Skip to main content

Advertisement

Log in

Efficacy and safety of DT56a compared to hormone therapy in Greek post-menopausal women

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Background: Hormone therapy (HT) is the treatment of choice for the alleviation of menopausal symptoms; concerns, however, about its concomitant long-term health risks have limited its use. DT56a is a unique enzymatic isolate of soybeans. The purpose of our study was to evaluate the efficacy and safety of DT56a, compared to HT, in symptomatic post-menopausal women. Subjects and methods: Eighty-nine post-menopausal women were studied prospectively. Women with climacteric symptoms were randomly assigned to receive eitherDT56a (no.=27) or oral low dose continuous combined HT (no.=26). Symptomatic women not wishing to receive any treatment served as controls (no.=36). Menopausal symptoms as assessed through the Kupperman index, serum lipids and lipoproteins, calcium, as well as bone mineral density (BMD), endometrial thickness, and mammography were assessed at baseline and at 12 months. Results: Patients receiving HT and DT56a showed a significant and independent decrease in menopausal symptoms (mean difference in Kupperman score, DT56a group: −3.98, HT group −5.601, no treatment group +1.76, p-value <0.001). Lumbar spine BMD T-score was significantly lower in women receiving no treatment, as opposed to the two treatment arms which showed no significant change (No treatment, baseline: −0.60, final: −0.85, p=0.001; HT, baseline: −84, final −0.99, p=0.79; DT56a, baseline −0.51, final: −0.76, p=0.75). No differences in femoral bone density, ET or mammography classification were detected in any of the treatment arms. Likewise, serum lipids or lipoproteins did not differ between the three groups. Conclusions: DT56a decreased menopausal symptoms significantly and in the same degree as HT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Grady D. Clinical practice. Management of menopausal symptoms. N Engl J Med 2006, 355: 2338–47.

    Article  PubMed  Google Scholar 

  2. Nachtigall LE. The symptoms of perimenopause. Clin Obstet Gynecol 1998, 41: 921–7.

    Article  PubMed  Google Scholar 

  3. Couzi R, Helzlsouer K, Fetting J. Prevelance of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J Clin Oncol 1995, 13: 2737–44.

    PubMed  Google Scholar 

  4. Sturdee DW. The menopausal hot flush—Anything new? Maturitas 2008, 60: 42–9.

    Article  PubMed  Google Scholar 

  5. Stevenson JC, Crook D, Godsland IF. Influence of age and menopause on serum lipids and lipoproteins in healthy women. Atherosclerosis 1993, 98: 83–90.

    Article  PubMed  Google Scholar 

  6. Samsioe G. Medical and surgical strategies for treating urogynecological disorders. Int J Fertil Menopausal Stud 1996, 41: 136–41.

    PubMed  Google Scholar 

  7. Johnell O, Kanis JA, Jonsson B, Oden A, Johansson H, De Laet C. The burden of hospitalized fractures in Sweden. Osteoporos Int 2005, 16: 222–8.

    Article  PubMed  Google Scholar 

  8. Brincat M, Calleja-Agius J, Erel CT, et al. EMAS position statement: Bone densitometry screening for osteoporosis. Maturitas 2011, 68: 98–101.

    Article  PubMed  Google Scholar 

  9. Pachman DR, Jones JM, Loprinzi CL. Management of menopause-associated vasomotor symptoms: Current treatment options, challenges and future directions Int J Women Health 2010, 2: 123–35.

    Google Scholar 

  10. Utian WH, Archer DF, Bachmann GA, et al. Estrogen and progestogen use in postmenopausal women: 2008 position statement of The North American Menopause Society. Menopause 2008, 15: 584–602.

    Article  PubMed  Google Scholar 

  11. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA 2002, 288: 321–33.

    Article  PubMed  Google Scholar 

  12. Abbey M, Owen A, Susakawa M, Roach P, Nestel PJ. Effects of menopause and hormone replacement therapy on plasma lipids, lipoproteins and LDL receptor activity. Maturitas 1999, 33: 259–69.

    Article  PubMed  Google Scholar 

  13. Dias AR, Melo RN, Gebara OC, et al. Effect of conjugated equine estrogens or raloxifene on lipid profile, coagulation and fibrinolysis factors in postmenopausal women. Climacteric 2005, 8: 63–70.

    Article  PubMed  Google Scholar 

  14. Bachmann GA, Schaefers M, Uddin A, Utian WH. Lowest effective transdermal 17beta-estradiol dose for relief of hot flushes in postmenopausal women: a randomized controlled trial. Obstet Gynecol 2007, 110: 771–9.

    Article  PubMed  Google Scholar 

  15. NIH State-of-the-Science Panel on Management of Menopause-Related Symptoms. National Institutes of Health State-of-the-Science Conference statement: management of menopause- related symptoms. Ann Intern Med 2005, 142: 1003–13.

    Article  Google Scholar 

  16. Gajdos C, Jordan VC. Selective estrogen receptor modulators as a new therapeutic drug group: concept to reality in a decade. Clin Breast Cancer 2002, 2: 272–81.

    Article  PubMed  Google Scholar 

  17. Eden JA. Phytoestrogens for menopausal symptoms: a review. Maturitas 2012, 72: 157–9.

    Article  PubMed  Google Scholar 

  18. Lagari VS, Levis S. Phytoestrogens and bone health. Curr Opin Endocrinol Diabetes Obes 2010, 17: 546–53.

    Article  PubMed  Google Scholar 

  19. Howes LG, Howes JB, Knight DC. Isoflavone therapy for menopausal flushes: a systematic review and meta-analysis. Maturitas 2006, 55: 203–11.

    Article  PubMed  Google Scholar 

  20. Alekel DL, Germain AS, Peterson CT, Hanson KB, Stewart JW, Toda T. Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. Am J Clin Nutr 2000, 72: 844–52.

    PubMed  Google Scholar 

  21. Arjmandi BH, Smith BJ. Soy isoflavones’ osteoprotective role in postmenopausal women: mechanism of action. J Nutr Biochem 2002, 13: 130–7.

    Article  PubMed  Google Scholar 

  22. Sparringa RA, Owens JD. Protein utilization during soybean tempe fermentation. J Agric Food Chem 1999, 47: 4375–8.

    Article  PubMed  Google Scholar 

  23. Somjen D, Yoles I. DT56a (Tofupill/Femarelle) selectively stimulates creatine kinase specific activity in skeletal tissues of rats but not in the uterus. J Steroid Biochem Mol Biol 2003, 86: 93–8.

    Article  PubMed  Google Scholar 

  24. Yoles I, Yogev Y, Frenkel Y, Nahum R, Hirsch M, Kaplan MB. Tofupill® (DT56a)—a new phyto-selective estrogen receptor modulator-like substance for the treatment of postmenopausal bone loss. Menopause 2003, 10: 522–52.

    Article  PubMed  Google Scholar 

  25. Yoles I, Yogev Y, Frenkel Y, Hirsch M, Nahum R, Kaplan B. Efficacy and safety of standard versus low dose of femarelle (Tofupill) for the treatment of menopausal symptoms. Clin Exp Obstet Gynecol 2004, 31: 123–6.

    PubMed  Google Scholar 

  26. Blake GM, Fogelman I. An update on dual-energy X-ray absorptiometry. Semin Nucl Med 2010, 40: 62–73.

    Article  PubMed  Google Scholar 

  27. Bonnick S. Bone density data among technologies and manufacturers in bone densitometry in clinical practice: application and interpretation. 3rd ed. Humana Press; 2010.

  28. Kupperman HS, Wetchler BB. Contemporary therapy of the menopausal syndrome. JAMA 1959, 171: 1627–37.

    Article  Google Scholar 

  29. Christodoulakos GE, Lambrinoudaki IV, Vourtsi AD, et al. The effect of low dose hormone therapy on mammographic breast density. Maturitas 2006, 54: 78–85.

    Article  PubMed  Google Scholar 

  30. Somjen D, Kohen F, Jaffe A, Amir-Zaltzman Y, Knoll E, Stern N. Effect of gonadal steroids and their antagonists on DNA synthesis in human vascular cells. Hypertension 1998, 32: 39–45.

    Article  PubMed  Google Scholar 

  31. Katzburg S, Lieberherr M, Ornoy A, Klein B, Hendel D, Somjen D. Isolation and hormone responsiveness of primary cultures of human bone-derived cells: gender and age differences. Bone 1999, 25: 667–73.

    Article  PubMed  Google Scholar 

  32. Somjen D, Katzburg S, Lieberherr M, Hendel D, Yoles I. DT56a stimulates gender-specific human cultured bone cells in vitro. J Steroid Biochem Mol Biol 2006, 98: 90–6.

    Article  PubMed  Google Scholar 

  33. Somjen D, Yoles I. DT56a (Tofupill®) stimulates creatine kinase specific activity in vascular tissues of rats. J Endocrinol Invest 2003, 26: 966–71.

    PubMed  Google Scholar 

  34. Somjen D, Katzburg S, Sharon O, Hendel D, Yoles I. DT56a (Femarelle), contrary to estradiol-17, is effective inhuman derived female osteoblasts in hyperglycemic condition. J Steroid Biochem Mol Biol 2011, 123: 25–9.

    Article  PubMed  Google Scholar 

  35. Yoles I, Lilling G. Pharmacological doses of the natural phyto-SERM DT56a (Femarelle) have no effect on MCF-7 breast cancer cell-line. Eur J Obstet Gynecol Reprod Biol 2007, 130: 140–1.

    Article  PubMed  Google Scholar 

  36. Nachtigall MJ, Jessel RH, Flaumenhaft R, Nachtigall R, Yoles I, Naftolin F, Nachtigall LE. The selective estrogen receptor modulator DT56a (Femarelle) does not affect platelet reactivity in normal or thrombophilic postmenopausal women. Menopause 2011, 18: 285–8.

    Article  PubMed  Google Scholar 

  37. Oddens BJ. The climacteric cross-culturally: the International Health Foundation South-east Asia study. Maturitas 1994, 19: 155–6.

    Article  PubMed  Google Scholar 

  38. Tham DM, Gardner CD, Haskell WL. Clinical review 97: Potential health benefits of dietary phytoestrogens: a review of the clinical, epidemiological, and mechanistic evidence. J Clin Endocrinol Metab 1998, 83: 2223–35.

    PubMed  Google Scholar 

  39. Nelson HD, Vesco KK, Haney E, et al. Nonhormonal therapies for menopausal hot flashes: systematic review and meta-analysis. JAMA 2006, 295: 2057–71.

    Article  PubMed  Google Scholar 

  40. Quella SK, Loprinzi CL, Barton DL, et al. Evaluation of soy phytoestrogens for the treatment of hot flashes in breast cancer survivors: A North Central Cancer Treatment Group Trial. J Clin Oncol 2000, 18: 1068–74.

    PubMed  Google Scholar 

  41. Lethaby AE, Brown J, Marjoribanks J, Kronenberg F, Roberts H, Eden J. Phytoestrogens for vasomotor menopausal symptoms. Cochrane Database Syst Rev 2007, 4: CD001395.

    PubMed  Google Scholar 

  42. Dalais FS, Rice GF, Wahlqvist ML, et al. Effects of dietary phytoestrogens in postmenopausal women. Climacteric 1998, 1: 124–9.

    Article  PubMed  Google Scholar 

  43. Somjen D, Katzburg S, Livne E, Yoles I. DT56a (Femarelle) stimulates bone formation in female rats. BJOG 2005, 112: 981–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to I. Lambrinoudaki MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Labos, G., Trakakis, E., Pliatsika, P. et al. Efficacy and safety of DT56a compared to hormone therapy in Greek post-menopausal women. J Endocrinol Invest 36, 521–526 (2013). https://doi.org/10.3275/8926

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.3275/8926

Key-words

Navigation