRT) for treatment of menopause even though medical indications for estrogens may be present. Prior breast cancer or fear of breast cancer is a major consideration. This review of alternatives to estrogen discusses the evidence linking breast cancer to HRTs and compares potential risks and benefits of HRT to nonHRT alternatives for relief of vasomotor symptoms, vaginal atrophy, neurocognitive changes and prevention of heart disease and osteoporosis. Practical guidelines are suggested for use of alternatives for each problem.

Topics: Aged; Antidepressive Agents; Atrophy; Bone Density; Bone Resorption; Breast Neoplasms; Calcitonin; Calcium; Cardiovascular Agents; Cardiovascular Diseases; Clinical Trials as Topic; Contraindications; Diphosphonates; Double-Blind Method; Estrogen Replacement Therapy; Estrogens; Estrogens, Non-Steroidal; Female; Fractures, Bone; Hot Flashes; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Isoflavones; Life Style; Menopause; Mental Disorders; Meta-Analysis as Topic; Middle Aged; Multicenter Studies as Topic; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy; Plant Preparations; Randomized Controlled Trials as Topic; Risk; Safety; Selective Estrogen Receptor Modulators; Urothelium; Vagina

Topics: Bone Density; Breast Neoplasms; Cholesterol; Estrogens, Non-Steroidal; Female; Hormone Replacement Therapy; Hot Flashes; Humans; Isoflavones; Menopause; Osteoporosis; Phytoestrogens; Plant Preparations; Soybean Proteins

Topics: Adult; Aged; Alzheimer Disease; Breast Neoplasms; Cardiovascular Diseases; Cohort Studies; Diet; Double-Blind Method; Embryonal Carcinoma Stem Cells; Estrogens; Estrogens, Non-Steroidal; Female; Follow-Up Studies; Gonadal Steroid Hormones; Hormone Replacement Therapy; Hot Flashes; Humans; Isoflavones; Longevity; Menopause; Menopause, Premature; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Hormone-Dependent; Neoplasms, Second Primary; Neoplastic Stem Cells; Obesity; Osteoporosis, Postmenopausal; Phytoestrogens; Plant Preparations; Randomized Controlled Trials as Topic; Safety; Selective Estrogen Receptor Modulators; Survivors; Weight Gain

Topics: Bone Density; Cardiovascular Diseases; Diet; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Plant Preparations

For most women, the menopause presents two sets of problems. First, most notice unpleasant symptoms such as hot flushes and vaginal dryness, but second, there are long-term sequelae arising from oestrogen deficiency. The main long-term problems are an increased risk of bone loss and cardiovascular disease. This chapter will focus on the role of phytoestrogens in alleviating menopausal symptoms. Studies to date would suggest that phytoestrogenic products may help around two-thirds of women to cope with menopausal symptoms such as hot flushes, but there is little evidence that these products will help with vaginal dryness. It seems probable that these products lower cholesterol and therefore cardiovascular risk; however, it is important that women who use such products to alleviate menopausal symptoms have a bone density performed every 2 or 3 years to assess their risk of osteoporosis.

Topics: Asia; Cardiovascular Diseases; Diet; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Menopause; Osteoporosis, Postmenopausal; Phytoestrogens; Plant Preparations; Randomized Controlled Trials as Topic

PhytoSERM is a selective estrogen receptor beta (ERβ) modulator comprised of three phytoestrogens: genistein, daidzein, and S-equol. The PhytoSERM formulation promotes estrogenic action in the brain while largely inactive or inhibitory in reproductive tissue. A phase Ib/IIa clinical trial (ClinicalTrial.gov ID: NCT01723917) of PhytoSERM demonstrated safety and pharmacokinetics profile of PhytoSERM. While this study was not powered for efficacy analysis, we conducted a pilot, retrospective analysis to identify potential responders to PhytoSERM treatment, and to determine the optimal populations to pursue in a phase II clinical trial of efficacy of the PhytoSERM formulation.. In this retrospective analysis involving 46 participants (n = 16, placebo; n = 18, 50 mg/d PhytoSERM; and n = 12, 100 mg/d PhytoSERM), the therapeutic effect of PhytoSERM was stratified by 2 genetic risk modulators for Alzheimer's disease: mitochondrial haplogroup and APOE genotype.. Our retrospective responder analysis indicated that participants on 50 mg of daily PhytoSERM (PS50) for 12 weeks significantly reduced hot flash frequency compared with their baseline (mean [95% CI])-1.61, [-2.79, -0.42], P = 0.007). Participants on 50 mg of PhytoSERM also had significantly greater reduction in hot flash frequency at 12 weeks compared with the placebo group (-1.38, -0.17 [median PS50, median placebo], P = 0.04). Fifty milligrams of daily PhytoSERM also preserved cognitive function in certain aspects of verbal learning and executive function. Our analysis further suggests that mitochondrial haplogroup and APOE genotype can modify PhytoSERM response.. Our data support a precision medicine approach for further development of PhytoSERM as a safe and effective alternative to hormone therapy for menopause-associated hot flash and cognitive decline. While definitive determination of PhytoSERM efficacy is limited by the small sample size, these data provide a reasonable rationale to extend analyses to a larger study set powered to address statistical significance.

Topics: Apolipoproteins E; Cognition; Cognitive Dysfunction; Double-Blind Method; Equol; Feasibility Studies; Female; Genistein; Haplotypes; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Mitochondria; Phytoestrogens; Pilot Projects; Retrospective Studies; Selective Estrogen Receptor Modulators; Treatment Outcome

The effect of acupuncture and phytoestrogens on climacteric symptoms was compared to the effect of hormone therapy (HT) with estrogen plus progestin. A total of 75 postmenopausal women with hot flushes were randomized to receive for 3 months conjugated estrogens/medroxyprogesterone acetate (0.30 mg/1.5 mg/d), acupuncture weekly or soy isoflavones (75 mg/2/d). Evaluations were performed prior to, at the end, and 3 months after treatments. Main outcomes were modification of the Greene's climacteric scale and menopause quality of life (MenQoL). The Greene's score significantly declined (

Topics: Acupuncture Therapy; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Progestins

To verify the efficacy of phytoestrogen supplementation combined with aerobic and resistance training on the improvement of climacteric symptoms and health-related quality of life (HRQoL) in postmenopausal women.. From a pool of women who had participated in a 1-year intervention study and were randomly assigned to either exercise + phytoestrogen (EX + PHY) or exercise + placebo (EX + PL), a total of 31 healthy but overweight women (mean age 59.2 ± 4.8 years, body mass index 29.1 ± 3.5 kg/m. After 1 year of intervention, physical functioning (p = 0.003), role-emotional (p = 0.031), vitality (p = 0.007), and global health (p < 0.001) were significantly and similarly increased in both groups. Regarding climacteric symptoms, an improvement in the Kupperman index total score (p = 0.015) was observed.. Our results demonstrate that adding phytoestrogens to exercise training does not provide the additive effect for HRQoL in postmenopausal and overweight women. Moreover, exercise and phytoestrogen may interfere in the improvement of climacteric symptoms in the long term.

Topics: Aged; Anthropometry; Dietary Supplements; Exercise; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Quality of Life; Resistance Training; Surveys and Questionnaires; Treatment Outcome

The aim of this study was to assess the efficacy of a combined nutraceutical supplement on symptoms and early metabolic alterations during the menopausal transition. This pilot randomized study was conducted at the service for menopause disorders of the Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.. Ninety women in menopausal transition who attended our service with menopausal symptoms were enrolled in the study. Sixty patients, randomly assigned to the treatment group, were prescribed one daily tablet of a combined nutraceutical compound with phytoestrogen substances, vitamins, micronutrients and passion flower herbal medicine for 6 months. Thirty patients did not receive any treatment and comprised the control group. The intensity of perimenopausal symptoms was assessed by the modified Kuppermann Index (KI) at enrollment and at 3 and 6 months of treatment. At baseline and at the end of the study, patients underwent a clinical evaluation, a pelvic ultrasound and analysis of blood samples.. In the nutraceutical supplemented group, a significant reduction in menopausal symptoms was demonstrated according to the KI after 3 and 6 months of supplementation (p < 0.01). The within-group analysis of different KI parameters in the treated group showed a significant improvement in hot flushes (p < 0.001), insomnia (p < 0.01), fatigue (p < 0.01) and irritability (p < 0.01). Metabolic parameters did not change significantly in the nutraceutical supplemented group. In the control group, total cholesterol level showed a significant increase (p < 0.05).. Combined nutraceutical supplementation provides an effective and safe solution for early symptoms occurring during menopausal transition.

Topics: Dietary Supplements; Female; Hot Flashes; Humans; Isoflavones; Italy; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Pilot Projects; Plants, Medicinal; Quality of Life; Rome; Treatment Outcome

During menopause, an increased prevalence of metabolic syndrome (MetS) and central obesity seems to increase hot flashes (HFs). Visfatin is an inflammatory adipokine secreted by visceral fat. We investigated visfatin levels and its relationship with hot flash number and BMI, in postmenopausal women with MetS. We also evaluated the effect of genistein, an isoflavone effective in reducing HFs, on visfatin levels and HFs after 1 year of treatment. This was a randomized, double-blind, placebo-controlled trial. Postmenopausal women with MetS were randomly assigned to receive placebo (n = 60) or 54 mg genistein (n = 60), daily for 1 year. As main outcome measures, hot flashes number and circulating visfatin levels were evaluated. Visfatin significantly correlated with BMI and HFs number in women with MetS at basal. After 6 and 12 months, our results indicate a strong correlation and a significant effect of genistein in reducing both HFs and visfatin in women with MetS. The present study suggests that visfatin plays a role in the vasomotor symptoms, at least in postmenopausal women with metabolic syndrome. Genistein may reduce HFs decreasing the circulating levels of this inflammatory adipokine.

Topics: Aged; Body Mass Index; Double-Blind Method; Female; Genistein; Hot Flashes; Humans; Metabolic Syndrome; Middle Aged; Nicotinamide Phosphoribosyltransferase; Phytoestrogens; Postmenopause; Treatment Outcome

This study was designed to evaluate the effects of equol and resveratrol supplementation on health-related quality of life (HRQoL) in otherwise healthy menopausal women with hot flashes, anxiety and depressive symptoms.. Sixty recently menopausal women aged 50-55 years were randomized in a 12-week, placebo-controlled trial to receive 200mg of fermented soy containing 10mg of equol and 25mg of resveratrol (1 tablet/day). The primary outcome was the change in score on the Menopause Rating Scale (MRS), used to evaluate the severity of age-/menopause-related complaints. Additional outcome measures included the subject-reported score on the Hamilton Rating Scale for Depression (HAM-D) and Nottingham Health Profile (NHP), which was used specifically to assess sleep quality.. The symptoms assessed by the MRS improved during treatment in the active group. Comparison between placebo and treatment groups revealed statistically significant improvement in particular for dryness of vagina (-85.7%) (p<0.001), heart discomfort (-78.8%; p<0.001) and sexual problems (-73.3%; p<0.001). On the HAM-D significant improvements at week 12 were seen in work and activities (-94.1%) (p<0.001). Subjects treated with equol and resveratrol also had significant differences in the sleep domain of the NHP (p<0.001).. These findings provide evidence that 12 weeks of dietary supplementation with equol and resveratrol may improve menopause-related quality of life in healthy women.

Topics: Anxiety; Depression; Dietary Supplements; Double-Blind Method; Drug Combinations; Equol; Female; Hot Flashes; Humans; Menopause; Middle Aged; Phytoestrogens; Quality of Life; Resveratrol; Sexual Dysfunction, Physiological; Sleep; Stilbenes; Treatment Outcome; Vagina

To assess the effects of 2 months of treatment with Femarelle for climacteric syndrome in Taiwanese postmenopausal women.. A multi-center, open-label trial of 260 postmenopausal women, age ≥ 45 years with vasomotor symptoms. Women were enrolled after obtaining a detailed medical history and a thorough physical examination. They then received Femarelle (640 mg/d) twice daily for 8 weeks. The primary outcome was the changes in the frequency and severity of hot flushes from baseline to 4 weeks (1 month) and 8 weeks (2 months). Changes of general climacteric syndrome were assessed using a modified climacteric scale designed by Greene.. The frequency and severity of hot flushes were significantly improved with Femarelle use (p < 0.001). After 8 weeks of treatment, the percentage of women with various climacteric syndromes was reduced (from 100% to 20.9% for hot flushes, from 97.7% to 87.9% for psychological symptoms, from 93.8% to 78.8% for somatic symptoms, and from 87.8% to 74.9% for sexual symptoms). General climacteric syndrome scores also significantly decreased, from 20.8 ± 0.7 at the time of enrollment to 12.9 ± 0.7 after 8 weeks of Femarelle treatment (p < 0.0001). Participants experienced improvement of various climacteric symptoms and signs after 8 weeks of treatment (75.1% for hot flushes, 68.7% for psychological symptoms, 70.6% for somatic symptoms, and 69.0% for sexual problems respectively). After 4 weeks and 8 weeks of treatment with Femarelle, patients showed statistically significant improvement in climacteric symptoms (p < 0.0001). Three women (1.2%) withdrew from the study after 4 weeks of treatment due to adverse effects.. Femarelle significantly improved climacteric symptoms in Taiwanese postmenopausal women. However, further evaluation is needed regarding the safety of long-term consumption.

Topics: Aged; Female; Hot Flashes; Humans; Middle Aged; Phytoestrogens; Plant Extracts; Postmenopause; Severity of Illness Index; Sexual Dysfunction, Physiological; Sexuality; Syndrome

The aim of this study was to assess the effects of a phyto complex on menopausal symptoms.. A total of 151 women aged 42-67 years were enrolled. They were in spontaneous or surgical menopause by at least 12 months, reporting symptoms referable to the climacteric syndrome. Two validated and standardized tests were given to the whole sample at the entrance of the study (T0) and after 6 months of treatment (T6): the Greene Climacteric Scale (GCS) and the Beck Depression Inventory (BDI). Interim evaluations were carried out at 1-3 months (T1 and T3) on five symptoms selected from the GCS. The phyto complex was given to each enrolled woman, from the T0 to T6 time-points, for a total of 180 days.. At the T0 time-point, the average scores were: GCS, 28.98 (standard deviation [SD] ± 10.71); BDI, 14.48 (SD ± 6.5). At the T1 time-point, five parameters of the GCS were assessed with a reduction of 36.25% in symptoms (5.69, SD ± 3.53). At the T6 time-point the assessment was completed: average GCS results were 11.54 (SD ± 8.01) with a 60.17% improvement; and average BDI results were 6.11 (SD ± 4.6) with a 58.91% improvement in the depressive symptoms.. The phyto complex under consideration is an effective tool to counter, in a quick and long-lasting manner, the most common and nagging symptoms of the climacteric syndrome, such as hot flushes, insomnia and depression.

Topics: Adult; Aged; Anxiety; Cholecalciferol; Depression; Diagnostic and Statistical Manual of Mental Disorders; Dietary Supplements; Drug Combinations; Female; Genistein; Gluconates; Hot Flashes; Humans; Middle Aged; Phytoestrogens; Plant Extracts; Plant Preparations; Postmenopause; Psychiatric Status Rating Scales; Severity of Illness Index; Sicily; Sleep Initiation and Maintenance Disorders; Vitamin E

Dietary supplements containing soy or isoflavones are widely used as alternatives to hormone therapy. However, their efficacy is still inconclusive, and limited data on equol producers are available. The aim of this study was to examine the effect of whole soy (soy flour) or purified daidzein (one major soy isoflavone and the precursor of equol) on menopausal symptoms in equol-producing postmenopausal women, a population most likely to benefit from soy intervention.. This is a 6-month parallel-group, double-blind, randomized, placebo-controlled trial. Two hundred seventy equol-producing prehypertensive Chinese postmenopausal women were randomized to one of three treatment groups: 40 g of soy flour (whole soy group), 40 g of low-fat milk powder + 63 mg of daidzein (daidzein group), or 40 g of low-fat milk powder (placebo group) daily, each given as a solid beverage for 6 months. Changes in menopausal symptoms were assessed by a validated and structured symptom checklist at baseline and 6 months.. Two hundred fifty-three participants completed the study according to protocol. Urinary isoflavones indicated good compliance with the interventions. Baseline menopausal symptoms were comparable among the three study groups. Intention-to-treat analysis indicated that there was no significant difference in the 6-month changes or percent changes in the total number of menopausal symptoms, in the five dimensions of symptoms, and in the frequencies of individual symptoms among the three treatment groups.. Whole soy and purified daidzein have no significant effect on alleviation of menopausal symptoms among equol-producing postmenopausal women with prehypertension.

Topics: Anxiety; Back Pain; China; Cognition; Cough; Depression; Dietary Supplements; Double-Blind Method; Dyspnea; Equol; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Phytotherapy; Plant Preparations; Postmenopause; Sleep Wake Disorders

The relatively modest benefit of vasomotor symptom relief in clinical trials of isoflavones may reflect once-daily dosing and low percentages of participants who are able to metabolize daidzein into equol, a potentially more biologically active isoflavone. This pilot study examined whether symptom reduction was greater with more frequent administration and with higher daily doses. In addition, we explored possible effect modification by equol producer status.. We randomized 130 perimenopausal (no menses in the past 3 mo) and postmenopausal (≥12 mo of amenorrhea) women with a mean of five or more moderate/severe hot flashes per day to treatment arms with varying total daily isoflavone doses and dosing frequency, separately for equol producers and nonproducers. Participants recorded the daily frequency and severity of hot flashes. Analyses compared mean daily hot flash intensity scores (sum of hot flashes weighted by severity) by total daily dose and by dosing frequency. Dose- and frequency-related differences were also compared for equol producers and nonproducers.. Hot flash intensity scores were lowest in women randomized to the highest total daily dose (100-200 mg) and in women randomized to the highest dosing frequency (twice daily to thrice daily), with greater benefits on nighttime scores than on daytime scores. Dose- and frequency-related differences were somewhat larger in equol producers than in nonproducers.. These results suggest that a twice-daily to thrice-daily dosing frequency may improve the benefit of isoflavones for vasomotor symptom relief, particularly in equol producers and for nighttime symptoms. Larger studies are needed to confirm these findings.

Topics: Adult; Dietary Supplements; Dose-Response Relationship, Drug; Drug Administration Schedule; Equol; Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Pilot Projects; Quality of Life; Treatment Outcome; Women's Health

The aim of this prospective randomized study was to evaluate a red clover based isoflavones supplementation in the treatment of climacteric syndrome and its effects on cardiovascular risk serum profile.. The study included 150 healthy postmenopausal women that were randomly assigned to receive phytoestrogens tablets, amounting in a total daily intake of 60.8 mg red clover isoflavones plus 19.2 mg soy isoflavones (n = 75), or placebo (n = 75). The authors evaluated teh following: daily number of hot flushes and Kupperman Index at baseline and after one and three months; serum total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides, prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, and antithrombin III (ATIII) at baseline and after three and six months.. One hundred twenty-eight patients completed the study: 67 in the active group and 61 in the placebo group. The treatment led to a progressive significant reduction (p < 0.05) of the number of hot flushes in the active group compared to placebo already after one month, while Kupperman Index was statistically reduced after three months. No significant variation in total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, PT, PTT, fibrinogen, and ATIII were found.. The present findings suggest that a red clover based isoflavones supplementation in healthy postmenopausal women is promptly effective on climacteric syndrome, improves neurovegetative symptoms, safe on cardiovascular risk serum profile, and does not modify lipids and coagulation.

Topics: Cardiovascular Diseases; Female; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Phytotherapy; Risk Assessment; Trifolium

The objective of this clinical trial was to examine the efficacy of a supplement containing natural S-(-)equol, a daidzein metabolite, in reducing menopausal symptoms.. In this multicenter, double-blind placebo-controlled trial, 160 equol nonproducing, postmenopausal Japanese women who experienced at least 1 hot flush/day were randomly assigned to consume 10 mg/day S-(-)equol (n=77 women) or placebo (n=83 women) for 12 weeks. Participants completed a standardized menopausal symptom checklist and rated five common menopause symptoms by a visual analog scale at baseline, week 12, and week 18 (6-week postintervention). Physical, blood, and urine examinations were conducted. One hundred twenty-six women completed the study.. At baseline, daily hot flush frequency was 2.9±2.1 for the S-(-)equol group and 3.2±2.4 for the placebo group. After the 12-week intervention, the S-(-)equol group had a greater decrease from baseline in hot flush frequency compared with the placebo group (-1.9±1.8/day, -58.7%, vs. -1.0±2.0/day, -34.5%, p=0.009). The severity of hot flushes and neck or shoulder muscle stiffness significantly decreased in the S-(-)equol group compared with the placebo group. No changes in clinical parameters or serious adverse effects were reported.. This is the first trial to show beneficial effects of a 10-mg natural S-(-)equol supplement consumed daily for 12 weeks on major menopausal symptoms, specifically, hot flushes and neck or shoulder muscle stiffness, in postmenopausal Japanese women. This supplement offers a promising alternative for management of menopausal symptoms.

Topics: Asian People; Dietary Supplements; Double-Blind Method; Equol; Female; Gonadal Steroid Hormones; Hot Flashes; Humans; Japan; Menopause; Middle Aged; Phytoestrogens; Thyroid Hormones

Estrogen therapy is, to date, the most effective treatment of menopausal syndrome and also has a favorable effect on lipid profiles. Because of its potential adverse effects, however, a more acceptable alternative therapy needs to be identified. This study examines the effect of soy germ isoflavones on menopausal symptoms and serum lipids.. Ninety early postmenopausal Chinese women, aged 45 to 60 years, were randomly assigned to three treatment groups (30 each) receiving daily doses of 0 (placebo), 84, and 126 mg of soy germ isoflavones. Hot flush frequency, Kupperman scores, serum 17β-estradiol, follicle-stimulating hormone, luteinizing hormone, and serum lipids, including triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A-I, and apolipoprotein B100, were assessed at baseline and at 12 and 24 weeks after treatment.. Both the frequency of hot flushes and the Kupperman index score decreased in all three treatment groups during the intervention period, but the percentage decreases in both were significantly greater in the two isoflavone groups (44.3 ± 19.1 and 57.8 ± 37.4 [84 mg isoflavones]; 48.5 ± 27.2 and 56.7 ± 26.7 [126 mg isoflavones]) than in the placebo group (27.8 ± 15.5 and 34.6 ± 46.2; p < 0.01). There was no significant difference in the changes in estradiol, follicle-stimulating hormone, and luteinizing hormone among the three treatment groups during the study, and no significant differences were observed in the lipid components.. A daily supplement of 84 or 126 mg soy germ isoflavones may improve menopausal symptoms, although neither dose was found to affect lipid profiles in early postmenopausal Chinese women after 24 weeks of treatment. The favorable effects are unlikely to be associated with female hormones.

Topics: China; Estradiol; Estrogens; Female; Follicle Stimulating Hormone; Glycine max; Hot Flashes; Humans; Isoflavones; Lipids; Luteinizing Hormone; Middle Aged; Phytoestrogens; Postmenopause; Severity of Illness Index; Single-Blind Method; Treatment Outcome

S-equol, a metabolite of the soy isoflavone daidzein, has been proposed as having potential for relief of menopausal symptoms. This study compared the efficacy of the natural S-equol supplement, SE5-OH, with isoflavones for relieving hot flashes and other menopausal symptoms.. An 8-week randomized, double-blind, active comparator trial with SE5-OH was conducted in postmenopausal women (aged 45-65 years), who experienced ≥5 hot flashes/day. Participants (n=102) were assigned to one of four treatment groups: 10 (n=24), 20 (n=27), or 40 (n=25) mg S-equol/day or soy isoflavones (n=26). Participants recorded their hot flash frequency and rated their menopause symptom severity.. Reductions in hot flash frequency at week 8 were similar for all treatment groups. However, based on analyses of the cumulative effect for the 8-week period, 40 mg/day S-equol had a greater reduction of hot flash frequency compared to isoflavones (p=0.021). A subgroup analysis further indicated that for subjects with >8 hot flashes/day at baseline, 20 and 40 mg/day S-equol were superior to isoflavones in reducing hot flash frequency (p=0.045 and p=0.001, respectively). In addition, 10 and 20 mg/day S-equol improved muscle and joint pain score compared with isoflavones (p=0.003 and p=0.005, respectively).. S-equol, 10 mg/day, appears to be as effective as soy isoflavones at reducing hot flash frequency and more effective for relieving muscle and joint pain in postmenopausal women. S-equol, ≥20 mg/day, alleviates hot flashes to a greater extent than soy isoflavones in those women who experience >8 hot flashes/day.

Topics: Aged; Dietary Supplements; Double-Blind Method; Female; Hot Flashes; Humans; Isoflavones; Middle Aged; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy; Postmenopause; Soybean Proteins; Treatment Outcome; United States

To investigate the effects of standardized soy extract on climacteric symptoms, lipid profiles, bone markers, and serum isoflavone concentration in healthy Taiwanese postmenopausal women.. A multicenter, open-labeled, randomized, prospective, comparative study design was used. A total of 130 outpatients who had undergone natural menopause were randomly administered either 70 mg or 35 mg soy extract daily for 24 weeks.. The evidence suggests that the soy extract treatment that was administered to both groups for 1 month could help reduce climacteric scores (reductions of 19.66% [p<0.01] and 18.85% [p<0.01] in the 35 mg and 70 mg groups compared with baseline, respectively), and the efficacy was more potent after 6 months of treatment. Soy isoflavone significantly reduced the total cholesterol (reductions of 4.50% [p<0.01] and 3.06% [p<0.05] in the 35 mg and 70 mg groups, respectively) and low density lipoprotein cholesterol levels (reductions of 4.67% [p<0.05] and 5.09% [p<0.05] in the 35 mg and 70 mg groups, respectively) in patients with total cholesterol > 200 mg/dL after 6 months of treatment. In patients with high bone turnover (urinary deoxypyridinoline/creatinine > 7.4 nM/mM), soy extract treatment reduced the deoxypyridinoline/creatinine level by 10.53% (p<0.05) and 11.58% (p<0.05) in the 35 mg and 70 mg groups, respectively. Serum levels of isoflavone increased in both groups after 6 months of treatment.. Soy extract is highly efficacious at relieving menopausal symptoms and demonstrates a positive effect on the cardiovascular system and skeleton.

Topics: Amino Acids; Analysis of Variance; Cholesterol; Cholesterol, LDL; Creatinine; Female; Genistein; Glycine max; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Postmenopause; Severity of Illness Index

The objective of this study was to evaluate the efficacy of flaxseed meal and flaxseed extract in reducing climacteric symptoms of menopausal women. Ninety menopausal women were randomly distributed into three study groups: group I received 1 g per day of flaxseed extract containing at least 100 mg of secoisolariciresinol diglucoside (SDG), group II received 90 g per day of flaxseed meal containing at least 270 mg of SDG, and group III received 1 g per day of collagen (placebo group). Subjects were assessed for menopausal symptoms by the Kupperman index at the beginning and at the end of the 6 months of treatment. Subjects were also assessed for endometrial thickness and vaginal cytology. The Kupperman index values at the beginning and end of the treatments were analyzed using the paired t-test. Both the flaxseed extract (P=.007) and the flaxseed meal (P=.005) were effective in reducing the menopausal symptoms when compared with the placebo control (P=.082). Alternatively, the changes in Kupperman index were also computed and submitted to analysis of variance. In this case, no significant differences were found (P=.084) although the data indicate a decreasing tendency for the Kupperman index by both the flaxseed extract and the flaxseed meal groups. Neither the flaxseed extract nor the flaxseed meal exerted clinically important estrogenic effects on the vaginal epithelium or endometrium as revealed by the absence of changes in the blood levels of follicle stimulating hormone and estradiol, as well as in the endometrial thickness, and vaginal epithelial maturation value. No serious adverse events related to the treatments were reported. Although the results of the present study do not allow an unequivocal conclusion about the action of flaxseed on the menopausal symptoms, they suggest that it could be premature to conclude that no such action exists. Clearly the matter still deserves further experimental attention.

Topics: Aged; Brazil; Butylene Glycols; Dietary Supplements; Endometrium; Epithelial Cells; Estradiol; Female; Flax; Follicle Stimulating Hormone, Human; Glucosides; Hot Flashes; Humans; Hypertrophy; Menopause; Middle Aged; Phytoestrogens; Plant Extracts; Seeds; Severity of Illness Index; Ultrasonography; Vagina

Pumpkin seed oil is rich in phytoestrogens and animal studies suggest that there is some benefit to supplementation in low estrogen conditions. This study is the first to evaluate the benefit of pumpkin seed oil in postmenopausal women.. This pilot study was randomized, double-blinded and placebo-controlled. Study participants included 35 women who had undergone natural menopause or had iatrogenically entered the climacteric due to surgery for benign pathology. Wheat germ oil (placebo; n = 14) and pumpkin seed oil (n = 21) were administered to eligible participants over a 12-week period at a dose of 2 g per day. Serum lipids, fasting plasma glucose and blood pressure were measured and an 18-point questionnaire regarding menopausal symptoms was administered; the atherogenic index was also calculated. Differences between groups, as well as before and after the period of supplementation, were evaluated with Student's t-test, Wilcoxon matched-pair signed-ranked test and Mann-Whitney test, as appropriate (Stata version 10.1).. Women receiving pumpkin seed oil showed a significant increase in high density lipoprotein cholesterol concentrations (0.92 ± 0.23 mmol/l vs. 1.07 ± 0.27 mmol/l; p = 0.029) and decrease in diastolic blood pressure (81.1 ± 7.94 mmHg vs. 75.67 ± 11.93 mmHg; p < 0.046). There was also a significant improvement in the menopausal symptom scores (18.1 ± 9.0 vs. 13.2 ± 6.7; p < 0.030), with a decrease in severity of hot flushes, less headaches and less joint pains being the main contributors. Women in the group receiving wheat germ oil reported being more depressed and having more unloved feeling.. This pilot study showed pumpkin seed oil had some benefits for postmenopausal women and provided strong evidence to support further studies.

Topics: Aged; Blood Pressure; Cholesterol, HDL; Cucurbita; Double-Blind Method; Female; Hot Flashes; Humans; Middle Aged; Phytoestrogens; Phytotherapy; Pilot Projects; Placebos; Plant Oils; Postmenopause; Seeds

Concerns regarding the risk of estrogen replacement have resulted in a significant increase in the use of soy products by menopausal women who, despite the lack of evidence of the efficacy of such products, seek alternatives to menopausal hormone therapy. Our goal was to determine the efficacy of soy isoflavone tablets in preventing bone loss and menopausal symptoms.. The study design was a single-center, randomized, placebo-controlled, double-blind clinical trial conducted from July 1, 2004, through March 31, 2009. Women aged 45 to 60 years within 5 years of menopause and with a bone mineral density T score of -2.0 or higher in the lumbar spine or total hip were randomly assigned, in equal proportions, to receive daily soy isoflavone tablets, 200 mg, or placebo. The primary outcome was changes in bone mineral density in the lumbar spine, total hip, and femoral neck at the 2-year follow-up. Secondary outcomes included changes in menopausal symptoms, vaginal cytologic characteristics, N -telopeptide of type I bone collagen, lipids, and thyroid function.. After 2 years, no significant differences were found between the participants receiving soy tablets (n = 122) and those receiving placebo (n = 126) regarding changes in bone mineral density in the spine (-2.0% and -2.3%, respectively), the total hip (-1.2% and -1.4%, respectively), or the femoral neck (-2.2% and -2.1%, respectively). A significantly larger proportion of participants in the soy group experienced hot flashes and constipation compared with the control group. No significant differences were found between groups in other outcomes.. In this population, the daily administration of tablets containing 200 mg of soy isoflavones for 2 years did not prevent bone loss or menopausal symptoms.. clinicaltrials.gov Identifier: NCT00076050.

Topics: Dietary Supplements; Double-Blind Method; Estrogen Replacement Therapy; Female; Genistein; Glycine max; Hot Flashes; Humans; Isoflavones; Logistic Models; Middle Aged; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy

Postmenopausal women seem to favor alternative therapies such as exercise and phytoestrogens as a substitute for potentially harmful hormone replacement therapy. Based on previous research, we hypothesized that phytoestrogens combined with exercise could have a synergic effect on women's health.. To verify whether phytoestrogens enhance the response to mixed training regarding menopausal symptoms and quality of life in postmenopausal women.. From a pool of women participating in a 6-month randomized, controlled exercise study, 21 received a placebo (mean age 58.3 ± 5.4 years, body mass index 29.8 ± 5.1 kg/m(2)) and 19 received phytoestrogen supplements (mean age 60.1 ± 3.4 years; body mass index 30.3 ± 4.6 kg/m(2)). Body weight, fat mass and lean body mass (dual-energy X-ray absorptiometry) were assessed. Quality of life was estimated by the Short Form-36 (SF-36) and Perceived Stress Scale-10 (PSS-10) questionnaires, and menopausal symptoms by the Kupperman index. All measurements were performed before and after the intervention.. Although the Kupperman index and PSS-10 remained unchanged in both groups, the SF-36 Physical Component Summary and almost all the SF-36 subscales (except for role-emotional and mental health) increased only in the exercise group taking phytoestrogens (0.001 < p < 0.04).. While phytoestrogens combined with mixed exercise were not sufficient to improve menopausal symptoms, it seemed to be a better strategy than exercise alone to improve the general quality of life in postmenopausal women.

Topics: Body Mass Index; Dietary Supplements; Exercise; Female; Hot Flashes; Humans; Middle Aged; Obesity; Overweight; Phytoestrogens; Placebos; Postmenopause; Quality of Life

Following the results of the Women's Health Initiative, many women now decline estrogen replacement at the time of menopause and seek natural remedies that would treat menopausal symptoms and prevent bone loss and other long-term consequences of estrogen deficiency, but without adverse effects on the breast, uterus, and cardiovascular system. The results of most soy studies in this population have had limitations because of poor design, small sample size, or short duration. This report describes the study rationale, design, and procedures of the Soy Phytoestrogens As Replacement Estrogen (SPARE) study, which was designed to determine the efficacy of soy isoflavones in preventing spinal bone loss and menopausal symptoms in the initial years of menopause. Women ages 45 to 60 without osteoporosis and within 5 years from menopause were randomized to receive soy isoflavones 200mg daily or placebo for 2 years. Participants have yearly measurements of spine and hip bone density, urinary phytoestrogens, and serum lipids, thyroid stimulating hormone, and estradiol. Menopausal symptoms, mood changes, depression, and quality of life are assessed annually. The SPARE study recruited 283 women, 66.1% were Hispanic white. With a large cohort, long duration, and large isoflavone dose, this trial will provide important, relevant, and currently unavailable information on the benefits of purified soy isoflavones in the prevention of bone loss and menopausal symptoms in the first 5 years of menopause. Given the high proportion of Hispanics participating in the study, the results of this trial will also be applicable to this minority group.

Topics: Analysis of Variance; Bone Density; Chi-Square Distribution; Double-Blind Method; Estrogen Replacement Therapy; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Logistic Models; Lumbar Vertebrae; Menopause; Middle Aged; Patient Selection; Phytoestrogens; Radiography; Vagina

The aim of the present study was to assess the efficacy and safety of a standardized compound based on an extract of soy phytoestrogens, with high doses of isoflavones in the management of menopausal hot flushes.. A total of 180 women aged 40-65 years with a minimum of five moderate-to-severe hot flushes in the last 7 days at baseline and absence of menstruation for at least 6 months participated in a 12-week prospective, randomized, double-blind, placebo-controlled multicenter trial. After a 2-week run-in period, women received one tablet a day of 80 mg isoflavones (corresponding to 60 mg of genistein) or a matching placebo.. The mean daily number of moderate-to-severe hot flushes decreased in both study groups, but the reduction was greater in the isoflavones arm at 6 (36.2%) and 12 weeks (41.2%) than in the placebo arm (24.0% at 6 weeks, 29.3% at 12 weeks), with a difference of 1.1 (95% CI [-2.0 to -0.06]) (P = 0.038) at 6 weeks and 1.1 (95% CI [-2.05 to -0.15]) (P = 0.023) at 12 weeks. Similar findings were obtained for hot flushes of any intensity. The Kupperman index decreased in both study groups. Relief of hot flushes was greater when time to menopause was >or=12 months and in cases of BMI >or=27 kg/m(2).. In daily practice conditions, high doses of isoflavones, particularly genistein, can be used for the management of hot flushes in postmenopausal women not treated with hormone replacement therapy due to their superior efficacy to placebo and very good safety profile.

Topics: Adult; Aged; Double-Blind Method; Female; Genistein; Glycine max; Hot Flashes; Humans; Menopause; Middle Aged; Patient Satisfaction; Phytoestrogens; Phytotherapy; Prospective Studies

To evaluate the effect of soy isoflavones on menopausal symptoms in women who do and who do not produce equol, a daidzein metabolite.. A randomized, double-blind, placebo-controlled clinical trial was conducted over 6 months with 96 healthy menopausal women. After taking take 135 mg of isoflavones daily for 1 week, the women in the study group were assigned to the equol-producing (EP) or the non-EP group according to the presence or absence of equol in their urine. Menopausal symptoms were evaluated using a modified Kupperman Index.. Compared with the placebo group, the scores for hot flashes and excessive sweating were significantly reduced after 3 months, and the scores for weakness, palpitations, limb paresthesia, and total symptoms after 6 months, in the EP group only.. Isoflavone supplementation improves menopausal symptoms only in women with the ability to produce equol.

Topics: Dietary Supplements; Double-Blind Method; Equol; Female; Hot Flashes; Humans; Intestinal Mucosa; Isoflavones; Middle Aged; Phytoestrogens; Postmenopause; Soybean Proteins

Black cohosh (Actaea racemosa) is an herb commonly used to treat menopausal symptoms. Little is known about its effect on other physiologic parameters that could result in untoward events. This study examines the effect of black cohosh on lipids, fibrinogen, glucose and insulin.. Three hundred and fifty-one, 45-55 years old, peri or post-menopausal women experiencing vasomotor symptoms participated in a 3-month, double blind trial with randomization to: (1) black cohosh (160 mg daily); (2) multibotanical including black cohosh (200 mg daily); (3) multibotanical plus soy diet counseling; (4) conjugated equine estrogen .625 mg, with or without medroxyprogesterone acetate 2.5mg daily, for women with or without a uterus, respectively; (5) placebo. Baseline and month 3 total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol (calculated), triglyceride, insulin, glucose, and fibrinogen serum concentrations were measured in 310 women. Baseline information was also collected on medical history, demographic characteristics, and diet.. There were no statistically significant differences in the adjusted mean change from baseline to 3 months between the herbal groups and placebo in total cholesterol, LDL, HDL, triglycerides, glucose, and insulin. Adjusted fibrinogen levels appear to increase in the multibotanical treatment group in comparison with the other herbal groups and placebo overall (P = .02), but there was no statistically significant difference in the pairwise test against placebo (P = .11).. Black cohosh containing therapies had no demonstrable effects on lipids, glucose, insulin or fibrinogen.

Topics: Blood Glucose; Cimicifuga; Double-Blind Method; Estrogen Replacement Therapy; Female; Fibrinogen; Hot Flashes; Humans; Insulin; Lipids; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Treatment Outcome

To investigate the efficacy-safety balance of the isopropanolic extract of Actaea (=Cimicifuga) racemosa (iCR, Remifemin) in comparison with tibolone in Chinese women with climacteric complaints.. The randomized, double-blind, controlled 3-month study in 5 centers of 3 cities in China enrolled 244 menopausal patients aged 40-60 years and with a Kupperman Menopause Index (KMI)>or=15. The participants were assigned to either iCR corresponding to 40 mg crude drug/day (N=122) or tibolone 2.5mg/day (N=122) orally. The primary endpoint was the combination of the Mann-Whitney values (MWV) of the KMI and the frequency of adverse events (benefit-risk balance) at end of treatment (MWV>0.5 shows superiority; MWV>0.36 shows non-inferiority).. KMI decreased from 24.7+/-6.1 to 11.2+/-6.2 and 7.7+/-5.8 (iCR) and to 11.2+/-7.2 and 7.5+/-6.8 (tibolone) at 4 and 12 weeks. This remarkable and clinically relevant improvement was similar in both treatment groups (MWV=0.47; 95% CI=0.39-0.54; p(non-inferiority)=0.002) showing statistical significant non-inferiority of iCR to tibolone. The KMI-responder rate was similar in both groups (84% and 85%). The safety evaluation showed for both groups a good safety and tolerability profile, however, there is a significant lower incidence of adverse events (p<0.0001) in favor of the herbal treatment. None of the postmenopausal iCR patients experienced vaginal bleeding in contrast to tibolone (17 cases). Breast and abdominal pain as well as leukorrhea was mostly observed in the tibolone group (p=0.015, p=0.008, p=0.002). No serious adverse event was observed in the iCR-group, however, two occurred in the tibolone-group. The benefit-risk balance for iCR was significantly (p=0.01) superior to tibolone (MWV=0.56; 95% confidence interval [0.51-0.62]).. The efficacy of iCR (medicinal product Remifemin) is as good as tibolone for the treatment of climacteric complaints, even for moderate to severe symptoms, whereby iCR is clearly superior regarding the safety profile. This iCR containing medicinal product is an excellent option for treatment of climacteric complaints which has now for the first time been verified in Asian women.

Topics: Adult; Asian People; China; Cimicifuga; Confidence Intervals; Dose-Response Relationship, Drug; Double-Blind Method; Estrogen Receptor Modulators; Female; Hot Flashes; Humans; Menopause; Metrorrhagia; Middle Aged; Norpregnenes; Odds Ratio; Phytoestrogens; Phytotherapy; Plant Extracts; Statistics, Nonparametric

In recent years, considerable attention has been paid to isoflavones and their proprieties to alleviate the climacteric symptoms. The goal of this study was to evaluate the efficacy of standardized isoflavones extract (Soyfem) in moderate and medium-severe climacteric syndrome.. 555 postmenopausal women were recruited for the study. Out of this group, 169 women completed the study (12-month observation period). The patients were classified according to the intensity of climacteric symptoms (< or = 34 points in Kupperman index). 1 or 2 tablets of Soyfem were administered twice a day.. A regular decrease of Kupperman index value and improvement of life quality were observed in the group of 169 postmenopausal women. We have noted a decrease in the intensity and number of hot flushes, diaphoresis (p < 0.05), diminished sleep disturbances (p < 0.05), decreased headache, dizziness, and arthrosis pain. The diminished intensity of tiredness, palpitation and breathlessness have been also observed (p < 0.05). 80% of all investigated women noted the regression of paresthesis, 20% indicated the decreased number of paresthesis (p < 0.05). Influence of Soyfem on the variability and moderation of depressive mood (p < 0.05) have been also positive evaluated by patients.. Administration of Soyfem in the dosage 52 to 104 mg/24 hours (2 times daily 1 or 2 tablets) is a safe and effective therapy in the postmenopausal women with moderate and medium-severe climacteric syndrome evaluated according to the Kupperman index. Administration of Soyfem is connected with a good compliance and correlated with well-being in the investigated women allowing a long-term administration.

Topics: Adult; Aged; Anxiety; Dizziness; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Glycine max; Headache; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Plant Extracts; Poland; Postmenopause; Quality of Life; Severity of Illness Index; Sleep Initiation and Maintenance Disorders; Women's Health

To evaluate the efficacy comparison of Pueraria mirifica (PM), name in Thai is Kwao Kruea Khao, against conjugated equine estrogen (CEE) with/without medroxyprogesterone acetate (MPA) in the treatment of perimenopuasal women with climacteric symptoms.. Perimenopausal women attending the Menopausal clinic of Hat Yai Regional Hospital were voluntarily recruited. The vasomotor symptoms such as hot flushes and night sweats, as well as other unpleasant symptoms, urogenital and psychological symptoms, were also assessed. Patients were voluntarily enrolled and randomly received daily 50 mg raw material of PM, Group A, or daily 0.625 mg of conjugated equine estrogen (CEE) with/without 2.5 mg of medroxyprogesterone acetate (MPA), Group B, depend on non-hysterectomized/hysterectomized condition.. Seventy-one patients were enrolled. Eleven of those were excluded for failing to complete the initial work-up and follow-up. Sixty cases were evaluated, 30 cases in Group A and 30 cases in Group B. After medication, the mean of modified Greene climacteric scale (MGCS) in Group A/Group B had decreased from 29.0/32.26 to 17.86/18.1, 12.56/9.57 and 9.9/8.16 at 1-, 3-, and 6- month respectively. The clinical satisfaction using MGCS was not statistically significant between PM (Group A) and CEE with/without MPA (Group B) in the alleviation of climacteric symptoms (p-value > 0.05). There were no statistically significant changes of three serum markers: estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) between both groups.. PM, containing phytoestrogens, has estrogenic effect as similar as CEE, and can alleviate the climacteric symptoms in perimenopausal women. PM demonstrates great promise in the treatment of climacteric symptoms. However, optimal doses should be clinically assessed to meet appropriate individual responses.

Topics: Adult; Climacteric; Estrogen Replacement Therapy; Estrogens, Conjugated (USP); Female; Hot Flashes; Humans; Medroxyprogesterone Acetate; Middle Aged; Perimenopause; Phytoestrogens; Prospective Studies; Pueraria; Thailand

Menopausal symptoms are a major survivorship issue for patients treated for breast cancer. There are increasing concerns over the use of hormone replacement therapy (HRT) in this setting and a growing consumer interest in "natural" therapies. It had been suggested that soy phyto-oestrogens might be beneficial in the treatment of menopausal symptoms. Seventy-two patients with a histologically confirmed pre-existing diagnosis of breast cancer who were having menopausal symptoms were randomised between 12 weeks of treatment with soy capsules or placebo. Quality of life and menopausal symptom scores were assessed at baseline, 4, 8 and 12 weeks. There was no statistical difference in menopausal symptom scores or quality of life between the two arms of the study.

Topics: Adult; Aged; Breast Neoplasms; Capsules; Double-Blind Method; Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Nonprescription Drugs; Phytoestrogens; Quality of Life; Soybean Proteins

To evaluate the preliminary efficacy and safety of Pueraria mirifica in the treatment of vasomotor symptoms.. Open-label study.. Hat Yai Regional Hospital, Thailand.. Pre and postmenopausal women with vasomotor symptoms, such as hot flushes and night sweats. Other unpleasant symptoms, urogenital and psychological symptoms, were also evaluated.. Patients were enrolled voluntarily and randomly received 50 mg or 100 mg of Pueraria mirifica in capsules, once daily for six months.. Of the 48 enrolled patients, 11 cases were excluded for failing to complete the initial work-up. Thirty-seven cases were evaluated. 20 of 37 (54.1%) randomly received a dose of 50 mg/day of Pueraria mirifica (Group A), and 17 of 37 (45.9%) received 100 mg/day of Pueraria mirifica (Group B). The mean of the modified Greene climacteric scale decreased from 35.6 to 26.6, 17.2 and 15.1 in group A, while group B, declined from 32.6 to 21.0, 14.8 and 13.6 at 1-, 3- and 6-month respectively. The mean serum estradiol, fluctuated from the baseline of 76.6 to 55.4, 56.7, 72.5, 69.2, 114.2 and 74.5 pg/ml at 1-, 2-, 3-, 4-, 5- and 6-month respectively. Whereas the mean serum follicle-stimulating hormone (FSH)/luteinizing hormone (LH) was stable in the range of; 27.1/12.6, 28.3/12.9 and 22.5/11.4 mIU/ml at baseline, 3- and 6-month respectively.. Pueraria mirifica, containing phytoestrogens, relatively alleviated the climacteric symptoms in perimenopausal women. The transient negative profiles occurred in a small number of subjects that included anemia, and liver profiles. While there was a slight decrease in lipoproteins and an increase in hormonal profiles, Pueraria mirifica demonstrates great promise in the treatment of climacteric symptoms among perimenopausal women. However, optimal doses should be clinically assessed, to meet appropriate individual responses.

Topics: Adult; Climacteric; Female; Female Urogenital Diseases; Follow-Up Studies; Hot Flashes; Humans; Isoflavones; Mental Disorders; Middle Aged; Phytoestrogens; Phytotherapy; Plant Preparations; Pueraria; Treatment Outcome; Vasomotor System

High phytoestrogen intake among Asian women has been thought to explain the low risk of bone fractures in these populations. In a randomized placebo-controlled trial we studied the effects of isoflavonoids on urinary output of the N-terminal cross-linked telopeptide of type I collagen, pyridinoline (Pyr), and deoxypyridinoline (Dpyr) (bone resorption markers) and serum levels of bone-specific alkaline phosphatase and N-terminal and C-terminal procollagen type I (bone formation markers). Fifty-five postmenopausal women with a history of breast cancer used phytoestrogens (114 mg of isoflavonoids) or placebo tablets daily for 3 months; the treatment regimens were then crossed over after a 2-month washout period. The markers were measured before and on the last day of each treatment period. Bone resorption was reduced during phytoestrogen use, as reflected in falls in the urinary output of Pyr (9%; P = 0.001) and Dpyr (5%; P = 0.008). Compared with the placebo group, the fall in Dpyr was significant (P = 0.022) and the falls in Pyr (P = 0.084) and N-terminal cross-linked telopeptide of type I collagen (P = 0.082) showed a trend toward significance. Bone formation markers were not affected by this regimen. Thus, isoflavonoid-induced inhibition of bone resorption may contribute to the low risk of osteoporosis in Asian women.

Topics: Adult; Aged; Bone Remodeling; Breast Neoplasms; Cross-Over Studies; Female; Hot Flashes; Humans; Isoflavones; Middle Aged; Osteoporosis, Postmenopausal; Phytoestrogens; Plant Preparations; Postmenopause; Risk Factors

Dietary soy supplementation may reduce the incidence of hot flushes in postmenopausal women due to the presence of phytoestrogens in soy foods. The aim of this study was to assess the effects of a 3-month administration of different doses of either oral or transdermal soy isoflavones on climacteric complaints in postmenopausal women.. Sixty postmenopausal women were assigned randomly to one of the following groups: groups A and B received 50 mg/day or 75 mg/day of oral isoflavones respectively, while groups C and D received 6 mg/day or 12 mg/day of transdermal isoflavones. A control group (group E) was composed of 15 patients that did not receive any treatment. Hot flushes, Kupper-man index and vaginal dryness at baseline and then after 5, 9 and 13 weeks were evaluated.. The isoflavone treatment led to a progressive significant (p<0.01) reduction of the number of hot flushes in the groups A, B and D with a dose-related effect in group D. At week 13, the Kupperman index and hot flush score decreased significantly in all the treated groups, while vaginal dryness score was reduced only in group B.. Our findings suggest that both oral and transdermal soy isoflavones are effective to attenuate slight to moderate menopausal neurovegetative symptoms with a dose-related effect.

Topics: Administration, Cutaneous; Administration, Oral; Case-Control Studies; Drug Administration Schedule; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens

Clinical trials demonstrating increased risk of cardiovascular disease and breast cancer among women randomized to hormone replacement therapy have increased interest in other therapies for menopausal symptoms. Dietary supplements containing isoflavones are widely used as alternatives to hormonal therapies for hot flashes, but there is a paucity of data supporting their efficacy.. To compare the efficacy and safety of 2 dietary supplements derived from red clover with placebo in symptomatic menopausal women.. Randomized, double-blind, placebo-controlled trial of menopausal women, aged 45 to 60 years, who were experiencing at least 35 hot flashes per week. The study was conducted between November 1999 and March 2001 at 3 US medical centers and included women who were recently postmenopausal (mean [SD], 3.3 [4.5] years since menopause) experiencing 8.1 hot flashes per day. Women were excluded if they were vegetarians, consumed soy products more than once per week, or took medications affecting isoflavone absorption.. After a 2-week placebo run-in, 252 participants were randomly assigned to Promensil (82 mg of total isoflavones per day), Rimostil (57 mg of total isoflavones per day), or an identical placebo, and followed-up for 12 weeks.. The primary outcome measure was the change in frequency of hot flashes measured by participant daily diaries. Secondary outcome measures included changes in quality of life and adverse events.. Of 252 participants, 246 (98%) completed the 12-week protocol. The reductions in mean daily hot flash count at 12 weeks were similar for the Promensil (5.1), Rimostil (5.4), and placebo (5.0) groups. In comparison with the placebo group, participants in the Promensil group (41%; 95% confidence interval [CI], 29%-51%; P =.03), but not in the Rimostil group (34%; 95% CI, 22%-46%; P =.74) reduced hot flashes more rapidly. Quality-of-life improvements and adverse events were comparable in the 3 groups.. Although the study provides some evidence for a biological effect of Promensil, neither supplement had a clinically important effect on hot flashes or other symptoms of menopause.

Topics: Dietary Supplements; Double-Blind Method; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Plant Extracts; Plant Preparations; Postmenopause; Quality of Life; Trifolium

In order to evaluate the efficacy of soya isoflavones (genistein and daidzein) in the treatment of the principal menopausal disorders, a double blind randomized study was performed on a sample of 50 women (with an average age of 53.3 +/- 3.1 years) with Climacteric syndrome referred to the I Clinica Ostetrica e Ginecologica, Policlinico Umberto I, Roma. The research protocol involved the random subdivision of the enrolled sample into two groups of 25 women, group 1 (with an average age of 53.3 +/- 3.5 years, and an average menopausal age of 51.6 +/- 1.8 years) and group 2 (with an average age of 53.1 +/- 2.9 years, and an average menopausal age of 51.3 +/- 1.2 years), who were to receive treatment for three months with the product being studied and with a placebo. After the three-month period, as an additional check, the group initially treated with the placebo would move to the phyto-oestrogens and viceversa. All of the patients were subjected to a series of clinical and instrumental examinations and were asked to fill in a questionnaire concerning their complaints, at the start, at halfway (third month) and at the end (sixth month) of the trial. The results of the evaluation of the questionnaires performed on the 47 patients who had completed the trial showed, in the first three months, an improvement in the symptoms (hot flushes) in 11 patients treated with phyto-oestrogens against 6 patients from the group that received only the placebo. In the second three-month period the hot flushes reappeared in 4 of the 11 patients who had previously seen improvements and had then passed to the placebo. In contrast, the group that passed to the phyto-oestrogens, after treatment with the placebo, experienced the disappearance of hot flushes in 11 women, including the 6 who had already improved in the first three months. There was no significant reduction in anxiety, insomnia or vaginal dryness. None of the enrolled patients indicated complaints linked to the treatment. It can be concluded that the use of a product based on phyto-oestrogens, such as the one experimented, can lead to a significant reduction in some of the disorders linked with the menopause, especially hot flushes.

Topics: Climacteric; Cross-Over Studies; Double-Blind Method; Estrogens, Non-Steroidal; Female; Genistein; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Plant Preparations; Surveys and Questionnaires; Treatment Outcome

Vasomotor symptoms, such as hot flashes and night sweats, in breast cancer survivors are often worsened by chemotherapy and tamoxifen, and/or the discontinuation of hormone replacement therapy at diagnosis. This study evaluated the acceptability and effectiveness of a soy beverage containing phytoestrogens as a treatment for hot flashes in postmenopausal women with breast cancer.. A randomized, placebo-controlled, double-blind clinical trial was conducted in postmenopausal women with moderate hot flashes who were previously treated for early-stage breast cancer. Women were stratified for tamoxifen use and randomized to a soy beverage (n = 59) containing 90 mg of isoflavones or to a placebo rice beverage (n = 64). Women recorded the number and severity of hot flashes daily with a daily menopause diary for 4 weeks at baseline and for 12 weeks while consuming 500 mL of a soy or placebo beverage.. There were no significant differences between the soy and placebo groups in the number of hot flashes or hot flash scores. However, presumably because of a strong placebo effect, both groups had significant reductions in hot flashes. Mild gastrointestinal side effects were experienced by both groups but occurred with greater frequency and severity with soy. The mean serum genistein concentration at 6 weeks was significantly higher in women who consumed soy (0.61 +/- 0.43 micromol/L) compared with placebo (0.43 +/- 0.37 micromol/L) (P =.02). Overall acceptability and compliance were high and similar in both groups.. The soy beverage did not alleviate hot flashes in women with breast cancer any more than did a placebo. Future research into other compounds is recommended to identify safe and effective therapies for hot flashes in breast cancer survivors.

Topics: Breast Neoplasms; Double-Blind Method; Estrogens, Non-Steroidal; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Plant Preparations; Postmenopause; Treatment Outcome

A multicentric, open, prospective, observational and no-randomized clinical trial was carried out in Spain with 190 postmenopausal women receiving a soy preparation rich in isoflavones (PHYTO SOYA, capsules containing 17.5 mg isoflavones). The main object of the present study was to investigate its efficacy in alleviating the symptomatology derived from the lack of estrogen, mainly hot flushes, but also other symptoms such as sleep disorder, anxiety, depression, vaginal dryness, loss of libido and bone pain. Each patient received 35 mg isoflavones per day in two doses. During the four months' treatment, a statistically significant decrease in the number of hot flushes with PHYTO SOYA was experienced by 80.82% women; only 5,48% patients did not improve with the treatment. The average reduction was 47.8%, which is equivalent to 4 hot flushes. All the other studied parameters also showed a statistically significant decrease. No severe side-effects were reported and tolerance was excellent. Treatment with PHYTO SOYA resulted in a significant improvement of the symptomatology that accompanies the lack of estrogen during menopause.

Topics: Anxiety; Blood Pressure; Chromatography, High Pressure Liquid; Climacteric; Depression; Estrogens, Non-Steroidal; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Menopause; Metrorrhagia; Middle Aged; Molecular Structure; Pain; Phytoestrogens; Phytotherapy; Plant Extracts; Plant Preparations; Prospective Studies; Sleep Wake Disorders; Spectrum Analysis; Statistics as Topic; Surveys and Questionnaires; Treatment Outcome

Hot flashes represent a significant clinical problem for some breast cancer survivors. Safe, effective treatment is needed for this prominent clinical problem. Although it has been shown that estrogen or progesterone replacement therapy can alleviate this problem, there are continued safety concerns regarding the use of hormonal therapies in these women. Based on anecdotal information, we hypothesized that soy-derived phytoestrogens, weak estrogen-like substances in the soybean that demonstrate estrogen agonist and/or antagonist effects when they bind to estrogen receptors, could alleviate hot flashes. This current trial was designed to investigate this hypothesis.. This double-blind clinical trial involved breast cancer survivors with substantial hot flashes. After randomization, patients underwent a 1-week baseline period with no therapy. This was followed by 4 weeks of either soy tablets or placebo. The patients then crossed over to the opposite arm in a double-blind manner for the last 4 weeks. Patients completed a daily questionnaire documenting hot flash frequency, intensity, and perceived side effects.. Of the 177 women who were randomized and started the study substance, 155 (88%) provided useable data over the first 5 weeks; 149 provided usable data over the entire 9 weeks. There was no suggestion that the soy product was more effective in reducing hot flashes than the placebo. At study completion, patients preferred the soy product 33% of the time, the placebo 37% of the time, and neither substance 31% of the time. No toxicity was observed.. The soy product did not alleviate hot flashes in breast cancer survivors.

Topics: Adolescent; Adult; Breast Neoplasms; Double-Blind Method; Estrogens, Non-Steroidal; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Plant Preparations; Treatment Outcome

To investigate the relationship between levels of phytoestrogens in blood and urine and symptom control in postmenopausal women whose diets were supplemented with soy containing high levels of phytoestrogen.. Phytoestrogen levels in blood and urine were correlated with the number of hot flushes and vaginal maturation indices in 104 postmenopausal women whose diets were supplemented with 60 g of soy powder daily for 3 months in a double-masked, parallel, placebo-controlled trial. The effect of soy supplementation on menopausal symptoms in this study population was reported previously.. Serum levels of genistin, daidzin, and equol were significantly higher in women after soy diet supplementation (+756%, +593%, +1008%, and 57% respectively). The concentration of enterolactone in the soy group was increased by 57% compared with baseline, but the difference with placebo was not statistically significant. The increase in phytoestrogen levels in the soy group in blood or urine did not correlate with fewer hot flushes. Vaginal maturation indices did not change in the soy group.. Phytoestrogen levels increased in women who consumed soy supplement, but that does not fully explain climacteric symptom reduction. It is possible that other types of yet unknown phytoestrogens or components in soy other than phytoestrogen influence hot flushes.

Topics: Climacteric; Dietary Supplements; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Plant Preparations; Plants; Soybean Proteins

The aim of this study was to test the hypothesis that increased dietary intake of phytoestrogens reduces the health impact of the menopause. To test this hypothesis, a double-blind, randomized, entry-exit, cross-over study was conducted to assess the effects of three dietary manipulations--soy and linseed diets (high in phytoestrogens) and a wheat diet (low in phytoestrogens). Postmenopausal women were recruited and randomly assigned to one of the three dietary regimens. Urinary phytoestrogen concentrations, hot flush rate, vaginal smears, bone mineral density and bone mineral content were assessed for two 12-week periods. Comparative analysis showed no significant differences, but, when analyzed separately, groups consuming high phytoestrogen diets had between 10 and 30 times higher urinary excretion of phytoestrogens compared to those consuming the low phytoestrogen diet (p < 0.01). Study participants consuming soy, linseed and wheat diets had a 22% (not significant, n.s.), 41% (p < 0.009) and 51% (p < 0.001) reduction in hot flush rate; a 103% (p < 0.04), 5.5% (n.s.) and 11% (n.s.) increase in vaginal cytology maturation index; and a 5.2% (p < 0.04), 5.2% (n.s.) and 3.8% (n.s.) increase in bone mineral content, respectively. No changes were detected in bone mineral density. The differential effects of high phytoestrogen dietary manipulations on outcomes may represent tissue-specific responses to isoflavones and lignans contained in soy and linseed, respectively. Whilst health outcome measures were not significantly different between groups, the data obtained from separate analysis suggest that phytoestrogens in soy and linseed may be of use in ameliorating some of the symptoms of menopause. Furthermore, the significant decrease in hot flush rate in the wheat group cannot be attributable to phytoestrogens measured in this study. Due to subject variability, larger studies are still needed to evaluate population benefit.

Topics: 4-Butyrolactone; Aged; Bone Density; Diet; Double-Blind Method; Estrogens, Non-Steroidal; Female; Genistein; Glycine max; Hot Flashes; Humans; Isoflavones; Lignans; Linseed Oil; Middle Aged; Phytoestrogens; Plant Preparations; Postmenopause; Triticum

There is a longstanding interest in the relationship between diet and hot flash symptoms during midlife, especially in whether phytoestrogens ease menopausal symptoms. The purpose of this study was to examine hot flashes, night sweats, trouble sleeping, and vaginal dryness in relation to the intake of foods rich in phytoestrogens among Bangladeshi women aged 35 to 59 years who were living either in Sylhet, Bangladesh (

Topics: Bangladesh; Female; Hot Flashes; Humans; Isoflavones; Lignans; London; Phytoestrogens

Phytoestrogen rich-foods such as soy may be associated with less frequent/severe vasomotor menopausal symptoms (VMS), although evidence is limited. We thus investigated the associations between the consumption of soy products and soy milk and the frequency/severity of VMS.. We pooled data from 19,351 middle-aged women from five observational studies in Australia, UK, USA, and Japan that contribute to the International Collaboration for a Life course Approach to reproductive health and Chronic disease Events (InterLACE). Information on soy consumption, VMS and covariates were collected by self-report. We included 11,006 women who had complete data on soy consumption, VMS and covariates at baseline for the cross-sectional analysis. For the prospective analysis, 4522 women who were free of VMS at baseline and had complete data on VMS at follow-up were considered. Multinomial logistic regression and binary logistic regression models were used.. No statistically significant evidence of an association was found between soy products (relative risk ratio (RRR): 0.92, 95% CI: 0.76-1.11) or soy milk (RRR: 1.24, 95% CI: 0.93-1.65) and the likelihood of reporting frequent or severe VMS cross-sectionally. Prospective results indicated that frequent consumption of soy products (odds ratio (OR): 0.63, 95% CI: 0.45-0.89) but not soy milk (OR: 1.11, 95% CI: 0.85-1.45) was associated with lower likelihood of reporting subsequent VMS, after adjustment for socio-demographic and reproductive factors.. These are the first ever findings from pooled observational data of association between consumption of soy products and VMS.

Topics: Cross-Sectional Studies; Diet; Female; Hot Flashes; Humans; Menopause; Middle Aged; Phytoestrogens; Soy Foods

Aromatherapy is often used as a complementary therapy for women's health. This systematic review aims to evaluate the therapeutic effects of aromatherapy as a management for menopausal symptoms.. Eleven electronic databases will be searched from inception to February 2018. Randomized controlled trials that evaluated any type of aromatherapy against any type of control in individuals with menopausal symptoms will be eligible. The methodological quality will be assessed using the Cochrane risk of bias tool. Two authors will independently assess each study for eligibility and risk of bias and to extract data.. This study will provide a high quality synthesis of current evidence of aromatherapy for menopausal symptoms measured with Menopause Rating Scale, the Kupperman Index, the Greene Climacteric Scale, or other validated questionnaires.. The conclusion of our systematic review will provide evidence to judge whether aromatherapy is an effective intervention for patient with menopausal women.. Ethical approval will not be required, given that this protocol is for a systematic review. The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print.. PROSPERO CRD42017079191.

Topics: Aromatherapy; Female; Hot Flashes; Humans; Menopause; Meta-Analysis as Topic; Phytoestrogens; Research Design; Women's Health

Phytoestrogens (PE) are widely used as a dietary supplement. PE affect oestrogen receptors. PE have been investigated regarding menopausal hot flushes, bone mineral density and prostate hyperplasia/cancer. It seems consistent, that PE increase bone mineral density, whereas the effect on hot flushes is controversial. Due to the effect on oestrogen receptors, concerns exist on the risk of cancer and venous thromboembolism related to the intake of PE. To date, no studies with PE have been large enough to clarify their safety. Widespread use of PE should therefore be discouraged.

Topics: Bone Density; Dietary Supplements; Hot Flashes; Humans; Phytoestrogens

EXECUTIVE SUMMARY This American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) Position Statement is designed to update the previous menopause clinical practice guidelines published in 2011 but does not replace them. The current document reviews new clinical trials published since then as well as new information regarding possible risks and benefits of therapies available for the treatment of menopausal symptoms. AACE reinforces the recommendations made in its previous guidelines and provides additional recommendations on the basis of new data. A summary regarding this position statement is listed below: New information available from randomized clinical trials and epidemiologic studies reported after 2011 was critically reviewed. No previous recommendations from the 2011 menopause clinical practice guidelines have been reversed or changed. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, selective estrogen-receptor modulators (SERMs), and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, SERMs, and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. New recommendations in this position statement include: 1.. the use of menopausal hormone therapy in symptomatic postmenopausal women should be based on consideration of all risk factors for cardiovascular disease, age, and time from menopause. 2.. the use of transdermal as compared with oral estrogen preparations may be considered less likely to produce thrombotic risk and perhaps the risk of stroke and coronary artery disease. 3.. when the use of progesterone is necessary, micronized progesterone is considered the safer alternative. 4.. in symptomatic menopausal women who are at significant risk from the use of hormone replacement therapy, the use of selective serotonin re-uptake inhibitors and possibly other nonhormonal agents may offer significant symptom relief. 5.. AACE does not recommend use of bioidentical hormone therapy. 6.. AACE fully supports the recommendations of the Comité de l'Évolution des Pratiques en Oncologie regarding the management of menopause in women with breast cancer. 7.. HRT is not recommended for the prevention of diabetes. 8.. In women with previously diagnosed diabetes, the use of HRT should be individualized, taking in to account age, metabolic, and cardiovascular risk factors.. AACE = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; BMI = body mass index; CAC = coronary artery calcification; CEE = conjugated equine estrogen; CEPO = Comité de l'Évolution des Pratiques en Oncologie; CAD = coronary artery disease; CIMT = carotid intima media thickness; CVD = cardiovascular disease; FDA = Food and Drug Administration; HDL = high-density lipoprotein; HRT = hormone replacement therapy; HT = hypertension; KEEPS = Kronos Early Estrogen Prevention Study; LDL = low-density lipoprotein; MBS = metabolic syndrome; MPA = medroxyprogesterone acetate; RR = relative risk; SERM = selective estrogen-receptor modulator; SSRI = selective serotonin re-uptake inhibitor; VTE = venous thrombo-embolism; WHI = Women's Health Initiative.

Topics: Administration, Cutaneous; Administration, Oral; Aged; Amines; Breast Neoplasms; Cardiovascular Diseases; Cimicifuga; Cognition; Cyclohexanecarboxylic Acids; Diabetes Mellitus; Endocrinology; Estradiol; Estrogen Replacement Therapy; Estrogens; Excitatory Amino Acid Antagonists; Female; Gabapentin; gamma-Aminobutyric Acid; Hot Flashes; Humans; Menopause; Middle Aged; Osteoporosis; Phytoestrogens; Phytotherapy; Progesterone; Progestins; Risk Assessment; Selective Serotonin Reuptake Inhibitors; Societies, Medical; Thrombosis; Vasomotor System

Many women suffering from vasomotor symptoms (VMS) are now seeking nonpharmaceutical treatments for symptom relief. Recently, S-equol, an intestinal bacterial metabolite of the soybean isoflavone daidzein has received attention for its ability to alleviate VMS and provide other important health benefits to menopausal women. S-equol is found in very few foods and only in traces. About 50% of Asians and 25% of non-Asians host the intestinal bacteria that convert daidzein into S-equol. Clinical trials that evaluated the efficacy of an S-equol-containing product found that VMS were alleviated but these trials were limited in scope and primarily involved Japanese women for whom hot flashes are a minor complaint. The only trial in the United States evaluating hot flashes found symptoms were significantly reduced by S-equol, but the study lacked a placebo group, although it did include a positive control. The daily dose of S-equol used in most trials was 10 mg, and because the half-life of S-equol is 7-10 hours, to maximize efficacy, it was taken twice daily. Subanalysis of epidemiologic studies suggests that equol producers are more likely to benefit from soyfood consumption than nonproducers with respect to both cardiovascular disease and osteoporosis, although the data are inconsistent. The limited safety data for S-equol do not suggest cause for concern, especially with regard to its effects on breast and endometrial tissue. Further studies are needed before definitive conclusions of its effectiveness for VMS can be made, but the preliminary evidence warrants clinicians discussing the potential of S-equol for the alleviation of VMS with patients.

Topics: Clinical Trials as Topic; Dose-Response Relationship, Drug; Equol; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Quality of Life; Treatment Outcome; United States; Women's Health

DT56a (Femarelle®) is a natural medication that contains a variety of phytoestrogens derived from tofu. Treatment with DT56a affects bones, vascular tissues and the nervous system in a manner similar to that of estrogen but DT56a acts as an estrogen antagonist in breast and uterine tissues.. The objective of this study was to analyze the efficacy of DT56a in the reduction of menopause symptoms in Spanish women who participated in the Post Marketing Menopausal Symptoms International Survey (POMMSIS).. A total of 631 Spanish menopausal or perimenopausal women with vasomotor symptoms who took DT56a for 4 weeks participated in this study. This study was an observational, questionnaire-based investigation that consisted of a baseline questionnaire, a hot flushes daily diary and a feedback questionnaire.. A statistically significant (p < 0.01) reduction in the number and intensity of hot flushes was experienced after 2 and 4 weeks of DT56a treatment. After 4 weeks of treatment with DT56a, 80.7% of the patients reported that their hot flushes were 'better' or 'much better'. The severity of hot flushes was also reduced by 38% in all study participants and by 36% in women who had experienced more than seven hot flushes per day initially, before treatment.. Treatment with DT56a resulted in a significant reduction in the number and intensity of hot flushes in postmenopausal women, especially in those with frequent symptoms, and these effects were observed within the first month of treatment.

Topics: Female; Hot Flashes; Humans; Menopause; Middle Aged; Phytoestrogens; Plant Extracts; Prospective Studies; Quality of Life; Severity of Illness Index; Surveys and Questionnaires

Topics: Female; Hot Flashes; Humans; Menopause; Phytoestrogens; Phytotherapy; Review Literature as Topic

Over the past 2 decades, soy foods have been the subject of a vast amount of research, primarily because they are uniquely rich sources of isoflavones. Isoflavones are classified as both phytoestrogens and selective estrogen receptor modulators. The phytoestrogenic effects of isoflavones have led some to view soy foods and isoflavone supplements as alternatives to conventional hormone therapy. However, clinical research shows that isoflavones and estrogen exert differing effects on a variety of health outcomes. Nevertheless, there is substantial evidence that soy foods have the potential to address several conditions and diseases associated with the menopausal transition. For example, data suggest that soy foods can potentially reduce ischemic heart disease through multiple mechanisms. Soy protein directly lowers blood low-density lipoprotein-cholesterol concentrations, and the soybean is low in saturated fat and a source of both essential fatty acids, the omega-6 fatty acid linoleic acid and the omega-3 fatty acid alpha-linolenic acid. In addition, soflavones improve endothelial function and possibly slow the progression of subclinical atherosclerosis. Isoflavone supplements also consistently alleviate menopausal hot flashes provided they contain sufficient amounts of the predominant soybean isoflavone genistein. In contrast, the evidence that isoflavones reduce bone loss in postmenopausal women is unimpressive. Whether adult soy food intake reduces breast cancer risk is unclear. Considerable evidence suggests that for soy to reduce risk, consumption during childhood and/or adolescence is required. Although concerns have been raised that soy food consumption may be harmful to breast cancer patients, an analysis in 9514 breast cancer survivors who were followed for 7.4 y found that higher postdiagnosis soy intake was associated with a significant 25% reduction in tumor recurrence. In summary, the clinical and epidemiologic data indicate that adding soy foods to the diet can contribute to the health of postmenopausal women.

Topics: Breast Neoplasms; Cardiovascular Diseases; Diet; Fatty Acids, Unsaturated; Female; Glycine max; Health; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Postmenopause; Soy Foods; Soybean Proteins

Topics: Female; Hot Flashes; Humans; Phytoestrogens; Sweating

Use of food supplements-containing phytoestrogens among postmenopausal women is rapidly increasing. Although phytoestrogens are often perceived as safe, evidence for overall positive risk-benefit profile is still inconclusive. The chance to buy them by user's initiative does not facilitate surveys on their prevalence and pattern of use. The aim of this study was to describe the pattern of use and self-reported positive and negative perceptions of phytoestrogens in post-menopausa.. A questionnaire was administered to women who were buying food supplements containing phytoestrogens in 22 pharmacies located in the Bologna area (400,000 inhabitants). Questionnaire was structured into 3 sections: (a) socio-demographic information, (b) pattern of use, (c) positive and negative perceptions.. Data on 190 peri- and post-menopausal women (aged 38-77) were collected. Women stated to use phytoestrogens to reduce hot flushes (79%), insomnia (15%), mood disturbances (14%) and prevent osteoporosis (15%). The majority (59%) took phytoestrogens routinely, whereas 28% in 3-month cycles. Among positive perceptions between short- and long-term users, a not negligible difference was reported for relief of hot-flushes (68% in short-term vs. 81% in long-term users; p = 0.04). Negative perceptions were reported more frequently in the long-term group, and this difference was statistically significant for edema (6% in short-term vs. 17% in long-term users; p = 0.04), but not for other effects: e.g., swelling sensation (10% vs. 21%; p = 0.09), somnolence (7% vs. 10% p = 0.62), fatigue (4% vs.11% p = 0.15).. In the Bologna area, the pattern of use of phytoestrogens for menopausal symptoms is heterogeneous, and women overall find these substances to be beneficial, especially for relief of hot-flushes. Other positive perceptions decreased with long-term use. Negative perceptions, especially estrogen-like effects, seem to be infrequent and increase with long-term therapy. Physicians should pay attention to effects perceived by post-menopausal women and routinely monitor the use of phytoestrogens, in order to recognize possible adverse effects and actual benefits.

Topics: Adult; Aged; Dietary Supplements; Female; Hot Flashes; Humans; Middle Aged; Patient Satisfaction; Phytoestrogens; Postmenopause; Spain; Surveys and Questionnaires

The majority of instruments used to evaluate menopausal symptoms are long and complex. In this sense, more simple tests are being designed to rapidly obtain a snapshot of the global clinical picture.. To assess menopausal symptoms in mid-aged women using the short 10 item version of the original menopause Cervantes Scale (CS-10).. This was a cross sectional study in which a total of 451 Ecuadorian women (40-59 years) were surveyed with the CS-10 and a general socio-demographic questionnaire containing personal and partner data.. Median age of the whole sample was 48 years. A 41.2% were postmenopausal, 44.3% abdominally obese (waist circumference >88cm), 6% diabetic, 16.9% hypertense, 11.5% smoked, 6.9% currently used hormone therapy, 9.5% phytoestrogens and 6.7% psychotropic drugs. For the entire sample, median [interquartile range] CS-10 global scores were 10.0 [9.5], and for pre-, peri- and postmenopausal women: 5.0 [7.0], 11.0 [9.0] and 13.5 [8.0], respectively. The CS-10 displayed good internal consistency (Cronbach's alpha 0.87). According to the CS-10, the three most prevalent menopausal symptoms were: muscle and joint pains (88.5%), hot flushes (77.6%) and skin dryness (71.4%). Multiple linear regression analysis found that postmenopausal status, parity, unhealthy perceived status, psychotropic drug use, partner erectile dysfunction, lower coital frequency and living at high altitude were related to higher CS-10 global scores.. In this mid-aged Ecuadorian female sample severity of menopausal symptoms, as determined by the CS-10, were related to environmental and female/partner personal and socio-demographical aspects.

Topics: Adult; Arthralgia; Attitude to Health; Coitus; Cross-Sectional Studies; Diabetes Mellitus; Ecuador; Erectile Dysfunction; Female; Hormone Replacement Therapy; Hot Flashes; Humans; Hypertension; Male; Menopause; Middle Aged; Myalgia; Obesity, Abdominal; Parity; Perimenopause; Phytoestrogens; Postmenopause; Premenopause; Psychotropic Drugs; Smoking

Although reduction of vasomotor symptoms (VMS; hot flashes and night sweats) has been reported in postmenopausal women who used isoflavones, a clear dose response has not been shown, has largely not been reported for perimenopausal women, and has largely only been reported for reducing prevalent VMS, not preventing newly developing VMS. We analyzed longitudinal data from the Study of Women's Health Across the Nation for the relation of dietary phytoestrogen and fiber intake to incident VMS in this multiracial/ethnic cohort.. The Study of Women's Health Across the Nation included 3,302 premenopausal and early perimenopausal women, 1,651 of whom reported no VMS at baseline and were followed with annual visits for 10 years. Dietary intakes of isoflavones, coumestrol, lignans, and fiber were assessed by a food frequency questionnaire at baseline and in annual visits 5 and 9 and interpolated for intervening years. The number of days experiencing VMS in the past 2 weeks was self-reported annually. Using multinomial logistic regression with generalized estimating equations, we modeled incident VMS in relation to isoflavones, lignans, fiber, coumestrol, or total phytoestrogen intake and covariates.. No consistent monotonic relations were observed between any dietary phytoestrogen or fiber and incident VMS, although adjusted odds ratios for some individual quartiles were statistically significant.. For certainty of any effect of dietary phytoestrogens or fiber on the prevention of incident VMS, a randomized, placebo-controlled, double-masked trial with sufficient numbers of women in different racial/ethnic, menopausal status, and metabolic groups over years of follow-up is required, but our results suggest that a clinically significant or large effect is improbable.

Topics: Adult; Coumestrol; Diet; Dietary Fiber; Ethnicity; Female; Hot Flashes; Humans; Isoflavones; Lignans; Logistic Models; Longitudinal Studies; Middle Aged; Perimenopause; Phytoestrogens; Premenopause; Racial Groups; Surveys and Questionnaires; Sweating; Women's Health

Topics: Female; Hot Flashes; Humans; Menopause; Phytoestrogens

Topics: Female; Glycine max; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens

Menopause is the interruption of menstrual and reproductive capacity, therefore, that occurs naturally in all women between 48 and 55 years, due to a lower production of gonadal steroids. The period becomes progressively irregular and lack of ovulation and menstrual flow decrease, and finally disappears. The time between the first symptoms and the cessation of the menstrual cycle is called menopause. With the onset of menopause the woman undergoes a series of changes related to estrogen deficiency, which occur in all tissues of the body. In this period one can distinguish an early stage, characterized by hot flashes, mood swings, night sweats and insomnia, and a late phase in which we highlight more symptoms related to the interruption of hormonal such as osteoporosis, obesity, at urogenital and increased incidence of cardiovascular disease. In Italy, only 5.2% of women aged 45-64 years used hormone replacement therapy, and only 20-30% follow a therapy for more than two years, both for psychological reasons, and for fear of side effects. Not surprisingly, therefore, phytoestrogens are given a high importance, as they are considered a natural alternative tank to to their plant origin. Interest in phytoestrogens was born from the observation that postmenopausal women who live in the East have a lower incidence of symptoms, cardiovascular disease, cancer and osteoporosis hormone use, compared to Western women.

Topics: Cardiovascular Diseases; Estrogen Replacement Therapy; Female; Gonadal Steroid Hormones; Hot Flashes; Humans; Menopause; Phytoestrogens

In developing countries, around 80% of the population still resorts on traditional medicine for their primary health care. Erythrina poeppigiana (Walp.) O.F. Cook, one of these medicinal plants, was found to be particularly rich in isoflavonoids which exhibited, individually, significant estrogenic activity in vitro. The possible combined effects of these bioactive isoflavones, as they are naturally found in the crude extracts of E. poeppigiana, prompted us to assess their in vivo estrogenicity. We first tested the ability of the extracts to transactivate estrogen receptor alpha (ERα) in vitro using U2OS human osteosarcoma cells. We next investigated their effects in vivo in an uterotrophic assay, using ovariectomized rats treated with the extracts at the doses of 50, 100, 200, and 400 mg/kg BW/d orally for 3 days. Finally, we assessed their ability to relieve hot flushes, using data loggers. At the end of treatments, animals were sacrificed, and organs (mammary glands, vagina, and uteri) were collected for histo-morphometric analyses. The methanol extract significantly and dose-dependently transactivated ERα at all tested doses. All extracts induced significant increases of vaginal and uterine epithelial heights. Only the dichloromethane extract could significantly relieve hot flushes as estradiol. These results indicate that E. poeppigiana extracts have estrogen-like effects in vivo, suggesting that its active principles act in synergy when they are taken in combination in the crude extract. These findings, therefore, support the traditional use of E. poeppigiana to alleviate some menopausal problems; our previous phytochemical investigations contribute to the standardization of this phytomedicine.

Topics: Animals; Cell Line; Dose-Response Relationship, Drug; Erythrina; Estrogen Receptor alpha; Female; Hot Flashes; Humans; Isoflavones; Ovariectomy; Phytoestrogens; Phytotherapy; Plant Extracts; Rats; Rats, Wistar

Phytoestrogens may be an alternative therapy in control of menopausal symptoms but their definite effects on breast tissue must be determined. Our study aimed to define the clinical and ultrasonographic changes of the breast after use of soy isoflavones in menopausal women.. Menopausal women with hot flashes were randomly grouped as cases and controls and cases received soy isoflavones for 12 weeks. Breast examination (BE) and ultrasonography (US) were done at 0, 6 and 12 weeks. Tenderness and nodularity on BE were graded 1-4 by breast surgeons.. There were 30 women in the case and 26 in the control group. The mean age was 51.3 years and the mean age of menopause was 49.2 years. There was no change in the BE and US at 6 weeks in controls. In the case group, 10% had grade 1 tenderness and 13.3% grade 2 tenderness and grade 1 nodularity in BE accompanied with diffuse small cysts in US. At 12 weeks, there was no change in BE and US in the 2 groups.. There was no statistically significant difference in the BE of the 2 groups at 6 and 12 weeks (p value=0.36 and 0.41 for nodularity and tenderness respectively) and in the US results. Although the literature contains many facts concerning PEs and the breast, further prospective studies are needed to identify structural breast changes produced by PEs in order to identify the appropriate dosage and indications of use.

Topics: Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Prospective Studies

Hormone therapy with estrogen alone or combined with progestogen has come into disrepute because of safety concerns. Herbal medicinal products with an estrogenic action caused by their content of phytoestrogens constitute an alternative therapy. However, the estrogenic adverse effects of such products have caused some concern. The pollen extract Femal has been shown to be effective in the treatment of menopausal symptoms like hot flushes and sleeplessness. The present investigation was undertaken to examine if this pollen extract preparation contained phytoestrogens in a concentration sufficient to give the preparation an estrogenic effect.. Samples of the pollen extract in Femal were subjected to high-performance liquid chromatography analyses of phytoestrogens. The pollen extract was tested for estrogenic activity in the immature rat uterotropic bioassay.. The pollen extracts were found to contain low, subeffective concentrations of daidzin, daidzein, and genistin. Genistein, formononetin, and biochanin A could not be detected. Pollen extract in the high dose of 500 mg kg day did not cause any uterine growth in immature female rats.. The results show that the pollen extract in Femal does not give the preparation any estrogenic effect. Thus, Femal, which has proven clinical efficacy, is a nonestrogenic alternative to hormone therapy in women with menopausal symptoms.

Topics: Animals; Biological Assay; Chromatography, High Pressure Liquid; Complementary Therapies; Estrogens; Female; Hormone Replacement Therapy; Hot Flashes; Humans; Menopause; Phytoestrogens; Plant Extracts; Pollen; Rats; Sleep Wake Disorders; Treatment Outcome; Uterus

Topics: Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Menopause; Phytoestrogens; Vasomotor System

The health benefits associated with soya food consumption have been widely studied, with soya isoflavones and soya protein implicated in the protection of CVD, osteoporosis and cancers such as those of the breast and prostate. Equol (7-hydroxy-3-(4'-hydroxyphenyl)-chroman), a metabolite of the soya isoflavone daidzein, is produced via the formation of the intermediate dihydrodaidzein, by human intestinal bacteria, with only approximately 30-40% of the adult population having the ability to perform this transformation following a soya challenge. Inter-individual variation in conversion of daidzein to equol has been attributed, in part, to differences in the diet and in gut microflora composition, although the specific bacteria responsible for the colonic biotransformation of daidzein to equol are yet to be identified. Equol is a unique compound in that it can exert oestrogenic effects, but is also a potent antagonist of dihydrotestosterone in vivo. Furthermore, in vitro studies suggest that equol is more biologically active than its parent compound, daidzein, with a higher affinity for the oestrogen receptor and a more potent antioxidant activity. Although some observational and intervention studies suggest that the ability to produce equol is associated with reduced risk of breast and prostate cancer, CVD, improved bone health and reduced incidence of hot flushes, others have reported null or adverse effects. Studies to date have been limited and well-designed studies that are sufficiently powered to investigate the relationship between equol production and disease risk are warranted before the clinical relevance of the equol phenotype can be fully elucidated.

Topics: Antioxidants; Bone Diseases; Cardiovascular Diseases; Dihydrotestosterone; Equol; Glycine max; Hot Flashes; Humans; Intestinal Mucosa; Intestines; Isoflavones; Neoplasms; Phenotype; Phytoestrogens; Phytotherapy; Plant Extracts; Receptors, Estrogen; Risk Factors

The aim of this study was to compare the effect of SE5-OH, a fermented soy product containing S-equol, with purified S-equol on hot flushes in an ovariectomized rat model.. Eleven-week-old female Sprague-Dawley rats were assigned to either the sham group (vehicle; n = 30) or one of four ovariectomized groups: control (vehicle; n = 30), conjugated equine estrogens (CEE; 6.0 mg kg(-1) d(-1) CEE; n = 10), SE5-OH (2,000 mg kg(-1) d(-1) SE5-OH containing 11.7 mg kg(-1) d(-1) as S-equol; n = 30), and S-equol (11.7 mg kg(-1) d(_1) S-equol; n = 30). Three days after sham operation or ovariectomy, animals were treated once daily for 38 days. Tail skin temperature (TST) was assessed on days 21, 28, and 35 after surgery. Plasma estradiol and follicle-stimulating hormone levels and uterine weight and uteri histology were evaluated at the end of treatment.. The rise in TST resulting from ovariectomy was inhibited by CEE, SE5-OH, and S-equol. Compared with the control, TST was decreased by 68.9% and 86.2% in SE5-OH group on days 21 and 28, respectively (P = 0.014, 0.020), and by 60.1% and 89.1% in S-equol group, respectively (P = 0.038, 0.016). Unlike in the CEE group, plasma estradiol and follicle-stimulating hormone levels, uterine weight, epithelial height, stromal expansion, and myometrial thickness were not affected in SE5-OH and S-equol groups.. The results of this animal model of hot flushes suggest that S-equol is one of the primary components of SE5-OH and that both SE5-OH and S-equol represent promising alternatives for the treatment of menopausal symptoms. Clinical research is needed to confirm these findings.

Topics: Animals; Equol; Estradiol; Female; Fermentation; Follicle Stimulating Hormone; Glycine max; Histological Techniques; Hot Flashes; Humans; Isoflavones; Menopause, Premature; Models, Animal; Monitoring, Physiologic; Ovariectomy; Phytoestrogens; Rats; Rats, Sprague-Dawley; Skin Temperature; Tail; Uterus

As an alternative to estrogen therapy, the efficacy of an estrogen receptor β-selective phytoestrogenic (phyto-β-SERM) formulation to regulate climacteric symptoms and decline in brain responses associated with ovarian hormone loss in menopause was assessed.. A phyto-β-SERM formulation-containing diet was compared with a commercial soy extract diet and a phytoestrogen-free base/control diet in an ovariectomized (OVX) mouse model of human menopause. Two treatment studies were conducted: (1) a 2-month study assessed the effects of experimental diets on tail skin temperature as a model of menopausal hot flashes, and (2) a 9-month study assessed the long-term impact of the diets on overall health, hair thinning/loss, spatial working memory, and associated protein expression in the hippocampus.. The phyto-β-SERM diet prevented OVX-induced menopause-like changes including the rise in skin temperature, hair thinning/loss, deficit in spatial memory function, and reversed OVX-induced decline in the expression of hippocampal proteins involved in neural plasticity and β-amyloid degradation/clearance. The soy extract diet had no effect or exacerbated OVX-induced changes.. Overall, the phyto-β-SERM diet induced physical and neurological responses comparable with ovary-intact mice, suggesting the therapeutic potential of the phyto-β-SERM formulation for the prevention/alleviation of climacteric symptoms and decline in brain responses induced by ovarian hormone loss, which provides the basis for further work in postmenopausal women.

Topics: Amyloid beta-Peptides; Animals; Disease Models, Animal; Estrogen Receptor beta; Female; Hair; Hippocampus; Hot Flashes; Humans; Memory Disorders; Memory, Short-Term; Menopause; Mice; Mice, Inbred C57BL; Neuronal Plasticity; Phytoestrogens

Topics: Estrogen Replacement Therapy; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy

It remains unclear whether estrogenic botanical supplement (EBS) use influences breast cancer survivors' health-related outcomes.. We examined the associations of EBS use with health-related quality of life (HRQOL), with fatigue, and with 15 hormone-related symptoms such as hot flashes and night sweats among 767 breast cancer survivors participating in the Health, Eating, Activity, and Lifestyle (HEAL) Study. HRQOL was measured by the Medical Outcomes Study short form-36 physical and mental component scale summary score. Fatigue was measured by the Revised-Piper Fatigue Scale score.. Neither overall EBS use nor the number of EBS types used was associated with HRQOL, fatigue, or hormone-related symptoms. However, comparisons of those using each specific type of EBS with non-EBS users revealed the following associations. Soy supplements users were more likely to have a better physical health summary score (odds ratio [OR] = 1.66, 95% confidence interval [CI] = 1.02-2.70). Flaxseed oil users were more likely to have a better mental health summary score (OR = 1.76, 95% CI = 1.05-2.94). Ginseng users were more likely to report severe fatigue and several hormone-related symptoms (all ORs ≥ 1.7 and all 95% CIs exclude 1). Red clover users were less likely to report weight gain, night sweats, and difficulty concentrating (all OR approximately 0.4 and all 95% CIs exclude 1). Alfalfa users were less likely to experience sleep interruption (OR = 0.28, 95% CI = 0.12-0.68). Dehydroepiandrosterone users were less likely to have hot flashes (OR = 0.33, 95% CI = 0.14-0.82).. Our findings indicate that several specific types of EBS might have important influences on a woman's various aspects of quality of life, but further verification is necessary.

Topics: Adult; Breast Neoplasms; Dietary Supplements; Fatigue; Female; Hot Flashes; Humans; Middle Aged; Phytoestrogens; Phytotherapy; Plant Preparations; Prospective Studies; Quality of Life; Survivors; Sweating

An integrated approach can be employed when counselling women about menopausal management options, where lifestyle, complementary therapies and hormone replacement therapy (HRT) are discussed. Women might opt to use an alternative approach to HRT for a variety of reasons, e.g. fear of side-effects and risks or contraindications to HRT. There are many choices of dietary and herbal approaches for menopausal symptoms, which essentially divide into food supplements and herbal medicines. The choice can often be overwhelming and confusing for the woman. Of concern, the evidence for efficacy and safety of some of these complementary therapies can be extremely limited or non-existent. In order to enable women to make a fully informed choice, it is important that, when a recommendation is made regarding a specific complementary therapy, it should focus on preparations for which a significant dataset exists for efficacy and safety and in which there is ongoing research and development. One of the most extensively studied food supplements has been the phytoestrogenic preparation containing red clover isoflavones. There have been six randomized trials thus far studying the impact on vasomotor symptoms, three of which have shown a significant benefit compared to placebo. There are also data from small randomized and observational trials showing positive outcomes for surrogate markers of osteoporosis and cardiovascular disease. A recent study using validated depression scales has shown that women using red clover isoflavones may also derive psychological benefits. Safety data are reassuring for the endometrium and breast, although further studies would be welcome, particularly in women with significant medical risks.

Topics: Breast; Cardiovascular Diseases; Complementary Therapies; Dietary Supplements; Endometrium; Female; Hot Flashes; Humans; Isoflavones; Menopause; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy; Placebos; Randomized Controlled Trials as Topic; Trifolium

Topics: Estrogen Replacement Therapy; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Osteoporosis, Postmenopausal; Phytoestrogens; Phytotherapy

Hot flashes are a common and distressing symptom of menopause, affecting approximately 62-83% of women undergoing the menopausal transition. Several pharmacologic treatments for hot flashes, including hormone replacement therapy (HRT) have been shown to reduce the frequency and intensity of hot flashes. However, some women prefer not to use HRT and seek alternative treatments, such as phytoestrogens. Feminorm, Feminorm Duo and Feminorm good night have a beneficial effect on vasomotor symptoms, depression, osteoporosis and cardio-vascular diseases.

Topics: Depression; Female; Hot Flashes; Humans; Menopause; Osteoporosis; Phytoestrogens; Plant Extracts; Trifolium

To determine whether the prescribing practice of physicians with regard to estrogen replacement therapy (ERT) in symptomatic women with previous endometrial cancer is consistent with the available evidence.. A descriptive survey was conducted among physicians in Germany, using a questionnaire containing two hypothetical cases of endometrial cancer patients ('low-risk' and 'high-risk' disease) and menopausal symptoms. Physicians were asked about their prescribing practice concerning moderate to severe menopausal symptoms.. Four hundred and twenty questionnaires were sent out, with an overall response rate of 39.8%; 45.6% in the 'low-risk' case and 75.4% in the 'high-risk' case (p < 0.0001) stated that ERT is contraindicated. Only 12.9% were willing to prescribe ERT; 81.9% preferred to prescribe non-estrogenic alternatives (44.8% phytoestrogens, 29.0% selective serotonin reuptake inhibitors).. Despite the evidence that ERT does not increase the risk of recurrence of endometrial cancer, many physicians are reluctant to prescribe ERT in women suffering from moderate to severe menopausal symptoms.

Topics: Adenocarcinoma; Attitude of Health Personnel; Contraindications; Endometrial Neoplasms; Estrogen Replacement Therapy; Female; Germany; Hot Flashes; Humans; Libido; Menopause; Phytoestrogens; Practice Patterns, Physicians'; Risk Assessment; Selective Serotonin Reuptake Inhibitors; Surveys and Questionnaires

To explore the effect of equol of a isoflavone metabolite on menopausal women and the menopausal syndrome.. 71 menopausal women living in Harbin were assessed, and the participants were at the age of 45-55 years. The concentrations of Isoflavone and equol in first-void morning urines were analyzed by HPLC. All participants completed Kupperman questionnaire tables which were used to evaluate the severity of menopausal symptoms. The association between the equol concentrations in menopausal women and the menopausal syndrome were examine by statistical analysis method.. The negative association between the urinary equol concentrations and the menopausal index score (P < 0.05) were found, and the negative correlation only exists in EP group after grouping at the concentration of 0.5 microg/ml equol.. It was suggested that it were more higher of urinary equol concentration in menopausal women, more less of the menopausal symptoms.

Topics: Equol; Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Soybean Proteins; Surveys and Questionnaires; Syndrome

There are virtually no prospective cohort studies in Germany regarding the changes of menopausal hormone therapy (HT) use pattern and factors associated with HT discontinuation after the release of the Women's Health Initiative (WHI) trial results.. We assessed HT prevalence and use pattern as well as factors associated with HT discontinuation in a cohort of 903 women 40 years of age and older, who participated in two consecutive follow-up visits in a 20-year prospective health study from July 2000 to February and from August 2002 to December 2004.. Overall, the prevalence of HT users in the cohort declined significantly from 35.4% in 2000-2002 to 22.5% in 2002-2004. Adjusting for aging of the population, a statistically significant decrease in HT user prevalence was consistently observed across subgroups of HT users defined by type and duration of HT use. The decline was most pronounced with respect to women using combined estrogen-progestin regimens (-10.5%), higher-dose estrogens (-11.6%), oral preparations (-11.1%), as well as long-term HT users (-8.4%). The prevalence of women indicating HT use for climacteric symptoms decreased significantly (-12.4%), whereas the prevalence of women reporting use of HT for the prevention of osteoporosis increased (+1.8%) significantly. Irrespective of hysterectomy status, half of the women who continued HT changed their HT preparations and switched to lower estrogen doses (11.5%), topical estrogens (8.2%), or phytohormones (3.8%). We did not observe any significant differences between women who continued and discontinued HT regarding health-related characteristics of the study population as of 2000-2002. However, women seeing a gynecologist in the 12 months preceding the 2002-2004 visit were significantly less likely to discontinue HT use in bivariate and multivariate analyses.. Substantial declines in HT user prevalence as well as changes in HT use patterns to lower-dose estrogen preparations and non-oral routes of administration are likely to reflect effects of the publication of the WHI results. Consulting a gynecologist appeared to be relevant for a woman's decision to continue HT.

Topics: Administration, Cutaneous; Adult; Aged; Cohort Studies; Estradiol; Estrogen Replacement Therapy; Estrogens; Female; Hot Flashes; Humans; Hysterectomy; Longitudinal Studies; Menopause; Middle Aged; Osteoporosis, Postmenopausal; Phytoestrogens; Progestins; Prospective Studies; Selective Estrogen Receptor Modulators; Sweating; Women's Health

Topics: Breast Neoplasms; Climacteric; Complementary Therapies; Coronary Artery Disease; Female; Hormone Replacement Therapy; Hot Flashes; Humans; Life Style; Osteoporosis, Postmenopausal; Phytoestrogens; Risk Factors; Thrombosis

Topics: Endometrium; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Postmenopause

There is a growing body of scientific evidence that complementary therapies such as isoflavone containing phytoestrogens might help menopausal symptoms. Women are now using them, believing them to be safer and "more natural" especially following the current controversies regarding HRT. However, the choice of treatments is confusing and with some preparations, little is known about their active ingredients, safety or side effects or how they may interact with other therapies. This paper examines the available evidence for management of menopause symptoms with isoflavone containing phytoestrogens, both in terms of efficacy and safety. An algorithm is suggested to demonstrate how these preparations may be integrated with conventional therapies to effectively manage menopause symptoms.

Topics: Clinical Trials as Topic; Complementary Therapies; Female; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Phytotherapy; Plant Extracts; Treatment Outcome

Topics: Australia; Canada; Community Pharmacy Services; Drug Labeling; Estrogen Replacement Therapy; Evidence-Based Medicine; Female; Hot Flashes; Humans; Menopause; Nonprescription Drugs; Phytoestrogens; Phytotherapy

In recent years, considerable attention has been paid to isoflavones and their proprieties to alleviate the climacteric symptoms. The goal of this study was to evaluate the efficacy of standardized isoflavones extract (Soyfem) in moderate and medium-severe climacteric syndrome.. 555 postmenopausal women were recruited for the study. Out of this group, 169 women completed the study (12-month observation period). The patients were classified according to the intensity of climacteric symptoms (< or =34 points in Kupperman index). 1 or 2 tablets of Soyfem were administered twice a day,.. A regular decrease of Kupperman index value and improvement of life quality were observed in the group of 169 postmenopausal women. We have noted a decrease in the intensity and number of hot flushes, diaphoresis (p < 0.05), diminished sleep disturbances (p < 0.05), decreased headache, dizziness, and arthrosis pain. The diminished intensity of tiredness, palpitation and breathlessness have been also observed (p < 0.05). 80% of all investigated women noted the regression of paresthesis, 20% indicated the decreased number of paresthesis (p < 0.05). Influence of Soyfem on the variability and moderation of depressive mood (p < 0.05) have been also positive evaluated by patients.. Administration of Soyfem in the dosage 52 to 104 mg/24 hours (2 times daily 1 or 2 tablets) is a safe and effective therapy in the postmenopausal women with moderate and medium-severe climacteric syndrome evaluated according to the Kupperman index. Administration of Soyfem is connected with a good compliance and correlated with well-being in the investigated women allowing a long-term administration.

Topics: Adult; Aged; Anxiety; Depression; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Middle Aged; Phytoestrogens; Postmenopause; Quality of Life; Surveys and Questionnaires; Women's Health

(1) Short-term clinical trials have shown that soy phytoestrogens have a slight preventive effect on hot flushes. However, this finding is based on a low level of evidence. (2) A double-blind placebo-controlled trial involving about 300 women and lasting 5 years showed that phytoestrogens were associated with an increase in the incidence of endometrial hyperplasia (3.8% versus 0%). (3) In practice, the risk-benefit ratio of phytoestrogens has not been adequately assessed. Their effect on the endometrium, and the many unknowns concerning the risk of thromboembolism and breast cancer, may offset the modest effect of phytoestrogens on hot flushes.

Topics: Clinical Trials as Topic; Cost-Benefit Analysis; Endometrial Hyperplasia; Female; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Postmenopause; Treatment Outcome

Topics: Alzheimer Disease; Breast Neoplasms; Cardiovascular Diseases; Colorectal Neoplasms; Dehydration; Estrogen Replacement Therapy; Estrogens; Female; Hot Flashes; Humans; Menopause; Osteoporosis; Phytoestrogens; Progesterone; Urination Disorders; Vaginal Diseases

Topics: Female; Fungi; Genistein; Glycine max; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Pilot Projects; Postmenopause

Hormone replacement therapy has become a controversial treatment for symptoms of menopause, leading many women and their physicians to search for safer, effective alternatives. Certain botanicals are known to contain phytoestrogenic activity, which may be helpful in alleviating menopausal symptoms. We report the results of a study using a combination botanical supplement to treat menopausal symptoms.. Prospective pilot study.. Family practice medical center, Phoenix metropolitan area.. Eight (8) women with moderate vasomotor and somatic symptoms of menopause.. Combination botanicals daily for 3 months.. Modified Kupperman Index (KI), daily hot flashes severity, and overall quality of life (QoL) using the SF-36 index, which were collected at enrollment, during treatment, and at the end of treatment.. Mean KI total symptoms decreased from 30.3 +/- 7.5 to 22.9 +/- 8.4 (95% CI, 25-34), p = 0.0028. Daily hot flashes decreased from 68.1 +/- 14.3 to 39.6 +/- 9.7 (95% CI, 38-46), p = 0.0003, and the overall QoL also improved at the end of treatment.. This pilot study demonstrates the potential benefit of a combination botanical for improving moderate menopausal symptoms in women. The efficacy and role of combination botanicals for long-term use to reduce menopausal symptoms requires further exploration.

Topics: Adult; Arizona; Female; Hot Flashes; Humans; Menopause; Middle Aged; Phytoestrogens; Pilot Projects; Plant Extracts; Prospective Studies; Quality of Life; Surveys and Questionnaires; Time Factors; Vasomotor System; Women's Health

There is evidence that diets which contain high levels of phytoestrogenic isoflavanoids are associated with a low incidence of osteoporosis and menopausal vasomotor symptoms. Plant extracts such as red clover, which contain high levels of isoflavanoids, have been used to reduce menopausal symptoms and have been shown to reduce bone loss in healthy women. A placebo-controlled clinical trial [ISRCTN42940165] of red clover is reported in this issue of Breast Cancer Research and shows that these phytoestrogens do not cause any oestrogenic increase in breast density, which would indicate that they are unlikely to cause an increased risk of breast cancer.

Topics: Anticarcinogenic Agents; Bone and Bones; Breast; Breast Neoplasms; Female; Hormone Replacement Therapy; Hot Flashes; Humans; Isoflavones; Menopause; Osteoporosis, Postmenopausal; Phytoestrogens; Plant Extracts; Plant Preparations; Selective Estrogen Receptor Modulators; Thromboembolism; Trifolium

The subject of phytoestrogen use must be seen against the background of increasing controversy surrounding the role of hormone replacement therapy. Phytoestrogens such as those derived from red clover may help with hot flushes, which are a common menopausal complaint. Red clover isoflavones have more evidence base than most herbal medicinal products, although the literature is beset by difference in methodologies making direct comparison between studies difficult. There certainly does not appear to be any increased risk for women with breast cancer, who often suffer severely from sweats and flushes. There is currently insufficient evidence to recommend its use for bone protection in a group of women who are at high risk.

Topics: Female; Hot Flashes; Humans; Menopause; Phytoestrogens; Phytotherapy; Plant Preparations; Practice Patterns, Physicians'; Randomized Controlled Trials as Topic; Trifolium; United Kingdom

Topics: Cimicifuga; Complementary Therapies; Drug Interactions; Estrogens, Non-Steroidal; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Plant Extracts; Plant Preparations; United States

For Cimicifuga racemosa, well-founded investigations concerning multiplication, germination of seeds and field cultivation have not yet been published. Defined origins or varieties with certain agronomic properties and a specific pattern of active compounds are not commercially available. Special challenges are found with regard to growing of young plantlets from seeds. Comprehensive investigations have been started to find optimal conditions for all steps of the whole process to establish cultivation for Cimicifuga. Aim is to get defined varieties or sources with desirable agronomic characteristics and specific reproducible compound patterns in order to reach homogeneous plant raw material.. For analytical tests, validated HPLC and TLC methods were used.. Results from germination experiments with different temperature regimens show that the time for germination can be shortened from about 20 months to about 6 months. Gibberellic acid had positive influence on the development of the embryo. Content of triterpenglycosides and phenolic compounds was highest in May and June and decreased then from July until September. The quality of the ethanolic extract BNO 1055 (contained in Klimadynon(R) and Menofem(R)) differs from that of an isopropanolic extract. Comparison was carried out by means of TLC pattern of triterpenglycosides and phenolic compounds.. Extensive systematic research on cultivation parameters with regard to all stages from the seeds to the herbal drug enables commercial field cultivation of Cimicifuga. Controlled cultivation (according to good agricultural practice or GAP) ensures the availability of homogenous standardized raw material. For pharmacological and clinical studies, standardized extracts and finished herbal medicinal products are required. Results of these studies are never transferable to other products and therefore valid only for the tested extracts/products.

Topics: Chromatography, High Pressure Liquid; Chromatography, Thin Layer; Cimicifuga; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Phytotherapy; Plant Extracts; Plant Preparations

Topics: Animals; Disease Models, Animal; Estrogens, Non-Steroidal; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Phytotherapy; Plant Preparations; Sheep

Topics: Dietary Supplements; Female; Herb-Drug Interactions; Hot Flashes; Humans; Isoflavones; Menopause; Physician-Patient Relations; Phytoestrogens; Phytotherapy; Plant Preparations; Treatment Outcome; Women's Health

Topics: Anticarcinogenic Agents; Breast Neoplasms; Estrogen Replacement Therapy; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Plant Preparations; Plants; Soybean Proteins; Tamoxifen

Topics: Adrenergic alpha-Agonists; Antineoplastic Agents; Estrogens; Estrogens, Non-Steroidal; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Neoplasms; Phytoestrogens; Plant Preparations; Selective Serotonin Reuptake Inhibitors

Topics: Controlled Clinical Trials as Topic; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Plant Preparations; Plants; Postmenopause

Topics: Cholesterol; Estrogens, Non-Steroidal; Female; Glycine max; Hot Flashes; Humans; Isoflavones; Male; Phytoestrogens; Plant Preparations

Topics: Antineoplastic Agents; Breast Neoplasms; Estrogens, Non-Steroidal; Genistein; Hot Flashes; Humans; Isoflavones; Phytoestrogens; Plant Preparations

Most randomised placebo-controlled trials show no benefit of phytoestrogens in managing menopausal vasomotor symptoms. Concentrated phytoestrogen supplements appear to have oestrogenic actions in the breast and may interfere with the therapeutic use of tamoxifen. Unlike concentrated supplements, foods rich in phytoestrogens, such as vegetables, grains and legumes, are also excellent sources of fibre, unsaturated protein, vitamins and minerals and their consumption should be encouraged.

Topics: Adult; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Menopause; Middle Aged; Phytoestrogens; Phytotherapy; Plant Preparations; Plants; Postmenopause; Women's Health

Topics: Coronary Disease; Estrogens, Non-Steroidal; Female; Hot Flashes; Humans; Isoflavones; Menopause; Phytoestrogens; Plant Preparations; Soybean Proteins