Phytoestrogens: endocrine disrupters or replacement for hormone replacement therapy?
OBJECTIVE
This review presents findings with clear statements from the literature as well as own results of effects of soy, red clover and their isoflavones as well as of the Cimicifuga racemosa extract BNO 1055. Experimental and clinical effects on climacteric complaints, osteoprotective effects, activity in the urogenital tract, and risks concerning cardiovascular diseases and mammary and endometrial tissue will be compared, also in comparison to classical hormone preparations. The question whether soy and red clover products and/or Cimicifuga racemosa (CR) preparations are endocrine disrupters or may fulfill the criteria of the so-called phyto-SERMs will be discussed.


METHODS
Review of selected publications since 1980 and summary of unpublished own results of the authors.


RESULTS
Experimental and clinical evidences suggest that soy/red clover and their isoflavones do not fulfill the criteria of an ideal SERM. They appear to have mild osteoprotective effects but do not improve climacteric complaints. Furthermore, they seem to stimulate uterine growth and mammary epithelial proliferation. In ovariectomized rats, the CR extract BNO 1055 showed many of the beneficial effects of 17beta-estradiol, including effects in the brain/hypothalamus to reduce serum LH levels, effects in the bone to prevent osteoporosis and estrogenic effects in the urinary bladder. The CR extract BNO 1055 had no uterotrophic effect.


CONCLUSIONS
If clinical studies confirm these results, the Cimicifuga racemosa preparation BNO 1055 would appear as an ideal SERM and may therefore be an alternative to hormone replacement therapy.
Wuttke
Wolfgang
W
Department of Clinical and Experimental Endocrinology, University of Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany. ufkendo@med.unigoettingen.de
Jarry
Hubertus
H
Becker
Tamara
T
Schultens
Alexander
A
Christoffel
Volker
V
Gorkow
Christoph
C
Seidlová-Wuttke
Dana
D
D000818:Animals; D001842:Bone and Bones / Q000187:drug effects; D001940:Breast / Q000187:drug effects; D031885:Cimicifuga; D004195:Disease Models, Animal; D004703:Endocrine System / Q000187:drug effects; D004717:Endometrium / Q000187:drug effects; D015914:Estrogen Replacement Therapy; D004968:Estrogens, Non-Steroidal / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D007529:Isoflavones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D008593:Menopause; D048789:Phytoestrogens; D008517:Phytotherapy; D010936:Plant Extracts / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D028321:Plant Preparations; D051381:Rats; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D013025:Glycine max; D029921:Trifolium; D001743:Urinary Bladder / Q000187:drug effects; D014599:Uterus / Q000187:drug effects
D004968:Estrogens, Non-Steroidal; D007529:Isoflavones; D048789:Phytoestrogens; D010936:Plant Extracts; D028321:Plant Preparations; D020845:Selective Estrogen Receptor Modulators