***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Concerns regarding the risk of estrogen replacement have result ed in a significant increase in the use of soy products by menopausal women who , despite the lack of evidence of the efficacy of such products , seek alternatives to menopausal hormone therapy . Our goal was to determine the efficacy of soy isoflavone tablets in preventing bone loss and menopausal symptoms . METHODS The study design was a single-center , r and omized , placebo-controlled , double-blind clinical trial conducted from July 1 , 2004 , through March 31 , 2009 . Women aged 45 to 60 years within 5 years of menopause and with a bone mineral density T score of -2.0 or higher in the lumbar spine or total hip were r and omly assigned , in equal proportions , to receive daily soy isoflavone tablets , 200 mg , or placebo . The primary outcome was changes in bone mineral density in the lumbar spine , total hip , and femoral neck at the 2-year follow-up . Secondary outcomes included changes in menopausal symptoms , vaginal cytologic characteristics , N -telopeptide of type I bone collagen , lipids , and thyroid function . RESULTS After 2 years , no significant differences were found between the participants receiving soy tablets ( n = 122 ) and those receiving placebo ( n = 126 ) regarding changes in bone mineral density in the spine ( -2.0 % and -2.3 % , respectively ) , the total hip ( -1.2 % and -1.4 % , respectively ) , or the femoral neck ( -2.2 % and -2.1 % , respectively ) . A significantly larger proportion of participants in the soy group experienced hot flashes and constipation compared with the control group . No significant differences were found between groups in other outcomes . CONCLUSIONS In this population , the daily administration of tablets containing 200 mg of soy isoflavones for 2 years did not prevent bone loss or menopausal symptoms . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00076050 Objective This study aims to evaluate the effects of soy isoflavones on breast tissue in postmenopausal women . Methods In this r and omized , double-blind , placebo-controlled study , 80 women ( aged ≥45 y and with amenorrhea > 12 mo ) with vasomotor symptoms were r and omized to receive either 250 mg of st and ardized soy extract corresponding to isoflavone 100 mg/day ( n = 40 ) or placebo ( n = 40 ) for 10 months . Breasts were evaluated through mammographic density and breast parenchyma using ultrasound ( US ) at baseline and 10-month follow-up . Independent t test , analysis of variance , Mann-Whitney U test , and & khgr;2 trend test were used in statistical analysis . Results Baseline clinical characteristics showed no significant differences between the isoflavone group and the placebo group , with mean ( SD ) age of 55.1 ( 6.0 ) and 56.2 ( 7.7 ) years , mean ( SD ) menopause duration of 6.6 ( 4.8 ) and 7.1 ( 4.2 ) years , and mean ( SD ) body mass index of 29.7 ( 5.0 ) and 28.5 ( 4.9 ) kg/m2 , respectively ( P > 0.05 ) . The study was completed by 32 women on isoflavone and 34 women on placebo . The groups did not differ in mammographic density or breast parenchyma by US ( P > 0.05 ) . Within each group , the baseline and final moments did not differ in mammography or US parameters significantly ( P > 0.05 ) . Conclusions The use of soy isoflavone extract for 10 months does not affect breast density , as assessed by mammography and US , in postmenopausal women Because soy food consumption may influence breast tissue activity , we examined its effect on the presence of epithelial cells in nipple aspirate fluid ( NAF ) . In a r and omized , crossover design , 82 premenopausal women completed a high-soy and a low-soy diet  for 6 mo each , separated by a 1-mo washout period . They provided NAF sample s at baseline , 6 mo , and 13 mo during the midluteal phase of the menstrual cycle . Papanicolaou-stained cytology slides ( for 33 women at baseline , 24 at low-soy , and 36 at high-soy ) were evaluated in women with sufficient NAF . Mixed models evaluated the effect of the high-soy diet on epithelial cytology as compared to baseline and the low-soy diet . At the end of the  high-soy diet , cytological subclass had decreased in 8 ( 24 % ) and increased in 3 ( 9 % ) women as compared to baseline , whereas the respective values were 3 ( 14 % ) and 6 ( 29 % ) for the low-soy diet sample s ( P = 0.32 ) . Only the change in subclass indicated a trend in lower cytological class ( P = 0.06 ) . Contrary to an earlier report , the number of NAF sample s with hyperplastic epithelial cells did not increase after a soy intervention in amounts consumed by Asians Background . Risk-benefit issues raised after the WHI have significantly increased the use of alternative treatments for the menopause . Despite this , data regarding the effect of soy isoflavones over mood and menopausal symptoms in high risk population s is still lacking . Objective . To evaluate the effect of soy derived isoflavones over hot flushes , menopausal symptoms and mood in climacteric women with increased body mass index ( BMI ) . Methods . Fifty symptomatic climacteric women aged 40 to 59 with increased BMI ( ≥25 ) were recruited to receive oral 100 mg/day of soy derived isoflavones ( Climasoy ® ) for 3 months  . Hot flushes ( frequency/intensity ) , menopausal symptoms ( Menopause Rating Scale [ MRS ] ) and mood ( Hamilton Depressive Rating Scale [ HDRS ] ) were evaluated at baseline and at 90 days . Results . A total of 45 women completed the study . After 3 months of soy isoflavone supplementation hot flushes significantly decreased in percentage , number and severity ( 100 % to 31.1 % ; 3.9 ± 2.3 to 0.4 ± 0.8 and 2.6 ± 0.9 to 0.4 ± 0.8 , respectively , p < 0.001 ) . MRS scores ( total and for subscales ) reflecting general menopausal symptoms also significantly decreased compared to baseline . Regarding mood , after three months total HDRS scores and the rate of women presenting depressed mood ( scores ≥ 8) significantly decreased ( 16.3 ± 5.4 to 6.9 ± 5.2 and 93.3 % to 28.9 % , respectively , p < 0.05 ) . There was no effect on blood pressure levels or BMI values after treatment . Conclusion . In this high risk climacteric population  , soy derived isoflavone treatment improved mood as well as vasomotor and general menopausal symptoms . More research is required to determine if the positive effect over mood is a direct or an indirect one through hot flush alleviation OBJECTIVE To investigate the effects of st and ardized soy extract on climacteric symptoms , lipid profiles , bone markers , and serum isoflavone concentration in healthy Taiwanese postmenopausal women . MATERIAL S AND METHODS A multicenter , open-labeled , r and omized , prospect i ve , comparative study design was used . A total of 130 out patients who had undergone natural menopause were r and omly administered either 70 mg or 35 mg soy extract daily for 24 weeks . RESULTS The evidence suggests that the soy extract treatment that was administered to both groups for 1 month could help reduce climacteric scores ( reductions of 19.66 % [ p<0.01 ] and 18.85 % [ p<0.01 ] in the 35 mg and 70 mg groups compared with baseline , respectively ) , and the efficacy was more potent after 6 months of treatment . Soy isoflavone significantly reduced the total cholesterol ( reductions of 4.50 % [ p<0.01 ] and 3.06 % [ p<0.05 ] in the 35 mg and 70 mg groups , respectively ) and low density lipoprotein cholesterol levels ( reductions of 4.67 % [ p<0.05 ] and 5.09 % [ p<0.05 ] in the 35 mg and 70 mg groups , respectively ) in patients with total cholesterol > 200 mg/dL after 6 months of treatment . In patients with high bone turnover ( urinary deoxypyridinoline/creatinine > 7.4 nM/mM ) , soy extract treatment reduced the deoxypyridinoline/creatinine level by 10.53 % ( p<0.05 ) and 11.58 % ( p<0.05 ) in the 35 mg and 70 mg groups , respectively . Serum levels of isoflavone increased in both groups after 6 months of treatment . CONCLUSION Soy extract is highly efficacious at relieving menopausal symptoms and demonstrates a positive effect on the cardiovascular system and skeleton Background and objectives : The potential of soy isoflavones to interfere with thyroid function has been reported . However , there are limited data regarding their effect on thyroid function and autoimmunity in surgical menopausal women . The present study aim ed to evaluate the effect of isoflavones on thyroid function and autoimmunity , menopausal symptoms , serum follicle stimulating hormone ( FSH ) and estradiol levels in oophorectomised women . Methods : A r and omized , double blind , placebo-controlled trial was conducted in 43 oophorectomised women to evaluate the effect of soy isoflavones ( 75 mg/day for 12 wk ) on serum thyroid profile ( free T3 , free T4 , TSH , TBG and anti-TPO antibody titres ) assessed at baseline , 6 and 12 wk after r and omization . Assessment was also done for menopause symptom score ( MSS ) three weekly , and FSH and estradiol levels at baseline and at study completion . Results : There was a significant alteration in free T 3 levels in the group receiving isoflavones ( 4.05 ± 0.36 , 4.12 ± 0.69 and 3.76 ± 0.55 pmol/l at baseline , 6 and 12 wk , respectively ; P=0.02 ) . However , the mean change in various thyroid parameters at 12 wk from baseline was not significantly different between the two groups . MSS was also significantly decreased at 9 and 12 wk from baseline with isoflavones ( 12.47 ± 8.15 , 9.35 ± 5.23 and 9 ± 5.14 at baseline , 9 and 12 wk respectively ; P=0.004 ) with significant improvement in urogenital symptoms  compared to placebo . Isoflavones did not significantly affect other parameters during study period . There were no serious adverse events reported and the proportion of patients experiencing adverse events was similar between the two groups . Interpretation and conclusions : Modest reduction in serum free T3 levels in the isoflavone group in the absence of any effect on other thyroid parameters might be considered clinical ly unimportant OBJECTIVE Menopause is associated with broad , though generally not massive changes in a large number of metabolic parameters . The aim of our study was to evaluate the efficacy and tolerability of a combined nutraceutical approach on a large number of cardiometabolic risk markers and menopause symptoms in otherwise healthy , mildly dyslipidemic postmenopausal women . DESIGN / SETTING Forty women were enrolled in the context of a controlled , r and omized , prospect i ve study with parallel groups at the Lipid Clinic of the University of Bologna . INTERVENTION The women were r and omized to treatment with a nutraceuticals containing soy isoflavones ( 60 mg ) and berberine ( 500 mg ) or a placebo at a dosage of one tablet daily between meals for 12 weeks . RESULTS All patients completed the study without significant side effects . Anthropometric measures , blood pressure , HOMA index , and basal homocysteinemia significantly improved in isoflavones-berberine-treated group when compared to the baseline , but not when compared to the placebo-treated patients . Compared to placebo-treated patients , those treated with isoflavones-berberine experienced a significant improvement in plasma lipid and metalloproteinase serum levels , as well as the main menopausal symptoms . CONCLUSION The short-term consumption of a nutraceutical containing isoflavones and berberine was well-tolerated and improved menopausal symptoms , plasma lipid level , and serum levels of matrix metalloproteinases in a cohort of mildly dyslipidemic postmenopausal women when compared with a neutral control Objective This study aims to determine whether long-term isoflavone soy protein ( ISP ) supplementation affects endometrial thickness and rates of endometrial hyperplasia and cancer in postmenopausal women . Methods In this r and omized , double-blind , placebo-controlled trial , 350 postmenopausal women aged 45 to 92 years were r and 
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The citation analysis revealed a growing interest for this topic and the papers on thyroid function are the most cited .
In particular , literature show that a specific dosage of isoflavones reduces cardiovascular disease ( from 20 to 100 mg/die ) , may be protective in osteoporosis and muscular fatigue ( from 20 to 80 mg/die ) , may be useful for cancer prevention on endometrium , mammary gl and s and liver ( from 50 to 100 mg/die ) , might improve menopausal symptoms , particularly in reducing the frequency of hot flashes ( from 50 to 120 mg/die ) , can reduce abdominal fat and circulating inflammatory markers ( from 80 to 160 mg/die ) , may ameliorate the possible interaction between endogenous estrogen and thyroid function ( 75 mg/die ) and improve visual memory ( from 50 to 100 mg/die )