Vasomotor symptoms (VMS), such as flushes, sweating, and sleep disturbances, are experienced by up to 80% of women during the menopausal transition. Night sweats, which are hot flushes that occur at night, can be particularly bothersome in women and contribute to disturbed sleep. These symptoms occur mainly during the 1-3 years prior to menopause (late perimenopause) and early menopause (\~4 years after menstruation ceases). Many women look to supplements for the management of menopausal symptoms. Soy isoflavones and their metabolites are one category of dietary supplements that have been extensively studied for the management of VMS. The most active soy isoflavone is S-equol, which is not found directly in soy, but rather is the metabolite that is produced by gut microflora from consumption of the soy isoflavone daidzein. However, only 20-30% of US women are actually able to produce S-equol from the consumption of daidzein. Equelle® is a currently available dietary supplement that has S-equol as its active component, which allows the delivery of the active soy isoflavone metabolite directly without dependence on the gut microflora metabolism. The intention of this study is to assess the effect of a product containing S-equol on the management of VMS in normally healthy women. Condition or disease: Vasomotor Symptoms Intervention/treatment: Dietary Supplement: S-equol Dietary Supplement: Placebo
This is a randomized, placebo-controlled, double-blind, parallel study, which will include a screening visit (Visit 1; week -3), a 2-week run-in period for baseline determination and assessment of placebo response (Visit 2; week -2; and Visit 3; week -1), one baseline visit (Visit 4; week 0), and three test visits (Visits 5, 6, and 7; weeks 4, 8, and 12). At Visit 1 (week -3), after subjects have provided informed consent, medical history will be reviewed, and clinic visit procedures will be performed, including assessments of prior/current medication/supplement use, evaluations of inclusion/exclusion criteria, and a last menses query. Fasting (10-14 h) blood samples will be collected for assessment of FSH and estradiol levels. The Soy Food Frequency Questionnaire will be administered and subjects will be instructed to maintain their habitual diets (with the exception of avoiding soy foods) and physical activity patterns throughout the study period. Additionally, subjects will be dispensed the Insomnia Severity Index Questionnaire (ISIQ) and the VMS Diary to assess insomnia and VMS, respectively. At Visit 2 (week -2), eligible subjects will be instructed to start the run-in placebo product for two weeks. Subjects will be also instructed to continue daily recording in the VMS Diary. At Visit 3 (week -1), the VMS Diary will be collected/reviewed to assess response to the run-in placebo product. Subjects who continue to meet the inclusion/exclusion criteria will be allowed to continue with the study and will be dispensed a sleep tracking device to wear for sleep/wake pattern evaluation. At Visit 4 (week 0), eligible subjects will be randomized to one of the study products (Active or Placebo) and instructed to consume with water for 12 weeks. Additionally, the Pittsburg Sleep Quality Index (PSQI), RAND-36 Questionnaire, Profile of Mood States (POMS), Day-to-Day Impact of Vaginal Aging Questionnaire (DIVQ), Chalder Fatigue Scale, and Menopause-Specific Quality of Life (MENQOL) Questionnaire will be administered. The VMS Diary and ISIQ will be collected and reviewed. At Visits 5 and 6 (weeks 4 and 8), the VMS Diary and ISIQ will be collected/reviewed, and the PSQI and MENQOL will be administered. Subjects will return to the clinic prior to Visit 7 (week 12) to receive the sleep tracking device to wear for sleep/wake pattern evaluation one week (7 d) prior to Visit 7 (week 12). At Visit 7 (week 12), the VMS Diary and ISIQ will be collected and reviewed. The PSQI, RAND-36, POMS, DIVQ, Chalder Fatigue Scale, and MENQOL will be administered and study product will be collected/reviewed, and compliance will be determined. Additionally, the sleep tracker will be collected, and data will be downloaded for evaluation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
118
Biofortis Clinical Research
Addison, Illinois, United States
Vasomotor symptoms
Daily frequency of vasomotor symptoms, including hot flushes and night sweats
Time frame: [Time Frame: Change from baseline to Week 12]
Vasomotor symptom
Daily frequency of vasomotor symptoms, including hot flushes and night sweats
Time frame: [Time Frame: Change from baseline to Weeks 4 and 8]
Hot Flush
Daily frequency of hot flush
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Night Sweat
Daily frequency of night sweat
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Vasomotor symptom severity - number
Average number of moderate-to-severe VMS episode per day
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Vasomotor symptom severity - total score
Average of VMS severity total score
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Hot flush symptom severity - number
Average number of moderate-to-severe hot flush episode per day
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Hot flush severity - total score
Average of hot flush severity total score
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Night sweat severity - number
Average number of moderate-to-severe night sweat episode per day
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Night sweat severity - total score
Average night sweat severity total score
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Insomnia score
Average insomnia score per day obtained from Insomnia severity questionnaire (ISIQ)
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Sleep duration
Average sleep duration per day, obtained from sleep tracker
Time frame: [Time Frame: Change from baseline to Week 12]
Actual sleep duration
Average actual sleep duration per day obtained from sleep tracker
Time frame: [Time Frame: Change from baseline to Week 12]
Sleep efficiency
Average sleep efficiency per day obtained from sleep tracker
Time frame: [Time Frame: Change from baseline to Week 12]
Sleep onset latency
Average sleep onset latency per day obtained from sleep tracker
Time frame: [Time Frame: Change from baseline to Week 12]
Latency to persistent sleep
Average latency to persistent sleep per day obtained from sleep tracker
Time frame: [Time Frame: Change from baseline to Week 12]
Wake after sleep onset
Average wake after sleep onset per day obtained from sleep tracker
Time frame: [Time Frame: Change from baseline to Week 12]
Fatigue
Average fatigue score obtained from Chalder fatigue scale. Higher scores mean a worse outcome.
Time frame: [Time Frame: Change from baseline to Week 12]
Sleep quality
Average sleep quality obtained from Pittsburgh sleep quality index
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
Vaginal bothersome score
Average bothersome score obtained from Vaginal bothersome symptoms diary
Time frame: [Time Frame: Change from baseline to Week 12]
Vaginal aging score
Average vaginal aging score obtained from Day-to-day impact vaginal aging questionnaire
Time frame: [Time Frame: Change from baseline to Week 12]
Menopause-specific quality of life
Average score obtained from Menopause-specific quality of life
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
General quality of life
Average score obtained from RAND-36 questionnaire
Time frame: [Time Frame: Change from baseline to Week 12]
Mood
Average score obtained from Profile of mood states (POMS)
Time frame: [Time Frame: Change from baseline to Weeks 4, 8, and 12]
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