title: Effects of isoflavones and amino acid therapies for hot flashes and co-occurring symptoms during the menopausal transition and early postmenopause: a systematic review.
abstract: OBJECTIVE
  Review controlled clinical trials of isoflavones and amino acid preparation effects on hot flashes and at least one other symptom including mood, sleep, pain, and cognitive function that women report during the menopausal transition and early postmenopause.
  
  
  METHODS
  An experienced reference librarian searched PubMed/Medline, CINAHL Plus, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, AMED, and Alt-Health Watch for English-language randomized controlled trials between 2004 and July 2011. Seventeen trials of isoflavones and amino acid effects on hot flashes and one additional symptom were identified.
  
  
  RESULTS
  In five trials of soy isoflavone preparations, two (6g soy germ extract and 25 g soy protein in soy nuts) significantly decreased hot flashes, but no other symptoms. In the seven trials of other isoflavones, six significantly reduced hot flashes; in addition, red clover (80 mg) significantly reduced mood symptoms; Rexflavone (350 mg) for women with Kupperman Index>20 significantly reduced sleep symptoms; two trials had significant reductions for pain: isoflavone powder (90 mg) and red clover (80 mg). The only trial in this systematic review that significantly reduced cognitive symptoms was red clover (80 mg). In one trial, red clover isoflavone (80 mg/day) significantly relieved hot flashes, mood, pain, and cognitive symptoms. Amino acids yielded no significant results. Equol supplements of 30 mg/day for non-Equol producing women significantly reduced mood symptoms in one trial. The magnolia bark extract combination significantly reduced hot flashes, mood, and sleep symptoms.
  
  
  CONCLUSIONS
  Isoflavone trials yielded significant reductions on hot flashes and co-occurring symptoms during the menopausal transition and postmenopause, but studies require replication with larger sample sizes and attention to measurement of outcomes.
authors.affiliation: University of Washington School of Nursing, United States. Electronic address: ajthomas@uw.edu.
authors.forename: Annette J
authors.initials: AJ
authors.lastname: Thomas
authors.affiliation: University of Washington School of Nursing, United States and Ministry of Health, Republic of Indonesia, United States.
authors.forename: Rita
authors.initials: R
authors.lastname: Ismail
authors.affiliation: University of Washington School of Nursing, United States.
authors.forename: Lisa
authors.initials: L
authors.lastname: Taylor-Swanson
authors.affiliation: College of Nursing, Seattle University, United States.
authors.forename: Lori
authors.initials: L
authors.lastname: Cray
authors.affiliation: Health Sciences Library, University of Washington, United States.
authors.forename: Janet G
authors.initials: JG
authors.lastname: Schnall
authors.affiliation: Family and Child Nursing, University of Washington, United States.
authors.forename: Ellen Sullivan
authors.initials: ES
authors.lastname: Mitchell
authors.affiliation: Biobehavioral Nursing and Health Systems, University of Washington, United States.
authors.forename: Nancy Fugate
authors.initials: NF
authors.lastname: Woods
mesh_terms: D000339:Affect / Q000187:drug effects*; D000596:Amino Acids / Q000494:pharmacology*; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy*; D005260:Female; D019584:Hot Flashes / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007529:Isoflavones / Q000494:pharmacology / Q000627:therapeutic use*; D008593:Menopause; D010146:Pain / Q000150:complications / Q000188:drug therapy*; D048789:Phytoestrogens / Q000494:pharmacology / Q000627:therapeutic use; D017698:Postmenopause; D012893:Sleep Wake Disorders / Q000150:complications / Q000188:drug therapy*
chemical_list: D000596:Amino Acids; D007529:Isoflavones; D048789:Phytoestrogens
keywords: Amino acids; Hot flashes; Isoflavones; Menopausal transition; Soy; Symptom clusters