Soy Supplements, Herbal Remedies May Reduce Hot Flashes

Posted 28 June 2016

(Reuters Health) – Soy isoflavones in foods or supplements, and some herbal remedies may help reduce menopause symptoms like hot flashes and vaginal dryness, according to a review of 62 studies.

But not all complementary therapies have an effect.

“Hot flashes, night sweats and vaginal dryness are very common symptoms of menopause, affecting up to 80 percent of menopausal women,” said senior author Dr. Taulant Muka of Erasmus University Medical Center in Rotterdam, The Netherlands. “Many women in Western countries try herbs or other products from plants to manage these symptoms,” he noted, but these natural products may not necessarily be useful or safe.

“Our results simply indicate that some plant-based therapies, such as soy and red clover, can be beneficial in reducing menopausal symptoms, but some others not (e.g. black cohosh and Chinese medicinal herbs),” Muka told Reuters Health by email.

The researchers extracted data from 62 randomized controlled trials of plant-based alternative therapies and their effects on hot flashes, night sweats and vaginal dryness: 36 addressed phytoestrogens, 16 tested black cohosh and 10 tested other medicinal herbs.

Together, the trials included more than 6,600 women ranging in age from 18 to 75 years old, and followed for between four weeks and two years.

Using phytoestrogens was associated with fewer hot flashes during the day and with less vaginal dryness, but did not influence night sweats.

Some studies tied black cohosh therapies to a lessening of overall menopause symptoms score but not specifically to fewer hot flashes or night sweats. Chinese medicinal herbs were not associated with a decrease in menopause symptoms, according to the results in JAMA June 21.

In early postmenopause, hormone replacement is an effective therapy for menopausal symptoms, Muka said, but it may not be an option for women at increased risk of breast cancer.

Phytoestrogens like those found in soy can act like estrogen in the body, Muka said. “This may explain the aggregate beneficial effects on menopausal symptoms we found for phytoestrogens.”

The long-term efficacy and safety of these plant-based therapies is unclear, however, and “healthy lifestyle changes form the backbone for easing the discomfort related to menopausal symptoms and keeping you healthy in the long run,” he said.

There is little evidence for long-term effectiveness – or risks – of plant based therapies, since most studies only last 12 to 16 weeks, he added.

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JAMA 2016.

Use of Plant-Based Therapies and Menopausal Symptoms A Systematic Review and Meta-analysis

Oscar H. Franco, MD, PhD1; Rajiv Chowdhury, MD, PhD2; Jenna Troup, MSc1; Trudy Voortman, PhD1,3; Setor Kunutsor, MD, PhD2; Maryam Kavousi, MD, PhD1; Clare Oliver-Williams, PhD2; Taulant Muka, MD, PhD1,3
JAMA. 2016;315(23):2554-2563. doi:10.1001/jama.2016.8012.

Importance  Between 40% and 50% of women in Western countries use complementary therapies to manage menopausal symptoms.

Objective  To determine the association of plant-based therapies with menopausal symptoms, including hot flashes, night sweats, and vaginal dryness.

Data Sources  The electronic databases Ovid MEDLINE, EMBASE, and Cochrane Central were systematically searched to identify eligible studies published before March 27, 2016. Reference lists of the included studies were searched for further identification of relevant studies.

Study Selection  Randomized clinical trials that assessed plant-based therapies and the presence of hot flashes, night sweats, and vaginal dryness.

Data Extraction  Data were extracted by 2 independent reviewers using a predesigned data collection form.

Main Outcomes and Measures  Hot flashes, night sweats, and vaginal dryness.

Results  In total, 62 studies were identified, including 6653 individual women. Use of phytoestrogens was associated with a decrease in the number of daily hot flashes (pooled mean difference of changes, −1.31 [95% CI, −2.02 to −0.61]) and vaginal dryness score (pooled mean difference of changes, −0.31 [95% CI, −0.52 to −0.10]) between the treatment groups but not in the number of night sweats (pooled mean difference of changes, −2.14 [95% CI, −5.57 to 1.29]). Individual phytoestrogen interventions such as dietary and supplemental soy isoflavones were associated with improvement in daily hot flashes (pooled mean difference of changes, −0.79 [−1.35 to −0.23]) and vaginal dryness score (pooled mean difference of changes, −0.26 [−0.48 to −0.04]). Several herbal remedies, but not Chinese medicinal herbs, were associated with an overall decrease in the frequency of vasomotor symptoms. There was substantial heterogeneity in quality across the available studies, and 46 (74%) of the included randomized clinical trials demonstrated a high risk of bias within 3 or more areas of study quality.

Conclusions and Relevance  This meta-analysis of clinical trials suggests that composite and specific phytoestrogen supplementations were associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats. However, because of general suboptimal quality and the heterogeneous nature of the current evidence, further rigorous studies are needed to determine the association of plant-based and natural therapies with menopausal health.

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