Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis.
OBJECTIVE
Between 40% and 50% of women in Western countries use complementary therapies to manage menopausal symptoms.


OBJECTIVE
To determine the association of plant-based therapies with menopausal symptoms, including hot flashes, night sweats, and vaginal dryness.


METHODS
The electronic databases Ovid MEDLINE, EMBASE, and Cochrane Central were systematically searched to identify eligible studies published before March 27, 2016. Reference lists of the included studies were searched for further identification of relevant studies.


METHODS
Randomized clinical trials that assessed plant-based therapies and the presence of hot flashes, night sweats, and vaginal dryness.


METHODS
Data were extracted by 2 independent reviewers using a predesigned data collection form.


METHODS
Hot flashes, night sweats, and vaginal dryness.


RESULTS
In total, 62 studies were identified, including 6653 individual women. Use of phytoestrogens was associated with a decrease in the number of daily hot flashes (pooled mean difference of changes, -1.31 [95% CI, -2.02 to -0.61]) and vaginal dryness score (pooled mean difference of changes, -0.31 [95% CI, -0.52 to -0.10]) between the treatment groups but not in the number of night sweats (pooled mean difference of changes, -2.14 [95% CI, -5.57 to 1.29]). Individual phytoestrogen interventions such as dietary and supplemental soy isoflavones were associated with improvement in daily hot flashes (pooled mean difference of changes, -0.79 [-1.35 to -0.23]) and vaginal dryness score (pooled mean difference of changes, -0.26 [-0.48 to -0.04]). Several herbal remedies, but not Chinese medicinal herbs, were associated with an overall decrease in the frequency of vasomotor symptoms. There was substantial heterogeneity in quality across the available studies, and 46 (74%) of the included randomized clinical trials demonstrated a high risk of bias within 3 or more areas of study quality.


CONCLUSIONS
This meta-analysis of clinical trials suggests that composite and specific phytoestrogen supplementations were associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats. However, because of general suboptimal quality and the heterogeneous nature of the current evidence, further rigorous studies are needed to determine the association of plant-based and natural therapies with menopausal health.
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Oscar H
OH
Franco
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Rajiv
R
Chowdhury
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Jenna
J
Troup
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands3Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Trudy
T
Voortman
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Setor
S
Kunutsor
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Maryam
M
Kavousi
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Clare
C
Oliver-Williams
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands3Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Taulant
T
Muka
D000529:Complementary Therapies; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D048789:Phytoestrogens / Q000627:therapeutic use*; D008517:Phytotherapy; D028321:Plant Preparations / Q000627:therapeutic use*; D013546:Sweating; D014623:Vaginal Diseases / Q000188:drug therapy / Q000209:etiology
D048789:Phytoestrogens; D028321:Plant Preparations