A phytoestrogen-rich multivitamin supplement should be considered as first line treatment for women suffering from hot flushes and other menopausal symptoms, said researchers in London last week.
The 12-week double-blind placebo-controlled study, conducted by the Natural Menopause Advice Service (NMAS), an initiative funded by UK supplement maker Wassen, found that the Wassen-manufactured supplement Estroven improved five of the commonest menopause symptoms including libido, hot flushes and particularly insomnia.
Natural treatments for menopause symptoms have seen a significant boost following two major trials showing the negative impact of HRT. Most recently, a study published in The Lancet found an association between combined oestrogen/progestogen hormone replacement therapy (HRT) and a substantial increase in breast cancer risk. The results also identified an increase in breast cancer death risk for the first time.
But while phytoestrogens, such as soy isoflavones, are thought to have a positive effect on menopause symptoms because they have chemical resemblances to the human hormone oestrogen, there has been much conflicting evidence for foods and supplements containing the plant chemicals. So far evidence suggests that soy-containing foods are more effective than isoflavones in reducing menopause symptoms.
The NMAS trial involved 107 women who had stopped having periods 12 months previously and were suffering from significant symptoms of the menopause. They were asked to keep diaries throughout the 12 weeks period, assessing 15 symptoms associated with the menopause.
Thirty-three women on Estroven and 24 on placebo completed the trial. After three months, 27 per cent of the women taking Estroven (compared to 18 per cent on placebo) reported that low libido was much less of a problem than with women in the placebo group.
By the last four weeks of the study other main symptoms to improve were night sweats (31 per cent reduction in the number of days with severe or moderate symptoms in the Estroven group compared to only 2 per cent reduction in the placebo group). A reduction in insomnia was also reported by 69 per cent of women on Estroven, compared to 21 per cent in the placebo group.
On each of the five symptoms found to cause most concern - hot flushes, loss of libido, night sweats, aches and pains and insomnia - Estroven appeared to bring greater improvements than in those taking placebo.
It also reduced the number of days when symptoms were a problem. For example, women taking Estroven had on average 12.1 days of hot flushes in the first month and on average 8.9 days in the third month - a 27 per cent reduction.
"This NMAS trial makes it very clear that Estroven is a valuable product for women approaching or in the menopause," said Dr Shirley Bond, medical advisor to NMAS, presenting the data in London last week.
"I consider that Estroven can be used as an alternative to HRT for those experiencing mild to moderate menopausal problems. It will help those with severe problems but whether or not it would be enough on its own will depend to a large extent upon the individual. Isoflavones, such as Estroven, should certainly be the first port of call though and not HRT," said Dr Bond.
She added that the positive effect against insomnia may be related to the reduction in night sweats. She also suggested that Estroven could be used to help wean women off HRT.
"Libido was one of the problems really helped with Estroven and in significant numbers. This is a big plus because it is one of the most difficult problems to deal with. While HRT will usually produce a quick response with sweats and flushes it is not without side effects. In my experience, if women have it explained to them that isoflavones are not a quick fix but that they will work eventually, they are prepared to wait, especially if they want to avoid HRT," said Dr Bond.
Wassen's Estroven tablets each contain 55mg of isoflavones from Japanese Arrowroot and non-GMO soya, a typical daily isoflavone intake of people in some Asian countries where soya features in the daily diet. It also includes vitamin E, B1, B2, B3, B6, B12, folic acid and three minerals, selenium, calcium and boron.