Northern Clinical School, Sydney Medical Programme, Royal North Shore Hospital, Sydney, Australia.
University of Sydney Faculty of Medicine and Health, The Royal North Shore Hospital Division of Women and Child Health, Sydney, Australia.
Climacteric. 2021 Feb;24(1):57-63. doi: 10.1080/13697137.2020.1863356. Epub 2021 Jan 4.
Phytoestrogens are a group of non-steroidal polyphenolic plant-based substances, commonly used for the treatment of menopause-related conditions. They have both genomic and non-genomic effects, displaying weak affinity for estrogen receptors (ER) and preferentially binding to ER-B over ER-A. However, evidence for the benefits of phytoestrogen consumption has been limited. We conducted a review of recent literature, focusing on systematic reviews and meta-analyses reporting on postreproductive health effects of phytoestrogens. While many trials concerning dietary and supplementary phytoestrogens have been conducted, evidence of clinical efficacy is heterogeneous and inconclusive. There appears to be reduction in the vasomotor symptoms of menopause with phytoestrogen intake; however, it is likely small and slow in onset. Phytoestrogens also appear to improve bone mineral density and markers of cardiovascular risk; however, there is inadequate research regarding long-term outcomes. There appear to be no harmful effects of phytoestrogens on breast, endometrial cancer or colorectal cancer and phytoestrogens intake may in fact be protective. Research regarding the effect of phytoestrogens on cognition is mixed, with most studies reporting no significant association. Overall, individual variations in the metabolism of phytoestrogens and age-related genomic effects may account for the considerable variability in the measured effects of phytoestrogens.
植物雌激素是一组非甾体类多酚植物物质，常用于治疗与更年期相关的疾病。它们具有基因组和非基因组效应，对雌激素受体 (ER) 的亲和力较弱，优先与 ER-B 结合，而不是 ER-A。然而，植物雌激素摄入有益的证据有限。我们对最近的文献进行了综述，重点关注系统评价和荟萃分析报告植物雌激素对生殖后健康的影响。虽然已经进行了许多关于饮食和补充植物雌激素的试验，但临床疗效的证据存在异质性和不明确性。植物雌激素摄入似乎可以减少更年期的血管舒缩症状；然而，其效果可能较小且缓慢。植物雌激素似乎还可以改善骨密度和心血管风险标志物；然而，关于长期结果的研究还不够充分。植物雌激素似乎对乳腺癌、子宫内膜癌或结直肠癌没有有害影响，实际上可能具有保护作用。关于植物雌激素对认知影响的研究结果不一，大多数研究报告没有显著关联。总的来说，植物雌激素代谢和与年龄相关的基因组效应的个体差异可能解释了植物雌激素测量效果的相当大的可变性。
