Article information
Resumen
La menopausia se caracteriza por el cese de la función ovárica y la disminución hormonal de estrógenos. Estos cambios conllevan una serie de trastornos que pueden afectar a la vida de la mujer. La medicina, debido a la influencia de la industria farmacéutica, tiende a actuar de forma agresiva, y como consecuencia tenemos una población polimedicada. Los médicos suelen recetar tratamientos, como la terapia hormonal sustitutiva (THS), que ayuda a controlar estos síntomas. No obstante, recientemente varios estudios han demostrado efectos adversos asociados a la THS. Actualmente se conoce la influencia de la dieta en muchas de las enfermedades que afectan a la población de los países occidentales. Así, sla soja dietética y algunos suplementos de isoflavonas se han propuesto como alternativas para paliar los síntomas de la menopausia. Varios estudios indican que se puede utilizar las isoflavonas, de gran potencia estrogénica, como alternativa a la THS por su capacidad de reducir los síntomas menopáusicos. No obstante, el conocimiento sobre los efectos de la ingesta de isoflavonas en los síntomas de la menopausia es escaso y las publicaciones científicas recientes muestran resultados dispares. Para esclarecer esta información, el objetivo de esta revisión es describir algunos de los mecanismos mediante los cuales ejercen su acción las isoflavonas, y sus acciones beneficiosas, postulando que, como suplementos alimentarios, se podría utilizarlos como tratamiento complementario para algunos de los síntomas de la menopausia, lo que permitiría disminuir las dosis de THS.
Palabras clave:
Fitoestrógenos
Isoflavonas de soja
Menopausia
Terapia hormonal sustitutiva
Abstract
The menopause is characterized by a reduction in ovarian function and estrogen production. Altogether, these changes together lead to a series of disorders that may affect the woman's life style. Currently, medicine, influenced by the pharmaceutical industry, is prone to act aggressively against any symptoms, resulting in. polymedicated population. Doctors usually prescribe treatments such as hormone replacement therapy (HRT), to help them manage menopause symptoms. However, recently, several studies have reported adverse effects associated with this treatment. The influence of diet on several chronic diseases in western societies is currently well known. Therefore, dietary therapies, including dietary soy and isoflavone supplements, have been proposed for the reduction of menopause symptoms. Several published studies have suggested isoflavones, which have a great estrogenic power, as an HRT alternative for the relief of menopause symptoms. However, our current understanding on the effects of isoflavone supplements on the menopause symptoms is limited, and scientific publications show heterogenous results. Due to those arguments, the objective of this review is to address some of the mechanisms of isoflavones and their role in the menopausal period, postulating that, as food supplements, they could be used as a complementary therapy for menopause symptoms.
Keywords:
Hormone replacement therapy
Menopause
Phytoestrogens
Soy isoflavones
Full text is only aviable in PDF
Bibliografía
[1.]
F. Atsma, M. Bartelin, D. Grobbee, Y. Van der Schouw.
Postmenopausal status and early menopause as independen risk factors for cardiovascular disease: a meta-analysis.
Menopause, 13 (2006), pp. 265-279
[2.]
A. Becerra.
La edad de la menopausia.
Díaz de Santos, (2003),
[3.]
M. Birkhäuser.
Depression, menopause and estrogenes: is there a correlation?.
Maturitas, 41 (2002), pp. 3-8
[4.]
A.H. Maclennan.
HRT in difficult circumstances: are there any absolute contraindications?.
Climateric, 14 (2011), pp. 409-417
[5.]
P.J. Phillips, G. Phillipov.
Bone mineral density –frequently asked questions.
Aust Fam Physician, 35 (2006), pp. 341-344
[6.]
M.D. Recker, J. Lappe, M. Davies, R. Heaney.
Bone remodelling increases substantially in the years after menopause and remains increased in older osteoporosis patients.
J Bone Mineral Res, 19 (2004), pp. 1628-1633
[7.]
M. Carr.
The emergence of the metabolic síndrome with menopause.
Cardiovasc End, 88 (2003), pp. 2404-2411
[8.]
P. Strazzullo, L. D'Elia, G. Cairella, et al.
Excess body weight and incidence of stroke: meta-analysis of prospective studies with 2 million participants.
Stroke, 41 (2010), pp. 418-426
[9.]
K. Schenck-Gustafsson, M. Brincat, C.T. Erel, et al.
EMAS position statement: Managing the menopause in the context of coronary heart disease.
Maturitas, 68 (2011), pp. 94-97
[10.]
G. Vazquez, S. Duval, D.R. Jacobs Jr., K. Silventoinen.
Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis.
Epidemiol Rev, 29 (2007), pp. 115-128
[11.]
M. Harvie, L. Hooper, A.H. Howell.
Central obesity and breast cancer risk: a systematic review.
Obes Rev, 4 (2003), pp. 157-173
[12.]
A.A. Moghaddam, M. Woodward, R. Huxley.
Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events.
Cancer Epidemiol Biomarkers Prev, 16 (2007), pp. 2533-2547
[13.]
R.J. MacInnis, D.R. English.
Body size and composition and prostate cancer risk: systematic review and meta-regression analysis.
Cancer Causes Control, 17 (2006), pp. 989-1003
[14.]
A. López, J. Costa i Pagés.
Tractament de la simptomatologia menopáusica.
Butlletí Inf Terap, 19 (2007), pp. 47-52
[15.]
North American Menopause Society.
Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society.
Menopause, 17 (2010), pp. 242-255
[16.]
C. MacLean, S. Newberry, M. Maglione, et al.
Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis.
Ann Intern Med., 148 (2008), pp. 197-213
[17.]
R. Alberti, J. Altimiras, M. Bosch, F. Camós, A. Catalán.
Tractament hormonal substitutiu.
Butlletí Inform Terap., 13 (2001), pp. 1-4
[18.]
C. Farquhar, J. Marjoribanks, A. Lethaby, et al.
Long term hormone therapy for perimenopausal and postmenopausal women.
Cochrane Database Syst Rev, (2009), pp. CD004143
[19.]
V. Olié, M. Canonico, P.Y. Scarabin.
Risk of venous thrombosis with oral versus transdermal estrogen therapy among postmenopausal women.
Curr Opin Hematol, 17 (2010), pp. 457-463
[20.]
C.M. Greiser, E.M. Greiser, M. Dören.
Menopausal hormone therapy and risk of lung cancer –Systematic review and meta-analysis.
Maturitas, 65 (2010), pp. 198-204
[21.]
S. Furness, H. Roberts, J. Marjoribanks, et al.
Hormone therapy in postmenopausal women and risk of endometrial hyperplasia.
Cochrane Database Syst Rev, (2009), pp. CD000402
[22.]
T. López Luengo.
Fitoestrógenos, eficacia y seguridad.
Ámbito Farmacéutico, 29 (2010), pp. 86-90
[23.]
C.B. Tempfer, G. Froese, G. Heinze, E.K. Bentz, L.A. Hefler, J.C. Huber.
Side effects of phytoestrogens: a meta-analysis of randomized trials.
Am J Med, 122 (2009), pp. 939-946
[24.]
M. Messina.
A brief historical overview of the past two decades of soy and isoflavone research.
J Nutr, 140 (2010), pp. S1350-S1354
[25.]
M.L. Lemos.
Effects of soy phytoestrogens genistein and daidzein on brest cáncer growth.
Ann Pharmacother, 35 (2001), pp. 118-121
[26.]
Y. Somekawa, M. Chiguchi, T. Ishibashi, T. Aso.
Soy intake related to menopausal symptoms, serum lipids, and bone mineral density in postmenopausal Japanese women.
Obstet Gynecol, 97 (2001), pp. 109-115
[27.]
C.A. González.
Estimation of dietary sources and flavonoid intake in a Spanish adult population (EPIC-Spain).
J Am Diet Assoc, 110 (2010), pp. 390-398
[28.]
T. Larkin, W.E. Price, L. Astheimer.
The key importance of soy isoflavone bioavailability to understanding health benefits.
Crit Rev Food Sci Nutr, 48 (2008), pp. 538-552
[29.]
A. Vincent, A. Lorraine, M.D. Fitzpatrick.
Soy isoflavones: are they useful in menopause?.
Mayo Clin Proc, 75 (2000), pp. 1174-1184
[30.]
E. Gold, B. Sternfeld, J. Kelsey, et al.
Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40–55 years of age.
Am J Epidemiol, 152 (2000), pp. 463-473
[31.]
T. Cornwell, W. Cohick, I. Raskin.
Dietary phytoestrogens and health.
Phytochemistry, 656 (2004), pp. 995-1016
[31.]
M. Kurzer.
Phytoestrogen supplement use by women.
J Nutr, 133 (2003), pp. 19835-19865
[33.]
S. Bhagwat, D.B. Haytowitz, J.M. Holden.
USDA Database for the Isoflavone Content of Selected Foods.
Human Nutrition Research Center, U. S. Department of Agriculture, (2008),
[34.]
S. Vergne, K. Titier, V. Bernard, et al.
Bioavailability and urinary excretion of isoflavones in humans: effects of soy-based supplements formulation and equol production.
J Pharm Biomed Anal, 43 (2007), pp. 1488-1494
[35.]
I.L. Nielsen, G. Williamson.
Review of the factors affecting bioavailability of soy isoflavones in humans.
Nutr Cancer, 57 (2007), pp. 1-10
[36.]
A. Cassidy, P. Albertazzi, I. Lise Nielsen, et al.
Critical review of health effects of soyabean phyto-oestrogens in post-menopausal women.
Proc Nutr Soc, 65 (2006), pp. 76-92
[37.]
K. Taku, N. Lin, D. Cai, et al.
Effects of soy isoflavone extract supplements on blood pressure in adult humans: systematic review and meta-analysis of randomized placebo-controlled trials.
J Hypertens, 28 (2010), pp. 1971-1982
[38.]
S.H. Li, X.X. Liu, Y.Y. Bai, et al.
Effect of oral isoflavone supplementation on vascular endothelial function in postmenopausal women: a meta-analysis of randomized placebo-controlled trials.
Am J Clin Nutr, 91 (2010), pp. 480-486
[39.]
K. Taku, K. Umegaki, Y. Sato, et al.
Soy isoflavones lower serum total and LDL cholesterol in humans: a meta-analysis of 11 randomized controlled trials.
Am J Clin Nutr, 85 (2007), pp. 1148-1156
[40.]
X.G. Zhuo, M.K. Melby, S. Watanabe.
Soy isoflavone intake lowers serum LDL cholesterol: a meta-analysis of 8 randomized controlled trials in humans.
J Nutr, 134 (2004), pp. 2395-2400
[41.]
R.M. Weggemans, E.A. Trautwein.
Relation between soy-associated isoflavones and LDL and HDL cholesterol concentrations in humans: a meta-analysis.
Eur J Clin Nutr, 57 (2003), pp. 940-946
[42.]
R. Weggemans, E.A. Trautwein.
Relation between soy-associated isoflavons and LDL and HDL colesterol concentrations in humans: a metanalysis.
Eur J Cli Nutr, 57 (2003), pp. 940-946
[43.]
European Food Safety Authority (EFSA).
Scientific Opinion on the substantiation of a health claim related to soy protein and reduction of blood cholesterol concentrations pursuant to Article 14 of the Regulation (EC) No 1924/2006.
EFSA J, 8 (2010), pp. 1688
[44.]
R. Bolaños, J. Francia.
Isoflavones versus hormone therapy for reduction of vertebral fracture risk: indirect comparison.
Menopause, 17 (2010), pp. 1201-1205
[45.]
K. Taku, M.K. Melby, M.S. Kurzer, et al.
Effects of soy isoflavone supplements on bone turnover markers in menopausal women: systematic review and meta-analysis of randomized controlled trials.
Bone, 47 (2010), pp. 413-423
[46.]
K. Taku, M.K. Melby, J. Takebayashi, et al.
Effect of soy isoflavone extract supplements on bone mineral density in menopausal women: meta-analysis of randomized controlled trials.
Asia Pac J Clin Nutr, 19 (2010), pp. 33-42
[47.]
J. Liu, S.C. Ho, Y.X. Su, et al.
Effect of long-term intervention of soy isoflavones on bone mineral density in women: a meta-analysis of randomized controlled trials.
Bone, 44 (2009), pp. 948-953
[48.]
D.F. Ma, L.Q. Qin, P.Y. Wang, R. Katoh.
Soy isoflavone intake increases bone mineral density in the spine of menopausal women: meta-analysis of randomized controlled trials.
Clin Nutr, 27 (2008), pp. 57-64
[49.]
D.F. Ma, L.Q. Qin, P.Y. Wang, R. Katoh.
Soy isoflavone intake inhibits bone resorption and stimulates bone formation in menopausal women: meta-analysis of randomized controlled trials.
Eur J Clin Nutr, 62 (2008), pp. 155-161
[50.]
W.P. Koh, A.H. Wu, R. Wang, et al.
Gender-specific associations between soy and risk of hip fracture in the Singapore Chinese Health Study.
Am J Epidemiol, 170 (2009), pp. 901-909
[51.]
European Food Safety Authority (EFSA).
Scientific Opinion on the substantiation of health claims related to soy isoflavones and maintenance of bone mineral density (ID 1655) pursuant to Article 13(1) of Regulation (EC) No 1924/20061.
EFSA J, 7 (2009), pp. 1270
[52.]
R. Bolaños, A. Del Castillo, J. Francia.
Soy isoflavones versus placebo in the treatment of climacteric vasomotor symptoms: systematic review and meta-analysis.
Menopause, 17 (2010), pp. 660-666
[53.]
A.E. Lethaby, J. Brown, J. Marjoribanks, F. Kronenberg, H. Roberts, J. Eden.
Phytoestrogens for vasomotor menopausal symptoms.
Cochrane Database Syst Rev, (2007), pp. CD001395
[54.]
L.G. Howes, J.B. Howes, D.C. Knight.
Isoflavone therapy for menopausal flushes: a systematic review and meta-analysis.
Maturitas, 55 (2006), pp. 203-211
[55.]
H.D. Nelson, K.K. Vesco, E. Haney, et al.
Nonhormonal therapies for menopausal hot flashes: systematic review and meta-analysis.
JAMA, 295 (2006), pp. 2057-2071
[56.]
M. Durán.
Fitoestrógenos.
Rev Gin Obst, 2 (2001), pp. 138-147
[57.]
European Food Safety Authority (EFSA).
Scientific Opinion on the substantiation of health claims related to soy isoflavones and protection of DNA, proteins and lipids from oxidative damage, maintenance of normal blood LDL-cholesterol concentrations, reduction of vasomotor symptoms associated with menopause, maintenance of normal skin tonicity, contribution to normal hair growth, “cardiovascular health”, treatment of prostate cancer and “upper respiratory tract” pursuant to Article 13(1) of Regulation (EC) No 1924/20061.
EFSA J, 9 (2011), pp. 2264
[58.]
J.Y. Dong, L.Q. Qin.
Soy isoflavones consumption and risk of breast cancer incidence or recurrence: a meta-analysis of prospective studies.
Breast Cancer Res Treat, 125 (2011), pp. 315-323
[59.]
C.A. Enderlin, E.A. Coleman, C.B. Stewart, R. Hakkak.
Dietary soy intake and breast cancer risk.
Oncol Nurs Forum, 36 (2009), pp. 531-539
[60.]
L. Hooper, G. Madhavan, J.A. Tice, et al.
Effects of isoflavones on breast density in pre- and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials.
Hum Reprod Update, 16 (2010), pp. 745-760
[61.]
L.Q. Qin, J.Y. Xu, P.Y. Wang, K. Hoshi.
Soyfood intake in the prevention of breast cancer risk in women: a meta-analysis of observational epidemiological studies.
J Nutr Sci Vitaminol (Tokyo), 52 (2006), pp. 428-436
[62.]
T. Shimazu, M. Inoue, S.J. Sasazuki, PHC Study Group, et al.
Plasma isoflavones and the risk of lung cancer in women: a nested case-control study in Japan.
Cancer Epidemiol Biomarkers Prev, 20 (2011), pp. 419-427
[63.]
T. Shimazu, M. Inoue, et al.
Isoflavone intake and risk of lung cancer: a prospective cohort study in Japan.
Am J Clin Nutr, 91 (2010), pp. 722-728
[64.]
R.C. Travis, N.E. Allen, et al.
A prospective study of vegetarianism and isoflavone intake in relation to breast cancer risk in British women.
Int J Cancer, 122 (2008), pp. 705-710
[65.]
N. Kurahashi, M. Inoue, JPHC Study Group, et al.
Isoflavone consumption and subsequent risk of hepatocellular carcinoma in a population-based prospective cohort of Japanese men and women.
Int J Cancer, 124 (2009), pp. 1644-1966
[66.]
N. Kurahashi, M. Iwasaki, et al.
Isoflavones and subsequent risk of prostate cancer in a nested case-control study: the Japan Public Health Center.
J Clin Oncol, 26 (2008), pp. 5923-5929
[67.]
M. Akhter, M. Inoue, N. Kurahashi, Japan Public Health Center-Based Prospective Study Group, et al.
Dietary soy and isoflavone intake and risk of colorectal cancer in the Japan public health center-based prospective study.
Cancer Epidemiol Biomarkers Prev, 17 (2008), pp. 2128-2135
[68.]
A.H. Wu, W.P. Koh, R. Wang, H.P. Lee.
Soy intake and breast cancer risk in Singapore Chinese Health Study.
Br J Cancer, 99 (2008), pp. 196-200
[69.]
M. Iwasaki, M. Inoue, T. Otani, Japan Public Health Center-based prospective study group, et al.
Plasma isoflavone level and subsequent risk of breast cancer among Japanese women: a nested case-control study from the Japan Public Health Center-based prospective study group.
J Clin Oncol, 26 (2008), pp. 1677-1683
[70.]
N. Guha, M.L. Kwan, et al.
Soy isoflavones and risk of cancer recurrence in a cohort of breast cancer survivors: the Life After Cancer Epidemiology study.
Breast Cancer Res Treat, 118 (2009), pp. 395-405
[71.]
S.Y. Park, S.P. Murphy, L.R. Wilkens, et al.
Legume and isoflavone intake and prostate cancer risk: The Multiethnic Cohort Study.
Int J Cancer, 123 (2008), pp. 927-932
[72.]
B.C. Mathew, S.D. Reji, A.B. Jamal, I.W. Campbell.
Phytoestrogens and cancer.
J Inst Med, 21 (2009), pp. 11-19
Copyright © 2012. Asociación Española de Dietistas-Nutricionistas