Phytoestrogens in the treatment of vasomotor symptoms in peri-and postmenopausal periods

Abstract

Objective: To review the efficacy of phytoestrogens for the treatment of perimenopausal and postmenopausal vasomotor symptoms. Data Sources: UptoDate, MEDLINE, Cochrane Library, Bandolier, DARE, TRIP, National Guideline Clearinghouse, Index of Portuguese Medical Journals and specialty journals. Review Methods: Studies were identified using the MeSH terms phytoestrogens, perimenopause, postmenopause and hot flashes, published between January of 2000 and January of 2011, in English and Portuguese. The Strength of Recommendation Taxonomy (SORT) was used to assess the quality of the studies and assign evidence levels and a strength of recommendation score. Results: Of 78 articles identified, 14 were selected (one clinical decision support system, four guidelines, three meta-analyses, four systematic reviews and two randomized controlled trials). The recommendation of UptoDate and a meta-analysis published in Cochrane (level of evidence 1) conclude that phytoestrogens are not effective. The results of the remaining articles reviewed, generally with level of evidence 2, are conflicting, with the majority demonstrating no benefit with the use of phytoestrogens in reducing the severity and frequency of perimenopausal and postmenopausal vasomotor symptoms. Conclusions: This review of the evidence found that the use of phytoestrogens appears to be ineffective in reducing perimenopausal and postmenopausal vasomotor symptoms (SOR A). It found differences in study designs, particularly in the type and dose of compound evaluated.