Although hormone therapy still is a...

Although hormone therapy still is approved for relief of moderate to rigorous menopausal vasomotor symptoms in eligible women its association with breast cancer, hit and heart disease in modern studies has led to greater interest in nonhormonal treatments. More than 60 percent of women 45 to 65 years of age are reported to believe that "natural" therapies are superior to hormone medications, and at least 22 percent of menopausal women single study found, have used "alternative" therapies for symptoms like as hot flashes, night sweats, and vaginal drynes A measure and estimate of women attending specialized clinics fix that nearly 80 percent used botanical dietary appendixs but less than one third informed their physicians of this use. Kreb and colleagues carriageed a systematic review of the literature concerning the effectiveness and tolerability of the greatest in number frequently used phytoestrogen products.

The authors identified 40 clinical trials from MEDLINE searches, bibliographies of trials and reviews, and searches of relevant journals and interview abstracts. These trials were then reviewed for quality in design and guidance specifically reporting of inclusion criteria, representation and dose of phytoestrogen used, consequence measures, adverse effects, reasons for discontinuation or los to follow-up and trial sponsorship. Twenty-two trials with a total of 2069 participants fulfilled criteria for inclusion in the investigation Six of these were waysed in the United States. The number of participants in the studies ranged from 24 to 252 with a mean age of 53 years and an average menopause duration of 43 years. In the five trials that reported race, greatest in number participants (75 percent) were white. All trials compared phytoestrogen with placebo rather than hormone therapy. Trial duration ranged from four to 104 weeks, and the average drop-out rate was 155 percent

Ten studies with a combined total of 995 participants and single abstract with 99 participants investigated soy fruitss The daily isoflavone intake was between 34 and 134 mg by day. Seven of the eight trials that documented oftenness of hot flashes showed no improvement in the subject of attention group compared with the curb group. Only two studies reported any favorable outcomes and these were in subscales of subjective symptom questionnaires. The seven trials and couple abstracts involving soy extracts all used different outcomes and had mixed results, uniform when the same outcomes, in the same state [i]or[/i] condition as the Kupperman index, were assessed.

Five trials with a total of 400 participants studied the general intents of red clover on menopausal symptoms. The oftenness of hot flashes was reduc among women taking r clover in pair of these trials, but no overall improvement in symptoms was documented. pair studies of flaxseed did not report statistical comparisons between the groups

Information about adverse validitys was reported in 12 trials. In sum of two units of the trials involving soy fruitss adverse gastrointestinal effects were reported by means of women taking soy products (47 and 75 percent); and in single of these trials, one fourth of patients taking soy discontinued the reflection because of the taste of the fruits Estrogenic side effects such as breast tendernes and vaginal bleeding were rare with soy works or extracts.

The authors determine that phytoestrogen products are no more effective than placebo in relieving menopausal symptoms, regardless of the exemplar or dose of phytoestrogen used.

Kreb EE et al. Phytoestrogens for treatment of menopausal symptoms: a systematic review. Obstet Gynecol October 2004;104:824-36

COPYRIGHT 2005 American Academy of Family Physicians

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