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Plant Estrogens and Menopause©By R. E. Burki MD, FACOG Plant Estrogens for the Treatment of Menopausal Symptoms Plant estrogens are also called phytoestrogens and contain isoflavons, the scientific name for the active ingredients. When looking at different treatment menopausal options one has to consider both the symptoms of menopause and also the long-term effects of living without functioning ovaries. Symptoms of menopause such as hot flashes, night sweats, vaginal dryness and mood swings make you miserable, but are not life threatening. On the other hand, the main long-term effect of not getting enough estrogen is osteoporosis, which is responsible for the death of about 5% of women. Interestingly, most women think that their biggest risk is breast cancer, which in fact kills less than 4% of women. Heart disease and stroke are the main treat to an older woman=s life. Together they kill about 45% of women. We know that traditional Hormone Replacement Therapy (HRT) treats both the symptoms of menopause and protects women from osteoporosis as well as colorectal cancer. It does not protect from heart disease and strokes, but actually slightly increases the risk of cardiovascular disease and blood clots. Long-term use of HRT may also slightly increase the risk of breast cancer (less than 1/10th of one percent per year of use). Another drawback of traditional HRT are vaginal bleeding and sore breasts, which in turn make women worry about uterine and breast cancer. This may be one of the reasons why less than 10% of postmenopausal women take HRT long-term. Unfortunately there are few reliable studies on the effects of plant estrogens available, and most the evidence is circumstantial, such as the fact the Japanese women, who eat a diet rich in soy products have a lower rate of osteoporosis and breast cancer. Rats who are fed soy proteins have stronger bones, but not as strong as the ones given estrogen. Studies in women have shown no osteoporosis prevention benefit from using plant estrogens. There is a well designed study from Italy that shows that menopausal women who supplemented their daily diet with 60 g of pure soy protein had a 45 % reduction in hot flashes - though women on placebo had a 30 % reduction as well. That is certainly not as effective as traditional HRT, but may be a good alternative for women in their 40's who are still having more or less regular periods, but are beginning to have some hot flashes, night sweats and insomnia, especially the week before their periods, and are looking for an alternative to full fledged prescription hormonal therapy. Soy proteins or other plants that contain Isoflavons are also a good alternative for postmenopausal women with hot flashes and night sweats who cannot or will not take estrogen for a variety of reasons. It is generally believed that plant estrogens do not stimulate breast and uterine tissues and are safe for women who have or have had breast cancer. There are however no good scientific studies on plant estrogens and breast cancer. Plant estrogens do not treat vaginal dryness and bladder symptoms caused by lack of estrogen. And before you reject them outright, it is helpful to remember that some of the estrogens used in traditional estrogen replacement therapy prescribed by doctors are actually made from plant sources such as soy and yam. An alternative plant product that has been successful in treating hot flashes is black cohosh, Red clover also helps reduce hot flashes. A word of caution, however: I recommend that you actually eat the phyto-estrogen containing soy protein as soy milk, tofu and soy flour products, and not buy capsules in the health food store that claim to contain phyto (plant) estrogens. Since that is an industry operating outside of government quality control, you really have no idea what actually is in those capsules and you are better off eating the actual plant product containing the plant estrogens. There are pharmacies that specialize in selling only high quality pharmaceutical grade plant derived products. (Jolley Pharmacies in Salt Lake City). Furthermore, many of the so called herbal remedies for menopausal symptoms contain natural progesterone. Unlike synthetic progesterone most of the natural progesterone is converted by the body into estrogen and therefore quite effective in the treatment of hot flashes. Synthetic progesterone in combination with estrogen has been shown to increase breast cancer in postmenopausal women more than estrogen replacement therapy alone. Whether natural progesterone has the same breast cancer enhancing effect is not known at this time, though there are some studies pointing in that direction.