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Effect of oral phytoestrogen on androgenicity and insulin sensitivity in postmenopausal women.
Lee, CC, Bloem, CJ, Kasa-Vubu, JZ, Liang, LJ
Diabetes, obesity & metabolism. 2012;(4):315-9
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Abstract
AIM: The aim of this study was to determine and compare the effect of treatment with transdermal oestrogen and phytoestrogen on insulin sensitivity and sex hormone-binding globulin (SHBG) levels in healthy postmenopausal women. METHODS Forty-three healthy postmenopausal women aged 68 ± 7 (mean ± SD) years who were not receiving hormonal replacement therapy completed a 3 month randomized drug therapy study. The participants were randomized to one of four groups: 0.05 mg or 0.1 mg transdermal oestrogen/day, or 40 or 80 mg oral phytoestrogen (Promensil)/day insulin sensitivity was indirectly measured using the quantitative insulin sensitivity check index (QUICKI). SHBG, total testosterone, oestradiol, and fasting glucose and insulin levels for calculation of insulin sensitivity were obtained at baseline and at monthly intervals during the 3 months of therapy. RESULTS In healthy nondiabetic postmenopausal women, the rate of change in QUICKI was significantly different between the red clover based phytoestrogen and transdermal oestrogen groups, so that after three months of therapy, QUICKI with red clover based phytoestrogen therapy was lower than that in the transdermal oestrogen group, p = 0.01. Red clover based phytoestrogen therapy was not associated with any changes in SHBG levels whereas transdermal estrogen therapy significantly increased SHBG levels, p = 0.05. CONCLUSIONS In contrast to transdermal oestrogen therapy, oral phytoestrogen therapy does not decrease androgenicity and is associated with a decrease in insulin sensitivity. These effects are similar to those of raloxifene and consistent with phytoestrogen's selective oestrogen receptor modulator properties.
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Urinary (1)H-NMR metabonomics study on intervention effects of soya milk in Africans.
Ogegbo, OL, Dissanyake, W, Crowder, J, Asekun, O, Familoni, O, Branford-White, CJ, Annie Bligh, SW
Phytotherapy research : PTR. 2012;(1):127-35
Abstract
Metabonomics is an important tool in understanding the toxicological or therapeutic effects of interventions by analysing metabolic profiles and interpreting complex multi-dimensional spectroscopic/spectrometric data using multivariate data analysis. The objectives of this study were to evaluate the metabolic changes following a short-term 5 day soya milk intervention, and to investigate factors that influence soy-phytoestrogen metabolism focused on Africans based in either UK or Nigeria. (1)H-NMR metabonomics was applied to analyse urine samples collected at four phases I-IV (pre, days 3 and 5, and post) of the soy-intervention from African volunteers (n = 40 in total). Individual proton NMR spectra were visually and statistically assessed using multivariate analyses (MVA): principal component analysis (PCA) and (orthogonal-) partial-least square-discriminant analysis ((O-) PLS-DA). In addition, 22 endogenous metabolites were quantified using a Chenomx NMR suite. The results showed the levels of analysed endogenous metabolites (creatinine adjusted) present ranged from 4 µM to 12 mM with large inter-subject variances in acetate, acetone, lactate and trimethylamine. The MVA results showed high inter-individuality and sampling variances based on PCA score plots, and demonstrated soy metabolism to be significantly influenced by location and gender by both PLS-DA and O-PLS-DA.
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Side effects of phytoestrogens: a meta-analysis of randomized trials.
Tempfer, CB, Froese, G, Heinze, G, Bentz, EK, Hefler, LA, Huber, JC
The American journal of medicine. 2009;(10):939-46.e9
Abstract
BACKGROUND Phytoestrogens are widely used by postmenopausal women for the treatment of the climacteric syndrome. The risk of adverse effects of this treatment, however, is unknown. METHODS Using a fixed-effects model, we performed a meta-analysis of side effects comparing phytoestrogen treatment with placebo or no treatment in randomized controlled trials. RESULTS We identified 174 randomized controlled trials. Side effects were reported in 92/174 randomized controlled trials with 9629 participants. The overall incidence of side effects in the phytoestrogen and control groups was 2019/5502 (36.7%) and 1824/4806 (38.0%), respectively (P=.2; incidence rate ratio [IRR] 1.01; 95% confidence interval [CI], 0.95-1.08). Comparing various side effect categories, we found significantly higher rates of gastrointestinal side effects among phytoestrogen users (P=.003; IRR 1.28; 95% CI, 1.08-1.50). Gynecological (IRR 0.94; 95% CI, 0.74-1.20), musculoskeletal (IRR 1.20; 95% CI, 0.94-1.53), neurological (IRR 0.91; 95% CI, 0.70-1.19), and unspecific side effects (IRR 0.95; 95% CI, 0.88-1.03) were not significantly different between groups. Within side effect categories, we found no significantly higher rates of side effects in women using phytoestrogens. Specifically, the rates of hormone-related side effects such as endometrial hyperplasia, endometrial cancer, and breast cancer were not significantly different between groups. CONCLUSIONS Based on the available evidence, phytoestrogen supplements have a safe side-effect profile with moderately elevated rates of gastrointestinal side effects. Rates of vaginal bleeding, endometrial hyperplasia, endometrial cancer, and breast cancer were not significantly increased among phytoestrogen users in the investigated studies.
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Psychological assessment of the effects of treatment with phytoestrogens on postmenopausal women: a randomized, double-blind, crossover, placebo-controlled study.
Casini, ML, Marelli, G, Papaleo, E, Ferrari, A, D'Ambrosio, F, Unfer, V
Fertility and sterility. 2006;(4):972-8
Abstract
OBJECTIVE To investigate the effects of soy isoflavones on mood and cognitive function in postmenopausal women. DESIGN Randomized, double-blind, cross-over, placebo-controlled trial. SETTING University Hospital, Milan, Italy; A.G.UN.CO. Obstetrics and Gynaecology Centre, Rome, Italy. PATIENT(S): Seventy-eight postmenopausal women. INTERVENTION(S): We administered 60 mg/day isoflavones or placebo for 6 months. After a washout period of 1 month, the patients who had been treated with phytoestrogens received placebo, and those who previously received placebo were administered phytoestrogens (for 6 months). MAIN OUTCOME MEASURE(S): Cognitive performance and mood were assessed by a battery of tests at the end of each treatment period. At the end of the study, the patients were also asked whether they preferred the first or second treatment. RESULT(S): The 17 scores on cognitive performance test and the 6 for mood assessments 6 showed an advantage for the treatment with phytoestrogens. Similarly, of the 8 visual analogue scales used to indicate mood, 7 improved significantly after the treatment with phytoestrogens. Moreover, 49 patients preferred phytoestrogens, 9 placebo, and 18 had no preference. The preference was not related to the order of treatment. CONCLUSION(S): These results suggest that isoflavones may have positive effects on postmenopausal women improving cognitive performance and mood.
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Phytoestrogens and prostate cancer risk.
Ganry, O
Preventive medicine. 2005;(1):1-6
Abstract
BACKGROUND Phytoestrogens are natural plant substances. The four main classes are isoflavones, flavonoids, coumestans, and lignans. Phytoestrogens have anti-carcinogenic potential. For evaluation of the effect of phytoestrogens on prostate cancer risk, we reviewed analytical epidemiological data. METHODS Up to now, there are few studies that have assessed the direct relation between the individual dietary intake of soy products and other nutrients with phytoestrogens and the risk of prostate cancer. We decided to review analytical epidemiological studies providing data on (a) dietary soy intake or flavonoids intake, (b) urinary excretion of isoflavones or lignans, or (c) blood measurements of isoflavones or lignans. Soy is used as a marker for isoflavone intake. RESULTS Overall, the results of these studies do not show protective effects. Only four of these studies are prospective, and none of them found statistically significant prostate cancer reductions. Two prospective studies measured flavonoid intake and one reported a preventive effect on prostate cancer for the assumption of myricetin. One study assessed enterolactone concentrations in three different countries and showed no reduction in prostate cancer occurrence. CONCLUSION Few studies showed protective effect between phytoestrogen intake and prostate cancer risk.
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High dose of phytoestrogens can reverse the antiestrogenic effects of clomiphene citrate on the endometrium in patients undergoing intrauterine insemination: a randomized trial.
Unfer, V, Casini, ML, Costabile, L, Mignosa, M, Gerli, S, Di Renzo, GC
Journal of the Society for Gynecologic Investigation. 2004;(5):323-8
Abstract
OBJECTIVE To compare the effectiveness of clomiphene citrate (CC) alone or combined with phytoestrogens (PE) in ovulation induction in patients who had intrauterine insemination in a randomized, double-blind study. METHODS A total of 134 women aged 25-35 years, who were infertile for at least 2 years and who had oligomenorrhea or amenorrhea associated with a positive menstrual response to the intramuscular progesterone-challenge test were enrolled. They were randomly treated with CC (100 mg daily for 5 days) and CC (100 mg daily for 5 days) in combination with PE (1500 mg daily for 10 days). We estimated the difference in uterine artery pulsatily index, number of preovulatory follicles, endometrial thickness, and pregnancy rate. RESULTS Both treatments increased follicle-stimulating hormone, luteinizing hormone, and 17beta-estradiol plasma concentrations, but the differences were not statistically significant. However, the differences in endometrial thickness of the two groups were statistically significant. No significant differences in the pulsatility index values and in the number of preovulatory follicles were noted. CONCLUSION A high dose of phytoestrogens can reverse the deleterious effects of clomiphene citrate on endometrial thickness and could contribute to higher pregnancy rates.