Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. iJieyun meta-analysis Li and review systematic postmenopausal A of disorders: treatment depressive the in phytoestrogens of Effects lmcei oe oprdt h lcb SD-.1 5 C]-.4t 02;I=24;P for I2=72.4%; symptoms -0.29; depressive Review on to and effect [CI]=-0.74 positive Stata12.0 95% significant the (SMD=-0.51; a articles, have placebo screening a Biomedical the for had Chinese to used Library, Phytoestrogens compared Cochrane was Results: the women X9 PubMed, data. 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Extracts”) OR blue* Plant OR period” ”Estrogen-Like Depress* ”climacteric OR OR OR ”Phyto-Estrogen” (depression menopause* Literature OR included OR Biomedical Estrogens” words (climacteric* Chinese key (”Plant Library, search AND Cochrane The melancho*) EMBASE. the OR and PubMed, June Science as and of 1951 such Web January1, databases between Database, Chinese in or conducted English was in published 30,2020 studies relevant for search comprehensive A strategy search and sources guide Data to review used 2.1. was this Statement of PRISMA reporting and Interventions and of conduct Reviews the Systematic for Handbook Cochrane future The of development the to to contribute health phytoestrogens 2.Method evidence to public of scientific order of effects development synthesize in the the investigate and post-menopause, and to in review research (RCTs) symptoms systematically much trials depressive to controlled is alleviating aims randomized There in of was meta-analysis study women. a our conduct postmenopausal So than women. depression women menopausal to perimenopausal vulnerable on more research are and women working Perimenopausal continue to depressive abilities for now reduction their until available regarding were expectations improvement depression their menopausal members in on family changes im- for cultural long-term caring and to immediate population due their the with and of mainly health women associated health cognitive post-menopause the risks and of on physical the attention pacts their increasing to maintaining the themselves on given focus exposing Therefore, greater than a rather with therapy, medicine replacement estrogens herbal hormone with with associated associated risks relieve the treatments including estrogens without endogenous post-menopause depression, modulate post-menopause the or treating mimic treat that not isoflavones primarily could them plants, (HRT) in therapy symptoms replacement hormone depressive that diseases said vascular and menopause et.al cancer, of breast symptoms events, relieving thromboembolism of stroke, method death a is and depression and disability and depression burdens to concentrating, palpi- economic lead difficulty chills, and and can chest, social, sweating that and sudden disorder head flushing, psychiatric the include common in menopause men- pressure of symptoms of feeling specific “cessation” tations, and as common defined most generally The menopause life, months through reproductive consecutive pass woman’s twelve women of for end periods the strual as considered is Menopause 1.Introduction Isoflavones; Depression; Phytoestrogens; women; Post-menopausal Foundation KEYWORDS: Translation safe GSXZYZH2018006) Knowledge no. and a Medicine (Grant as Based Province Evidence Gansu considered of of Laboratory be Key by should post- Supported estrogens. Phytoestrogen Funding: of among place in depression dosages. symptoms reduce larger postmenopausal for for significantly medicine effect phytoestrogen complementary effective more that and with demonstrated women, study menopausal Our Conclusions: 20,21 hl oesuiscnlddta h ramn fsyioaoe i o rdc a produce not did isoflavones soy of treatment the that concluded studies some while , 22 . 18 oee,n entv ocuin eadn h ffcso phytoestrogens of effects the regarding conclusions definitive no However, . 9 cuuaigeiec ugssta srgncudpasarl ntreating in role a plays could estrogen that suggests evidence Accumulating . 12 oaas aepooe htetoes-cmonsetatdfrom extracted compounds - phytoestrogens proposed have Nowadays, . 2 eoas-eae odtosaenwamjrpbi elhconcern health public major a now are conditions Menopause-related . 23 16 u eaieyls eerho o oalvaedpeso npost- in depression alleviate to how on research less relatively but , h neeti tdigteaxeyaddpeso a increased has depression and anxiety the studying in interest the , 24 ieauesac a oeuigfu lcrncdatabases. electronic four using done was search literature A . 1 1 ohhat ed n ikfcosaelkl ocag as change to likely are factors risk and needs health Both . . 19 2 oersaces nig niae significant a indicated findings researchers’ Some . 10 u a ra ieeet n ik,sc as such risks, and effects side great has but 7,8 11 asn usata esnl family, personal, substantial causing , Hwvr ntemawie Morrison meanwhile, the in .However, 13 sa lentv prahto approach alternative an as – 14 Mn oe o choose now women .Many 4-6 ersini a is Depression . 3,15 17 . 3 , . Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. ewe h tde ocre,maue ihthe using variation in with of after heterogeneity percentage for measured symptoms total allowed the We concerned, depressive by trial. studies 2 interpreted in heterogeneity each the score of in extent between used change the criteria studies, the the between to was effects treatment according substantial efficacy phytoestrogen, is of of there kinds measurement this different when outcome especially for analysis; primary model, effect The fixed random-effects the a than estimate using reliable contin- heterogeneity pooled for more sizes a were intervals(95%CI) effect generates confidence estimate outcomes 95% To model with depressive 5.3. 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All and the reviewers eligibility 2020, two for by reviewed 30, were screened or June outcome inclusion were on the databases approach among numerical the considered standardized (4) not in was depression identified disorders without Articles mood illness of mental degree researched The study criteria. provided. exclusion (3)the therapy, not cancer were hormone breast data hypertension, of relative outcome of or degree use diabetes first history of hyperprolactinemia, current a history asthma, epilepsy, or having (2) endometriosis, symptoms severe previous menopausal thromboembolism, no reasons:(1)reported of or history hysterectomy, following the or (5) the ovariectomy of phytoestrogen for history oral excluded an experiencing were at (3)women with Studies IU/L intervention menopause undergone 25 (4) of had RCT. to therapy months or an equal year hormone 12 was detectable; or preceding any study least clinically than the without symptoms at greater in depression symptoms with levels period and menopausal years, plasma vasomotor menstrual of 70 (FSH) a presence hormone to not the follicle-stimulating 45 had (2) health, from menopause induced general age surgically good (1) in as follows: were registered as baseline, were were criteria that extractionInclusion trials Data randomized relevant and for other criteria any Selection searched identify 2.2. also to was published scanned yet website manually not Trials.gov were but articles Clinical searched completed review were The and studies trials the studies. identified of databases of lists in lists reference indexed Reference not the studies Moreover, additional Table.1. identify to Material manually Supplemental the in provided > 5 and 25% < 29 5) rhg ( high or 75%), . 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Data may be preliminary. efidta h hne aai sflvnsSD-.4 5 C]-.7t -0.32; to KMI(Fig.4), -0.07; [CI]=-0.97 and to 95% GCS [CI]=-0.93 isoflavones(SMD=-0.64; of 95% index in (SMD=-0.5; the data non-isoflavones excluded than changed we better the when However, that 0.23; significant. find to not we 0.92 are (Fig.3)that differences [CI]=- showed these 95% scales though non-isoflavones(SMD=-0.57; assess all in in women phytoestrogens P menopausal of types of different effectiveness on the based analyses subgroup first The Rimostil group. 0.23)or placebo to Analyses the 95%[CI]=-0.38 Subgroups to (SMD=-0.08; 3.2.2. compared Promensil groups in 0.13) either to item 95%[CI]=-0.48 ‘depression’ (SMD=-0.18; GCS’s of subscale in the in classified were 9g than less and 0 than more calculated amounts we The intuitively, dose. 0 more median study. 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Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. 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LJY data the cross-checked LJW form. and extraction LJY data data. the extracted designed LHJ and and searches LJW literature the did LHJ and LJY study. the designed YPJ and as LJY depression menopausal menopausal most the the in relieving unify depression Contributors to to order of applications in management treatment phytoestrogens, possible. other the different as on and conclusion, for much trials duration In phytoestrogens clinical dosage, more of women. need appropriate middle-aged effect still in there favorable However, common a women. is showed imbalances study hormonal our by caused discomfort Menopausal associations, the elucidate conclusions. quality further draw Conclusion low to to 4.5. the needed (such needed Given are studies are studies method), phytoe- included studies well-designed blinding of normative the more unclear types more in evidence, the and and current methodologies that size the of fact of sample weakness much the small and of to allocation, differences Due treatment in mentioned. inadequate were be as and dosages to comprehensively their need and that depression strogens limitations women’s several we are menopausal analysis, there post- However, subgroups on in four intake. phytoestrogens depression the after on different reactions with phytoestrogens adverse of Combined of detailed effects effect women. the the menopausal of explored 1,248 meta-analysis and including review women, systematic menopausal first the is This limitations and Strengths 4.4. 7 Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. 5 a ,Ln ,Eomm ,e l ytmtcrve fqetonie bu ain’ ausand values patient’s about questionnaires of review systematic A al. et G, guidelines. Esoimeme practice J, clinical in Ling symptoms preferences F, depression Bai and life study. 15. of controlled quality double-blind, on randomized, effects 2-year Genistein a al. ternational. women: et postmenopausal A, Bitto osteopenic treating S, in trials. for Mazzaferro San) controlled M, Shaoyao randomized Atteritano (Danggui 14. medicine of Herbal meta-analysis MS. and Lee CH, for review Lee estradiol systematic 2016;85:19-26. BS, of Ko A efficacy KJ, of dysmenorrhea: Kil Lack primary JH, M. Jun Battistini HW, trial. K, Lee controlled Tweedy 13. randomized, I, a Katz women: T, postmenopausal Have Ten in MJ, depression Kallan MF, Morrison symptoms. 12. menopausal and therapy 2 hormone Menopausal Type N. 2014;101(4):905-915. and Santoro Therapy ZA, Hormone Al-Safi Implications. Menopausal 11. Clinical VA. Fonseca and Mechanisms, JC, Evidence, Stevenson Prevention: JE, Diabetes Manson F, Mauvais-Jarvis to 10. 2010 from V) 2011;14:S97. (KNHANES Survey Birkh Examination 9. Nutrition replacement hormone and on women Health postmenopausal among National 2012. ideation Suicidal Korean al. symptoms. et The publique. depressive KH, sante to therapy: Cho YK, index de Park mass canadienne JY, body Revue Lee of 8. = relation health The public M. of Johnston P, journal McLeod Canadian S, Johnson E, Johnston 7. menopausal and mood, depressed women. Resilience, postmenopausal al. in et J, symptoms Fernandez-Inarrea G, Perez-Roncero FR, Perez-Lopez 6. menopause. and in disorders P´erez-L´opez phytoestrogens transition. Depressive B, and menopause FR. Armott progestins Llaneza-Su´arezthe Garc´ıa-Portilla D, MP, of P, role Llaneza the 5. Exploring C. receptor Hughes M, estrogen Medicine. Bievre selective grative G, natural Hale a 4. rosea, Rhodiola with menopause placebo-controlled 769. Pause randomized RP. A Brown modulator. PL, flashes: Gerbarg Hop hot of and 3. effect symptoms The menopausal H. post- early Nazemiyeh in trials. on S, trial. composition controlled Mohammad-Alizadeh-Charandabi L.) body M, randomized lupulus Mirghafourvand and (Humulus of V, supplementation Aghamiri meta-analysis Phytoestrogen and 2. al. review et systematic J, A Musa tas. N, of women: Kastrati effectiveness M, menopausal the Glisic with of continents 1. effectiveness four the of countries with Reference eight group depression. between remission doses’ Association to intake women menopausal Subgroup4: total The three Fig.7 between depression. remission Association to women menopausal Subgroup3: The Fig.6 2018;115:74-83. opeetTe lnPract. Clin Ther Complement ora faetv disorders. affective of Journal ue .Mnpue etoe ecec n depression. and deficiency oestrogen Menopause, M. ¨ auser 2014;25(3):1123-1129. htmdcn nentoa ora fpyohrp n phytopharmacology. and phytotherapy of journal international : Phytomedicine 1999;2(2-3):133-141. Maturitas. 2016;189:214-219. 2016;23:130-135. 2012;71(2):120-130. eoas NwYr,NY). York, (New Menopause ain rfrneadadherence. and preference Patient 8 2014;21(2):159-164. rhvso oe’ etlHealth. Mental Women’s of Archives ilPsychiatry. Biol norRev. Endocr 2004;95(3):179-183. 2018;12:2309-2323. 2017;38(3):173-188. etlt n Sterility. and Fertility 2004;55(4):406-412. seprssin- Osteoporosis 2016;23(7):763- Maturitas. Maturi- Inte- Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. 3 siaaN eb K iuoS aaaeS e qo upeetfrrleigmnpua symp- menopausal relieving for of supplement equol risk New assessing women. S. Japanese for Watanabe 148. of tool trial S, placebo-controlled Mizuno Collaboration’s randomized, MK, Cochrane toms: Melby The N, Ishiwata al. 33. et PC, meta-analyses. trials. Gotzsche in randomised DG, in inconsistency Altman bias Measuring JP, DG. Higgins improved. Altman 32. be JJ, to Deeks needs meta-analyses SG, Chinese Thompson in 2003;327(7414):557-560. JP, evidence Higgins of quality The 31. al. et reviews YL, systematic Epidemiol. of Chen Clin quality R, J reporting Sun guidelines and L, WHO methodological Yao The similar. in 30. F. are interest Song USA of K, the Yang conflicts and L, and Ge China declarations J, from Zhang of J, Reporting Tian methodological al. 29. and et characteristics L, improved. Yao reporting further Y, be The Chen can Z. X, Zong-jiu Wang research. Y, policy 28. Ke-hu health and C, about Yao-long reviews reporting Cochrane overall Z, of Ya and quality The L, registration Xiu-xia prospective Care: between Health 27. Association in study. Guidelines meta-epidemiological al. a Practice et for YN, reviews: 55. Tool systematic Li of JH, Reporting quality Tian be A methodological L, can al. Ge methodologists et GRADE 26. A, of Marusic experience and K, Yang skills Statement. RIGHT Y, The Chen al. symptoms et 25. depressive EA, tool. of Akl simple JJ, pattern a with Meerpohl Longitudinal assessed SL, R. Norris Zhang DW, 24. Boorman MD, climacteric menopause. Sammel the natural of EW, around symptoms Freeman depressive for isoflavones 23. soy of symp- Efficacy menopause RG. on Filizola syndrome. phytoestrogens RL, of Sousa-Munoz effect de The 22. S. Alizadeh review. M, systematic Hajifoghaha A S, toms: Golezar Z, Keshavarz postmenopausal 21. extracts. of clover Improvement red M. from Imhof climacteric derived M, isoflavones in with Stammler treatment 2010;65(3):258-261. A, symptoms after Gocan symptoms C, depressive anxiety Gruenhut and P, depressive on Chedraui phytoestrogens M, trials. Lipovac of controlled 20. Effects randomized WH. of Chien meta-analysis Medicine. TH, A Tung BYW, women: Su 19. behavior. sex in Care. perimenopause Health the Reproductive of and meta-analysis Aspects A A. women: Bazarra-Fernandez older 18. and midlife in Anal- trials. symptoms Systematic controlled depressive Outcomes on randomized Health P, exercise of programmed Chedraui of H, Effects Lajusticia P. SJ, yses Martinez-Dominguez meta- FR, and Perez-Lopez review 17. endometrial systematic on A phytoestrogens women: oral postmenopausal of and Effect DG. perimenopausal analysis. Goulis of I, density Lambrinoudaki breast D, and Vavilis thickness C, Abatzi E, Mareti 16. Maturitas. 2018;24(8):850-851. Maturitas. 2016;74:73-79. n nenMed. Intern Ann 2019;124:81-88. 2009;63(1):89-93. Bmj. lnEpidemiol. Clin J ora fIfhnMdclSchool. Medical Isfahan of Journal AAPsychiatry. JAMA lnEpidemiol. Clin J 2010;15:184-185. 2011;343:d5928. Maturitas. 2017;166(2):128-132. lnEpidemiol. Clin J 2017;106:38-47. 2018;98:1-8. 2014;71(1):36-43. 067:5-5 e151. 2016;79:150-158 9 2017;85:50-58. elhPolicy. Health ora fAtraieadComplementary and Alternative of Journal eoas NwYr,NY). York, (New Menopause 2018;36(477):446-459. uoenJunlo Contraception of Journal European 2015;119(4):503-510. lnEpidemiol. Clin J 2009;16(1):141- 2018;93:45- Maturitas. Bmj. Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. ery20 aaaRT5.(.1 61(.4 0Rdcoe sflvns5m/2g51/.8paeoI 84/83 I: placebo assessment Mood 5.13/7.38 Participant group Control Amount(g) Total I:15/19 57mg/82mg placebo Dose 9/18 isoflavones clover Red 200mg/day 100mg/day Methysticum) Piper of Kava-Kava(extract 90 26.14(4.94) intervention of Type 90 52.3(3.71) Duration(Day) 26.39(3.52) 50.73(0.79) RCT RCT BMI Age(years) Canada Design Italy Country 2003 Jeffrey P:34 2002 Cagnacci to approach important meta-analysis an the be References in might included guidelines studies of the gap of Research Characteristic 2015;68:341-6). K. 1 Epidemiol. Table Yang Clin Y, J Chen on: tubulin commenting X, III (Letter Wang beta prioritization Q, neuron-specific Wang and BAD of 48. expression the brain. modulate health isoflavones rat depression. physical Soy male of ED. and in Lephart Anxiety symptoms L, HA. severe Bu Flynn more 47. PM, having Maki women CL, of Battle odds Health. MC, the Kimmel menopausal increase DI, in Simeonova extract problems foetida SJ, Cimicifuga Weiss of evaluation safety 46. and Efficacy an al. et in W, Xue norms women. T, critique. Zheng a L, Scale: Gao index: Climacteric menopausal 45. Greene Blatt-Kupperman The SK. E. Khoo Alder 44. D, physiological Battistutta their and R, status. menopausal factors King Society. and the Menopause age SM, to relation States: O’Neill in population Mood C, Australian of Travers Profile J. 43. evaluating Volavka D, disease: Reker Parkinson’s DW, in Cho depression correlates. V, of Pollock Characteristics al. 42. et Scale. K, Depression Sekiguchi Self-Rating gold K, the Zung’s Oishi has with F, Scale: Kanda Rating Depression 41. Hamilton The weight? reduces MB. lead administration Marshall Kava-Kava a DR, A. Schuller become AG, Volpe standard Ryder S, RM, Malmusi Bagby AL, 40. Zanni A, women. Renzi perimenopausal S, in Arangino anxiety A, trial. controlled Cagnacci for randomized supplements a 39. Phytoestrogen Study: SR. (ICE) Cummings Extract Clover T, Isoflavone Blackwell the R, 2003;290(2):207-214. Wallace flashes: K, hot of Ensrud treatment B, the Ettinger Cere- JA, and Tice Mood 38. Performance, Intervention Cognitive Placebo-Controlled on Husk Randomised Resveratrol Fenugreek 14-Week of A of Trial. Effects Women; A Post-Menopausal Extract RHX. Wong in Novel Balance: Function PRC, brovascular A Howe Hormonal HM, the Evans al. Establish 37. et to HG, Study. Helps Vidyavathi Placebo-Controlled and Double-Blind, HK, Symptoms Randomized, Jayalakshmi Postmenopausal for S, chinensis Alleviates Begum (FenuSMART) Schisandra Shamshad of trial 36. placebo-controlled double-blind, randomized, A 580. KH. Kim symptoms. JY, menopausal alleviates Park aglycone placebo-controlled isoflavone double-blind, Low-dose 35. randomized, T. a Kubota women: K, Japanese Kato Y, in study. Owa menopause M, of Akiyoshi symptoms M, psychological Terauchi A, Hirose 34. Nutrients. rhvso yeooyadObstetrics. and Gynecology of Archives 2016;19(3):491-499. lmcei h ora fteItrainlMnpueSociety. Menopause International the of journal the : Climacteric h ora fnrosadmna disease. mental and nervous of Journal The 2017;9(1). ersiLett. Neurosci 2005;8(1):56-62. lmcei h ora fteItrainlMnpueSociety. Menopause International the of journal the : Climacteric SDS,GCS mJPsychiatry. J Am 2005;385(2):153-157. Maturitas. aknoim&rltddisorders. related & Parkinsonism 2016;293(3):609-615. 2003;44(2):103-109. 2004;161(12):2163-2177. 10 htteayResearch. Phytotherapy 1979;167(10):612-614. enS)Mean(SD) Mean(SD) lmcei h ora fteInternational the of journal the : Climacteric Maturitas. lnEpidemiol. Clin J 2018;21(1):69-74. 1998;29(1):19-24. 2008;14(1):19-23. 2016;30(11):1775-1784. rhWmn Ment Womens Arch 2016;69:251-252. 2016;19(6):574- Jama. Intervention/placebo Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. oa oa 03 91105 18 12 12 1 1 1 1 1 1 - - 1 2 1 29 7 - 5 - - 1 1 - 2 - - - 2 1 - 1 - - 1 20 - - 1 1 ------19 2 - 1 2 2 1 35 - - 1 1 2 - - 10 5 - - 5 - - 3 - - 40 ------8 2 7 - - 4 - 2 - - - - 3 ------3 - - - 4 3 ------3 - - - - - 9 - - - 1 - - - - - 8 ------1 - - - 10 1 ------1 I:38 - - Total 2 - chinensis - Schisandra Total - - isoflavones - placebo Soy I:18 - - isoflavone 1 Daidzein isoflavones clover Red Myalgia Arthralgia 2 - isoflavones placebo clover Rash Red - - Generalized Headache - Kava-Kava I:29 I:39 Kava-Kava 14.7 Insomnia Kava-Kava Dizziness Kava-Kava vision 2 - Blurred placebo placebo 8.232 breast I:50 Pain 150mg/day I:139 Events extremities I:28/29 Other Flatulence of Tremor appetite - placebo Epigastric in Total Increase Diarrhea Rash infection Generalized tract 14.4 respiratory 1.5 Nausea Upper Arthralgia or placebo Cold placebo 196mg Myalgia Constipation infection tract Headache respiratory Upper or Cold 19.71/39.42 pain Insomnia Abdominal 14.4 (1week)+ vision 500mg/day Blurred 120mg/day assessment Parameter Mood 25mg/day Dizziness extremities of 9/27 Tremor breast Pain appetite in Increase Resveratrol Events Other 80mg/day Participant Flatulence chinensis Schisandra group 54mg Epigastric Control Diarrhea Amount(g) Total 10mg/day Constipation Nausea 98 pain Abdominal extract Fenugreek aglycone Isoflavones symptoms Gastrointestinal 26.7(0.8) 42 isoflavones Soy 23.09(3.28) studies. Parameter 61.5(1.1) 52.28(5.26) included all isoflavones in clover events genistein Red adverse Phytoestrogen Scale; The Depression QOL, Table2 POMS, RCT Index; Studies RCT Menopause Dose Scale; SD=Standard-deviation Epidemiological Kupperman Life; Climacteric for KMI, 90 Scale; of Center Greene Depression 60 Quality the and the Anxiety CES-D, Hospital 26.92(4.09) GCS, States; the 120 22.03(3.06) HADS, Scale; Mood isoflavone of Depression Daidzein 53.31(4.32) Profile Self-Rating 365/730 the Australia Zung’s 48.7(5.18) the 24.31(4.85) SDS, Korea 180 RCT RCT 52.5(2) 24.7(3.9) / P:41 2017 Evans 53.5(7.1) RCT 90 53.2(5.7) P:18 2016 India Park intervention Japan of RCT Type RCT P:32 Duration(Day) (12weeks) 1000mg/day 22(3) 2016 Shamshad 50.53(4.78) Italy P:29 2015 Austria Hirose RCT BMI Brazil P:123 Age(years) 2014 Atteritano Design P:59 2010 Lipovac P:37 Japan 2009 Rilva Country P:33 2009 Ishiwata P:85 References 65paeoI:38 placebo POMS CES-D, KMI GCS 86.5 HADS SDS SDS HADS, CES-D POMS GCS 11 0 gdy20gdy20gdypaeo5m/a 2gdy3m/a 2m/a 196mg 120mg/day 30mg/day 82mg/day 57mg/day placebo 200mg/day 200mg/day mg/day 100 30mg/day Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. systematic-review-and-meta-analysis effects-of-phytoestrogens-in-the-treatment-of-postmenopausal-depressive-disorders-a- diagram.doc Flow Fig.1. file Hosted vial at available https://authorea.com/users/344317/articles/470895- 12 Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. 13 Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159526961.10587876 — This a preprint and has not been peer reviewed. Data may be preliminary. otdfile Hosted 14 Posted on Authorea 20 Jul 2020 — The copyright holder is the author/funder. 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