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Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis.
JAMA. 2016 Jun 21; 315(23):2554-63.JAMA

Abstract

IMPORTANCE

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.

DATA SOURCES

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.

STUDY SELECTION

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

DATA EXTRACTION

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

MAIN OUTCOMES AND MEASURES

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 AND RELEVANCE

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.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Franco OH
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Chowdhury R
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Troup J
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Voortman T
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands3Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Kunutsor S
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Kavousi M
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Oliver-Williams C
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Muka T
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands3Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.

MeSH

Complementary TherapiesFemaleHot FlashesHumansMenopauseMiddle AgedPhytoestrogensPhytotherapyPlant PreparationsSweatingVaginal Diseases

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

27327802

Clinical Trial Links

Womens Study to Alleviate Vasomotor Symptoms

Citation

Franco, Oscar H., et al. "Use of Plant-Based Therapies and Menopausal Symptoms: a Systematic Review and Meta-analysis." JAMA, vol. 315, no. 23, 2016, pp. 2554-63.
Franco OH, Chowdhury R, Troup J, et al. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016;315(23):2554-63.
Franco, O. H., Chowdhury, R., Troup, J., Voortman, T., Kunutsor, S., Kavousi, M., Oliver-Williams, C., & Muka, T. (2016). Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA, 315(23), 2554-63. https://doi.org/10.1001/jama.2016.8012
Franco OH, et al. Use of Plant-Based Therapies and Menopausal Symptoms: a Systematic Review and Meta-analysis. JAMA. 2016 Jun 21;315(23):2554-63. PubMed PMID: 27327802.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. AU - Franco,Oscar H, AU - Chowdhury,Rajiv, AU - Troup,Jenna, AU - Voortman,Trudy, AU - Kunutsor,Setor, AU - Kavousi,Maryam, AU - Oliver-Williams,Clare, AU - Muka,Taulant, PY - 2016/6/22/entrez PY - 2016/6/22/pubmed PY - 2016/6/25/medline SP - 2554 EP - 63 JF - JAMA JO - JAMA VL - 315 IS - 23 N2 - IMPORTANCE: 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. DATA SOURCES: 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. STUDY SELECTION: Randomized clinical trials that assessed plant-based therapies and the presence of hot flashes, night sweats, and vaginal dryness. DATA EXTRACTION: Data were extracted by 2 independent reviewers using a predesigned data collection form. MAIN OUTCOMES AND MEASURES: 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 AND RELEVANCE: 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. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/27327802/Use_of_Plant_Based_Therapies_and_Menopausal_Symptoms:_A_Systematic_Review_and_Meta_analysis_ DB - PRIME DP - Unbound Medicine ER -