Does Soy Ease Symptoms of Menopause?

Sora Song
Times Magazine

What is a menopausal woman to do? A new study finds that taking soy supplements, a popular alternative to hormone-replacement therapy, does not help relieve the symptoms of menopause or protect against bone loss.

After two years of taking daily soy isoflavone tablets, women showed no differences in bone density and no improvement in symptoms such as hot flashes or night sweats, compared with women taking a placebo. Indeed, by the end of the study, more women taking soy were having hot flashes than women taking placebos.

Soy has been considered a potentially safer alternative to hormone therapy because of its isoflavones, or plant-based estrogens. Researchers have also observed that women in Asia, whose diets are typically rich in soy, are less likely to have bone loss, osteoporosis and cardiovascular disease than their Western counterparts. To date, however, most clinical trials of soy have been limited by their small size, short duration or faulty design. The aim of the current study was, therefore, to offer a more definitive conclusion.

Researchers led by Dr. Silvina Levis, director of the Osteoporosis Center at the University of Miami Miller School of Medicine, randomly assigned 248 women to take either 200 mg of soy isoflavones — a dose that is roughly twice the amount of dietary soy isoflavones found in a typical Asian diet — or placebo tablets for two years. Neither the researchers nor the women knew who was taking which pills until the end of the study.

The women were 45 to 60 years old at enrollment, and all were within five years of the start of menopause.

Researchers used bone scans to measure women's bone mineral density at the hip and spine. At the end of the study, the scans showed no differences between the soy and placebo groups. Both groups had small amounts of bone loss.

The Natural Menopause Plan: Overcome the Symptoms with Diet, Supplements, Exercise and More Than 90 Delicious Recipes

Researchers also used questionnaires to gauge the frequency of women's menopausal symptoms. At the start of the study, 176 women reported at least one symptom. The most common ones: hot flashes (50%), night sweats (38%), insomnia (37%), loss of libido (37%) and vaginal dryness (31%).

At the end of the two-year intervention, the two groups showed no differences in symptom improvement. In fact, the frequency of hot flashes didn't change in the soy group, but decreased in the placebo group, so that more women taking soy (48%) ended up with hot flashes than those taking placebo (32%). Women in the soy group were also more likely to have constipation and bloating.

"When we started the study we wanted this to work, because it would provide an easy and healthy way to help women in the initial stages of menopause," Levis told Reuters.

Seeing as how it didn't, what other alternatives to hormone therapy do women have? For hot flashes, some antidepressants or the anti-seizure medication gabapentin may work. Exercise also helps, and so may deep breathing exercises done regularly. Some women say they have found relief through yoga and acupuncture.

To protect against bone loss, women should make sure to get enough calcium and vitamin D, get regular weight-bearing exercise and refrain from smoking or overindulging in alcohol. Taking bisphosphonates can also help maintain bone mass.

So far, efforts to develop alternative menopause therapies as effective as hormone replacement have come up short, notes Dr. Deborah Grady, a professor of medicine at the University of California, San Francisco, in an invited commentary accompanying the study.

"The important question for women is what degree of symptom relief is sufficient," Grady and co-author Katherine Newton, an epidemiologist at the University of Washington Seattle, write. "Perhaps efforts should be directed away from the hope of a one-size-fits-all therapy for menopausal symptoms toward using existing treatments to target the symptoms that disturb patients most."

Madeleine Pickens - the Mustangs' Messiah

By Tim McGirk / Wells, Nev
Times Magazine

As the wife of a billionaire and a wealthy woman in her own right, Madeleine Pickens is accustomed to traveling in limos and private jets. But this afternoon, she is bumping along in a rusty pickup truck. The truck halts in the middle of a sagebrush valley. Nearby, a broad mountain shifts in color from ochre to indigo in the fading afternoon light.

Pickens, 64, a petite blonde in a fringed buckskin jacket and matching boots, jumps from the truck and points to a low thundercloud of dust moving across the valley. It's a galloping herd of mustangs, tan and black and pinto, their manes streaming like water. Soon, the earth is drumming with their hoofbeats. "These horses were going to the slaughterhouse," she says, admiring the racing herd, "and so I brought them to my ranch, where they can run wild."

Her giant ranch, in northeastern Nevada, is spread across three valleys and two mountain ranges, and Pickens intends to turn it all into a wild-horse sanctuary, or as she calls it, Mustang Monument. The first arrivals are 500 horses she bought from a Paiute Indian reservation. The horses, she says, would otherwise have been slaughtered across the border.

The trouble is, many of Nevada's ranchers look upon wild horses as vermin, chomping grass that is meant for their cattle. These ranchers say they are afraid that Pickens, who is married to energy tycoon T. Boone Pickens, will lead a stampede of "touchy-feely" millionaire horse lovers who will start buying up pastures to save the pretty horses. And this, they insist, may run the cattlemen out of business.

Pickens may have money and high connections, but she is confronting powerful forces. The cattle ranchers, according to Chris Heyde, deputy director of the Animal Welfare Institute, an animal-rights group in Washington, have an "absolute choke hold on the state legislature in Nevada." The ranchers are trying, so far unsuccessfully, to push through a bill that would bar wild horses from having access to water — condemning them to die of thirst. In the U.S. Congress, the cattlemen have allies among legislators from 21 farm states and the influential agricultural lobby.

Nobody can dictate to ranchers if they want to raise cows or kangaroos on their own land. But in Nevada's high deserts and extreme weather, most ranches are granted access to vast tracts of federal land for grazing. Pickens' original spread of 28 sq. mi. (72.5 sq km) gives her access to another 875 sq. mi. (2,266 sq km) of federal grazing land. And it is this public land — controlled by the Bureau of Land Management (BLM) — that has become the battleground for Pickens and the cattlemen.

Pickens envisions Mustang Monument with a museum and lodging for visitors in futuristic teepee villages beside a creek from where they can view the roaming mustangs. Because her horse sanctuary will partly be on federal land, and because she is angling for federal help to keep the refuge running long after she is gone, Pickens needs approval from the BLM. So far, the agency has been slow to respond. Animal-rights advocate Heyde says the federal bureaucracy is lassoed to the cattlemen's interests, and has been "trying to tie Ms. Pickens' applications in knots." The BLM says it is studying Pickens' proposals before making a decision on whether to help her sanctuary.

Caught in the middle is Pickens' ranch manager, Clay Nannini, a rangy ex-rodeo cowboy from Wells, Nev., who is as adept with his smart phone as he is with his lariat. "Some of the local ranchers could care less, some are in favor, but mostly they're opposed to what Ms. Pickens is trying to do," he says with a shrug. "People I've been involved with all my life are giving me the bird and walking away."

Back in the sagebrush, Pickens grabs an armful of fresh-cut hay and walks boldly toward a wild stallion, black with a splash of white between its wary eyes. The stallion was gelded a few days before and is understandably skittish, retreating from her fearless advance. "Riding isn't a big part of my life," says Pickens, who was born in Iraq to a British father and a Lebanese mother. "I used to watch [the TV horse opera] Bonanza, and when I came to America, I saw that the things I loved about it — like the mustangs — were being destroyed."

Pickens has always had a soft spot for animals. After Hurricane Katrina in 2005, she and her husband arranged six airlifts for 800 stranded dogs and cats. Pickens says this gave her a direct, emotional satisfaction she never got by just writing checks for charity. Then an animal activist drew her attention to the plight of wild mustangs.

Brought to North America by the Spanish conquistadors in the 16th century, the horses thrived in the boundless, grassy plains of the West. Estimates in the early 1900s put the number of wild horses at over 2 million, but by the 1960s, the herds were on their way to extinction, with only 17,000 mustangs left. Herds were being rounded up and butchered. Domestic horses were not spared slaughter: even tottering old thoroughbreds ended up being sold for horseflesh. Today the BLM reckons that there are more than 33,000 horses in the wild, far too many, the agency insists.

This struck a chord with Pickens. With her first husband, the late Gulfstream Aerospace founder Allen Paulson, she had bred racehorses. "The Japanese actually made a big deal of eating a Kentucky Derby winner named Ferdinand," says Pickens, who is a dainty vegetarian. "I was horrified."

Her Bonanza-inspired spiritual quest to save America's mustangs belies the fact that Pickens is an astute operator. As T. Boone Pickens tells TIME, "When Madeleine sets her sights on something, you best get on board or get out of the way. She makes things happen. I'm amazed by her passion for horses and preserving this critical piece of America's heritage."

A formidable duo, the billionaire couple lobbied Congress successfully in 2007 to ban horse slaughter in the U.S. Consequently, many horses are trucked over the border to Canada and Mexico to be butchered and exported to Japan and Europe, where horse meat is a prized delicacy. In 2008, the BLM announced that it was considering a massive cull of wild horses. The BLM backed off on this due to public outrage, but it spurred Pickens into action nonetheless. In 2011, she closed on two adjacent Nevada ranches for her eco-sanctuary, a place where mustangs could roam free and the public could watch these equine icons of the Wild West.

The BLM keeps more than 41,700 horses in captivity. More than 15,000 are crammed into corrals, "butt to butt," says Pickens, while the others are kept in long-term pastures, costing taxpayers about $70 million a year to feed and care for the animals. "Forget about sentiment. You're talking about $70 million for a government that's busted," she argues. "I can look after mustangs more cheaply and humanely."

Prodded by the cattlemen, the BLM rounds up thousands of wild horses every year, using helicopters that swoop low over the stampeding herds and drive them until they are so exhausted, they can be easily caught. The BLM says more than 33,000 mustangs and wild burros still roam free, more than can be sustained by the available pasture, but animal-rights activists dispute this. Says Heyde: "There are 8 million cattle and sheep on government land, and yet a few horses get blamed for everything."

Pickens knows that even with her fortune, she can't save all of America's mustangs. With pasture sparse, even her massive ranch can handle only 1,800 mustangs. But she insists that her eco-sanctuary will serve as a model for other reserves where horses can run free and that the size of the herd can be managed. With no predators and ample food, a herd of mustangs can double in size in five years, a prospect that scares cattle ranchers. Steve Boyce, a former President of the Nevada Cattleman's Association, says, "We're made out to be the bad guys here. But there's a limited amount of forage out there. In the winter, it's all frozen out. We're worried that if the horses aren't gathered, they'll eat the pasture for our cattle."

A helicopter buzzes down to chauffeur Pickens on an aerial tour of her property. She is joined by Tommy, her pet dachshund, who is so accustomed to his mistress's jet-set lifestyle that, as soon as the helicopter roars skyward, he falls asleep in her lap. The helicopter banks over juniper-clad mountains, into the high meadows. And there below is a herd of mustangs, racing along the mountain ridge, wild and free-spirited. "To me, these mustangs are emblematic of America's freedom," Pickens says later. "And they're ending up on dinner plates in Japan and Europe."