Hops extract for menopausal discomfort.
Article Type: Report
Subject: Menopause (Health aspects)
Hops (Health aspects)
Isoflavones (Properties)
Materia medica, Vegetable (Health aspects)
Plant extracts (Health aspects)
Medicine, Botanic (Research)
Medicine, Herbal (Research)
Author: Finney-Brown, Tessa
Pub Date: 06/22/2010
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Summer, 2010 Source Volume: 22 Source Issue: 2
Topic: Event Code: 310 Science & research
Product: Product Code: 0139909 Hops NAICS Code: 111998 All Other Miscellaneous Crop Farming SIC Code: 0139 Field crops, except cash grains, not elsewhere classified
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 232178428
Full Text: Erkkola R, Vervarcke S, Vansteelandt S, Rompotti P, DeKeukeleire D, Heyerick E. 2010. A randomized, double blind, placebo controlled, cross over pilot study on the use of a standardized hop extract to alleviate menopausal discomforts. Phytomed 17:6,389-96.

Phytoestrogens are plant derived non steroidal polyphenolic compounds with weak activity to functionally mimic the effects of 17-OH estradiol in the human body. Evidence from epidemiological and experimental studies suggests that higher dietary intakes of these compounds may have beneficial effects on many estrogen related conditions and diseases. However studies examining their use in the reduction of vasomotor symptoms have yielded contradictory results. Some patient populations (e.g. women in early natural menopause with mild to moderate vasomotor symptoms) may benefit more clearly than others.

As the estrogenic principle from Humulus lupulus (8-prenylnaringenin or 8-PN) is one of the most potent phytoestrogens currently known, this trial was designed to examine the use of a herbal extract (75.1 mg) standardised to contain 100 mcg of 8-PN on menopausal discomfort.

The authors utilised a randomised double blind placebo controlled cross over design. Their 36 participants were healthy postmenopausal volunteers from Finland, aged between 45 and 60 years. Eligibility criteria included an intact uterus, lack of menses for 12 months, no recent history of hormone therapy or phytoestrogen supplements, and no history of breast, endometrial or other hormone dependant cancer. Twenty four women were in the initial active group, were administered the active treatment for 8 weeks and then crossed over to receive placebo for a further 8 weeks. Twelve women were enrolled in the other group and first took placebo then the active treatment. Menopausal discomforts were scored at baseline and the 8 and 16 week follow ups. Tools used were the Kupperman Index (Kupperman 1953), scored by a gynacologist, the Menopause Rating Scale (MRS) (Schneider 2000), and a multifactorial Visual Analogue Scale (VAS) which were all self reporting tools for the participants. The testing instruments used also measured general quality of life in relation to menopausal symptoms rather than being direct measures of vasomotor symptoms.

After 8 weeks both the active and placebo treatments resulted in significant improvements in all outcome measures compared with baseline, with higher average reductions for placebo. However at week 16 only the active treatment after placebo further reduced all outcome measures, while the placebo treatment after active resulted in a slight increase in all measures. Effects were more pronounced after 16 weeks. Statistical analysis showed marginal evidence of a treatment effect of active treatment after placebo.

Limitations of the study include the following: although the study was designed for 50 participants, only 36 ended up participating, which then affected the random allocation to treatment groups (showing the large difference in size between the groups); there was a lack of washout period between the groups which may have affected results. This was due partly to pharmacokinetic data suggesting that the active ingredients wash out within a relatively short period of time.

According to the authors, menopausal symptoms are typically sensitive to a larger and more persistent placebo affect than other types of symptoms, which may explain in part the results in the first part of the trial. These types of complaints also naturally reduce over longer time periods, which may affect these types of studies. The participants were a mean 4 years past menopause, which suggests that their symptoms may have been declining naturally anyway. Further studies may be required to confirm the observations in this study, which were that phytoestrogen preparations containing 8-PN may reduce discomforts and complaints associated with menopause.

Tessa Finney-Brown mnhaa

Gale Copyright: Copyright 2010 Gale, Cengage Learning. All rights reserved.