Next generation HRT - Designer Oestrogens
In her recently published book The Menopause Brain neuroscientist Dr Lisa Mosconi poses the question: “Could we develop a type of HRT that is proven to support brain function AND does not increase the risk of cancer?” In other words a type of oestrogen ”therapy” that has an affinity for the brain, yet not reproductive tissue, such as breast or uterus. She terms this, which I love! as a “designer oestrogen” - a PhytoSERM.
What is a SERM
A SERM is an acronym for a selective oestrogen receptor modulator possessing the ability to block certain oestrogen receptors in the body; like breast or uterus & potentiate others such as receptors in the brain and bone, hence it’s name “selective”.
Phyto means it’s plant derived.
In 2022 Mosconi & her mentor Dr Roberta Brinton developed a PhytoSERM that could well be the next generation of HRT. Their PhytoSERM product is a 50mg tablet of phytoestrogens daidzein, genistein and S-equol.
More on Phytoestrogens
Genistin and daidzin are naturally occurring compounds in foods including soybean red clover and alfalfa. After genistin & daidzin have been exposed to human gastrointestinal enzymes, they become genistein & daidzein (note the slight change in the spelling), as present in their PhytoSERM. Then, if the microbiome contains the right intestinal bacteria, these “equol producers” can further convert daidzein to S-equol, (the 3rd compound in their formula). S-equol is structurally very similar to oestrogen that “selectively” binds to oestrogen beta receptor- ERβ
Targeting ERβ selectively has numerous benefits for menopausal symptoms, including reduced anxiety and depression-like behaviours, promoted neurogenesis and may induce a significant reduction of ApoE expression - in other words, shielding the brain from degeneration.
The duo are now running a randomised placebo controlled trial using their PhytoSERM formulation to assess it’s efficacy in supporting brain energy & cognitive function in perimenopausal & early menopausal women - results pending early 2025.
The aim is to display this designer oestrogen can address hot flushes & neurological symptoms of menopause & provide extra protection for the brain!
Designer Oestrogens & Bone Health
Another significant change that occurs during menopause is the loss of bone mineral density (BMD), causing osteoporosis. As there are high levels of ERβ in bone the use of the phytoestrogens isoflavones; such as daidzein, genistein and S-equol could work to aid prevention of bone loss.
The spine in particular is thought to be the most sensitive to isoflavones because it has a higher content of trabecular bone compared to cortical bone. See the image below of normal trabecular bone vs osteoporotic trabecular bone.
Trabecular bone has a higher expression of ERβ and a larger surface area for receptor binding of our phytoestrogens.
Biphosphonate and hormone replacement therapy are effective in preventing bone loss in postmenopausal osteoporosis, BUT both they are coupled with severe adverse effects and risk respectively. By contrast Phytoestrogens are plant-based oestrogen-like compounds, which have been used for the treatment of menopause-related symptoms and do not pose side effects nor risk.
Researchers have been documenting the potential benefits of phytoestrogens due to studies pointing to a reduced risk of breast cancer in Asian populations compared to Western populations.The consumption of soy products was identified as one potential reason, as traditional Asian diets contain isoflavone intakes ranging from 15 – 50 mg per day compared to around 2 mg per day in traditional Western diets.
Soy products, as we now know, contain high amounts of phytoestrogens but in the west typically comes in a highly processed form. This study didn’t measure Japanese women drinking bucket loads of soya milk (stored in BPA clad cartons!) or eating soy “chicken nugget” alternatives. They were eating fermented soy. So, If you choose to consume soy, choosing organic and fermented soy products (e.g. miso, tamari, tempeh) is the best way to go.
There are nutritional supplemental formulas containing daidzein, genistein and S-equol that I am personally using and happy to share below:
Available from Amrita Nutrition, always consult your healthcare practitioner.
In health, Tanya x