[Phytoestrogenes in menopause: working mechanisms and clinical results in 28 patients]

Comparison of phytoestrogen treatment efficacy in menopausal women with and without ability to metabolise phytoestrogens.

Clinical trial.

Department of Obstetrics and Gynaecology, Regional Hospital, Mlada Boleslav.

28 menopausal women were treated with phytoestrogens in dose 80 mg daily. Before start and after finishing of treatment urinary concentrations of active metabolite S-equol were measured using ELISA method. Similarly before and after treatment Kupperman's index was measured. Patients with urinary concentrations of S-equol above 1 ng/ml were considered as S-equol producers, remaining patients formed control group.

16 out of 28 women were considered as S-equol producers, remainig 12 as a non-producers. Initial urinary concentrations of S-equol were 0.34 +/- 0.37 ng/ml in producers group and 0.29 +/- 0.30 ng/ml in non-producers. After finishing of therapy urinary concentration of S-equol increased to 10.67 +/- 11.57 ng/ml (p = 0.002) in producers group and 0.34 +/- 0.30 ng/ml (p = 0.701) in non-producers. Kupperman's index values were 23.44 +/- 11.57 in producers group and 17.25 +/- 7.78 in non-producers. After therapy value of Kupperman's index decreased to 14.44 +/- 9.97 (p = 0.003) in producers and to 12.00 +/- 7.18 (p = 0.100) in non-producers. No correlation between improvement in Kupperman's index and urinary concentration of S-equol after therapy was found similarly as between urinary concentration of S-equol before and after therapy in producents group.

Significant phytoestrogen treatment effect in menopausal women producing S-equol was proven. Testing method for S-equol production introduced by our team togehter with suggested threshold urine concentration level of 1 ng/ml allows precise distinction of producers and non-producers of S-equol and subsequently to predict better treatment effect of phytoestrogens.