Soy protein and isoflavone effects on vasomotor symptoms in peri- and postmenopausal women: the Soy Estrogen Alternative Study Effect of the insulin sensitizer pioglitazone on insulin resistance, hyperandrogenism, and ovulatory dysfunction in women with polycystic ovary syndrome. Managing menopause. Clinical and biochemical characterization of women with polycystic ovary syndrome in North Rhine-Westphalia.
Objective To investigate the efficacy of dietary soy proteins containing differing amounts of isoflavones on the number and severity of  vasomotor symptoms ( hot flashes and night sweats ) in peri- and postmenopausal women . Design A double-masked , r and omized , controlled , clinical trial was conducted . A total of 241 community-dwelling women reporting vasomotor symptoms at baseline were r and omized into one of three groups . In all groups , participants consumed a daily supplement containing 25 g of soy protein and were r and omly assigned to one of three groups : ( a ) isoflavone extracted soy protein ( control ) , ( b ) soy protein with a medium dose of isoflavones ( 42 mg/day ) , or ( c ) soy protein with a higher dose of isoflavones ( 58 mg/day ) . The primary outcome measure in this trial was change in reported vasomotor symptoms . Results A reduction in the number and severity of vasomotor symptoms was observed in all three treatment groups . No significant differences in the number and severity of vasomotor symptoms were observed among the high isoflavone , middle isoflavone , or control groups . The lack of a between-treatment group effect was observed even after stratified by number of baseline symptoms and use of traditional hormone replacement therapy . Conclusions These data suggest that soy protein containing 42 or 58 mg of isoflavones is no more effective than isoflavone-extracted soy protein for improving the number and severity of vasomotor symptoms in peri- and postmenopausal women Polycystic ovary syndrome ( PCOS ) is characterized by hyper and rogenism , chronic anovulation , and insulin resistance ; long-term consequences include diabetes mellitus type 2 . The aim of this r and omized , double-blind , controlled trial was to investigate whether the thiazolidinedione derivative pioglitazone diminishes insulin resistance and hyper and rogenism and enhances ovulation rates in women with PCOS . Forty premenopausal women with PCOS were r and omly allocated to treatment with either pioglitazone ( 30 mg/d ) or placebo for periods of 3 months . Administration of pioglitazone result ed in a remarkable decline in both fasting serum insulin levels ( P < 0.02 ) and the area under the insulin response curve after an oral glucose load ( P < 0.02 ) . This represented an increase in insulin sensitivity and a decrease in insulin secretion ( P < 0.05 ) . Furthermore , pioglitazone increased serum SHBG ( P < 0.05 ) , result ing in a significant decrease in the free and rogen index ( P < 0.05 compared with placebo ) . Treatment with pioglitazone was also associated with higher ovulation rates ( P < 0.02 ) . Thus , pioglitazone significantly improved insulin sensitivity , hyper and rogenism , and ovulation rates in women with PCOS , thereby providing both metabolic and reproductive benefits OBJECTIVE To provide up date d guidelines for health care providers on the management of menopause in asymptomatic healthy women as well as in women presenting with vasomotor or urogenital symptoms and on considerations related to cardiovascular disease , breast cancer , urogynaecology , and sexuality . OUTCOMES Lifestyle interventions , prescription medications , and complementary and alternative therapies are presented according to their efficacy in the treatment of menopausal symptoms . Counselling and therapeutic strategies for sexuality concerns in the peri- and postmenopausal years are review ed . Approaches to the identification and evaluation of women at high risk of osteoporosis , along with options for prevention and treatment , are presented in the companion osteoporosis guideline . EVIDENCE Published literature was retrieved through search es of PubMed and The Cochrane Library in August and September 2012 with the use of appropriate controlled vocabulary ( e.g. , hormone therapy , menopause , cardiovascular diseases , and sexual function ) and key words ( e.g. , hormone therapy , perimenopause , heart disease , and sexuality ) . Results were restricted to clinical practice guidelines , systematic review s , r and omized control trials/controlled clinical trials , and observational studies . Results were limited to publication date s of 2009 onwards and to material in English or French . Search es were up date d on a regular basis and incorporated in the guideline until January 5 , 2013 . Grey ( unpublished ) literature was identified through search ing the websites of health technology assessment and health technology assessment -related agencies , national and international medical specialty societies , and clinical practice guideline collection Polycystic ovary syndrome ( PCOS ) , defined as the combination of oligoanovulation and hyper and rogenism , affects more than 5 % of women of reproductive age . Insulin resistance and hyperinsulinemia appear to play an important role in its pathogenesis . Here , we will present a characterization of a PCOS cohort from North Rhine-Westphalia in Germany . Clinical features , family history as well as endocrine and metabolic parameters were prospect ively recorded from 200 successive patients . All patients were evaluated for insulin resistance and beta-cell-function by oral glucose tolerance test .  Patient data were compared with those of 98 age-matched control women . PCOS patients showed significantly higher BMI , body fat mass and and rogen levels as well as impaired glucose and insulin metabolism . A positive family history of PCOS and diabetes was more frequent in PCOS patients . Insulin resistance ( 71 % ) was the most common metabolic abnormality in PCOS patients followed by obesity ( 52 % ) and dyslipidemia ( 46.3 % ) , with an incidence of 31.5 % for the metabolic syndrome . C-reactive protein and other cardiovascular risk factors were frequently elevated even in young PCOS patients . While the clinical characteristics and endocrine parameters of this German PCOS cohort were heterogeneous , they were comparable to those from other Caucasian population
Because of the heterogeneity and the limited number of studies , there is no sufficient evidence on the potential role of vasomotor symptoms in metabolic health .
However , both high- quality cohort studies , with large study population s and adjustment for multiple confounding variables showed positive associations between vasomotor symptoms and insulin resistance and type 2 diabetes mellitus .
These findings suggest that there is an association between vasomotor symptoms and metabolic health outcomes .
The objective of this study was to systematic ally review studies describing the association between vasomotor symptoms and metabolic syndrome , type 2 diabetes and insulin resistance in peri- and postmenopausal women .