phytoestrogens and Sleep-Wake-Disorders

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

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

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

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

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

Current evidence on the relationship of phytoestrogens with sleep is limited and contradictory. In particular, studies on individual phytoestrogens and sleep have not been reported. Thus, this study aimed to appraise the associations of individual phytoestrogens with sleep disorders and sleep duration. This cross-sectional study comprising 4830 adults utilized data from the National Health and Nutrition Examination Survey 2005-2010. Phytoestrogens were tested in urine specimens. Sleep disorders and sleep duration were based on a self-reported doctor's diagnosis and usual sleep duration. The main analyses utilized logistic and multinomial logistic regression models and a restricted cubic spline. In the fully adjusted model, compared with tertile 1 (lowest), the odds ratios (95% confidence intervals (CIs)) of sleep disorders for the highest tertile of urinary concentrations of enterolactone, enterodiol, and O-desmethylangolensin were 0.64 (0.41-1.00), 1.54 (1.07-2.21), and 1.89 (1.26-2.85), respectively. Linear inverse, approximatively linear positive, and inverted L-shaped concentration-response relationships were found between enterolactone, enterodiol, and O-desmethylangolensin and sleep disorders, respectively. Compared with normal sleep (7-8 h/night), the relative risk ratio (RRR) (95% CI) of very short sleep for enterolactone was 0.56 (0.36-0.86), and the RRR (95% CI) of long sleep risk for genistein was 0.62 (0.39-0.99). Furthermore, negative associations of genistein with sleep disorders and enterolactone with long sleep risk, as well as positive associations of enterodiol with both long and very short sleep, were observed in the stratified analysis by age or gender. Finally, a notable finding was that urinary O-desmethylangolensin concentration was positively related to sleep disorders in both females aged 40-59 years and non-Hispanic Whites but inversely associated with sleep disorders in both females aged 60 years or over and other Hispanics. Our findings suggested that enterolactone and genistein might be beneficial for preventing sleep disorders or non-normal sleep duration among adults, and enterodiol might be adverse toward this goal. However, the association of O-desmethylangolensin with sleep disorders might be discrepant in different races and females of different ages.

Topics: 4-Butyrolactone; Adult; Age Factors; Aged; Biomarkers; Cross-Sectional Studies; Female; Humans; Isoflavones; Lignans; Male; Middle Aged; Phytoestrogens; Racial Groups; Sex Factors; Sleep; Sleep Wake Disorders

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