Phytoestrogens for hormone replacement therapy?

• Published in: Journal of steroid biochemistry and molecular biology Vol. 83; no. 1; pp. 133 - 147
• Main Authors: Wuttke, W, Jarry, H, Westphalen, S, Christoffel, V, Seidlová-Wuttke, D
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Elsevier Ltd 01.12.2002; Elsevier Science
• Subjects: Biological and medical sciences; Bone and Bones; Breast Neoplasms - prevention & control; Cardiovascular system; Cardiovascular System - drug effects; Cimicifuga; Cimicifuga racemosa; Climacteric complaints; Estrogens, Non-Steroidal - adverse effects; Estrogens, Non-Steroidal - therapeutic use; Female; Hormone Replacement Therapy; Hormones. Endocrine system; Humans; Isoflavones; Mammary cancer; Medical sciences; Menopause; Osteoporosis; Osteoporosis - drug therapy; Pharmacology. Drug treatments; Phytoestrogens; Plant Extracts - therapeutic use; Plant Preparations; Time Factors; Urogenital System - drug effects; Urogenital tract; Urogenital tract; Cardiovascular system; Osteoporosis; Cimicifuga racemosa; Mammary cancer; Climacteric complaints; Isoflavones; Mimetic hormone; Replacement therapy; Ranunculaceae; Diseases of the osteoarticular system; Bone disease; Climacteric; Review; Uterine cervix; Malignant tumor; Isoflavone derivatives; Female genital diseases; Phytoestrogen; Mammary gland diseases; Dicotyledones; Angiospermae; Spermatophyta; Hormone replacement therapy; Circulatory system; Mammary gland; Urogenital system; Uterine cervix diseases
• ISSN: 0960-0760; 1879-1220
• DOI: 10.1016/S0960-0760(02)00259-5

Due to some severe side effects “classical” hormone replacement therapy (HRT) is currently being challenged by a therapy with phytoestrogens. Particularly soy and red clover derived isoflavones are advertised as selective estrogen receptor modulators (SERMs) with only desired and no undesired estrogenic effects. Evidence that this is the case however is scarce. Most studies investigating climacteric complaints did not find beneficial effects. A proposed beneficial effect on mammary cancer is unproven. The majority of studies however indicate an antiosteoporotic effect of isoflavones, while putative beneficial effects in the cardiovascular system are questionable due to the fact that estradiol which—like isoflavones—increase HDL and decrease LDL concentrations appear not to prevent arteriosclerosis in the human. In the urogenital tract, including the vagina, soy and red clover derived isoflavones are without effects. Cimicifuga racemosa extracts are traditionally used for the treatment of climacteric complaints. Evidence is now available that the yet unknown compounds in Cimicifuga racemosa extracts prevent climacteric complaints and may also have antiosteoporotic effects.