Three well-done studies from three different research centers report that women who take both estrogen and progesterone after they reach the menopause are at increased risk for breast cancer, heart attacks and strokes. So doctors are likely to recommend hormones only for women who have severe postmenopausal hot flushes, night sweats, mood changes, loss of libido and vaginal dryness and osteoporosis. Giving these women the female hormone, estrogen , reduces the risk of these symptoms as well as osteoporosis, but increases risk for breast cancer, heart attacks and strokes.
Post-menopausal women who take estrogen have a 60 percent reduced risk for wrist fractures, a 40 percent reduced risk for hip fractures and a 35 percent reduced risk of all non spinal fractures. (1). The phytoestrogens in soy, which are similar in structure to the estrogen we produce in our bodies, reduce menopausal symptoms.(2). At the "Second International Symposium on the Role of Soy in Preventing and Treating Chronic Disease," which was held in Brussels, Belgium in September, 1996, there were six human studies that looked at the role of soy in reducing post-menopausal symptoms, especially hot flushes. Although all six found a decrease in the rate of hot flushes, only three found a significant decrease.
A more recent study conducted in Italy showed a 45 percent reduction in the number of hot flushes after 12 weeks in the group consuming 60 grams daily of soy protein isolate containing 76mg of isoflavones (9). Hot flushes are uncommon in women from Asian countries where people eat a lot of plants including soybeans (10). The Japanese have such a low incidence of postmenopausal flushing that their language has no word to describe a hot flush. In one study, Japanese women reported much fewer night sweats and hot flushes than Canadian women (11). Another study found that urinary excretion of isoflavonoids from soy products in Japanese women was 100 to 1000 times higher than in American and Finnish women, and that the high consumption of soy products may explain why Japanese women report having fewer hot flushes (12). Estrogen in plants such as soybeans may be useful in women with mild to moderate post-menopausal symptoms, and in preventing bone loss. One to four servings of soybeans and soy products per day may be effective in reducing symptoms, but more research needs to be done. It took years of research with thousands of participants to understand the risks associated with HRT; no comparable studies have been done on any proposed alternatives.
1) Cauley JA, Seeley DG, Ensrud K, Ettinger B, Black D, Cummings SR. Estrogen replacement therapy and fractures in older women: a prospective study. Ann Intern Med 1995;122 :9-16.
2) Dalais FS. Soy and Menopause. Soy Connection 1997;5:1,4.
3)Burke GL. The potential use of a dietary soy supplement as a post-menopausal hormone replacement therapy.
4) Woods MN, Senie R, Kronenberg F. Effect of a dietary soy bar on menopausal symptoms.
5)Dalais FS, Rice GE, Bell RJ, Murkies AL, Medley G, Strauss BJG, Wahlqvist ML. Dietary soy supplementation increases vaginal cytology maturation index and bone mineral content in postmenopausal women.
6) Murkies AL, Lombard C, Strauss BJG, Wilcox G, Burger HG, Morton MS. Dietary flour supplementation decreases post-menopausal hot flushes: Effect of soy and wheat. Maturitas 1995;21:189-195.
7) Eden J, Knight D, Mackey R. Hormonal effect of isoflavones.
8)Harding C, Morton M, Gould V, McMichael Phillips D, Howell A, Bundred NJ. Dietary soy supplementation is oestrogenic in menopausal women.
9) Albertazzi P, Pansini F, Bonaccorsi G, Zanotti L, Forini E, De Aloysio D. The effect of dietary soy supplementation on hot flushes. Obstet Gynecol 1998;91:6-11.
10)Boulet MJ, Oddens BJ, Lehert P, Vemer HM, Visser A. Climacteric and menopause in seven southeast Asian countries. Maturitis 1994;19:157-176.
11) Lock M. Contested meaning of the menopause. The Lancet 1991; 337:1270-1272.
12) Adlercreutz H, Hamalainen E, Gorbach S, Goldin B. Dietary phyto-oestrogens and the menopause in Japan. Lancet 1992;339:1233.
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