Palabras clave
Menopausa
Fitoestrógenos
Alimento Funcional
Suplementos Nutricionais
Fitoestrógenos
Alimento Funcional
Suplementos Nutricionais
Cómo citar
1.
Frigo M, Barros E de, Santos PC de B dos, Koehnlein EA. Isoflavonas como tratamento alternativo na sintomatologia climatérica: uma revisão sistemática. Rev Inst Adolfo Lutz [Internet]. 10 de diciembre de 2021 [citado 4 de diciembre de 2024];80:1-14,e37249. Disponible en: https://periodicos.saude.sp.gov.br/RIAL/article/view/37249
Resumen
O climatério é uma fase natural da vida da mulher que ocorre entre os 40 e 65 anos de idade e é caracterizado pela transição entre a fase reprodutiva e não reprodutiva. Neste período, devido às alterações hormonais, ocorrem alterações biológicas, endócrinas e clínicas. Sintomas vasomotores são típicos do hipoestrogenismo e podem interferir negativamente na qualidade de vida das mulheres. Este estudo teve como objetivo revisar os resultados dos estudos de intervenção que utilizaram isoflavonas na sintomatologia de mulheres climatéricas não usuárias de Terapia de Reposição Hormonal (TRH). Realizou-se uma revisão sistemática de artigos publicados entre os anos de 2008 e 2019 na base de dados PubMed. Foram encontrados 169 estudos, e considerando os critérios de inclusão, 18 artigos foram selecionados, em que houve intervenção com isoflavonas por meio de cápsulas e/ou suplementos ou alimentos para tratamento da síndrome climatérica. Foram verificados resultados positivos nos sintomas globais, com destaque para sintomas vasomotores, em mais da metade dos estudos avaliados, em que doses entre 45 mg a 160 mg diárias de isoflavonas por pelo menos 12 semanas foram administradas, especificadamente nas mulheres no período da pós-menopausa.
Citas
1. Souza SS, Santos RL, Santos ADF, Barbosa MO, Lemos ICS, Machado MFAS. Mulher e climatério: concepções de usuárias de uma unidade básica de saúde. Reprod Clim. 2017;32(2):85-9. http://dx.doi.org/10.1016/j.recli.2017.01.001
2. Silva HCS, Prata JN, Rezende LMS. Efeitos das isoflavonas de soja sobre os sintomas climatéricos. Cient Ciênc Biol Saúde. 2013;15(3):239-44. Disponível em: https://revista.pgsskroton.com/index.php/JHealthSci/article/view/687
3. Bień A, Rzońca E, Iwanowicz-Palus G, Pańczyk-Szeptuch M. The influence of climacteric symptoms on women’s lives and activities. Int J Environ Res Public Health. 2015;12(4):3835-46. https://doi.org/10.3390/ijerph120403835
4. Oliveira PC, Cerqueira EMM, Meireles JRC. Avaliação de danos genéticos e apoptose em mulheres menopausadas que fazem uso da terapia de reposição hormonal. Reprod Clim. 2016;31(3):163-8. http://dx.doi.org/10.1016/j.recli.2016.08.005
5. Souto NF, Moreira CB, Barros PAS, Fernandes AFC, Santos MCL. Hormone
replacement therapy in menopause as a risk factor for developing breast cancer. J res.: fundam care. Online. 2014;6(3):1302-12. http://dx.doi.org/10.9789/2175-5361.2014v6n3p1302
6. Colli MC, Bracht A, Soares AA, Oliveira AL, Bôer, CG, Souza CGM et al. Evaluation of the efficacy of flaxseed meal and flaxseed extract in reducing menopausal symptoms. J Med Food. 2012;15(9):840-5. https://doi.org/10.1089/jmf.2011.0228
7. Liu ZM, Ho CS, Chen YM, Woo J. Can soy intake affect serum uric acid level? Pooled analysis from two 6-month randomized controlled trials among Chinese postmenopausal women with pre diabetes or prehypertension. Eur J Nutr. 2015;54(1):51-8. http://dx.doi.org/10.1007/s00394-014-0684-1
8. Bedell S, Nachtigall M, Naftolin F. The pros and cons of plant estrogens for menopause. J Steroid Biochem Mol Biol. 2014;139:225-36. http://doi.org/10.13037/rbcs.vol14n49.3545
9. Guerra TRB, Boaventura GT. Consumo de fitoestrógeno linhaça e níveis lipídicos na menopausa: o que há de evidência? Rev Aten Saúde. 2016;14(49):92-7. Disponível em: https://www.researchgate.net/publication/312343518
10. Ministério da Saúde (BR). Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes metodológicas: elaboração de revisão sistemática e metanálise de ensaios clínicos randomizados. Brasília (DF): Editora do Ministério da Saúde, 2012. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_elaboracao_sistematica.pdf
11. Ferrari A. Soy extract phytoestrogens with high dose of isoflavones for menopausal symptoms. J Obstet Gynaecol Res. 2009;35(6):1083-90. http://dx.doi.org/10.1111/j.1447-0756.2009.01058.x
12. Lipovac M, Chedraui P, Gruenhut C, Gocan A, Stammler M, Imhof M. Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts. Maturitas. 2010;65:258-61. https://doi.org/10.1016/j.maturitas.2009.10.014
13. Hachul H, Brandão LC, D’Almeida V, Bittencourt LRA, Baracat EC, Tufik S. Isoflavones decrease insomnia in postmenopause. Menopause. 2011;18(2):178-84. https://doi.org/10.1097/gme.0b013e3181ecf9b9
14. Lipovac M, Chedraui P, Gruenhut C, Gocan A, Kurz C, Neuber B et al. The
effect of red clover isoflavone supplementation over vasomotor and menopausal symptoms in postmenopausal women. Gynecol Endocrinol. 2012;28(3):203-7. http://dx.doi.org/10.3109/09513590.2011.593671
15. Ye YB, Wang ZL, Zhuo SY, Lu W, Liao HF, Verbruggen M et al. Soy germ isoflavones improve menopausal symptoms but have no effect on blood lipids in early postmenopausal Chinese women: a randomized placebo–controlled trial. Menopause. 2012;19(7):791-8. http://dx.doi.org/10.1097/gme.0b013e31823dbeda
16. Amato P, Young RL, Steinberg FM, Murray MJ, Lewis RD, Cramer MA et al. Effect of soy isoflavone supplementation on menopausal quality of life. Menopause. 2013;20(4):443-7. http://dx.doi.org/10.1097/gme.0b013e318275025e
17. Malik S, Pannu D, Prateek S, Sinha R, Gaikwad H. Comparison of the symptomatic response in Indian menopausal women with different estrogen preparations for the treatment of menopausal symptoms: a randomized controlled trial. Arch Gynecol Obstet. 2016;293(6):1325-33. http://dx.doi.org/10.1007/s00404-016-4034-9
18. Carmignani LO, Pedro AO, Costa-Paiva LH, Pinto-Neto AM. The effect of dietary soy supplementation compared to estrogen and placebo on menopausal symptoms: a randomized controlled trial. Maturitas. 2010;67(3):262-9. https://doi.org/10.1016/j.maturitas.2010.07.007
19. Battaglia C, Cianciosi A, Mancini F, Fabbri R, Busacchi P, Nappi RE et al. Genistein supplements might not induce clitoral modifications in postmenopausal women: a prospective, pilot study. J Sex Medic. 2009;6(11):3132-8. https://doi.org/10.1111/j.1743-6109.2009.01427.x
20. Jenks BH, Iwashita S, Nakagawa Y, Ragland K, Lee J, Carson WH et al. A pilot study on the effects of S-Equol compared to soy isoflavones on menopausal hot flash frequency. J Womens Health. 2012;21(6):674-82. http://dx.doi.org/10.1089/jwh.2011.3153
21. Yang TS, Wang SY, Yang YC, Su CH, Lee FK, Chen SC et al. Effects of standardized phytoestrogen on Taiwanese menopausal women. Taiwan J Obstet Gynecol. 2012;51(2):229-35. http://dx.doi.org/10.1016/j.tjog.2012.04.011
22. Palma F, Fontanesi F, Facchinetti F, Cagnacci A. Acupuncture or phy (F) toestrogens vs. (E) strogen plus progestin on menopausal symptoms. A randomized study. Gynecol Endocrinol. 2019;35(11):995-8. https://doi.org/10.1080/09513590.2019.1621835
23. Chedraui P, San Miguel G, Schwager G. The effect of soy-derived isoflavones over hot flushes, menopausal symptoms and mood in climacteric women with increased body mass index. Gynecol Endocrinol. 2011;27(5):307-13. https://doi.org/10.3109/09513590.2010.490614
24. Palacios S, Lilue M, Mejia A, Menendez C. Omega-3 versus isoflavones in the control of vasomotor symptoms in postmenopausal women. Gynecol Endocrinol. 2017;33(12):951-7. https://doi.org/10.1080/09513590.2017.1332588
25. Husain D, Khanna K, Puri S, Haghighizadeh M. Supplementation of soy isoflavones improved sex hormones, blood pressure, and postmenopausal symptoms. J Am Coll Nutr. 2015;34(1):42-8. http://dx.doi.org/10.1080/07315724.2013.875434
26. Basaria S, Wisniewski A, Dupree K, Bruno T, Song M, Yao F et al. Effect of high-dose isoflavones on cognition, quality of life, androgens, and lipoprotein in post-menopausal women. J Endocrinol Invest. 2009;32(2):150-5. https://doi.org/10.1007/BF03345705
27. Liu ZM, Ho SC, Woo J, Chen YM, Wong C. Randomized controlled trial of whole soy and isoflavone daidzein on menopausal symptoms in equol-producing Chinese postmenopausal women. Menopause. 2014;21(6):653-60. http://dx.doi.org/10.1097/gme.0000000000000102
28. Tranche S, Brotons C, Pisa BP, Macías R, Hevia E, Marzo-Castillejo M. Impact of a soy drink on climacteric symptoms: an open-label, crossover, randomized clinical trial. Gynecol Endocrinol. 2016;32(6):477-82. http://dx.doi.org/10.3109/09513590.2015.1132305
29. Santos TR, Pereira SVM, Santos RL. Intensity of climacteric symptoms in postmenopausal women. Rev Rene. 2016;17(2):225-32. http://dx.doi.org/10.15253/2175-6783.2016000200010
30. Souza VA, Nakamura CV, Corrêa AG. Atividade antichásica de lignanas e neolignanas. Rev Virtual Quim. 2012;4(3):197-207. http://dx.doi.org/10.5935/1984-6835.20120017
31. Zakir MM, Freitas IR. Benefícios à saúde humana do consumo de isoflavonas presentes em produtos derivados da soja. J Bioen Food Sci. 2015;2(3):107-16. Disponível em: https://www.researchgate.net/publication/282893057
32. ACOG Practice Bulletin No. 141: management of menopausal symptoms. Obstet Gynecol. 2014;123(1),202-16. http://dx.doi.org/10.1097/01.AOG.0000441353.20693.78
33. Chen LR, Ko NY, Chen KH. Isoflavone supplements for menopausal women: a systematic review. Nutrients. 2019;11(11):2649. https://dx.doi.org/10.3390/nu11112649
34. Sousa RLD, Sousa ESS, Silva JCB, Filizola RG. Fidedignidade do Teste-Reteste na Aplicação do Índice Menopausal de Blatt e Kupperman. Rev Bras Ginecol Obstet. 2000;22(8):481-7. https://doi.org/10.1590/S0100-72032000000800003
2. Silva HCS, Prata JN, Rezende LMS. Efeitos das isoflavonas de soja sobre os sintomas climatéricos. Cient Ciênc Biol Saúde. 2013;15(3):239-44. Disponível em: https://revista.pgsskroton.com/index.php/JHealthSci/article/view/687
3. Bień A, Rzońca E, Iwanowicz-Palus G, Pańczyk-Szeptuch M. The influence of climacteric symptoms on women’s lives and activities. Int J Environ Res Public Health. 2015;12(4):3835-46. https://doi.org/10.3390/ijerph120403835
4. Oliveira PC, Cerqueira EMM, Meireles JRC. Avaliação de danos genéticos e apoptose em mulheres menopausadas que fazem uso da terapia de reposição hormonal. Reprod Clim. 2016;31(3):163-8. http://dx.doi.org/10.1016/j.recli.2016.08.005
5. Souto NF, Moreira CB, Barros PAS, Fernandes AFC, Santos MCL. Hormone
replacement therapy in menopause as a risk factor for developing breast cancer. J res.: fundam care. Online. 2014;6(3):1302-12. http://dx.doi.org/10.9789/2175-5361.2014v6n3p1302
6. Colli MC, Bracht A, Soares AA, Oliveira AL, Bôer, CG, Souza CGM et al. Evaluation of the efficacy of flaxseed meal and flaxseed extract in reducing menopausal symptoms. J Med Food. 2012;15(9):840-5. https://doi.org/10.1089/jmf.2011.0228
7. Liu ZM, Ho CS, Chen YM, Woo J. Can soy intake affect serum uric acid level? Pooled analysis from two 6-month randomized controlled trials among Chinese postmenopausal women with pre diabetes or prehypertension. Eur J Nutr. 2015;54(1):51-8. http://dx.doi.org/10.1007/s00394-014-0684-1
8. Bedell S, Nachtigall M, Naftolin F. The pros and cons of plant estrogens for menopause. J Steroid Biochem Mol Biol. 2014;139:225-36. http://doi.org/10.13037/rbcs.vol14n49.3545
9. Guerra TRB, Boaventura GT. Consumo de fitoestrógeno linhaça e níveis lipídicos na menopausa: o que há de evidência? Rev Aten Saúde. 2016;14(49):92-7. Disponível em: https://www.researchgate.net/publication/312343518
10. Ministério da Saúde (BR). Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes metodológicas: elaboração de revisão sistemática e metanálise de ensaios clínicos randomizados. Brasília (DF): Editora do Ministério da Saúde, 2012. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_elaboracao_sistematica.pdf
11. Ferrari A. Soy extract phytoestrogens with high dose of isoflavones for menopausal symptoms. J Obstet Gynaecol Res. 2009;35(6):1083-90. http://dx.doi.org/10.1111/j.1447-0756.2009.01058.x
12. Lipovac M, Chedraui P, Gruenhut C, Gocan A, Stammler M, Imhof M. Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts. Maturitas. 2010;65:258-61. https://doi.org/10.1016/j.maturitas.2009.10.014
13. Hachul H, Brandão LC, D’Almeida V, Bittencourt LRA, Baracat EC, Tufik S. Isoflavones decrease insomnia in postmenopause. Menopause. 2011;18(2):178-84. https://doi.org/10.1097/gme.0b013e3181ecf9b9
14. Lipovac M, Chedraui P, Gruenhut C, Gocan A, Kurz C, Neuber B et al. The
effect of red clover isoflavone supplementation over vasomotor and menopausal symptoms in postmenopausal women. Gynecol Endocrinol. 2012;28(3):203-7. http://dx.doi.org/10.3109/09513590.2011.593671
15. Ye YB, Wang ZL, Zhuo SY, Lu W, Liao HF, Verbruggen M et al. Soy germ isoflavones improve menopausal symptoms but have no effect on blood lipids in early postmenopausal Chinese women: a randomized placebo–controlled trial. Menopause. 2012;19(7):791-8. http://dx.doi.org/10.1097/gme.0b013e31823dbeda
16. Amato P, Young RL, Steinberg FM, Murray MJ, Lewis RD, Cramer MA et al. Effect of soy isoflavone supplementation on menopausal quality of life. Menopause. 2013;20(4):443-7. http://dx.doi.org/10.1097/gme.0b013e318275025e
17. Malik S, Pannu D, Prateek S, Sinha R, Gaikwad H. Comparison of the symptomatic response in Indian menopausal women with different estrogen preparations for the treatment of menopausal symptoms: a randomized controlled trial. Arch Gynecol Obstet. 2016;293(6):1325-33. http://dx.doi.org/10.1007/s00404-016-4034-9
18. Carmignani LO, Pedro AO, Costa-Paiva LH, Pinto-Neto AM. The effect of dietary soy supplementation compared to estrogen and placebo on menopausal symptoms: a randomized controlled trial. Maturitas. 2010;67(3):262-9. https://doi.org/10.1016/j.maturitas.2010.07.007
19. Battaglia C, Cianciosi A, Mancini F, Fabbri R, Busacchi P, Nappi RE et al. Genistein supplements might not induce clitoral modifications in postmenopausal women: a prospective, pilot study. J Sex Medic. 2009;6(11):3132-8. https://doi.org/10.1111/j.1743-6109.2009.01427.x
20. Jenks BH, Iwashita S, Nakagawa Y, Ragland K, Lee J, Carson WH et al. A pilot study on the effects of S-Equol compared to soy isoflavones on menopausal hot flash frequency. J Womens Health. 2012;21(6):674-82. http://dx.doi.org/10.1089/jwh.2011.3153
21. Yang TS, Wang SY, Yang YC, Su CH, Lee FK, Chen SC et al. Effects of standardized phytoestrogen on Taiwanese menopausal women. Taiwan J Obstet Gynecol. 2012;51(2):229-35. http://dx.doi.org/10.1016/j.tjog.2012.04.011
22. Palma F, Fontanesi F, Facchinetti F, Cagnacci A. Acupuncture or phy (F) toestrogens vs. (E) strogen plus progestin on menopausal symptoms. A randomized study. Gynecol Endocrinol. 2019;35(11):995-8. https://doi.org/10.1080/09513590.2019.1621835
23. Chedraui P, San Miguel G, Schwager G. The effect of soy-derived isoflavones over hot flushes, menopausal symptoms and mood in climacteric women with increased body mass index. Gynecol Endocrinol. 2011;27(5):307-13. https://doi.org/10.3109/09513590.2010.490614
24. Palacios S, Lilue M, Mejia A, Menendez C. Omega-3 versus isoflavones in the control of vasomotor symptoms in postmenopausal women. Gynecol Endocrinol. 2017;33(12):951-7. https://doi.org/10.1080/09513590.2017.1332588
25. Husain D, Khanna K, Puri S, Haghighizadeh M. Supplementation of soy isoflavones improved sex hormones, blood pressure, and postmenopausal symptoms. J Am Coll Nutr. 2015;34(1):42-8. http://dx.doi.org/10.1080/07315724.2013.875434
26. Basaria S, Wisniewski A, Dupree K, Bruno T, Song M, Yao F et al. Effect of high-dose isoflavones on cognition, quality of life, androgens, and lipoprotein in post-menopausal women. J Endocrinol Invest. 2009;32(2):150-5. https://doi.org/10.1007/BF03345705
27. Liu ZM, Ho SC, Woo J, Chen YM, Wong C. Randomized controlled trial of whole soy and isoflavone daidzein on menopausal symptoms in equol-producing Chinese postmenopausal women. Menopause. 2014;21(6):653-60. http://dx.doi.org/10.1097/gme.0000000000000102
28. Tranche S, Brotons C, Pisa BP, Macías R, Hevia E, Marzo-Castillejo M. Impact of a soy drink on climacteric symptoms: an open-label, crossover, randomized clinical trial. Gynecol Endocrinol. 2016;32(6):477-82. http://dx.doi.org/10.3109/09513590.2015.1132305
29. Santos TR, Pereira SVM, Santos RL. Intensity of climacteric symptoms in postmenopausal women. Rev Rene. 2016;17(2):225-32. http://dx.doi.org/10.15253/2175-6783.2016000200010
30. Souza VA, Nakamura CV, Corrêa AG. Atividade antichásica de lignanas e neolignanas. Rev Virtual Quim. 2012;4(3):197-207. http://dx.doi.org/10.5935/1984-6835.20120017
31. Zakir MM, Freitas IR. Benefícios à saúde humana do consumo de isoflavonas presentes em produtos derivados da soja. J Bioen Food Sci. 2015;2(3):107-16. Disponível em: https://www.researchgate.net/publication/282893057
32. ACOG Practice Bulletin No. 141: management of menopausal symptoms. Obstet Gynecol. 2014;123(1),202-16. http://dx.doi.org/10.1097/01.AOG.0000441353.20693.78
33. Chen LR, Ko NY, Chen KH. Isoflavone supplements for menopausal women: a systematic review. Nutrients. 2019;11(11):2649. https://dx.doi.org/10.3390/nu11112649
34. Sousa RLD, Sousa ESS, Silva JCB, Filizola RG. Fidedignidade do Teste-Reteste na Aplicação do Índice Menopausal de Blatt e Kupperman. Rev Bras Ginecol Obstet. 2000;22(8):481-7. https://doi.org/10.1590/S0100-72032000000800003
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