Zotero Mendeley EndNote BibTex Kaynak Göster

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Yıl 2003, Cilt 34, Sayı 2, 1 - 6, 01.03.2003

Öz

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Kaynakça

  • 1. Risks andbenefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. Jama 2002;288:321-33
  • 2. HuUeyS, GradyD, Bush T, Fumerg Ç, Henington D, Riggs B, et al Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. Jama 1998:280:605-13
  • 3. SetchellKD. Phftoestivgens: the biochemistry, physiology, and implications for human health of soy isoflavones. Am J Clin Nutr. 1998;68:1333-1346
  • 4. Kuİper GG, Carlsson B, Gvandien K, et al Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors a and b. Endocrinology. 1997:138:863-870
  • 5. Adlercreutz H, Mazur IV. Phyto-oestmgens and Western diseases. Ann Med. 1997;29:95-120
  • 6. Sammartino A, Di Carlo C, Mandato VD, Bifuko G, Di Stefano M, Nappi C. Effects of genişle in on the endometrium: ultras o no graphic evaluation. Gymecol Endocrinol 2003 ;17:45-9
  • 7. Filzpatrick I.A. Soy isoflavones: hope orhvpe? Maturitas 2003 14;44 :21-9
  • 8. Kayisli UA. Aksu CA, Berkkanoglu M, Arici A. Estrogenicify of isoflavones on human endometrial s tmmal and glandular cells J Clin Endocrinol Metab 2002 ;87:5539-44
  • 9. Han KK, Soares }MJr, HaidarMA, de Lima GR, BamcatEC Benefits of soy isoflavone therapeutic regimen on menopausalsymptoms.Obstet G\mecol 2002 ;99:389-94
  • 10. Duncan AM. Underbill KE, Xu X, Lavalleurj, Phipps WB, KurzerMS. Modest hormonal effects of sov isoflavones in postmenopausal women. J Clin' Endocrinol Metabl999;84;3479-84
  • 11. Bau-d ÜD, Umhach DM, Lansdeli L. Dietar}' inteivention study to asses estrogenicilyofdietaiy soy among postmenopausal women. J Clin Endocrinol Metab 1995:80:1685-1690 12. Greene JG. Constructing a standard climacteric scale. Maturitas 1998:29:25-31
  • 13. CassidyA, Bingham S, SetchellKDR. Biological effects of a dietojsoypivtein rich in isoflavone on menstrual cycle of postmenopausal women. Ant / Clin Nvtr 1994:60:333-40
  • 14. BloedonLT, JeffcoatAR, LopaczynskiW, Schell Mf, Black TM, Dix KJ, Thomas BE, Albright C, Busby MG, Crowell ] A, Zeisel SH. Safety and phaimacoidnetics afpuitfied soy isoflavones: single-dose administration to postmenopausal women. Am] Clin Nutr2002 ;76:1126-37
  • 15. NakamumY, TsujiS, TonogaiY. Determination of the levels of isoflavonoids in soybeans and soy-derived foods and estimation of isoflavonoids in the ] apanese daily intake, f AOAC M 2000 ;83:G35~ 50
  • 16. Quella SK, Loprinzi CL, Barton DL. Evaluation of soy phrtoestrogens for the treatment of hot flashes in breast cancer s un^ivors: A North Central Cancer treatment group Trial, f Clin Oncol 2000:18:1068-1074
  • 17. BaberBJ, Templeman C, Morton T, KeBv GE, WestL. Randomized placebo-controlled trial of an isoflavone supplement and menopausal s }mıploms in women.CUmacteric 1999 ;2:85-92, 18. Burke GL, Legaull C, Anthony M, Bland DH, Morgan TM, Naughton M], Leggett K, Washbum SA, Vitolins MZ. Soypmtein and inoflavone effects on vasomotor symptoms in peri- and postmenopausal women: the Soy Estrogen Alternatwe Study. Menopause 2003 ;10:147-53
  • 19. Washbum S, Burke GL, Morgan T, Anthony M. Effect of soy protein supplementation on serum lipoproteins, blood pressure and menopausal s}inptoms in perimenopausal women. Menopause 1999:6:7-13
  • 20. Scambia G, Mango D, Signoriîe PG. Clinical effects of standardized soy extract in postmenopausal women: a pilot study. Menopause 2000:7:105-111
  • 21. Upmaiis DH.Lobo R, Bradley L, Warren M, Cone FL, Lamia CA. Vasomotor sj^mptom relief by soy isoflavone extract tablets in postmenopausal women ; a multicenter, double-blind, randomized, placebo-controlled studv. Menopause 2000:7:236-242.- 22. Albertazzi P, PansiniF, BonaccorsiG, Zanotti L, ForiniE, DeAloysio D. The effect of dietary soy supplementation on hot flushes. Obstet Gynecol. 1998:91:6-11
  • 23. MurkiesAL, Lombard C, Straus B], Wilcox G, Burger HG, Morton MS,. Dietary flour supplementation dereases post-menopausai ho flushes: effect of soy and wheat. Maturitas. 1995:21:189-195
  • 24. van de WeijerPI-IM, Barents en R. isoflavones from red clover (Promensil) significantly reduce menopausal hot flush symptoms with placebo. Maturitas 2002:42: 187-193
  • 25. GermainAS, Peterson CT, Robinson]GAlakel L. isoflavone-rich or isoflavone- poor soy protein does not reduce menopausal symptoms during 24 weeks of treatment. Menopause.2001:8:17-24
  • 26. Wang C, Makeia T, Has e T, Adlercreutz H, Kurzer MS. Lignans and flavonoids inhibit aromatase enzyme in human preadipocytes. J Steroid Bio-chem Molec BioLl994;50:205-212
  • 27. CampbellDR, KurzerMS. Flavonoidinhibition of aromatase enzyme activity in human preadipocyt.es. f Steroid Bio-chem Molec Biol.l993;46:381-388,

The effect of soy isoflavones on menopousal symptoms

Yıl 2003, Cilt 34, Sayı 2, 1 - 6, 01.03.2003

Öz

Objective: To determine the effect of standardized soy isoflavones (Super Concentrated Isoflavones, Solgar, Türkiye), added to diet as an alternative modality, on menopausal complaints. Materials and methods: Thirty-eight healthy women who had amenorrhea and menopausal complaints -at least 12 months and did not accept hormone replacement therapy were included in the trial. The participants had 38 mg/day soy isoflavones (Daidzain: 18 mg, Gfycitein: 15 mg, Genistein: 5.5 mg) for 16 weeks in their diets. The efficacy was evaluated by the changes obtained in Greene Climacteric Scale scores at the beginning and at the end of the trial. Results: When the changes in menopausal symptoms were evaluated before and at the end of 16 weeks of soy isoflavons use; the anxiety symptom score (10,52 ±4,79 I 7,76 ±4,59), depression symptom score (4,65 ±3,44 I 3,34 ± 3.03), somatic symptom score (7,47 ±4,601 4,89 ±3,89), vasomotor symptom score (4,34 ±1,53 I 2,31 ±1,59) and sexual dysfunction score (1,84 ±1,15/1,52 ±1,08) showed statistically significant decreases (pO.OOl). Conclusion : We showed that the addition of 38 mg/day soy isoflavones in the diet significantly decreases menopausal symptoms. According to the findings of relieving the menopausal complaints, we advise to consider Super Concentrated Isoflavones as an alternative to the conventional hormone replacement therapies inpostmenopausal women, in this trial we determined that isoflavones are effective on anxiety symptom score, depression symptom score, somatic symptom score, vasomotor symptom score and sexual dysfunction score. We did not find any difference in endometrial thickness and vaginal citilogy before and after the treatment. Although it was well tolerated, the risks of longterm use of the doses which were higher than the traditional Asian diet is currently unclear.

Kaynakça

  • 1. Risks andbenefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. Jama 2002;288:321-33
  • 2. HuUeyS, GradyD, Bush T, Fumerg Ç, Henington D, Riggs B, et al Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. Jama 1998:280:605-13
  • 3. SetchellKD. Phftoestivgens: the biochemistry, physiology, and implications for human health of soy isoflavones. Am J Clin Nutr. 1998;68:1333-1346
  • 4. Kuİper GG, Carlsson B, Gvandien K, et al Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors a and b. Endocrinology. 1997:138:863-870
  • 5. Adlercreutz H, Mazur IV. Phyto-oestmgens and Western diseases. Ann Med. 1997;29:95-120
  • 6. Sammartino A, Di Carlo C, Mandato VD, Bifuko G, Di Stefano M, Nappi C. Effects of genişle in on the endometrium: ultras o no graphic evaluation. Gymecol Endocrinol 2003 ;17:45-9
  • 7. Filzpatrick I.A. Soy isoflavones: hope orhvpe? Maturitas 2003 14;44 :21-9
  • 8. Kayisli UA. Aksu CA, Berkkanoglu M, Arici A. Estrogenicify of isoflavones on human endometrial s tmmal and glandular cells J Clin Endocrinol Metab 2002 ;87:5539-44
  • 9. Han KK, Soares }MJr, HaidarMA, de Lima GR, BamcatEC Benefits of soy isoflavone therapeutic regimen on menopausalsymptoms.Obstet G\mecol 2002 ;99:389-94
  • 10. Duncan AM. Underbill KE, Xu X, Lavalleurj, Phipps WB, KurzerMS. Modest hormonal effects of sov isoflavones in postmenopausal women. J Clin' Endocrinol Metabl999;84;3479-84
  • 11. Bau-d ÜD, Umhach DM, Lansdeli L. Dietar}' inteivention study to asses estrogenicilyofdietaiy soy among postmenopausal women. J Clin Endocrinol Metab 1995:80:1685-1690 12. Greene JG. Constructing a standard climacteric scale. Maturitas 1998:29:25-31
  • 13. CassidyA, Bingham S, SetchellKDR. Biological effects of a dietojsoypivtein rich in isoflavone on menstrual cycle of postmenopausal women. Ant / Clin Nvtr 1994:60:333-40
  • 14. BloedonLT, JeffcoatAR, LopaczynskiW, Schell Mf, Black TM, Dix KJ, Thomas BE, Albright C, Busby MG, Crowell ] A, Zeisel SH. Safety and phaimacoidnetics afpuitfied soy isoflavones: single-dose administration to postmenopausal women. Am] Clin Nutr2002 ;76:1126-37
  • 15. NakamumY, TsujiS, TonogaiY. Determination of the levels of isoflavonoids in soybeans and soy-derived foods and estimation of isoflavonoids in the ] apanese daily intake, f AOAC M 2000 ;83:G35~ 50
  • 16. Quella SK, Loprinzi CL, Barton DL. Evaluation of soy phrtoestrogens for the treatment of hot flashes in breast cancer s un^ivors: A North Central Cancer treatment group Trial, f Clin Oncol 2000:18:1068-1074
  • 17. BaberBJ, Templeman C, Morton T, KeBv GE, WestL. Randomized placebo-controlled trial of an isoflavone supplement and menopausal s }mıploms in women.CUmacteric 1999 ;2:85-92, 18. Burke GL, Legaull C, Anthony M, Bland DH, Morgan TM, Naughton M], Leggett K, Washbum SA, Vitolins MZ. Soypmtein and inoflavone effects on vasomotor symptoms in peri- and postmenopausal women: the Soy Estrogen Alternatwe Study. Menopause 2003 ;10:147-53
  • 19. Washbum S, Burke GL, Morgan T, Anthony M. Effect of soy protein supplementation on serum lipoproteins, blood pressure and menopausal s}inptoms in perimenopausal women. Menopause 1999:6:7-13
  • 20. Scambia G, Mango D, Signoriîe PG. Clinical effects of standardized soy extract in postmenopausal women: a pilot study. Menopause 2000:7:105-111
  • 21. Upmaiis DH.Lobo R, Bradley L, Warren M, Cone FL, Lamia CA. Vasomotor sj^mptom relief by soy isoflavone extract tablets in postmenopausal women ; a multicenter, double-blind, randomized, placebo-controlled studv. Menopause 2000:7:236-242.- 22. Albertazzi P, PansiniF, BonaccorsiG, Zanotti L, ForiniE, DeAloysio D. The effect of dietary soy supplementation on hot flushes. Obstet Gynecol. 1998:91:6-11
  • 23. MurkiesAL, Lombard C, Straus B], Wilcox G, Burger HG, Morton MS,. Dietary flour supplementation dereases post-menopausai ho flushes: effect of soy and wheat. Maturitas. 1995:21:189-195
  • 24. van de WeijerPI-IM, Barents en R. isoflavones from red clover (Promensil) significantly reduce menopausal hot flush symptoms with placebo. Maturitas 2002:42: 187-193
  • 25. GermainAS, Peterson CT, Robinson]GAlakel L. isoflavone-rich or isoflavone- poor soy protein does not reduce menopausal symptoms during 24 weeks of treatment. Menopause.2001:8:17-24
  • 26. Wang C, Makeia T, Has e T, Adlercreutz H, Kurzer MS. Lignans and flavonoids inhibit aromatase enzyme in human preadipocytes. J Steroid Bio-chem Molec BioLl994;50:205-212
  • 27. CampbellDR, KurzerMS. Flavonoidinhibition of aromatase enzyme activity in human preadipocyt.es. f Steroid Bio-chem Molec Biol.l993;46:381-388,

Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi

Yıl 2003, Cilt 34, Sayı 2, 1 - 6, 01.03.2003

Öz

Amaç: Alternatif tedavi modalitesi olarak, standardize edilmiş soya İsoflavonlannın (SuperConcentratedIsoflavones, Solgar, Türkiye) diyete eklenmesinin menopozal şikayetler üzerine olan etkisini araştırmak. Gereç ve yöntem: En az 12 aydır amenoresi olan ve menopozal şikayetleri bulunan, hormon replasman tedavisini kabul etmeyen 38 sağlıklı kadın çalışmaya alındı. Katılımcıların diyetlerine 16 hafta süresince 38 mg / gün soya isoflavonlan (Daidzain: 18 mg, Glycitein: 15 mg, Genistein: 5.5 mg ) eklendi. Etkinliğin değerlendirilmesi, çalışmanın başlangıcında ve sonunda Greene Climacteric Scale skorundaM değişiklikler ölçülerek yapıldı. Bulgular: Menopozal semptomlardaki değişiklikler soy isoflavonlann 16 haftalık kullanımı öncesi ve sonrasında değerlendirildiğinde; anksiyete semptom skoru (10,52 ±4,79/7,76 ±4,59), depresyon semptom skoru (4,65 ±3,44/3,34 ±3.03), somatik semptom skora (7,47 ±4,60/4,89 ±3,89), vazomotor semptom skoru (4,34 ±1,53/2,31 ±1,59) ve seksüel fonksiyon bozukluğu skoru (1,84 ±1,15/1,52 ± 1,08) istatistiksel olarak anlamlı düşüşler göstermiştir (p

Kaynakça

  • 1. Risks andbenefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. Jama 2002;288:321-33
  • 2. HuUeyS, GradyD, Bush T, Fumerg Ç, Henington D, Riggs B, et al Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. Jama 1998:280:605-13
  • 3. SetchellKD. Phftoestivgens: the biochemistry, physiology, and implications for human health of soy isoflavones. Am J Clin Nutr. 1998;68:1333-1346
  • 4. Kuİper GG, Carlsson B, Gvandien K, et al Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors a and b. Endocrinology. 1997:138:863-870
  • 5. Adlercreutz H, Mazur IV. Phyto-oestmgens and Western diseases. Ann Med. 1997;29:95-120
  • 6. Sammartino A, Di Carlo C, Mandato VD, Bifuko G, Di Stefano M, Nappi C. Effects of genişle in on the endometrium: ultras o no graphic evaluation. Gymecol Endocrinol 2003 ;17:45-9
  • 7. Filzpatrick I.A. Soy isoflavones: hope orhvpe? Maturitas 2003 14;44 :21-9
  • 8. Kayisli UA. Aksu CA, Berkkanoglu M, Arici A. Estrogenicify of isoflavones on human endometrial s tmmal and glandular cells J Clin Endocrinol Metab 2002 ;87:5539-44
  • 9. Han KK, Soares }MJr, HaidarMA, de Lima GR, BamcatEC Benefits of soy isoflavone therapeutic regimen on menopausalsymptoms.Obstet G\mecol 2002 ;99:389-94
  • 10. Duncan AM. Underbill KE, Xu X, Lavalleurj, Phipps WB, KurzerMS. Modest hormonal effects of sov isoflavones in postmenopausal women. J Clin' Endocrinol Metabl999;84;3479-84
  • 11. Bau-d ÜD, Umhach DM, Lansdeli L. Dietar}' inteivention study to asses estrogenicilyofdietaiy soy among postmenopausal women. J Clin Endocrinol Metab 1995:80:1685-1690 12. Greene JG. Constructing a standard climacteric scale. Maturitas 1998:29:25-31
  • 13. CassidyA, Bingham S, SetchellKDR. Biological effects of a dietojsoypivtein rich in isoflavone on menstrual cycle of postmenopausal women. Ant / Clin Nvtr 1994:60:333-40
  • 14. BloedonLT, JeffcoatAR, LopaczynskiW, Schell Mf, Black TM, Dix KJ, Thomas BE, Albright C, Busby MG, Crowell ] A, Zeisel SH. Safety and phaimacoidnetics afpuitfied soy isoflavones: single-dose administration to postmenopausal women. Am] Clin Nutr2002 ;76:1126-37
  • 15. NakamumY, TsujiS, TonogaiY. Determination of the levels of isoflavonoids in soybeans and soy-derived foods and estimation of isoflavonoids in the ] apanese daily intake, f AOAC M 2000 ;83:G35~ 50
  • 16. Quella SK, Loprinzi CL, Barton DL. Evaluation of soy phrtoestrogens for the treatment of hot flashes in breast cancer s un^ivors: A North Central Cancer treatment group Trial, f Clin Oncol 2000:18:1068-1074
  • 17. BaberBJ, Templeman C, Morton T, KeBv GE, WestL. Randomized placebo-controlled trial of an isoflavone supplement and menopausal s }mıploms in women.CUmacteric 1999 ;2:85-92, 18. Burke GL, Legaull C, Anthony M, Bland DH, Morgan TM, Naughton M], Leggett K, Washbum SA, Vitolins MZ. Soypmtein and inoflavone effects on vasomotor symptoms in peri- and postmenopausal women: the Soy Estrogen Alternatwe Study. Menopause 2003 ;10:147-53
  • 19. Washbum S, Burke GL, Morgan T, Anthony M. Effect of soy protein supplementation on serum lipoproteins, blood pressure and menopausal s}inptoms in perimenopausal women. Menopause 1999:6:7-13
  • 20. Scambia G, Mango D, Signoriîe PG. Clinical effects of standardized soy extract in postmenopausal women: a pilot study. Menopause 2000:7:105-111
  • 21. Upmaiis DH.Lobo R, Bradley L, Warren M, Cone FL, Lamia CA. Vasomotor sj^mptom relief by soy isoflavone extract tablets in postmenopausal women ; a multicenter, double-blind, randomized, placebo-controlled studv. Menopause 2000:7:236-242.- 22. Albertazzi P, PansiniF, BonaccorsiG, Zanotti L, ForiniE, DeAloysio D. The effect of dietary soy supplementation on hot flushes. Obstet Gynecol. 1998:91:6-11
  • 23. MurkiesAL, Lombard C, Straus B], Wilcox G, Burger HG, Morton MS,. Dietary flour supplementation dereases post-menopausai ho flushes: effect of soy and wheat. Maturitas. 1995:21:189-195
  • 24. van de WeijerPI-IM, Barents en R. isoflavones from red clover (Promensil) significantly reduce menopausal hot flush symptoms with placebo. Maturitas 2002:42: 187-193
  • 25. GermainAS, Peterson CT, Robinson]GAlakel L. isoflavone-rich or isoflavone- poor soy protein does not reduce menopausal symptoms during 24 weeks of treatment. Menopause.2001:8:17-24
  • 26. Wang C, Makeia T, Has e T, Adlercreutz H, Kurzer MS. Lignans and flavonoids inhibit aromatase enzyme in human preadipocytes. J Steroid Bio-chem Molec BioLl994;50:205-212
  • 27. CampbellDR, KurzerMS. Flavonoidinhibition of aromatase enzyme activity in human preadipocyt.es. f Steroid Bio-chem Molec Biol.l993;46:381-388,

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Karsel ERTEKİN Bu kişi benim


Halenur BOZDAĞ Bu kişi benim


Sadiye EREN Bu kişi benim

Yayımlanma Tarihi 1 Mart 2003
Yayınlandığı Sayı Yıl 2003, Cilt 34, Sayı 2

Kaynak Göster

Bibtex @ { zktipb236753, journal = {Zeynep Kamil Tıp Bülteni}, issn = {1300-7971}, eissn = {2148-4864}, address = {}, publisher = {Zeynep Kamil Kadın ve Çocuk Hastalıkları EAH}, year = {2003}, volume = {34}, pages = {1 - 6}, doi = {10.16948/zktb.68708}, title = {Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi}, key = {cite}, author = {Ertekin, Karsel and Bozdağ, Halenur and Eren, Sadiye} }
APA Ertekin, K. , Bozdağ, H. & Eren, S. (2003). Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi . Zeynep Kamil Tıp Bülteni , 34 (2) , 1-6 . Retrieved from https://dergipark.org.tr/tr/pub/zktipb/issue/22048/236753
MLA Ertekin, K. , Bozdağ, H. , Eren, S. "Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi" . Zeynep Kamil Tıp Bülteni 34 (2003 ): 1-6 <https://dergipark.org.tr/tr/pub/zktipb/issue/22048/236753>
Chicago Ertekin, K. , Bozdağ, H. , Eren, S. "Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi". Zeynep Kamil Tıp Bülteni 34 (2003 ): 1-6
RIS TY - JOUR T1 - Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi AU - Karsel Ertekin , Halenur Bozdağ , Sadiye Eren Y1 - 2003 PY - 2003 N1 - DO - T2 - Zeynep Kamil Tıp Bülteni JF - Journal JO - JOR SP - 1 EP - 6 VL - 34 IS - 2 SN - 1300-7971-2148-4864 M3 - UR - Y2 - 2021 ER -
EndNote %0 Zeynep Kamil Tıp Bülteni Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi %A Karsel Ertekin , Halenur Bozdağ , Sadiye Eren %T Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi %D 2003 %J Zeynep Kamil Tıp Bülteni %P 1300-7971-2148-4864 %V 34 %N 2 %R %U
ISNAD Ertekin, Karsel , Bozdağ, Halenur , Eren, Sadiye . "Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi". Zeynep Kamil Tıp Bülteni 34 / 2 (Mart 2003): 1-6 .
AMA Ertekin K. , Bozdağ H. , Eren S. Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi. Zeynep Kamil Tıp Bülteni. 2003; 34(2): 1-6.
Vancouver Ertekin K. , Bozdağ H. , Eren S. Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi. Zeynep Kamil Tıp Bülteni. 2003; 34(2): 1-6.
IEEE K. Ertekin , H. Bozdağ ve S. Eren , "Soya isoflavonlarının menopozal semptomlar üzerine olan etkisi", Zeynep Kamil Tıp Bülteni, c. 34, sayı. 2, ss. 1-6, Mar. 2003, doi:10.16948/zktb.68708