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Villadsen AB, Holm-Jacobsen JN, Prabhala BK, Bundgaard-Nielsen C, Huntjens P, Kornum JB, Glavind K, Leutscher PDC, Christensen LP, Jeppesen PB, Sørensen S, Arenholt LTS. Use of Fermented Red Clover Isoflavones in the Treatment of Overactive Bladder in Postmenopausal Women: A Randomized, Double-Blinded, Placebo-Controlled Trial. Nutrients 2023; 15:4165. [PMID: 37836449 PMCID: PMC10574253 DOI: 10.3390/nu15194165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Postmenopausal women are at risk of developing an overactive bladder (OAB). Conventional vaginal estrogen has shown promise for symptom relief. Isoflavones have proven effective as an alternative to estrogen treatment against menopause-related symptoms. However, its effect on OAB symptoms has not been studied. This study investigates if fermented red clover isoflavones reduce OAB symptoms in postmenopausal women. In this randomized, double-blinded, placebo-controlled trial, women were administered red clover extract (RCE) or a placebo twice daily for three months. Women filled out the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and Urinary Incontinence Short Form (ICIQ-UI-SF), together with a fluid intake and voiding diary. A total of 33 women (16 in the RCE group and 17 in the placebo group) were included in the analysis. Baseline demographics and OAB characteristics were comparable across groups. Intake of RCE did not lead to significant relief in most urinary bladder symptom measures, although a significant reduction in the bother of urinary urgency (p = 0.033) and a tendency towards a decreased ICIQ-OAB score were observed (p = 0.056). In contrast, the placebo exhibited a significant decrease in the ICIQ-OAB score (p = 0.021) and in some diary outcomes. We found that an intake of isoflavones did not relieve OAB symptoms in postmenopausal women.
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Affiliation(s)
- Annemarie B. Villadsen
- Centre for Clinical Research, North Denmark Regional Hospital, 9800 Hjoerring, Denmark; (A.B.V.); (J.N.H.-J.); (C.B.-N.); (P.H.); (P.D.C.L.); (S.S.)
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
| | - Julie N. Holm-Jacobsen
- Centre for Clinical Research, North Denmark Regional Hospital, 9800 Hjoerring, Denmark; (A.B.V.); (J.N.H.-J.); (C.B.-N.); (P.H.); (P.D.C.L.); (S.S.)
| | - Bala K. Prabhala
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, 5230 Odense M, Denmark; (B.K.P.); (L.P.C.)
| | - Caspar Bundgaard-Nielsen
- Centre for Clinical Research, North Denmark Regional Hospital, 9800 Hjoerring, Denmark; (A.B.V.); (J.N.H.-J.); (C.B.-N.); (P.H.); (P.D.C.L.); (S.S.)
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
| | - Pam Huntjens
- Centre for Clinical Research, North Denmark Regional Hospital, 9800 Hjoerring, Denmark; (A.B.V.); (J.N.H.-J.); (C.B.-N.); (P.H.); (P.D.C.L.); (S.S.)
| | - Jette B. Kornum
- Department of Clinical Microbiology, Aalborg University, 9000 Aalborg, Denmark;
| | - Karin Glavind
- Department of Obstetrics and Gynecology, Aalborg University Hospital, 9000 Aalborg, Denmark;
| | - Peter D. C. Leutscher
- Centre for Clinical Research, North Denmark Regional Hospital, 9800 Hjoerring, Denmark; (A.B.V.); (J.N.H.-J.); (C.B.-N.); (P.H.); (P.D.C.L.); (S.S.)
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
| | - Lars P. Christensen
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, 5230 Odense M, Denmark; (B.K.P.); (L.P.C.)
| | - Per B. Jeppesen
- Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, 8200 Aarhus N, Denmark;
| | - Suzette Sørensen
- Centre for Clinical Research, North Denmark Regional Hospital, 9800 Hjoerring, Denmark; (A.B.V.); (J.N.H.-J.); (C.B.-N.); (P.H.); (P.D.C.L.); (S.S.)
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
- Steno Diabetes Center North Denmark, 9000 Aalborg, Denmark
| | - Louise T. S. Arenholt
- Centre for Clinical Research, North Denmark Regional Hospital, 9800 Hjoerring, Denmark; (A.B.V.); (J.N.H.-J.); (C.B.-N.); (P.H.); (P.D.C.L.); (S.S.)
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
- Department of Obstetrics and Gynecology, North Denmark Regional Hospital, 9800 Hjoerring, Denmark
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Hormone Replacement for Pelvic Floor Disorders. CURRENT BLADDER DYSFUNCTION REPORTS 2019. [DOI: 10.1007/s11884-019-00536-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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A Review of Phytoestrogens and Their Association With Pelvic Floor Conditions. Female Pelvic Med Reconstr Surg 2019; 24:193-202. [PMID: 29432329 DOI: 10.1097/spv.0000000000000559] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Urinary incontinence, pelvic organ prolapse, and fecal incontinence are pelvic floor disorders (PFDs) disproportionately experienced by postmenopausal women. Limited data exist suggesting that phytoestrogens may have an impact on the pathophysiology and symptom of PFDs. PURPOSE OF REVIEW The aim of the study was to review the current literature addressing the role of phytoestrogens on PFDs, including the pathophysiology, symptom, treatment, and possible prevention. FINDINGS Qualifying literature spans from 2003 to 2017 and included 14 studies ranging from in vitro, animal, and observational studies to randomized clinical trials. SUMMARY Although the literature is limited, most studies on phytoestrogens and PFDs support associations with pathophysiologic mechanisms, symptoms, and treatment for urinary incontinence and pelvic organ prolapse, but not fecal incontinence. Less is known regarding the prevention of PFDs with phytoestrogen intake over time. Overall, the potential influence of phytoestrogens on PFDs is not well understood, and more research is needed.
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Abstract
Several physiopathologic conditions lead to the manifestation of overactive bladder (OAB). These conditions include ageing, diabetes mellitus, bladder outlet obstruction, spinal cord injury, stroke and brain injury, Parkinson's disease, multiple sclerosis, interstitial cystitis, stress and depression. This review has discussed research findings in human and animal studies conducted on the above conditions. Several structural and functional changes under these conditions have not only been observed in the lower urinary tract, but also in the brain and spinal cord. Significant changes were observed in the following areas: neurotransmitters, prostaglandins, nerve growth factor, Rho-kinase, interstitial cells of Cajal, and ion and transient receptor potential channels. Interestingly, alterations in these areas showed great variation in each of the conditions of the OAB, suggesting that the pathophysiology of the OAB might be different in each condition of the disease. It is anticipated that this review will be helpful for further research on new and specific drug development against OAB.
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Affiliation(s)
- Phani B Patra
- King of Prussia, Drexel University College of Medicine, Philadelphia, Pa., USA
| | - Sayani Patra
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pa., USA
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The renin–angiotensin system plays a major role in voiding dysfunction of ovariectomized rats. Life Sci 2013; 93:820-9. [DOI: 10.1016/j.lfs.2013.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/26/2013] [Accepted: 09/03/2013] [Indexed: 01/13/2023]
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Owen SJ, Massa HM, Rose'Meyer RB. Dietary phytoestrogen improves relaxant responses to 17-β-estradiol in aged but not ovariectomised rat bladders. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2013; 386:917-28. [PMID: 23793100 DOI: 10.1007/s00210-013-0892-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 06/03/2013] [Indexed: 11/29/2022]
Abstract
This study examined the effect of age, ovariectomy and dietary phytoestrogen ingestion on 17-β-estradiol-mediated relaxant responses and messenger RNA (mRNA) and protein expression of oestrogen receptor subtypes in the rat isolated bladder. Female Wistar rats (8 weeks) were anaesthetised, and the ovaries were removed (ovx) or left intact (sham). Rats were fed either normal rat chow (soy, phytoestrogens) or a non-soy (phytoestrogen free) diet. Isolated bladder from rats aged 12, 24 or 52 weeks were pre-contracted with 3 μM carbachol prior to obtaining a concentration response curve to 17-β-estradiol. Protein and mRNA expression of the oestrogen receptor subtypes was completed using immunohistochemistry and real-time PCR, respectively. Relatively moderate relaxant responses to 17-β-estradiol were observed in bladders from all age and treatment groups. However, in soy-fed sham 52-week-old rats, the bladder exhibited enhanced relaxant responses to 17-β-estradiol when compared to tissues from other age-matched rat treatment groups (P < 0.05). In bladders from female rats, the mRNA and protein expression of oestrogen receptors β was significantly greater than the expression of the oestrogen receptor α. Oestrogen receptor α mRNA expression declined with age (P < 0.05), whereas oestrogen receptor β expression did not change in any of the treatment groups (P > 0.05). Diet, overiectomy or age did not alter the protein expression of either oestrogen receptor subtype in the bladder (P > 0.05). While a soy diet improved relaxant effects to the 17-β-estradiol with age, it did not alter relaxant responses in bladders from ovariectomised rats.
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Affiliation(s)
- Suzzanne J Owen
- School of Medical Sciences, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
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Owen SJ, Massa HH, Rose'Meyer RB. Loss of adenosine A2B receptor mediated relaxant responses in the aged female rat bladder; effects of dietary phytoestrogens. Naunyn Schmiedebergs Arch Pharmacol 2012; 385:539-49. [PMID: 22237834 DOI: 10.1007/s00210-011-0722-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 12/22/2011] [Indexed: 12/12/2022]
Abstract
This study examined the effect of age, ovariectomy and dietary phytoestrogen ingestion on adenosine A(2B) receptor mediated relaxant responses and mRNA expression of adenosine receptor subtypes in the rat isolated bladder. Female Wistar rats (8 weeks) were anaesthetised and the ovaries were removed (ovx) or left intact (sham). Rats were fed either normal rat chow (soy, phytoestrogens) or a non-soy (phytoestrogen free) diet. Isolated bladder from rats aged 12, 24 or 52 weeks were pre-contracted with 3 μM carbachol prior to a concentration response curve to 5'-(N-ethylcarboxamido) adenosine (NECA) being obtained. In 12-week-old rats, the bladder exhibited enhanced relaxant responses to NECA in soy-fed rats (P < 0.05), whilst at 24 weeks of age, the relaxant responses to NECA were attenuated in all the groups studied except soy-treated sham rat bladders in which the relaxant responses were enhanced. At 52 weeks of age, no relaxant effects were observed in any of the treatment groups and NECA-induced contractile responses occurred. In all bladders, the adenosine A(2B) receptor was the most abundantly expressed. In bladders from young and mature female rats, the mRNA expression of adenosine receptors (A(1), A(2A) and A(2B)) was lowest in the bladder from non-soy-fed ovariectomised animals and the use of phytoestrogens in the diet increased the mRNA expression of these receptors (P < 0.05). While a soy diet improves the relaxant effects to the adenosine analogue via adenosine A(2B) receptors in bladders from younger rats, the benefits are lost with advancing age.
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Affiliation(s)
- Suzzanne J Owen
- School of Medical Sciences, Griffith University, Gold Coast Campus, Queensland, 4222, Australia
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