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Published in: Archives of Gynecology and Obstetrics 4/2017

01-10-2017 | General Gynecology

The impact of combined nutraceutical supplementation on quality of life and metabolic changes during the menopausal transition: a pilot randomized trial

Authors: Paola Villa, Inbal D. Amar, Carolina Bottoni, Clelia Cipolla, Giorgia Dinoi, Maria C. Moruzzi, Giovanni Scambia, Antonio Lanzone

Published in: Archives of Gynecology and Obstetrics | Issue 4/2017

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Abstract

Purpose

The aim of this study was to assess the efficacy of a combined nutraceutical supplement on symptoms and early metabolic alterations during the menopausal transition. This pilot randomized study was conducted at the service for menopause disorders of the Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.

Methods

Ninety women in menopausal transition who attended our service with menopausal symptoms were enrolled in the study. Sixty patients, randomly assigned to the treatment group, were prescribed one daily tablet of a combined nutraceutical compound with phytoestrogen substances, vitamins, micronutrients and passion flower herbal medicine for 6 months. Thirty patients did not receive any treatment and comprised the control group. The intensity of perimenopausal symptoms was assessed by the modified Kuppermann Index (KI) at enrollment and at 3 and 6 months of treatment. At baseline and at the end of the study, patients underwent a clinical evaluation, a pelvic ultrasound and analysis of blood samples.

Results

In the nutraceutical supplemented group, a significant reduction in menopausal symptoms was demonstrated according to the KI after 3 and 6 months of supplementation (p < 0.01). The within-group analysis of different KI parameters in the treated group showed a significant improvement in hot flushes (p < 0.001), insomnia (p < 0.01), fatigue (p < 0.01) and irritability (p < 0.01). Metabolic parameters did not change significantly in the nutraceutical supplemented group. In the control group, total cholesterol level showed a significant increase (p < 0.05).

Conclusions

Combined nutraceutical supplementation provides an effective and safe solution for early symptoms occurring during menopausal transition.
Literature
1.
go back to reference Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, Sherman S, Sluss PM, de Villiers TJ, Straw Collaborative Group (2012) Executive summary of the stages of reproductive aging workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab 97(4):1159–1168. doi:10.1210/jc.2011-3362 CrossRefPubMedPubMedCentral Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, Sherman S, Sluss PM, de Villiers TJ, Straw Collaborative Group (2012) Executive summary of the stages of reproductive aging workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab 97(4):1159–1168. doi:10.​1210/​jc.​2011-3362 CrossRefPubMedPubMedCentral
2.
go back to reference Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, Woods N (2001) Executive summary: stages of reproductive aging workshop (STRAW). Fertil Steril 76(5):874–878CrossRefPubMed Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, Woods N (2001) Executive summary: stages of reproductive aging workshop (STRAW). Fertil Steril 76(5):874–878CrossRefPubMed
3.
4.
go back to reference Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 163(4):427–436CrossRefPubMedPubMedCentral Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 163(4):427–436CrossRefPubMedPubMedCentral
5.
go back to reference Matthews KA, Kuller LH, Sutton-Tyrrell K, Chang YF (2001) Changes in cardiovascular risk factors during the perimenopause and postmenopause and carotid artery atherosclerosis in healthy women. Stroke 32(5):1104–1111CrossRefPubMed Matthews KA, Kuller LH, Sutton-Tyrrell K, Chang YF (2001) Changes in cardiovascular risk factors during the perimenopause and postmenopause and carotid artery atherosclerosis in healthy women. Stroke 32(5):1104–1111CrossRefPubMed
6.
go back to reference Razay G, Heaton KW, Bolton CH (1992) Coronary heart disease risk factors in relation to the menopause. Q J Med 85(307–308):889–896PubMed Razay G, Heaton KW, Bolton CH (1992) Coronary heart disease risk factors in relation to the menopause. Q J Med 85(307–308):889–896PubMed
7.
go back to reference Lynch NA, Ryan AS, Berman DM, Sorkin JD, Nicklas BJ (2002) Comparison of VO2max and disease risk factors between perimenopausal and postmenopausal women. Menopause 9(6):456–462CrossRefPubMed Lynch NA, Ryan AS, Berman DM, Sorkin JD, Nicklas BJ (2002) Comparison of VO2max and disease risk factors between perimenopausal and postmenopausal women. Menopause 9(6):456–462CrossRefPubMed
8.
go back to reference Eisenhardt S, Fleckenstein J (2016) Traditional Chinese medicine valuably augments therapeutic options in the treatment of climacteric syndrome. Arch Gynecol Obstet 294(1):193–200CrossRefPubMed Eisenhardt S, Fleckenstein J (2016) Traditional Chinese medicine valuably augments therapeutic options in the treatment of climacteric syndrome. Arch Gynecol Obstet 294(1):193–200CrossRefPubMed
9.
go back to reference Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J, Writing Group for the Women’s Health Initiative I (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 288(3):321–333CrossRefPubMed Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J, Writing Group for the Women’s Health Initiative I (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 288(3):321–333CrossRefPubMed
11.
go back to reference Hirose A, Terauchi M, Akiyoshi M, Owa Y, Kato K, Kubota T (2016) Low-dose isoflavone aglycone alleviates psychological symptoms of menopause in Japanese women: a randomized, double-blind, placebo-controlled study. Arch Gynecol Obstet 293(3):609–615CrossRefPubMed Hirose A, Terauchi M, Akiyoshi M, Owa Y, Kato K, Kubota T (2016) Low-dose isoflavone aglycone alleviates psychological symptoms of menopause in Japanese women: a randomized, double-blind, placebo-controlled study. Arch Gynecol Obstet 293(3):609–615CrossRefPubMed
13.
go back to reference Setchell KD, Cole SJ (2006) Method of defining equol-producer status and its frequency among vegetarians. J Nutr 136(8):2188–2193PubMed Setchell KD, Cole SJ (2006) Method of defining equol-producer status and its frequency among vegetarians. J Nutr 136(8):2188–2193PubMed
14.
go back to reference Song KB, Atkinson C, Frankenfeld CL, Jokela T, Wahala K, Thomas WK, Lampe JW (2006) Prevalence of daidzein-metabolizing phenotypes differs between Caucasian and Korean American women and girls. J Nutr 136(5):1347–1351PubMed Song KB, Atkinson C, Frankenfeld CL, Jokela T, Wahala K, Thomas WK, Lampe JW (2006) Prevalence of daidzein-metabolizing phenotypes differs between Caucasian and Korean American women and girls. J Nutr 136(5):1347–1351PubMed
15.
go back to reference Muthyala RS, Ju YH, Sheng S, Williams LD, Doerge DR, Katzenellenbogen BS, Helferich WG, Katzenellenbogen JA (2004) Equol, a natural estrogenic metabolite from soy isoflavones: convenient preparation and resolution of R- and S-equols and their differing binding and biological activity through estrogen receptors alpha and beta. Bioorg Med Chem 12(6):1559–1567. doi:10.1016/j.bmc.2003.11.035 CrossRefPubMed Muthyala RS, Ju YH, Sheng S, Williams LD, Doerge DR, Katzenellenbogen BS, Helferich WG, Katzenellenbogen JA (2004) Equol, a natural estrogenic metabolite from soy isoflavones: convenient preparation and resolution of R- and S-equols and their differing binding and biological activity through estrogen receptors alpha and beta. Bioorg Med Chem 12(6):1559–1567. doi:10.​1016/​j.​bmc.​2003.​11.​035 CrossRefPubMed
16.
go back to reference Uchiyama S, Ueno T, Masaki K, Shimizu S, Aso T, Shirota T (2007) The cross-sectional study of the relationship between soy isoflavones, equol and the menopausal symptoms in Japanese women. J Jpn Menopause Soc 15(1):28–37 Uchiyama S, Ueno T, Masaki K, Shimizu S, Aso T, Shirota T (2007) The cross-sectional study of the relationship between soy isoflavones, equol and the menopausal symptoms in Japanese women. J Jpn Menopause Soc 15(1):28–37
20.
go back to reference Aso T, Uchiyama S, Matsumura Y, Taguchi M, Nozaki M, Takamatsu K, Ishizuka B, Kubota T, Mizunuma H, Ohta H (2012) A natural S-equol supplement alleviates hot flushes and other menopausal symptoms in equol nonproducing postmenopausal Japanese women. J Womens Health (Larchmt) 21(1):92–100. doi:10.1089/jwh.2011.2753 CrossRef Aso T, Uchiyama S, Matsumura Y, Taguchi M, Nozaki M, Takamatsu K, Ishizuka B, Kubota T, Mizunuma H, Ohta H (2012) A natural S-equol supplement alleviates hot flushes and other menopausal symptoms in equol nonproducing postmenopausal Japanese women. J Womens Health (Larchmt) 21(1):92–100. doi:10.​1089/​jwh.​2011.​2753 CrossRef
21.
go back to reference Jenks BH, Iwashita S, Nakagawa Y, Ragland K, Lee J, Carson WH, Ueno T, Uchiyama S (2012) A pilot study on the effects of S-equol compared to soy isoflavones on menopausal hot flash frequency. J Womens Health (Larchmt) 21(6):674–682. doi:10.1089/jwh.2011.3153 CrossRef Jenks BH, Iwashita S, Nakagawa Y, Ragland K, Lee J, Carson WH, Ueno T, Uchiyama S (2012) A pilot study on the effects of S-equol compared to soy isoflavones on menopausal hot flash frequency. J Womens Health (Larchmt) 21(6):674–682. doi:10.​1089/​jwh.​2011.​3153 CrossRef
22.
go back to reference Usui T, Tochiya M, Sasaki Y, Muranaka K, Yamakage H, Himeno A, Shimatsu A, Inaguma A, Ueno T, Uchiyama S, Satoh-Asahara N (2013) Effects of natural S-equol supplements on overweight or obesity and metabolic syndrome in the Japanese, based on sex and equol status. Clin Endocrinol (Oxf) 78(3):365–372. doi:10.1111/j.1365-2265.2012.04400.x CrossRef Usui T, Tochiya M, Sasaki Y, Muranaka K, Yamakage H, Himeno A, Shimatsu A, Inaguma A, Ueno T, Uchiyama S, Satoh-Asahara N (2013) Effects of natural S-equol supplements on overweight or obesity and metabolic syndrome in the Japanese, based on sex and equol status. Clin Endocrinol (Oxf) 78(3):365–372. doi:10.​1111/​j.​1365-2265.​2012.​04400.​x CrossRef
23.
go back to reference Hung LM, Chen JK, Huang SS, Lee RS, Su MJ (2000) Cardioprotective effect of resveratrol, a natural antioxidant derived from grapes. Cardiovasc Res 47(3):549–555CrossRefPubMed Hung LM, Chen JK, Huang SS, Lee RS, Su MJ (2000) Cardioprotective effect of resveratrol, a natural antioxidant derived from grapes. Cardiovasc Res 47(3):549–555CrossRefPubMed
26.
go back to reference Tomé-Carneiro J, Larrosa M, Yanez-Gascon MJ, Davalos A, Gil-Zamorano J, Gonzalvez M, Garcia-Almagro FJ, Ruiz Ros JA, Tomas-Barberan FA, Espin JC, Garcia-Conesa MT (2013) One-year supplementation with a grape extract containing resveratrol modulates inflammatory-related microRNAs and cytokines expression in peripheral blood mononuclear cells of type 2 diabetes and hypertensive patients with coronary artery disease. Pharmacol Res 72:69–82. doi:10.1016/j.phrs.2013.03.011 CrossRefPubMed Tomé-Carneiro J, Larrosa M, Yanez-Gascon MJ, Davalos A, Gil-Zamorano J, Gonzalvez M, Garcia-Almagro FJ, Ruiz Ros JA, Tomas-Barberan FA, Espin JC, Garcia-Conesa MT (2013) One-year supplementation with a grape extract containing resveratrol modulates inflammatory-related microRNAs and cytokines expression in peripheral blood mononuclear cells of type 2 diabetes and hypertensive patients with coronary artery disease. Pharmacol Res 72:69–82. doi:10.​1016/​j.​phrs.​2013.​03.​011 CrossRefPubMed
27.
go back to reference Gehm BD, McAndrews JM, Chien PY, Jameson JL (1997) Resveratrol, a polyphenolic compound found in grapes and wine, is an agonist for the estrogen receptor. Proc Natl Acad Sci USA 94(25):14138–14143CrossRefPubMedPubMedCentral Gehm BD, McAndrews JM, Chien PY, Jameson JL (1997) Resveratrol, a polyphenolic compound found in grapes and wine, is an agonist for the estrogen receptor. Proc Natl Acad Sci USA 94(25):14138–14143CrossRefPubMedPubMedCentral
28.
go back to reference Arteaga E, Villaseca P, Rojas A, Marshall G, Bianchi M (2004) Phytoestrogens possess a weak antioxidant activity on low density lipoprotein in contrast to the flavonoid quercetin in vitro in postmenopausal women. Climacteric 7(4):397–403CrossRefPubMed Arteaga E, Villaseca P, Rojas A, Marshall G, Bianchi M (2004) Phytoestrogens possess a weak antioxidant activity on low density lipoprotein in contrast to the flavonoid quercetin in vitro in postmenopausal women. Climacteric 7(4):397–403CrossRefPubMed
29.
go back to reference Zern TL, Wood RJ, Greene C, West KL, Liu Y, Aggarwal D, Shachter NS, Fernandez ML (2005) Grape polyphenols exert a cardioprotective effect in pre- and postmenopausal women by lowering plasma lipids and reducing oxidative stress. J Nutr 135(8):1911–1917PubMed Zern TL, Wood RJ, Greene C, West KL, Liu Y, Aggarwal D, Shachter NS, Fernandez ML (2005) Grape polyphenols exert a cardioprotective effect in pre- and postmenopausal women by lowering plasma lipids and reducing oxidative stress. J Nutr 135(8):1911–1917PubMed
30.
go back to reference Appel K, Rose T, Fiebich B, Kammler T, Hoffmann C, Weiss G (2011) Modulation of the gamma-aminobutyric acid (GABA) system by Passiflora incarnata L. Phytother Res 25(6):838–843. doi:10.1002/ptr.3352 CrossRefPubMed Appel K, Rose T, Fiebich B, Kammler T, Hoffmann C, Weiss G (2011) Modulation of the gamma-aminobutyric acid (GABA) system by Passiflora incarnata L. Phytother Res 25(6):838–843. doi:10.​1002/​ptr.​3352 CrossRefPubMed
32.
go back to reference Cao Z (2005) Chinese obstetrics and gynecology. People’s Medical Publishing House, Beijing Cao Z (2005) Chinese obstetrics and gynecology. People’s Medical Publishing House, Beijing
34.
go back to reference Tao M, Shao H, Li C, Teng Y (2013) Correlation between the modified Kupperman Index and the Menopause Rating Scale in Chinese women. Patient Prefer Adherence 7:223–229PubMedPubMedCentral Tao M, Shao H, Li C, Teng Y (2013) Correlation between the modified Kupperman Index and the Menopause Rating Scale in Chinese women. Patient Prefer Adherence 7:223–229PubMedPubMedCentral
35.
37.
go back to reference Sowers MF, Crawford S, Sternfeld B, Morganstein D, Gold EB, Greendale GA, Evans D, Neer RM, Matthews R, Sherman S, Lo A, Weiss G, Kelsey J (2000) Design, survey sampling and recruitment methods of SWAN: a multi-center, multi-ethnic, community-based cohort study of women and the menopausal transition. In: Lobos R, Marcus R, Kelsey JL (eds) Menopause. Academic Press, New York, pp 175–188CrossRef Sowers MF, Crawford S, Sternfeld B, Morganstein D, Gold EB, Greendale GA, Evans D, Neer RM, Matthews R, Sherman S, Lo A, Weiss G, Kelsey J (2000) Design, survey sampling and recruitment methods of SWAN: a multi-center, multi-ethnic, community-based cohort study of women and the menopausal transition. In: Lobos R, Marcus R, Kelsey JL (eds) Menopause. Academic Press, New York, pp 175–188CrossRef
38.
go back to reference Thurston RC, Sowers MR, Chang Y, Sternfeld B, Gold EB, Johnston JM, Matthews KA (2008) Adiposity and reporting of vasomotor symptoms among midlife women: the study of women’s health across the nation. Am J Epidemiol 167(1):78–85. doi:10.1093/aje/kwm244 CrossRefPubMed Thurston RC, Sowers MR, Chang Y, Sternfeld B, Gold EB, Johnston JM, Matthews KA (2008) Adiposity and reporting of vasomotor symptoms among midlife women: the study of women’s health across the nation. Am J Epidemiol 167(1):78–85. doi:10.​1093/​aje/​kwm244 CrossRefPubMed
41.
go back to reference Sutton-Tyrrell K, Wildman RP, Matthews KA, Chae C, Lasley BL, Brockwell S, Pasternak RC, Lloyd-Jones D, Sowers MF, Torrens JI, Investigators Swan (2005) Sex-hormone-binding globulin and the free androgen index are related to cardiovascular risk factors in multiethnic premenopausal and perimenopausal women enrolled in the Study of Women Across the Nation (SWAN). Circulation 111(10):1242–1249. doi:10.1161/01.CIR.0000157697.54255.CE CrossRefPubMed Sutton-Tyrrell K, Wildman RP, Matthews KA, Chae C, Lasley BL, Brockwell S, Pasternak RC, Lloyd-Jones D, Sowers MF, Torrens JI, Investigators Swan (2005) Sex-hormone-binding globulin and the free androgen index are related to cardiovascular risk factors in multiethnic premenopausal and perimenopausal women enrolled in the Study of Women Across the Nation (SWAN). Circulation 111(10):1242–1249. doi:10.​1161/​01.​CIR.​0000157697.​54255.​CE CrossRefPubMed
42.
go back to reference Yang JY, Della-Fera MA, Rayalam S, Ambati S, Hartzell DL, Park HJ, Baile CA (2008) Enhanced inhibition of adipogenesis and induction of apoptosis in 3T3-L1 adipocytes with combinations of resveratrol and quercetin. Life Sci 82(19–20):1032–1039. doi:10.1016/j.lfs.2008.03.003 CrossRefPubMed Yang JY, Della-Fera MA, Rayalam S, Ambati S, Hartzell DL, Park HJ, Baile CA (2008) Enhanced inhibition of adipogenesis and induction of apoptosis in 3T3-L1 adipocytes with combinations of resveratrol and quercetin. Life Sci 82(19–20):1032–1039. doi:10.​1016/​j.​lfs.​2008.​03.​003 CrossRefPubMed
43.
go back to reference Zhou M, Wang S, Zhao A, Wang K, Fan Z, Yang H, Liao W, Bao S, Zhao L, Zhang Y, Yang Y, Qiu Y, Xie G, Li H, Jia W (2012) Transcriptomic and metabonomic profiling reveal synergistic effects of quercetin and resveratrol supplementation in high fat diet fed mice. J Proteome Res 11(10):4961–4971. doi:10.1021/pr3004826 CrossRefPubMed Zhou M, Wang S, Zhao A, Wang K, Fan Z, Yang H, Liao W, Bao S, Zhao L, Zhang Y, Yang Y, Qiu Y, Xie G, Li H, Jia W (2012) Transcriptomic and metabonomic profiling reveal synergistic effects of quercetin and resveratrol supplementation in high fat diet fed mice. J Proteome Res 11(10):4961–4971. doi:10.​1021/​pr3004826 CrossRefPubMed
44.
go back to reference Clerici C, Setchell KD, Battezzati PM, Pirro M, Giuliano V, Asciutti S, Castellani D, Nardi E, Sabatino G, Orlandi S, Baldoni M, Morelli O, Mannarino E, Morelli A (2007) Pasta naturally enriched with isoflavone aglycons from soy germ reduces serum lipids and improves markers of cardiovascular risk. J Nutr 137(10):2270–2278PubMed Clerici C, Setchell KD, Battezzati PM, Pirro M, Giuliano V, Asciutti S, Castellani D, Nardi E, Sabatino G, Orlandi S, Baldoni M, Morelli O, Mannarino E, Morelli A (2007) Pasta naturally enriched with isoflavone aglycons from soy germ reduces serum lipids and improves markers of cardiovascular risk. J Nutr 137(10):2270–2278PubMed
Metadata
Title
The impact of combined nutraceutical supplementation on quality of life and metabolic changes during the menopausal transition: a pilot randomized trial
Authors
Paola Villa
Inbal D. Amar
Carolina Bottoni
Clelia Cipolla
Giorgia Dinoi
Maria C. Moruzzi
Giovanni Scambia
Antonio Lanzone
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 4/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-017-4491-9

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