***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: The soybean is rich in isoflavone phytoestrogens , which are lig and s for estrogen receptors , but it is unknown whether soy/phytoestrogens have similar procoagulant effects to estrogen . In this r and omized double-blind trial , 40 healthy postmenopausal women of age 50 - 75 yr received soy protein isolate ( 40 g soy protein , 118 mg isoflavones ) ( n = 19 ) or casein placebo ( n = 21 ) . Plasma markers of coagulation , fibrinolysis , and endothelial dysfunction were measured at baseline and 3 months . The baseline characteristics of the two groups were similar . Compared with casein placebo , soy decreased triglycerides ( P < 0.005 ) and low-density lipoprotein/high-density lipoprotein ratio ( P < 0.001 ) and increased lipoprotein ( a ) ( P < 0.05 ) . Activity of coagulation factor VII ( VIIc ) decreased similarly in both groups ( P < 0.005 ) . Prothrombin fragments 1 + 2 ( a marker of thrombin generation ) decreased in the soy group ( P < 0.005 ) , but the change was not different from the casein group . There was no effect of soy on soluble fibrin ( a marker of fibrin production ) , plasminogen activator inhibitor-1 ( a marker of fibrinolytic inhibitory potential ) , D-dimer ( a marker of fibrin turnover ) , or von Willebr and factor ( a marker of endothelial damage ) . In conclusion , the results of the current study do not support biologically significant estrogenic effects of soy/phytoestrogens on coagulation , fibrinolysis , or endothelial function Objective : To determine the safety and efficacy of an oral soy isoflavone extract for relief of  menopausal hot flushes . Design : This was a double‐blind , r and omized , parallel group , outpatient , multicenter ( 15 sites ) study . A total of 177 postmenopausal women ( mean age = 55 years ) who were experiencing five or more hot flushes per day were r and omized to receive either soy isoflavone extract ( total of 50 mg genistin and daidzin per day ) or placebo . Physical examinations and endometrial and biochemical evaluations were performed upon admission and completion . Body weight , symptoms , and safety were evaluated at all visits . Results : Relief of vasomotor symptoms was observed in both groups . Decreases in the incidence and severity of hot flushes occurred as soon as 2 weeks in the soy group , whereas the placebo group experienced no relief for the first 4 weeks . Differences between evaluable subjects in both groups were statistically significant over 6 weeks ( p = 0.03 ) . Over 12 weeks , between‐group differences approached significance ( p = 0.08 ) . Endometrial thickness evaluated by ultrasound , lipoproteins , bone markers , sex hormone‐binding globulin and follicle‐stimulating hormone , and vaginal cytology did not change in either group . Conclusions : Soy isoflavone extract was effective in reducing frequency and severity of flushes and did not stimulate the endometrium . Soy isoflavone extracts provide an attractive addition to the choices available for relief of hot flushes . ( Menopause 2000;7:236‐242 . © 2000 , The North American Menopause Society . Background . The aim of the study was to evaluate the effect , in postmenopausal women , of the phytoestrogen genistein and hormone replacement therapy ( HRT ) on circulating two independent factors of cardiovascular risk : homocysteine and C‐reactive protein ( CRP ) Phytoestrogens are thought to be beneficial to vascular health . Possible mechanisms of action could involve C-reactive protein ( CRP ) , endothelial E-selectin , and nitric oxide . We therefore design ed a r and omized , placebo-controlled , double-blind trial in which we studied the effects of isoflavonoids on CRP , E-selectin , and nitrate-nitrite ( NO(x ) ; reflecting the release of nitric oxide ) in postmenopausal women . Fifty-six postmenopausal women ( FSH > 30 U/liter ) with a history of breast cancer used ( in a r and omized order )  phytoestrogen ( 114 mg isoflavonoids ) or placebo tablets daily for 3 months ; the treatment regimens were crossed over after a 2-month washout period . The serum levels of CRP and E-selectin , and plasma levels of NO(x ) were measured before and on the last day of each treatment . The phytoestrogen regimen did not affect the levels of either CRP ( P = 0.584 ) or NO(x ) ( P = 0.270 ) , but the levels of E-selectin were reduced by 4.0 % ( 2.9 ng/ml ; P = 0.031 ) during phytoestrogen use and by 2.2 % ( 1.3 ng/ml ; P = 0.023 ) during placebo use . No difference was found at any marker at 3 months between the groups . In conclusion , our data , suggesting neutral effects of phytoestrogens on CRP , E-selectin , and nitric oxide , fail to support a vasoprotective role of phytoestrogens Background : Postmenopausia and hypercholesterolemia are related to endothelial dysfunction , a pathogenic event in atherosclerosis . Soy protein reduces plasma cholesterol , but there is scanty information about its effect on endothelial function . Objective : To evaluate the effect of isolated soy protein compared to caseinate on plasma lipoproteins and endothelial function in postmenopausal hypercholesterolemic women . Design : R and omized , double-blind , cross-over trial . Setting : Outpatient clinic of the Catholic University of Chile . Subjects : Eighteen healthy , postmenopausal women with hypercholesterolemia were recruited , included and completed the protocol . Interventions : During the trial , all patients followed a low fat/low cholesterol diet and were r and omly assigned to receive isolated soy protein or matching caseinate for 4 weeks , and then the alternative treatment until week 8 . At pre- study and at the end of the first and second period , plasma lipoprotein levels and endothelial function ( flow-mediated dilatation ( FMD ) of the brachial artery ) were evaluated . Results : Plasma total and low density lipoprotein (LDL)-cholesterol concentration were significantly lower with the low fat/low cholesterol diet compared to pre- study , either with caseinate or soy protein . No significant differences in plasma lipid concentration between caseinate or soy protein interventions were observed . FMD did not change with the caseinate . In contrast , when soy protein was administered , FMD was significantly higher compared to pre- study ( 9.471.8 % vs 5.371.2 % ; P<0.05 ) and compared to caseinate intervention ( 9.471.8 % vs 4.971.5 % ; P<0.033 ) . Conclusions : These results suggest that in postmenopausal hypercholesterolemic women , soy protein improves endothelial function , regardless of changes in plasma lipoproteins . Sponsorship : Pontificia Universidad Católica ( DIPUC99/09E ) , Protein Technology International and Gynopharm Laboratory ( Recalcine Group ) Objective : To evaluate in a 12-month , prospect i ve , r and omized , double-blind , placebo-controlled study whether pure administration of the phytoestrogen genistein ( 54 mg/d ) might reduce the number and severity of hot flushes in postmenopausal women with no adverse effect on the endometrium . Design : A total of 389 participants met the main study criteria and were r and omly assigned to receive the phytoestrogen genistein ( n = 198 ) or placebo ( n = 191 ) . About 40 % of participants in both groups did not suffer from hot flushes , and the evaluation was performed in a subgroup of 247 participants ( genistein , n = 125 ; placebo , n = 122 ) . Reductions from baseline in the frequency and severity of hot flushes were the principal criteria of efficacy . Endometrial thickness was evaluated by ultrasonography . The maturation value was also used to determine hormonal action on the vaginal cells . Results : There were no significant differences in age , time since menopause , body mass index , and vasomotor symptoms between groups at baseline ( 4.4 ± 0.33 hot flushes per day in the genistein group and 4.2 ± 0.35 hot flushes per day in the control group ) . The effect was already evident in the first month and reached its peak after 12 months of genistein therapy ( −56.4 % reduction in the mean number of hot flushes ) . Furthermore , there was a significant difference between the two groups at each evaluation time ( 1 , 3 , 6 , and 12 months ) . No significant difference was found in mean endometrial thickness and maturation value score between the two groups , either at baseline or after 12 months . Conclusions : The phytoestrogen genistein has been shown to be effective on vasomotor symptoms without an adverse effect on endometrium BACKGROUND Observational studies suggest that dietary isoflavones reduce breast cancer risk , and this may be caused in part by effects on endogenous hormone concentrations . Because intestinal bacteria metabolize isoflavones , it was hypothesized that consumption of probiotic bacteria would enhance the biologic effects of isoflavones , including effects on endogenous hormones . DESIGN Twenty ( 20 ) postmenopausal breast cancer survivors and 20 healthy postmenopausal women completed four 42-day diet periods in a r and omized , crossover design . They received one of the following : isolated soy protein ; isolated milk protein ; soy + probiotic capsules ; or milk + probiotic capsules . Each protein supplement provided 0.38 g protein/(kg body weight/day ) ( 26.6 + /- 4.5 g protein/day ) and soy protein provided 0.64 mg isoflavones/(kg body weight/day ) ( 44.4 + /- 7.5 mg isoflavones/day ) . Probiotic capsules provided 10(9 ) colony-forming units Lactobacillus acidophilus ( strain DDS-1 ) , Bifidobacterium longum , and 15 - 20 mg fructo-oligosaccharide . MEASURES Plasma sample s were collected at baseline and after each diet for analysis of estrogens , follicle-stimulating hormone ( FSH ) , and rogens , and sex hormone?binding globulin ( SHBG ) . RESULTS Hormone levels were not affected by soy , probiotic supplements , or equol producer status , and neither cancer status nor equol producer status altered the effects of soy or probiotics . Furthermore probiotics did not alter the effects of soy consumption . Soy protein tended to decrease SHBG compared to milk protein diets ( p = 0.05 ) , although both proteins significantly decreased SHBG relative to baseline ( p = 0.0001 and p = 0.03 ) . CONCLUSIONS These data suggest that short-term , moderate consumption of isoflavone-containing soy protein and consumption of these particular probiotic capsules do not significantly alter reproductive hormone concentrations in breast cancer survivors or controls , regardless of equol producer status OBJECTIVE Phytoestrogen consumption has been shown to reduce risk factors for cardiovascular disease . Type 2 diabetes confers an adverse cardiovascular risk profile particularly in women after menopause . The aim of this study was to determine whether a dietary supplement with soy protein and isoflavones affected insulin resistance , glycemic control , and cardiovascular risk markers in postmenopausal women with type 2 diabetes . RESEARCH DESIGN AND METHODS A total of 32 postmenopausal women with diet-controlled type 2 diabetes completed a r and omized , double blind , cross-over trial of dietary supplementation with phytoestrogens ( soy protein 30 g/day , isoflavones 132 mg/day ) versus placebo ( cellulose 30 g/day ) for 12 weeks , separated by a 2-week washout period . RESULTS Compliance with the dietary supplementation was > 90 % for both treatment phases . When compared with the mean percentage change from baseline seen after 12 weeks of placebo , phytoestrogen supplementation demonstrated significantly lower mean values for fasting insulin ( mean + /- SD 8.09 + /- 21.9 % , P = 0.006 ) , insulin resistance ( 6.47 + /- 27.7 % , P = 0.003 ) , HbA(1c ) ( 0.64 + /- 3.19 % , P = 0.048 ) , total cholesterol ( 4.07 + /- 8.13 % , P = 0.004 ) , LDL cholesterol ( 7.09 + /- 12.7 % , P = 0.001 ) , cholesterol/HDL cholesterol ratio ( 3.89 + /- 11.7 % , P = 0.015 ) , and free thyroxine ( 2.50 + /- 8.47 % , P = 0.004 ) . No significant change occurred in HDL cholesterol 
    Output:
    
CONCLUSIONS Isoflavone-rich soy products decrease FSH and LH in premenopausal women and may increase estradiol in post-menopausal women .