Oxidative Medicine and Cellular Longevity

Oxidative Medicine and Cellular Longevity / 2017 / Article
Special Issue

New Insights into the Benefits of Polyphenols in Chronic Diseases

View this Special Issue

Review Article | Open Access

Volume 2017 |Article ID 4749131 | https://doi.org/10.1155/2017/4749131

Berner Andrée Sandoval-Ramírez, Rosa M. Lamuela-Raventós, Ramon Estruch, Gemma Sasot, Monica Doménech, Anna Tresserra-Rimbau, "Beer Polyphenols and Menopause: Effects and Mechanisms—A Review of Current Knowledge", Oxidative Medicine and Cellular Longevity, vol. 2017, Article ID 4749131, 9 pages, 2017. https://doi.org/10.1155/2017/4749131

Beer Polyphenols and Menopause: Effects and Mechanisms—A Review of Current Knowledge

Academic Editor: Giuseppe Cirillo
Received04 Apr 2017
Revised26 Jun 2017
Accepted10 Jul 2017
Published17 Aug 2017


Beer is one of the most frequently consumed fermented beverages in the world, and it has been part of the human diet for thousands of years. Scientific evidence obtained from the development of new techniques of food analysis over the last two decades suggests that polyphenol intake derived from moderate beer consumption may play a positive role in different health outcomes including osteoporosis and cardiovascular risk and the relief of vasomotor symptoms, which are commonly experienced during menopause and are an important reason why women seek medical care during this period; here, we review the current knowledge regarding moderate beer consumption and its possible effects on menopausal symptoms. The effect of polyphenol intake on vasomotor symptoms in menopause may be driven by the direct interaction of the phenolic compounds present in beer, such as 8-prenylnaringenin, 6-prenylnaringenin, and isoxanthohumol, with intracellular estrogen receptors that leads to the modulation of gene expression, increase in sex hormone plasma concentrations, and thus modulation of physiological hormone imbalance in menopausal women. Since traditional hormone replacement therapies increase health risks, alternative, safer treatment options are needed to alleviate menopausal symptoms in women. The present work aims to review the current data on this subject.

1. Introduction

Beer is one of the most frequently consumed alcoholic beverages in the world. Beer consumption ranks first in Europe, slightly above wine consumption, according to the World Health Organization [1] and third amongst alcoholic beverage preferences in North America [2]. Archaeological findings show that Chinese villagers brewed fermented alcoholic drinks as far back as 7000 BC on a small individual scale, with a production process and methods similar to those of ancient Egypt and Mesopotamia [3]. Throughout human history, products, ingredients, procedures, and techniques have evolved due to technological advances and the implementation of industrialized processes [4] further enhancing the long history of beer as a part of the human diet.

During the last two decades, scientific evidence has suggested that moderate consumption of alcoholic beverages has positive outcomes on different aspects of cardiovascular risk, as evidenced by Nogueira et al. who correlated regular daily intake of 330 ml of beer with positive changes in insulin sensitivity and lipid profiles [5]. Fermented beverages have also shown positive associations with different cardiovascular disease endpoints such as coronary heart disease, peripheral arterial disease, chronic heart failure, and stroke in which regular moderate consumption of alcohol reduced the prevalence of adverse events [6], and fermented beverages have shown anti-inflammatory properties [7]; these findings may explain the benefits of regular and moderate alcohol intake on cardiovascular disease risk [811]. In the last decade, the development of new techniques for food analysis has allowed the quantification of phenolic profiles [12], which, in turn, has led to new studies suggesting that regular polyphenol consumption might provide health benefits for menopausal and postmenopausal women, reducing vasomotor symptoms [13, 14] and osteoporosis [15].

Hop (Humulus lupulus L) is the ingredient used for beer making and is rich in phenolic compounds. Mass spectrometry analysis show that it contains around 14.4% of phenolic acids, flavonoids, proanthocyanidins, prenylated chalcones, and catechins [16]. Furthermore, malt provides 70%–80% of the total polyphenolic compounds found in beer [17]. It has been shown through high-performance liquid chromatography and posterior ultrasound separation that fermentation, boiling, and the amount of hop used to manufacture beer significantly influence the final polyphenol concentrations [18].

Menopause is induced by the permanent cessation of menstruation due to the end of ovarian follicular activity. This affects the physiology of women [19] and leads to a diminished production of estradiol which is correlated with the night sweats and hot flushes experienced by many menopausal women [20]. According to the Menopause Epidemiology Study, in which 4402 women were surveyed, these symptoms are one of the main reasons for women to seek medical care and over-the-counter treatments that provide some relief and improve the quality of life [21]. For the present work, we review the current knowledge found through online scientific libraries, PubMed and Scopus, regarding moderate beer consumption, polyphenol intake from beer, and their possible benefits for menopausal women.

2. Polyphenolic Compounds in Beer

Beer contains amino acids, carbohydrates, vitamins, minerals, and polyphenols. As mentioned above, beer contains a diversity of polyphenols mainly derived from hops and malt [16, 22]. Moreover, during the beer fermentation process, a resin produced by hops that contains monoacyl-phlorogucinols is converted into bitter acids such as humulones and isohumulones. These molecules act as bioactive antioxidants and provide additional beneficial effects [23]. Tables 13 show the polyphenols found in different types of beer. Malt contains many free and total (bound) polyphenolic compounds; according to composition analysis using a liquid chromatography-antioxidant technique before and after fermentation, the concentrations of polyphenolic compounds may be increased by up to threefold after the fermentation process [24]. The main polyphenolic compounds present in beer are sinapic, ferulic, and caffeic acids. Vanillic acids are present in bound and unbound forms while 4-hydroxyphenylacetic and p-coumaric acids are present as free forms [17]. The main phenolic acids found in beer are shown in Figure 1.

MoleculeMean content (mg/100 ml)

Procyanidin dimer B30.1600
Procyanidin trimer C20.0300
Prodelphinidin trimer C-GC-C0.0200
Prodelphinidin trimer GC-C-C0.0100
Prodelphinidin trimer GC-GC-C0.0400
Prodelphinin dimer B30.1800
Quercetin 3-O-arabinoside0.0006
Quercetin 3-O-rutinoside0.0900
Biochanin A0.00050.0015

Data from the Phenol-Explorer database [12].

MoleculeMean content (mg/100 ml)

Hydroxybenzoic acids
2,6-Dihydroxybenzoic acid0.0900
2-Hydroxybenzoic acid0.00110.2000
3,5-Dihydroxybenzoic acid0.0300
3-Hydroxybenzoic acid0.0300
4-Hydroxybenzoic acid0.00730.11000.07000.9600
Gallic acid0.11000.03000.0700
Gallic 3-O-gallate0.2600
Gentisic acid0.0300
Protocatechuic acid0.27000.06000.04000.0500
Syringic acid0.11000.0200
Vanillic acid0.03000.29000.17000.0700
Hydroxycinnamic acids
4-Caffeoylquinic acid0.0100
5-Caffeoylquinic acid0.0800
Caffeic acid0.01000.00750.03000.0300
Ferulic acid0.12000.33000.09000.2600
m-Coumaric acid0.0200
o-Coumaric acid0.1500
p-Coumaric acid0.40000.12000.05000.1000
Sinapic acid0.00730.07000.03000.0200
Hydroxyphenylacetic acids
4-Hydroxyphenylacetic acid0.0300
Homovanillic acid0.0500

Data from the Phenol-Explorer database [12].

MoleculeMean content (mg/100 ml)


Data from the Phenol-Explorer database [12].

Polyphenolic metaboliteDose per dayMean concentration (plasma)T-Max (h)Ref.

Ferulic acid500 ml0.11 μmol/l0.5[34]
4-Hydroxyphenylacetic acid500 ml1.4 μmol/l0.5[30]
Vanillic acid500 ml0.11 μmol/l0.5[30]
p-Coumaric acid500 ml0.05–0.07 μmol/l0.5[30]
Caffeic acid500 ml0.05–0.07 μmol/l0.5[30]

T-Max: time when maximal concentration is achieved.

3. Polyphenol Metabolites in Plasma

Analysis of polyphenol concentrations in plasma reveals that after ingestion, beer goes through the gastrointestinal tract. An estimated amount of between 5–10% of beer is absorbed in the small intestine, with the remaining 90–95% continuing on to the colon where it is further fermented by the gut microbiota [25], increasing the amount of polyphenols such as 4-hydroxyphenylacetic and vanillic acids absorbed [2628]. After being absorbed, polyphenols undergo hepatic conjugation reactions with S-adenosyl methionine, sulfates, glucuronates, or a combination of them [29]. After 30 minutes, the plasma levels of nonconjugated hydroxyphenylacetic acid significantly increase. Vanillic, caffeic, and ferulic acid levels raise equally as conjugated and nonconjugated forms, with a slight prevalence of sulfate over glucuronate isoforms [30]. Composition analysis carried out in human urine samples after ingestion of wine, tea, beer, or coffee has shown that polyphenol compounds and metabolites such as resveratrol [31], 4-O-methylgallic acid, isoferulic acid [32], and isoxanthohumol [33] are excreted through renal filtration. Table 4 provides detailed information about the plasma levels of polyphenol metabolites after the ingestion of beer.

4. Menopause: Physiology, Symptoms, and Current Treatment

Menopause is defined as the permanent cessation of menstruation as a direct result of the end of ovarian follicular activity [35]. Follicular development is a cyclical process that occurs on average every 28 days during reproductive life. However, with age, these cycles become irregular and then stop completely. This cessation causes abnormal fluctuations of sex hormones, such as the follicle-stimulating hormone (FSH), anti-Müllerian hormone, estrogen, and insulin-like growth factors-I (ILGF-I), which eventually lead to physiological and morphological changes in many organs and systems in women [36].

These physiological changes induce different symptoms and signs which are characteristic of menopausal women, such as irregular bleeding, night sweats, hot flashes, tachycardia, breast pain, lack of energy, dyspareunia, joint soreness, atrophic vaginitis, interrupted sleeping patterns, anxiety, mood swings, dry skin, and loss of libido [37, 38]. Moreover, menopause may also predispose women to a series of risks, such as an increased risk of atherosclerosis [3943], osteopenia, and osteoporosis [44, 45] (Figure 2).

Hot flashes are one of the most frequent symptoms presented by women undergoing menopause. They have a profound impact on the quality of life and increase health costs [46]. Vasomotor symptoms represent one of the main reasons why menopausal women seek medical care and treatments in the hope of relieving their discomfort [47]. Hot flashes are the result of the brain’s response to diminished and fluctuating sex hormone concentrations that occur in menopause [48, 49]. Mechanisms of temperature homeostasis on the hypothalamus and peripheral vasculature are influenced by different hormones such as ovarian hormones, norepinephrine, and serotonin. Kronenberg described the links between vasomotor symptoms and different thermal, hormonal, and autonomic parameters, demonstrating the relevance of hormones in the deregulation of core body temperature that leads to hot flashes in menopause [50].

Current menopausal treatment includes estrogen hormone replacement therapy (HRT); selective estrogen receptor modulators, such as tamoxifen and raloxifene [51]; and other medications such as selective serotonin reuptake inhibitors that alleviate vasomotor symptoms [52]. However, in different studies carried out in human patients, it has been suggested that HRT has no benefit in preventing cardiovascular disease and may even lead to an increased risk of arterial and venous thrombotic events [53], ovarian cancer [54], nonalcoholic steatohepatitis [55], and other diseases. These reports have encouraged scientists to find alternative and safer treatment options for menopausal symptoms.

5. Moderate Beer Intake and Health

Although it is well known that ethanol is a carcinogenic substance for humans [56], several studies have shown that regular and moderate intake of fermented beverages, such as wine and beer, may be associated with different positive health effects, such as the reduction in the risk of cardiovascular disease as evidenced by the J-shaped relation found in wine [57] and beer [58] intake on cardiovascular risk, the reduction in atheroma plaque formation [59], prevention on different cancer types [23, 60, 61], and the reduction in bone mineral loss that leads to osteoporosis and osteopenia [15, 62]. The lack of evidence attributing the same effects to spirit intake suggests that polyphenolic compounds might play an important role in the beneficial effects of moderate alcoholic beverage intake on several health outcomes [6366].

6. Beer and Menopause

Several intervention studies have evaluated the effects of beer and menopause. An 8-week, randomized, double-blind, cross-over trial showed that consuming 8-prenylnaringenin (8-PN), a characteristic polyphenol from hops and beer, resulted in a significant reduction in menopause symptoms [14] and discomforts [67]. Vasomotor symptoms are believed to be caused by a slight increase in body temperature in conjunction with a smaller thermo-neutral zone [68]. These processes are controlled by a region of the anterior hypothalamus called the thermoregulatory nucleus. This area responds to sex hormones as shown by experimental models with ovariectomized rats. These rats presented significant differences in body temperature compared to a unovariectomized control group, and the differences reversed when the rats were treated with estrogens or clonidine, an alpha-adrenoceptor used for vasomotor symptom treatment, suggesting that temperature irregularities in menopause may be due to changes in the sex hormone regulatory system [69]. In the same animal model, low doses of approximately 400 μg/kg/day of 8-prenylnaringenin were also able to alleviate menopausal vasomotor symptoms [70].

The effect of 8-prenylnaringenin may be explained by its strong affinity for both alpha and beta estrogen receptors (ER). The binding of 8-PN and the consequent activation of ERs lead to the stimulation of alkaline phosphatase activity and upregulate the activity of progesterone receptors and presenelin-2 [14], both of which are estrogen-stimulated genes (Figure 3). In addition, low doses of 8-prenylnaringenin increase the libido of menopausal women [71].

The absorption of hop phenolic acid and the pharmacokinetics and possible health benefits of hops have been studied in women [72]; however, at present, no clinical trial has assessed the effects of moderate beer consumption on menopausal women.

7. Summary

Menopause is a physiological condition that causes significant discomfort in many women around the world with the presentation of a myriad of symptoms related to an imbalance in sex hormone levels. Hot flashes and night sweats are two of the most common clinical findings in menopausal women that lead them to seek medical care. Since traditional hormone replacement therapies increase health risks, alternative, safer treatment options are needed. Hop and beer polyphenols seem to be an alternative to alleviate the menopausal symptoms presented by women.

There is evidence that regular and moderate intake of the polyphenols commonly found in hop and beer may help to relieve many common symptoms presented by women undergoing menopause. Said benefits can also be obtained by menopausal women from regular alcohol-free beer consumption, since ingredients used and most processes are shared between alcohol-free and regular beer. Alcohol-free beer could provide women with all the same possible benefits, without the risk of gastrointestinal pathologies and cancer that frequent alcohol consumption represents to health. Nonetheless, randomized intervention clinical trials are needed to confirm their efficacy.


No foundation or institution was involved in the writing of the manuscript or the decision to submit the manuscript for publication.

Conflicts of Interest

Anna Tresserra-Rimbau, Rosa M. Lamuela-Raventós, and Ramon Estruch have received funding from The European Foundation for Alcohol Research (ERAB). Rosa M. Lamuela-Raventós and Ramon Estruch report serving on the board of and receiving lecture fees from Research Foundation on Wine and Nutrition (FIVIN) and Cerveceros de España. Rosa M. Lamuela-Raventós has received lecture fees and travel support from PepsiCo, and Ramon Estruch reports serving on the boards of the Mediterranean Diet Foundation, receiving lecture fees from Sanofi-Aventis, and receiving grant support through his institution from Novartis.


This work was supported by the European Foundation for Alcohol Research (ERAB) (EA 1324, EA 1514, EA 1515, and EA 1517), the CICYT (AGL2016-79113-R), and the Instituto de Salud Carlos III (ISCIII) (CIBEROBN) from the Ministerio de Economía, Industria y Competitividad (MEIC) (AEI/FEDER, UE) and Generalitat de Catalunya (GC) (2014 SGR 773).


  1. World Health Organization, Alcohol in the European Union. Consumption, Harm and Policy Approaches, World Health Organization, Regional office for Europe, Copenhaguen, Denmark, 2012.
  2. M. Adjemian and R. Volpe, Alcohol consumption and food-at-home dietary quality in the United States, Journal of Wine Economics. 2012 Annual Meeting, August 12-14, Agricultural and Applied Economics Association, Seattle, Washington, WA, USA, 2012.
  3. W. Jiajing, L. Li, B. Terry, Y. Linjie, L. Yuanqing, and X. Fulai, “Revealing a 5,000-y-old beer recipe in China,” Proceedings of the National Academy of Sciences of the United States of America, vol. 113, no. 23, pp. 6444–6448, 2016. View at: Publisher Site | Google Scholar
  4. R. W. Unger, Beer in the Middle Ages and the Renaissance Philadelphia, University of Pennsylvania Press, Philadelphia, PA, USA, 2007.
  5. L. C. Nogueira, R. F. do Rio, P. C. Lollo, and I. M. Ferreira, “Moderate alcoholic beer consumption: the effects on the lipid profile and insulin sensitivity of adult men,” Journal of Food Science, vol. 82, no. 7, pp. 1720–1725, 2017. View at: Publisher Site | Google Scholar
  6. C. Matsumoto, M. D. Miedema, P. Ofman, J. M. Gaziano, and H. D. Sesso, “An expanding knowledge of the mechanisms and effects of alcohol consumption on cardiovascular disease,” Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 34, no. 3, pp. 159–171, 2014. View at: Publisher Site | Google Scholar
  7. S. Arranz, G. Chiva-Blanch, P. Valderas-Martínez, A. Medina-Remón, R. M. Lamuela-Raventós, and R. Estruch, “Wine, beer, alcohol and polyphenols on cardiovascular disease,” Nutrients, vol. 4, no. 7, pp. 759–781, 2012. View at: Publisher Site | Google Scholar
  8. A. Hernandez-Hernandez, A. Gea, M. Ruiz-Canela et al., “Mediterranean alcohol-drinking pattern and the incidence of cardiovascular disease and cardiovascular mortality: the SUN project,” Nutrients, vol. 7, no. 11, pp. 9116–9126, 2015. View at: Publisher Site | Google Scholar
  9. G. Chiva-Blanch, E. Magraner, X. Condines et al., “Effects of alcohol and polyphenols from beer on atherosclerotic biomarkers in high cardiovascular risk men: a randomized feeding trial,” Nutrition, Metabolism, and Cardiovascular Diseases, vol. 25, no. 1, pp. 36–45, 2015. View at: Publisher Site | Google Scholar
  10. A. Di Castelnuovo, S. Costanzo, R. di Giuseppe, G. de Gaetano, and L. Iacoviello, “Alcohol consumption and cardiovascular risk: mechanisms of action and epidemiologic perspectives,” Future Cardiology, vol. 5, no. 5, pp. 467–477, 2009. View at: Publisher Site | Google Scholar
  11. T. Brügger-Andersen, V. Pönitz, S. Snapinn, and K. Dickstein, “Moderate alcohol consumption is associated with reduced long-term cardiovascular risk in patients following a complicated acute myocardial infarction,” International Journal of Cardiology, vol. 133, no. 2, pp. 229–232, 2009. View at: Publisher Site | Google Scholar
  12. J. A. Rothwell, J. Pérez-Jiménez, V. Neveu et al., “Phenol-explorer 3.0: a major update of the phenol-explorer database to incorporate data on the effects of food processing on polyphenol content,” Database: The Journal of Biological Databases and Curation, vol. 2013, 2013. View at: Publisher Site | Google Scholar
  13. K. Annekathrin, Z. Oliver, and K. Georg, “Hop extracts and hop substances in treatment of menopausal complaints,” Planta Medica, vol. 79, no. 7, pp. 576–579, 2013. View at: Publisher Site | Google Scholar
  14. A. Fatemeh, M. Hamid, and R. Nasibeh, “Hops for menopausal vasomotor symptoms: mechanisms of action,” Journal of Menopausal Medicine, vol. 22, no. 2, pp. 62–64, 2016. View at: Publisher Site | Google Scholar
  15. J. Pedrera-Zamorano, J. Lavado-Garcia, R. Roncero-Martin, J. Calderon-Garcia, T. Rodriguez-Dominguez, and M. Canal-Macias, “Effect of beer drinking on ultrasound bone mass in women,” Nutrition, vol. 25, no. 10, pp. 1057–1063, 2009. View at: Publisher Site | Google Scholar
  16. A. W. Taylor, E. Barofsky, J. A. Kennedy, and M. L. Deinzer, “Hop (Humulus lupulus L.) proanthocyanidins characterized by mass spectrometry, acid catalysis, and gel permeation chromatography,” Journal of Agricultural and Food Chemistry, vol. 51, no. 14, pp. 4101–4010, 2013. View at: Publisher Site | Google Scholar
  17. P. Quifer-Rada, A. Vallverdú-Queralt, M. Martínez-Huélamo et al., “A comprehensive characterisation of beer polyphenols by high resolution mass spectrometry (LC–ESI-LTQ-Orbitrap-MS),” Food Chemistry, vol. 169, pp. 336–343, 2015. View at: Publisher Site | Google Scholar
  18. D. Intelmann, G. Haseleu, and T. Hofmann, “LC-MS/MS quantitation of hop-derived bitter compounds in beer using the ECHO technique,” Journal of Agricultural and Food Chemistry, vol. 57, no. 4, pp. 1172–1182, 2009. View at: Publisher Site | Google Scholar
  19. J. E. Hall, “Neuroendocrine physiology of the early and late menopause,” Endocrinology and Metabolism Clinics of North America, vol. 33, no. 4, pp. 637–659, 2004. View at: Publisher Site | Google Scholar
  20. A. Ziv-Gal and J. A. Flaws, “Factors that may influence the experience of hot flushes,” Journal of Women's Health, vol. 19, no. 10, pp. 1905–1914, 2010. View at: Publisher Site | Google Scholar
  21. F. Kronenberg, “Menopausal hot flashes: a review of physiology and biosociocultural perspective on methods of assessment,” The Journal of Nutrition, vol. 140, no. 7, pp. 1380S–1385S, 2010. View at: Publisher Site | Google Scholar
  22. D. De Keukeleire, L. De Cooman, H. Rong, A. Heyerick, J. Kalita, and S. R. Milligan, “Functional properties of hop polyphenols,” Basic Life Sciences, vol. 66, pp. 739–760, 1999. View at: Publisher Site | Google Scholar
  23. C. Gerhauser, “Beer constituents as potential cancer chemopreventive agents,” European Journal of Cancer, vol. 41, no. 13, pp. 1941–1954, 2005. View at: Publisher Site | Google Scholar
  24. C. Leitao, E. Marchioni, M. Bergaentzlé et al., “Effects of processing steps on the phenolic content and antioxidant activity of beer,” Journal of Agricoultural and Food Chemistry, vol. 59, no. 4, pp. 1249–1255, 2011. View at: Publisher Site | Google Scholar
  25. M. N. Clifford, “Diet-derived phenols in plasma and tissues and their implications for health,” Planta Medica, vol. 70, no. 12, pp. 1103–1114, 2004. View at: Publisher Site | Google Scholar
  26. C. Cueva, I. Gil-Sánchez, B. Ayuda-Durán et al., “An integrated view of the effects of wine polyphenols and their relevant metabolites on gut and host health,” Molecules, vol. 22, no. 1, 2017. View at: Publisher Site | Google Scholar
  27. M. Monagas, M. Urpi-Sarda, F. Sánchez-Patán et al., “Insights into the metabolism and microbial biotransformation of dietary flavan-3-ols and the bioactivity of their metabolites,” Food & Function, vol. 1, no. 3, pp. 233–253, 2010. View at: Publisher Site | Google Scholar
  28. T. Requena, M. Monagas, M. Pozo-Bayón et al., “Perspectives of the potential implications of wine polyphenols on human oral and gut microbiota,” Trends in Food Science & Technology, vol. 21, no. 7, pp. 332–344, 2010. View at: Publisher Site | Google Scholar
  29. A. Scalbert and G. Williamson, “Dietary intake and bioavailability of polyphenols,” Journal of Nutrition, vol. 130, no. 8S, pp. 2073S–2085S, 2000. View at: Google Scholar
  30. M. Nardini, F. Natella, C. Scaccini, and A. Chiselli, “Phenolic acids from beer are absorbed and extensively metabolized in humans,” The Journal of Nutritional Biochemistry, vol. 17, no. 1, pp. 14–22, 2006. View at: Publisher Site | Google Scholar
  31. R. Zamora-Ros, M. Urpi-Sarda, R. M. Lamuela-Raventós et al., “Diagnostic performance of urinary resveratrol metabolites as a biomarker of moderate wine consumption,” Clinical Chemistry, vol. 52, no. 7, pp. 1373–1380, 2006. View at: Publisher Site | Google Scholar
  32. J. M. Hodgson, S. Y. Chan, I. B. Puddey et al., “Phenolic acid metabolites as biomarkers for tea- and coffee-derived polyphenol exposure in human subjects,” The British Journal of Nutrition, vol. 91, no. 2, pp. 301–306, 2004. View at: Publisher Site | Google Scholar
  33. P. Quifer-Rada, M. Martínez-Huelamo, G. Chiva-Blanch, O. Jauregui, R. Estruch, and R. M. Lamuela-Raventós, “Urinary isoxanthohumol is a specific and accurate biomarker of beer consumption,” The Journal of Nutrition, vol. 144, no. 4, pp. 484–488, 2014. View at: Publisher Site | Google Scholar
  34. R. A. Canccetta, K. D. Croft, L. J. Beilin, and I. B. Puddey, “Ingestion of red wine significantly increases plasma phenolic acid concentrations but does not acutely affect ex vivo lipoprotein oxidizability,” American Journal of Clinical Nutrition, vol. 71, no. 1, pp. 67–74, 2000. View at: Google Scholar
  35. J. S. Berek, Berek and Novak’s Gynecology, Lippincott Williams and Wilkins, Philadelphia, PA, USA, 15th edition, 2012.
  36. M. R. Sowers, A. D. Eyvazzadeh, D. McConnell et al., “Anti-Mullerian hormone and inhibin B in the definition of ovarian aging and the menopause transition,” Journal of Clinical Endocrinology and Metabolism, vol. 93, no. 9, pp. 3478–3483, 2008. View at: Publisher Site | Google Scholar
  37. P. Llaneza, M. P. García-Portilla, D. Llaneza-Suárez, B. Armott, and F. R. Pérez-López, “Depressive disorders and the menopause transition,” Maturitas, vol. 71, no. 2, pp. 120–130, 2012. View at: Publisher Site | Google Scholar
  38. B. Hoffman, J. Schorge, J. Schaffer, L. Halvorson, K. Bradshaw, and F. Cunningham, Williams Gynecology, McGraw-Hill Medical, New York, NY, USA, 2nd edition, 2012.
  39. H. Souza and G. Tezini, “Autonomic cardiovascular damage during post-menopause: the role of physical training,” Aging and Disease, vol. 4, no. 6, pp. 320–328, 2013. View at: Publisher Site | Google Scholar
  40. V. Malinauskiene and A. Tamosiunas, “Menopause and myocardial infarction risk among employed women in relation to work and family psychosocial factors in Lithuania,” Maturitas, vol. 66, no. 1, pp. 94–98, 2010. View at: Publisher Site | Google Scholar
  41. I. A. Ebong, K. E. Watson, D. C. Goff et al., “Age at menopause and incident heart failure: the multi-ethnic study of atherosclerosis,” Menopause, vol. 21, no. 6, pp. 585–591, 2014. View at: Publisher Site | Google Scholar
  42. E. Barrett-Connor, “Menopause, atherosclerosis, and coronary artery disease,” Current Opinion in Pharmacology, vol. 13, no. 2, pp. 186–191, 2013. View at: Publisher Site | Google Scholar
  43. M. Wellons, P. Ouyang, P. J. Schreiner, D. M. Herrington, and D. Vaidya, “Early menopause predicts future coronary heart disease and stroke: the multi-ethnic study of atherosclerosis,” Menopause, vol. 19, no. 10, pp. 1081–1087, 2012. View at: Publisher Site | Google Scholar
  44. D. McLemon, J. Powell, R. Jugdaohsingh, and H. Macdonald, “Do lifestyle choices explain the effect of alcohol on bone mineral density in women around menopause,” The American Journal of Clinical Nutrition, vol. 95, no. 5, pp. 1261–1269, 2012. View at: Publisher Site | Google Scholar
  45. L. Baig, F. A. Mansuri, and S. A. Karim, “Association of menopause with osteopenia and osteoporosis: results from population based study done in Karachi,” Journal of the College of Physicians and Surgeons–Pakistan, vol. 19, no. 4, pp. 240–244, 2009. View at: Google Scholar
  46. W. H. Utian, “Psychosocial and socioeconomic burden of vasomotor symptoms in menopause: a comprehensive review,” Health and Quality of Life Outcomes, vol. 3, no. 1, p. 47, 2005. View at: Publisher Site | Google Scholar
  47. R. E. Williams, L. Kalilani, D. B. DiBenedetti, X. Zhou, S. E. Fehnel, and R. V. Clark, “Healthcare seeking and treatment for menopausal symptoms in the United States,” Maturitas, vol. 58, no. 4, pp. 348–358, 2007. View at: Publisher Site | Google Scholar
  48. R. R. Friedman, “Pathophysiology and treatment of menopausal hot flashes,” Seminars in Reproductive Medicine Journal, vol. 23, no. 2, pp. 117–125, 2005. View at: Publisher Site | Google Scholar
  49. D. C. Deecher, “Physiology of thermoregulatory dysfunction and current approaches to the treatment of vasomotor symptoms,” Expert Opinion on Investigational Drugs, vol. 14, no. 4, pp. 434–448, 2005. View at: Publisher Site | Google Scholar
  50. F. Kronenberg, “Hot flashes: epidemiology and physiology,” Annals of the New York Academy of Sciences, vol. 592, pp. 52–86, 1990. View at: Google Scholar
  51. S. R. Davis, I. Dinatale, L. Rivera-Woll, and S. Davison, “Postmenopausal hormone therapy: from monkey glands to transdermal patches,” Journal of Endocrinology, vol. 185, no. 2, pp. 207–222, 2005. View at: Publisher Site | Google Scholar
  52. M. S. Krause and S. T. Nakajima, “Hormonal and nonhormonal treatment of vasomotor symptoms,” Obstetrics and Gynecology Clinics of North America, vol. 42, no. 1, pp. 163–179, 2015. View at: Publisher Site | Google Scholar
  53. H. M. Boardman, L. Hartley, A. Eisinga et al., “Hormone therapy for preventing cardiovascular disease in post-menopausal women,” The Cochrane Database of Systematic Reviews, vol. 10, no. 3, 2015. View at: Publisher Site | Google Scholar
  54. C. La Vecchia, “Ovarian cancer: epidemiology and risk factors,” European Journal of Cancer Prevention, vol. 26, no. 1, pp. 55–62, 2017. View at: Publisher Site | Google Scholar
  55. J. D. Yang, M. F. Abdelmalek, C. D. Guy et al., “Patient sex, reproductive status, and synthetic hormone use associate with histologic severity of nonalcoholic steatohepatitis,” Clinical Gastroenterology and Hepatology, vol. 15, no. 1, pp. 127–131, 2017. View at: Publisher Site | Google Scholar
  56. World Health Organization and International Agency for Research on Cancer. IARC, “Monographs on the evaluation of carcinogenic risks to humans: alcohol consumption and ethyl carbamate,” Monographs on the Evaluation of Carcinogenic Risks to Humans, World Health Organization, International Agency for Research on Cancer, Lyon, France, 2010, Report No.: 96. View at: Google Scholar
  57. R. Estruch, M. Urpi-Sarda, G. Chiva, E. S. Romero, M. I. Covas, and J. Salas-Salvadó, Cerveza, Dieta Mediterránea y Enfermedad Cardiovascular. Dossier de Prensa, Madrid, Spain, Centro de Información Cerveza y Salud, Cerveza y Salud, 2011.
  58. S. Costanzo, A. Di Castelnuovo, M. B. Donati, L. Iacoviello, and W. de Gaetano, “Wine, beer or spirit drinking in relation to fatal and non-fatal cardiovascular events: a meta-analysis,” European Journal of Epidemiology, vol. 26, no. 11, pp. 833–850, 2011. View at: Publisher Site | Google Scholar
  59. L. Brown, P. Kroon, D. Das et al., “The biological responses to resveratrol and other polyphenols from alcoholic beverages,” Alcoholism, Clinical and Experimental Research, vol. 33, no. 9, pp. 1513–1526, 2009. View at: Publisher Site | Google Scholar
  60. M. N. Gronbaek, T. I. Sorensen, D. Johansen et al., “Beer, wine, spirits and mortality,” Läkartidningen, vol. 98, no. 21, pp. 2585–2588, 2001. View at: Google Scholar
  61. S. Renaud, D. Lanzmann-Petithory, R. Gueguen, and P. Conard, “Alcohol and mortality from all causes,” Biological Research, vol. 37, pp. 183–187, 2004. View at: Google Scholar
  62. K. L. Tucker, R. Jugdaohsing, J. J. Powell et al., “Effects of beer, wine, and liquor intakes on bone mineral density in older men and women,” American Journal of Clinical Nutrition, vol. 89, no. 4, pp. 1188–1196, 2009. View at: Publisher Site | Google Scholar
  63. P. Gresele, C. Cerletti, G. Guglielmini, P. Pignatelli, G. de Gaetano, and F. Violi, “Effects of resveratrol and other wine polyphenols on vascular function: an update,” Journal of Nutritional Biochemistry, vol. 22, no. 3, pp. 202–211, 2011. View at: Publisher Site | Google Scholar
  64. N. Martinez, M. Urpi-Sarda, M. A. Martinez-Gonzalez, C. Andres-Lacueva, and M. T. Mitjavila, “Dealcoholised beers reduce atherosclerosis and expression of adhesion molecules in apoE-deficient mice,” British Journal of Nutrition, vol. 105, no. 5, pp. 721–730, 2011. View at: Publisher Site | Google Scholar
  65. A. Piazzon, M. Forte, and M. Nardini, “Characterization of phenolics content and antioxidant activity of different beer types,” Journal of Agricultural and Food Chemistry, vol. 58, no. 19, pp. 10677–10683, 2010. View at: Publisher Site | Google Scholar
  66. R. Estruch, E. Sacanella, E. Badia et al., “Different effects of red wine and gin consumption on inflammatory biomarkers of atherosclerosis: a prospective randomized crossover trial. Effects of wine on inflammatory markers,” Atherosclerosis, vol. 175, no. 1, pp. 117–123, 2004. View at: Publisher Site | Google Scholar
  67. R. Erkkola, S. Vervarcke, S. Vansteelandt, P. Rompotti, D. DeKeukeleire, and A. Heyerick, “A randomized, double-blind, placebo-controlled, cross-over pilot study on the use of a standardized hop extract to alleviate menopausal discomforts,” Phytomedicine, vol. 17, no. 6, pp. 389–396, 2010. View at: Publisher Site | Google Scholar
  68. R. R. Friedman, “Hot flashes: behavioral treatments, mechanisms, and relation,” American Journal of Medicine, vol. 118, no. 12Bf, pp. 124–130, 2005. View at: Publisher Site | Google Scholar
  69. H. H. Berendsen, A. H. Weekers, and H. J. Kloosterboer, “Effect of tibolone and raloxifene on the tail temperature of oestrogen-deficient rats,” European Journal of Pharmacology, vol. 419, no. 1, pp. 47–54, 2001. View at: Google Scholar
  70. J. Bowe, X. F. Li, J. Kinsey-Jones et al., “The hop phytoestrogen, 8-prenylnaringenin, reverses the ovariectomy-induced rise in skin temperature in an animal model of menopausal hot flushes,” Journal of Endocrinology, vol. 191, no. 2, pp. 399–405, 2006. View at: Publisher Site | Google Scholar
  71. A. Keiler, O. Zierau, and G. Kretzschmar, “Hop extracts and hop substances in treatment of menopausal complaints,” Planta Medica, vol. 79, no. 7, pp. 576–579, 2013. View at: Publisher Site | Google Scholar
  72. R. B. Van Breemen, Y. Yang, S. Banuvar et al., “Pharmacokinetics of prenylated hop phenols in women following oral administration of a standardized extract of hops,” Molecular Nutrition & Food Research, vol. 58, no. 10, pp. 1962–1969, 2014. View at: Publisher Site | Google Scholar

Copyright © 2017 Berner Andrée Sandoval-Ramírez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

More related articles

 PDF Download Citation Citation
 Download other formatsMore
 Order printed copiesOrder

Related articles

Article of the Year Award: Outstanding research contributions of 2020, as selected by our Chief Editors. Read the winning articles.