Isoflavone und das Endometrium

Zusammenfassung

Isoflavone als Phytoestrogene werden heute zunehmend im Rahmen der Selbstsupplementation eingesetzt. Phytoestrogene wie Isoflavone und Lignane können funktionell in Abhängigkeit von ihrer Konzentration, der Konzentration der endogenen Hormone und dem spezifischen Endorgan estrogene und antiestrogene Eigenschaften entfalten. Als Sicherheitsaspekt für den praktischen Einsatz ist das Wirkpotenzial von Phytoestrogenen am Endometrium von entscheidender klinischer Bedeutung. Der Artikel gibt einen Überblick über den aktuellen Wissensstand der Wirkung von Isoflavonen am Endometrium. Nach Wirkmechanismus, relevanten tierexperimentellen und der Mehrheit der klinischen Untersuchungen zeigen Isoflavone keine estrogene Wirkung am postmenopausalen Endometrium. Langzeituntersuchungen und große plazebokontrollierte Studien, wie sie z. B. zur Hormonersatztherapie vorliegen, fehlen jedoch. Gerade für höhere Dosierungen von 100 mg Isoflavonen/d und mehr fehlen aussagekräftige Untersuchungen. In der Praxis sollte deshalb Frauen mit Selbstsupplementation eine regelmäßige Vorsorgeuntersuchung einschließlich Vaginalsonographie empfohlen werden.

Abstract

Use of self-supplementation with phytoestrogens is increasing today. Isoflavones interact with the mammalian ER and appear to have both estrogen-agonist and estrogen-antagonist effects, depending on the tissue involved and the amounts circulating. For safety reasons possible effects of phytoestrogens on the endometrium are of clinical importance. This paper reviews epidemiological, experimental and clinical studies on the effects of isoflavones on the endometrium. Nearly all of the available trials with postmenopausal women have suggested an absence of endometrial growth in response to isoflavone supplementation. But for higher dosages of 100 mg isoflavones/d and above and for long-term supplementation limited data are available on the effects of isoflavones on the uterine endometrium. In women using self-supplementation gynaecological screening and vaginal ultrasound are recommended.

Schlüsselwörter

Endometrium - Isoflavone

Key words

Endometrium - isoflavones

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