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The pros and cons of plant estrogens for menopause.
J Steroid Biochem Mol Biol. 2014 Jan; 139:225-36.JS

Abstract

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'.

Authors+Show Affiliations

Interdisciplinary Program in Menopausal Medicine, Department of Obstetrics and Gynecology, New York University School of Medicine, New York 10016, United States.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23270754

Citation

Bedell, Sarah, et al. "The Pros and Cons of Plant Estrogens for Menopause." The Journal of Steroid Biochemistry and Molecular Biology, vol. 139, 2014, pp. 225-36.
Bedell S, Nachtigall M, Naftolin F. The pros and cons of plant estrogens for menopause. J Steroid Biochem Mol Biol. 2014;139:225-36.
Bedell, S., Nachtigall, M., & Naftolin, F. (2014). The pros and cons of plant estrogens for menopause. The Journal of Steroid Biochemistry and Molecular Biology, 139, 225-36. https://doi.org/10.1016/j.jsbmb.2012.12.004
Bedell S, Nachtigall M, Naftolin F. The Pros and Cons of Plant Estrogens for Menopause. J Steroid Biochem Mol Biol. 2014;139:225-36. PubMed PMID: 23270754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The pros and cons of plant estrogens for menopause. AU - Bedell,Sarah, AU - Nachtigall,Margaret, AU - Naftolin,Frederick, Y1 - 2012/12/25/ PY - 2012/11/28/received PY - 2012/12/04/revised PY - 2012/12/05/accepted PY - 2012/12/29/entrez PY - 2012/12/29/pubmed PY - 2014/2/4/medline KW - Coumestan KW - HRT alternatives KW - Isoflavone KW - Lignan KW - Phytoestrogen efficacy SP - 225 EP - 36 JF - The Journal of steroid biochemistry and molecular biology JO - J. Steroid Biochem. Mol. Biol. VL - 139 N2 - 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'. SN - 1879-1220 UR - https://www.unboundmedicine.com/medline/citation/23270754/The_pros_and_cons_of_plant_estrogens_for_menopause_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0960-0760(12)00256-7 DB - PRIME DP - Unbound Medicine ER -