Soy isoflavones, melatonin, not effective in relief of menopause symptoms

Townsend Letter for Doctors and Patients,  May, 2004  by Tori Hudson

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A total of 262 women were assigned to one of four treatment groups: soy isoflavones 80 mg and melatonin 3 mg, soy isoflavones 80 mg alone, and melatonin 3 mg alone. Study duration was for 3 months using the Greene Climacteric Scale.

There was a 39% improvement in the combination group, 38% improvement in the isoflavones alone group, 26% in the melatonin only group, and 38% in the placebo group. Individual symptoms such as hot flashes and psychological symptoms were also similar in all 4 groups although the combination group had somewhat higher improvements in psychological symptoms.

Commentary: This study now adds to the very mixed picture studies have shown us regarding soy isoflavones and menopausal symptoms, including hot flashes. A recent study by an expert researcher, Ken Setchell et al (Setchell, et al. J Nutr 2002), suggested that women may need to convert daidzein to equol in order to have a beneficial effect on hot flashes. Equol is a phytoestrogen that binds to both ER-alpha and ER-beta and is produced by 30% to 50% of women. Another study of hot flashes in breast cancer patients (Nikander et al. Obstet Gynecol 2003) also implied that there may be a different response to soy isoflavones with different urinary equol excretion. We have yet to understand why some studies show positive effects with soy isoflavones and hot flashes and others do not, even in well-controlled studies of adequate duration and dosage.

Secreto G, Chiechi L, Amadori A, et al. Soy isoflavones and melatonin for the relief of climacteric symptoms: a multicenter, double-blind, randomized study. Maturitas 2004;47:11-20.

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