Four trials that were not combined in meta-analyses suggested that extracts with high ( > 30 mg/d ) levels of genistein consistently reduced the frequency of hot flushes .
BACKGROUND Vasomotor symptoms , such as hot flushes and night sweats , are very common during the menopausal transition .
Hormone therapy has traditionally been used as a highly effective treatment , but concerns about increased risk of some chronic diseases have markedly increased the interest of women in alternative treatments .
Some of the most popular of these treatments are foods or supplements enriched with phytoestrogens-plant-derived chemicals that have estrogenic action .
OBJECTIVES To assess the efficacy , safety and acceptability of food products , extracts and dietary supplements containing high levels of phytoestrogens when compared with no treatment , placebo or hormone therapy for the amelioration of vasomotor menopausal symptoms ( such as hot flushes and night sweats ) in perimenopausal and postmenopausal women .
A double-blind randomized study on the effects of red clover isoflavones on the endometrium
Objective To assess the effects of a red clover-derived isoflavone extract on the Ki-67 proliferative marker of endometrial biopsies in 45-to 50-year-old perimenopausal women . We hypothesized that we would be able to detect a decrease in the Ki-67 proliferative index during the late follicular phase after a 3-month course of ∼50 mg red clover isoflavones . Isoflavones have been found to have some antiestrogenic effects , and an antiproliferative effect during the perimenopausal period may be especially useful owing to the excessive endometrial proliferation often characteristic of this period . Design In a double-blind , r and omized , controlled study , 30 women between the ages of 45 and 50 years consented to an endometrial biopsy  before and after a 3-month course of either placebo or active isoflavone extract . The biopsies were timed as close as possible to days 7–11 of the menstrual cycle , and simultaneous measurements of transvaginal endometrial thickness , uterine artery Doppler , hormone profiles , lipids , and bone markers were performed . Results Of 30 women , 2 did not return for a second biopsy , and a third had an unsuccessful second biopsy . Four subjects were excluded from the Intention to Treat analysis because they did not have a menstrual bleed within the time frame of the study ( 3 subjects ) or were tested on day 13 instead of between days 7 and 11 of the cycle ( 1 subject ) . There was no change in the Ki-67 proliferation index after treatment in either group . Eight subjects in the placebo group and eight in the P-07 group had proliferative endometrial biopsies that were synchronized with estradiol levels at baseline and post-treatment , and analysis of these subjects revealed no detectable change in the relationship between estradiol levels and Ki-67 with treatment in either group . There was no change in fasting lipids , bone markers , uterine Doppler resistance , or pulsatility index . Conclusion In this small pilot study , we did not find , using immunohistochemical quantification of the Ki-67 antigen , that red clover isoflavones had an antiproliferative effect in the endometrium . Small sample size , examination of a relatively short interval in the menstrual cycle , and isoflavone formulation may have contributed to our lack of findings ; however , we believe that the issue of isoflavones and their possible antiproliferative effect is deserving of further study . A simpler physiological model with less hormonal variability , such as healthy , recently menopausal women on predetermined doses of estrogen , may prove to be more informative
Four trials that were not combined in meta-analyses suggested that extracts with high ( > 30 mg/d ) levels of genistein consistently reduced the frequency of hot flushes .
BACKGROUND Vasomotor symptoms , such as hot flushes and night sweats , are very common during the menopausal transition .
Hormone therapy has traditionally been used as a highly effective treatment , but concerns about increased risk of some chronic diseases have markedly increased the interest of women in alternative treatments .
Some of the most popular of these treatments are foods or supplements enriched with phytoestrogens-plant-derived chemicals that have estrogenic action .
OBJECTIVES To assess the efficacy , safety and acceptability of food products , extracts and dietary supplements containing high levels of phytoestrogens when compared with no treatment , placebo or hormone therapy for the amelioration of vasomotor menopausal symptoms ( such as hot flushes and night sweats ) in perimenopausal and postmenopausal women .