Objective-The aim of this study was to determine the effect of DRIs on hot flash symptoms in menopausal women.Design-This was a randomized, double-blind, placebo-controlled trial of menopausal women, aged 38 to 60 years, who experienced 4 to 14 hot flashes per day. After a 1-week run-in period, a total of 190 menopausal women were randomized to receive a placebo or 40 or 60 mg/day of a DRI for 12 weeks. The primary outcome was the mean changes from baseline to week 12 in the frequency of hot flashes recorded in the participant diary. The secondary outcomes included changes in quality of life and hormonal profiles.Results-A total of 147 women (77%) completed the study. It was found that 40 and 60 mg of DRI improved hot flash frequency and severity equally. At 8 weeks hot flash frequency was reduced by 43% in the 40-mg DRI group and by 41% in the 60-mg DRI group, compared with 32% in the placebo group (P = not significant vs placebo). The corresponding numbers for 12 weeks were 52%, 51%, and 39%, respectively (P = 0.07 and 0.09 vs placebo). When comparing the two treatment groups with the placebo group, there were significant reductions in mean daily hot flash frequency. The supplement (either 40 or 60 mg) reduced hot flash frequency by 43% at 8 weeks (P = 0.1) and 52% at 12 weeks (P = 0.048) but did not cause any significant changes in endogenous sex hormones or thyroid hormones. Menopausal quality of life improved in all three groups, although there were no statistically significant differences between groups.Conclusions-DRI supplementation may be an effective and acceptable alternative to hormone treatment for menopausal hot flashes. Although hormone therapy (HT) is the most effective treatment for the relief of hot flashes to date, evidence suggests that long-term use of HT may increase the risk of developing certain medical disorders. The data from the Women's Health Initiative showed an increased risk of coronary heart disease, stroke, pulmonary embolism, and breast cancer with estrogen + progestogen therapy (conjugated equine estrogens + medroxyprogesterone acetate) after a mean of 5.2 years of follow-up. 3 Estrogen+ progestogen therapy was associated with a 24% increased risk of coronary heart disease. 4 Thus, safe and effective alternatives are needed. KeywordsRecently interest has arisen in isoflavones as a potential therapy for menopausal hot flashes.Isoflavones are one of several classes of phytoestrogens, compounds that exert both estrogenic and antiestrogenic properties. Daidzein and genistein are isoflavones that are found in rich supply in soybeans and soy products. Available data on isoflavones for the treatment of menopausal symptoms have been inconclusive; studies with positive results have reported only a slight improvement. Nonetheless, there are no studies showing harmful effects of isoflavones on menopausal symptoms. This inconsistency may, in part, be due to differences in methods used to isolate isoflavones, concentrations of bioavailable isoflavones, and the composition of isoflav...
Recent studies have reported that estrogen replacement therapy (ERT) reduces the risk of cardiovascular diseases in postmenopausal women. However, mechanisms responsible for this effect are not yet completely understood, and ERT is associated with carcinogenic side effects in women and feminizing effects in men. Because soybean isoflavones, a group of natural phytoestrogens, have only weak estrogenic activity and are not known to have side effects such as carcinogenesis and feminization, we evaluated the effects of genistein, daidzein and glycitein on the growth and DNA synthesis of aortic smooth muscle cells (SMC) from stroke-prone spontaneously hypertensive rats (SHRSP). SMC were cultured in dishes and proliferated on 10% dextran-coated charcoal/fetal bovine serum, and then treated with 0.1-30 micromol/L of genistein, daidzein or glycitein to investigate cell proliferation (cell number) and DNA synthesis (cell proliferation ELISA system), respectively. We also studied their effects on platelet-derived growth factor (PDGF)-BB (20 microg/L)-induced SMC proliferation. Soybean isoflavones inhibited proliferation and DNA synthesis of SMC from SHRSP in a concentration-dependent manner. Inhibition was significant at 3 micromol/L of genistein and 10 micromol/L of both daidzein and glycitein. For significant inhibition of PDGF-BB-induced SMC proliferation, concentrations as low as 0.1 micromol/L of each isoflavone were effective. These isoflavones, with their inhibitory effects on natural and PDGF-BB-induced SMC proliferation, may be useful in attenuatating such proliferation, a basic mechanism involved in atherosclerotic vascular change, thereby preventing atherosclerotic cardiovascular diseases.
Further research is warranted to investigate whether soy and tea combinations may prevent breast or prostate cancer in a synergistic manner in part by alleviating metabolic disorders.
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