Carmignani Lucio O, Pedro Adriana Orcesi, Montemor Eliana B, Arias Victor A, Costa-Paiva Lucia H, Pinto-Neto Aarão M
From the 1Department of Obstetrics and Gynecology, State University of Campinas (Universidade Estadual de Campinas), Campinas, São Paulo, Brazil; and 2Department of Pathology, Federal University of São Paulo (Universidade Federal de São Paulo), São Paulo, São Paulo, Brazil.
Menopause. 2015 Jul;22(7):741-9. doi: 10.1097/GME.0000000000000380.
This study aims to compare the effects of a soy-based dietary supplement, low-dose hormone therapy (HT), and placebo on the urogenital system in postmenopausal women.
In this double-blind, randomized, placebo-controlled trial, 60 healthy postmenopausal women aged 40 to 60 years (mean time since menopause, 4.1 y) were randomized into three groups: a soy dietary supplement group (90 mg of isoflavone), a low-dose HT group (1 mg of estradiol plus 0.5 mg of norethisterone), and a placebo group. Urinary, vaginal, and sexual complaints were evaluated using the urogenital subscale of the Menopause Rating Scale. Vaginal maturation value was calculated. Transvaginal sonography was performed to evaluate endometrial thickness. Genital bleeding pattern was assessed. Statistical analysis was performed using χ(2) test, Fisher's exact test, paired Student's t test, Kruskal-Wallis test, Kruskal-Wallis nonparametric test, and analysis of variance. For intergroup comparisons, Kruskal-Wallis nonparametric test (followed by Mann-Whitney U test) was used.
Vaginal dryness improved significantly in the soy and HT groups (P = 0.04). Urinary and sexual symptoms did not change with treatment in the three groups. After 16 weeks of treatment, there was a significant increase in maturation value only in the HT group (P < 0.01). Vaginal pH decreased only in this group (P < 0.01). There were no statistically significant differences in endometrial thickness between the three groups, and the adverse effects evaluated were similar.
This study shows that a soy-based dietary supplement used for 16 weeks fails to exert estrogenic action on the urogenital tract but improves vaginal dryness.
本研究旨在比较大豆基膳食补充剂、低剂量激素疗法(HT)和安慰剂对绝经后女性泌尿生殖系统的影响。
在这项双盲、随机、安慰剂对照试验中,60名年龄在40至60岁(绝经平均时间为4.1年)的健康绝经后女性被随机分为三组:大豆膳食补充剂组(90毫克异黄酮)、低剂量HT组(1毫克雌二醇加0.5毫克炔诺酮)和安慰剂组。使用绝经评定量表的泌尿生殖亚量表评估泌尿、阴道和性方面的不适。计算阴道成熟值。进行经阴道超声检查以评估子宫内膜厚度。评估生殖器出血模式。使用χ²检验、Fisher精确检验、配对学生t检验、Kruskal-Wallis检验、Kruskal-Wallis非参数检验和方差分析进行统计分析。组间比较采用Kruskal-Wallis非参数检验(随后进行Mann-Whitney U检验)。
大豆组和HT组的阴道干涩情况显著改善(P = 0.04)。三组治疗后泌尿和性症状均未改变。治疗16周后,仅HT组的成熟值显著增加(P < 0.01)。仅该组阴道pH值下降(P < 0.01)。三组之间的子宫内膜厚度无统计学显著差异,评估的不良反应相似。
本研究表明,使用16周的大豆基膳食补充剂对泌尿生殖道未发挥雌激素作用,但可改善阴道干涩。