Original Article

Effect of Soy Isoflavone on Hot Flushes, Endometrial Thickness, and Breast Clinical as well as Sonographic Features

Abstract

Background: Phytoestrogens treatment to relieve hot flushes in menopausal women was considered recently. However, the actual effectiveness and safety are not clear.

Methods: Randomized clinical trial (IRCT#20100706004329N5) was performed in 204 patients who complained of hot flushes in Arash Women's Hospital, Tehran, Iran from 2013-2015. The first group received 50 mg isoflavone (group A) once daily and the second group received placebo (group B) in the same regimen. Patients were evaluated for breast examination (BE) and breast sonography (BS) as well as vaginal sonography at initial presentation and at 6th and 12th week follow-ups. Patients were educated to record frequency and severity of hot flushes.

Results: Group A experienced less hot flushes attack (6 vs 9 patients with 5< attacks in 6 wk (P= 0.05), 7 Vs 13 patients with 5< in 12 wk (P=0.01)) which was also less severe (8 vs 12 patients with severe symptoms in 6 wk (0.04) and 3 Vs 10 patients with severe symptoms in 12 wk (0.001). Isoflavone had no effect on neither breast density nor nodularity (in 6 wk, P=0.50 and 0.80, respectively and in 12 wk, P=0.32 and 0.43) and neither breast tenderness nor nipple discharge (in 6 wk, P=0.40 and 0.34 respectively and in 12 wk, P= 0.31 and 0.26). There were no significant differences in endometrial thickness in 6 and 12wk.

Conclusion: Effects of isoflavone on frequency and severity of hot flushes in perimenopausal women is observed. Some clinical and ultrasonographic benign non-significant changes of the breast and endometrium are noted after isoflavone intake.

 

Chen MN, Lin CC, Liu CF (2015). Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric, 18: 260-9.

Aso T, Uchiyama S, Matsumura Y et al (2012). A natural S-equol supplement alleviates hot flushes and other menopausal symptoms in equol nonproducing postmenopausal Japanese women. J Women's Health(larchmt) , 21: 92-100.

Rossouw JE, Anderson GL, Prentice RL et al (2002). Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA, 288: 321-33.

Depypere HT, Comhaire FH (2014). Herbal preparations for the menopause: beyond isoflavones and black cohosh. Maturitas, 77: 191-4.

Shou C, Li J, Liu Z (2011). Complementary and alternative medicine in the treatment of menopausal symptoms. Chin J Integr Med, 17: 883-8.

Ismail R, Taylor-Swanson L, Thomas A et al (2015). Effects of herbal preparations on symptom clusters during the menopausal transition. Climacteric, 18: 11-28.

Al-Safi ZA, Santoro N (2014). Menopausal hormone therapy and menopausal symptoms. Fertil Steril, 101: 905-15.

Bedell S, Nachtigall M, Naftolin F (2014). The pros and cons of plant estrogens for menopause. J Steroid Biochem Mol Biol, 139: 225-236.

Thompson LU, Robb P, Serraino M et al (1991). Mammalian lignan production from various foods. Nutr Cancer, 16: 43-52.

Freeman EW, Sherif K (2007). Prevalence of hot flushes and night sweats around the world: a systematic review. Climacteric, 10: 197-214.

Messina M, Nagata C, Wu AH (2006). Estimated Asian adult soy protein and isoflavone intakes. Nutr Cancer, 55: 1-12.

Lethaby A, Marjoribanks J, Kronenberg F et al (2013). Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database Syst Rev, 10; (12): CD001395.

Penotti M, Fabio E, Modena AB et al (2003). Effect of soy-derived isoflavones on hot flushes, endometrial thickness, and the pulsatility index of the uterine and cerebral arteries. Fertil Steril, 79: 1112-7.

Setchell KD, Brown NM, Desai P et al (2001). Bioavailability of pure isoflavones in healthy humans and analysis of commercial soy isoflavone supplements. J Nutr, 131:1362S-75S.

Ferrari A (2009). Soy extract phytoestrogens with high dose of isoflavones for menopausal symptoms. J Obstet Gynaecol Res, 35: 1083-90.

SammartinoA, TommaselliGA, GarganoV et al (2006). Short-term effects of a combination of isoflavones, lignans and Cimicifuga racemosa on climacteric-related symptoms in postmenopausal women: a double-blind, randomized, placebo-controlled trial. Gynecol Endocrinol, 22: 646-50.

Del Giorno C, Da Fonseca AM, Bagnoli VR et al (1992). Effects of Trifolium pratense on the climacteric and sexual symptoms in postmenopausal women. Rev Assoc Med Bras, 56: 558-62.

Riesco E, Choquette S, Audet M et al (2011). Effect of exercise combined with phytoestrogens on quality of life in postmenopausal women. Climacteric, 14: 573-580.

Van Patten CL, Olivotto IA, Chambers GK et al (2002). Effect of soy phytoestrogens on hot flushes in postmenopausal women with breast cancer: a randomized, controlled clinical trial. J Clin Oncol, 20: 1449-55.

Jacobs A, Wegewitz U, Sommerfeld C et al (2009). Efficacy of isoflavones in relieving vasomotor menopausal symptoms–a systematic review. Mol Nutr Food Res, 53: 1084-1097.

Nahas EA, Nahas-Neto J, Orsatti FL et al (2007). Efficacy and safety of a soy isoflavone extract in postmenopausal women: a randomized, double-blind, and placebo-controlled study. Maturitas, 58: 249-58.

Welty FK, Lee KS, Lew NS et al (2007). The association between soy nut consumption and decreased menopausal symptoms. J Womens Health(larchmt), 16: 361-9.

Fritz MA, Speroff L (2011). Clinical gynecologic endocrinology and infertility. 8 th ed. lippincott Williams & Wilkins. Philadephia, USA, PP.: 673-748.

North American Menopause Society (2010). Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause, 17: 242-55.

Anderson LN, Cotterchio M, Boucher BA et al (2013). Phytoestrogen intake from foods, during adolescence and adulthood, and risk of breast cancer by estrogen and progesterone receptor tumor subgroup among Ontario women. Int J Cancer, 132: 1683-92.

Rekha C, Vijayalakshmi G (2011). Isoflavone phytoestrogens in soymilk fermented with β-glucosidase producing probiotic lactic acid bacteria. Int J Food Sci Nutr, 62: 111-20.

Adlercreutz CH, Goldin BR, Gorbach SL et al (1995). Soybean Phytoestrogen Intake and Cancer Risk. J Nutr, 125: 757S-770S.

Messina M, Barnes S (1991). The role of soy products in reducing risk of cancer. J Natl Cancer Inst, 83: 541-6.

Santell RC, Kieu N, Helferich WG (2000). Genistein inhibits growth of estrogen-independent human breast cancer cells in culture but not in athymic mice. J Nutr, 130: 1665-9.

Ju YH, Doerge DR, Woodling KA et al (2008). Dietary genistein negates the inhibitory effect of letrozole on the growth of aromatase-expressing estrogen-dependent human breast cancer cells (MCF-7Ca) in vivo. Carcinogenesis, 29: 2162-68.

Colacurci N, De Franciscis P, Atlante M et al (2013). Endometrial, breast and liver safety of soy isoflavones plus Lactobacillus sporogenes in post-menopausal women. Gynecol Endocrinol, 29: 209-12.

McCormack VA, dos Santos Silva I (2006). Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev, 15: 1159-69.

Lowry SJ, Sprague BL, Aiello Bowles EJ et al (2012). Mammographic breast density and serum phytoestrogen levels. Nutr Cancer, 64: 783-9.

Hooper L, Madhavan G, Tice JA et al (2010). Effects of isoflavones on breast density in pre-and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials. Hum Reprod Update, 16: 745-60.

Alipour S, Afshar S, Moini A et al (2012). Clinical and Ultrasonographic Changes of the Breast after Use of Soy Isoflavones. Asian Pac J Cancer Prev, 13: 6093-5.

Balk JL, Whiteside DA, Naus G et al (2002). A pilot study of the effects of phytoestrogen supplementation on postmenopausal endometrium. J Soc Gynecol Investig, 9: 238-42.

Wedrén S, Lovmar L, Humphreys K et al (2008). Estrogen receptor alpha gene polymorphism and endometrial cancer risk–a case-control study. BMC Cancer, 8: 322.

Quaas AM, Kono N, Mack WJ et al (2013). Effect of isoflavone soy protein supplementation on endometrial thickness, hyperplasia, and endometrial cancer risk in postmenopausal women: a randomized controlled trial. Menopause , 20: 840-4.

Spandorfer SD, Arrendondo-Soberon F, Loret de Mola JL et al (1998). Reliability of intraobserver and interobserver sonographic endometrial stripe thickness measurements. Fertil Steri, 70: 152-4.

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IssueVol 47 No 3 (2018) QRcode
SectionOriginal Article(s)
Keywords
Isoflavone Hot flushes Breast tissue Endometrial thickness

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How to Cite
1.
VAHID DASTJERDI M, ESLAMI B, ALSADAT SHARIFI M, MOINI A, BAYANI L, MOHAMMAD KHANI H, ALIPOUR S. Effect of Soy Isoflavone on Hot Flushes, Endometrial Thickness, and Breast Clinical as well as Sonographic Features. Iran J Public Health. 2018;47(3):382-389.