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Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Meta-Analysis

The Effects of Evening-Primrose Oil on Menopausal Symptoms: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Author(s): Karen Christelle*, Maryam Mohd Zulkfili, Norhayati Mohd Noor and Nani Draman

Volume 16, Issue 4, 2020

Page: [265 - 276] Pages: 12

DOI: 10.2174/1573404816999200702162750

Price: $65

Abstract

Background: Evening primrose oil (EPO) has been a treatment option for reducing menopausal symptoms, but evidence for its use is inadequate.

Objective: The study aimed to determine the effectiveness of EPO in treating menopausal symptoms among peri and postmenopausal women.

Study Design: This is a systematic review with meta-analyses of randomised clinical trials (RCTs).

Methods: We searched CENTRAL, Medline, Embase and trial registries for relevant RCTs. The methodology and reporting were carried out grounded on references from the Cochrane collaboration and the preferred reporting items for systematic reviews and meta-analyses statement. Review Manager version 5.3.5 was used to perform all the statistical analyses.

Results: Five RCTs, recruiting a total of 402 peri and postmenopausal women were identified. EPO did not reduce the frequency of daily vasomotor symptoms (MD 0.01 episodes, 95% CI -0.54 to 0.57, P=0.960), frequency of daytime hot flash episodes (MD -0.51 episodes, 95% CI -2.05 to 1.03, P=0.510), frequency of night sweat episodes (MD 0.33 episodes, 95% CI -0.48 to 1.13, P=0.430) and severity of vasomotor symptoms (SMD -0.45, 95% CI -1.56 to 0.66, P=0.420) in comparison to control. EPO was associated with a minimal reduction in the severity of overall menopausal symptoms in comparison to control (SMD -1.18; 95% CI-2.18 to -0.18, P=0.02). There were insufficient data to pool results for musculoskeletal symptoms, mood, sexuality, sleeping disorders and quality of life.

Conclusion: EPO may reduce the severity of overall menopausal symptoms but is not effective to reduce the frequency and severity of vasomotor symptoms. The evidence quality ranged from very low to moderate. Further research is needed to enhance related evidence.

Keywords: Evening primrose oil, menopause, perimenopausal, postmenopausal, menopausal symptoms, vasomotor symptoms, complementary alternative medicine, systematic review, meta-analysis.

Graphical Abstract
[1]
Harlow SD, Gass M, Hall JE, et al. Executive summary of the stages of reproductive aging workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab 2012; 97(4): 1159-68.
[http://dx.doi.org/10.1210/jc.2011-3362] [PMID: 22344196]
[2]
Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev 2012; 2012(9)Cd007244
[http://dx.doi.org/10.1002/14651858.CD007244.pub2] [PMID: 22972105]
[3]
McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Am J of Hum Biol 1992; 4(1): 37-46.
[http://dx.doi.org/10.1002/ajhb.1310040107] [PMID: 28524413]
[4]
Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med 2015; 175(4): 531-9.
[http://dx.doi.org/10.1001/jamainternmed.2014.8063] [PMID: 25686030]
[5]
Mishra G, Kuh D. Perceived change in quality of life during the menopause. Soc Sci Med 2006; 62(1): 93-102.
[http://dx.doi.org/10.1016/j.socscimed.2005.05.015] [PMID: 15990213]
[6]
Peeyananjarassri K, Baber R. Effects of low-dose hormone therapy on menopausal symptoms, bone mineral density, endometrium, and the cardiovascular system: a review of randomized clinical trials. Climacteric 2005; 8(1): 13-23.
[http://dx.doi.org/10.1080/13697130400012288] [PMID: 15804728]
[7]
Maclennan AH, Broadbent JL, Lester S, Moore V. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes. Cochrane Database Syst Rev 2004; 2004(4)Cd002978
[http://dx.doi.org/10.1002/14651858.CD002978.pub2] [PMID: 15495039]
[8]
Lumsden MA, Davies M, Sarri G. Diagnosis and management of menopause: The National Institute of Health and Care Excellence (NICE) Guideline. JAMA Intern Med 2016; 176(8): 1205-6.
[http://dx.doi.org/10.1001/jamainternmed.2016.2761] [PMID: 27322881]
[9]
Stuenkel CA, Davis SR, Gompel A, et al. Treatment of symptoms of the menopause: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2015; 100(11): 3975-4011.
[http://dx.doi.org/10.1210/jc.2015-2236] [PMID: 26444994]
[10]
Kalati M, Kashanian M, Jahdi F, Naseri M, Haghani H, Sheikhansari N. Evening primrose oil and labour, is it effective? A randomised clinical trial. J Obstet Gynaecol 2018; 38(4): 488-92.
[http://dx.doi.org/10.1080/01443615.2017.1386165] [PMID: 29426270]
[11]
Kataria K, Dhar A, Srivastava A, Kumar S, Goyal A. A systematic review of current understanding and management of mastalgia. Indian J Surg 2014; 76(3): 217-22.
[http://dx.doi.org/10.1007/s12262-013-0813-8] [PMID: 25177120]
[12]
Douglas S. Premenstrual syndrome. Evidence-based treatment in family practice. Can Fam Physician 2002; 48: 1789-97.
[PMID: 12489244]
[13]
Bayles B, Usatine R. Evening primrose oil. Am Fam Physician 2009; 80(12): 1405-8.
[PMID: 20000302]
[14]
Granica S, Czerwinska ME, Piwowarski JP, Ziaja M, Kiss AK. Chemical composition, antioxidative and anti-inflammatory activity of extracts prepared from aerial parts of Oenothera biennis L. and Oenothera paradoxa Hudziok obtained after seeds cultivation. J Agric Food Chem 2013; 61(4): 801-10.
[http://dx.doi.org/10.1021/jf304002h] [PMID: 23311638]
[15]
Doshi SB, Agarwal A. The role of oxidative stress in menopause. J Midlife Health 2013; 4(3): 140-6.
[http://dx.doi.org/10.4103/0976-7800.118990] [PMID: 24672185]
[16]
Signorelli SS, Neri S, Sciacchitano S, et al. Behaviour of some indicators of oxidative stress in postmenopausal and fertile women. Maturitas 2006; 53(1): 77-82.
[http://dx.doi.org/10.1016/j.maturitas.2005.03.001] [PMID: 16325025]
[17]
Asiri YA. The ABC clinical guide to herbs. Ann Saudi Med 2004; 24(2): 149.
[http://dx.doi.org/10.5144/0256-4947.2004.149]
[18]
Golmakani N, Parnan Emamverdikhan A, Zarifian A, Sajadi Tabassi SA, Hassanzadeh M. Vitamin E as alternative local treatment in genitourinary syndrome of menopause: a randomized controlled trial. Int Urogynecol J 2019; 30(5): 831-7.
[http://dx.doi.org/10.1007/s00192-018-3698-z] [PMID: 29971469]
[19]
Ziaei S, Kazemnejad A, Zareai M. The effect of vitamin E on hot flashes in menopausal women. Gynecol Obstet Invest 2007; 64(4): 204-7.
[http://dx.doi.org/10.1159/000106491] [PMID: 17664882]
[20]
Philp HA. Hot flashes -- A review of the literature on alternative and complementary treatment approaches. Altern Med Rev 2003; 8(3): 284-302.
[PMID: 12946239]
[21]
Newton KM, Buist DS, Keenan NL, Anderson LA, LaCroix AZ. Use of alternative therapies for menopause symptoms: results of a population-based survey. Obstet Gynecol 2002; 100(1): 18-25.
[http://dx.doi.org/10.1097/00006250-200207000-00004] [PMID: 12100799]
[22]
Keenan NL, Mark S, Fugh-Berman A, Browne D, Kaczmarczyk J, Hunter C. Severity of menopausal symptoms and use of both conventional and complementary/alternative therapies. Menopause 2003; 10(6): 507-15.
[http://dx.doi.org/10.1097/01.GME.0000064865.58809.3E] [PMID: 14627858]
[23]
Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions: The Cochrane Collaboration 2011.
[24]
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009; 339: b2700.
[http://dx.doi.org/10.1136/bmj.b2700] [PMID: 19622552]
[25]
Guyatt GH, Oxman AD, Kunz R, Vist GE, Falck-Ytter Y, Schunemann HJ. What is “quality of evidence” and why is it important to clinicians? BMJ 2008; 336(7651): 995-8.
[http://dx.doi.org/10.1136/bmj.39490.551019.BE] [PMID: 18456631]
[26]
Review Manager (RevMan). Version. 5.3.5 ed.. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration 2014.
[27]
Balshem H, Helfand M, Schunemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 2011; 64(4): 401-6.
[http://dx.doi.org/10.1016/j.jclinepi.2010.07.015] [PMID: 21208779]
[28]
GRADEpro GDT. In: [Software] GGDT, editor. GRADEpro Guideline Development Tool [Software] Evidence Prime Inc. In: McMaster University 2015.
[29]
Darsareh F. Effect of oral consumption of evening primrose oil on menopausal symptoms in 45-60 years old menopausal women 2019. IRCT20181107041585N2. March 11, 2019. World Health Organization Available from: http://apps.who.int/trialsearch/Trial2.aspx? TrialID= [Accessed on: July 10: 2019].
[30]
Chenoy R, Hussain S, Tayob Y, O’Brien PMS, Moss MY, Morse PF. Effect of oral gamolenic acid from evening primrose oil on menopausal flushing. BMJ 1994; 308(6927): 501-3.
[http://dx.doi.org/10.1136/bmj.308.6927.501] [PMID: 8136666]
[31]
Farzaneh F, Fatehi S, Sohrabi MR, Alizadeh K. The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Arch Gynecol Obstet 2013; 288(5): 1075-9.
[http://dx.doi.org/10.1007/s00404-013-2852-6] [PMID: 23625331]
[32]
Mehrpooya M, Rabiee S, Larki A, et al. A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes. J Educ Health Promot 2018; 7: 36.
[PMID: 29619387]
[33]
Motaghi Dastenaei B, Safdari F, Raisi Dehkordi Z, Karimian Z. The effect of evening primrose plant on physical symptoms of menopause. J Babol Univ Med Sci 2017; 19(2): 34-40.
[34]
Yakoot M, Salem A, Omar AM. Effectiveness of a herbal formula in women with menopausal syndrome. Forsch Komplementm ed 2011; 18(5): 264-8.
[http://dx.doi.org/10.1159/000333430] [PMID: 22105039]
[35]
Huntley AL, Ernst E. A systematic review of herbal medicinal products for the treatment of menopausal symptoms. Menopause 2003; 10(5): 465-76.
[http://dx.doi.org/10.1097/01.GME.0000058147.24036.B0] [PMID: 14501609]
[36]
Kronenberg F, Fugh-Berman A. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Ann Intern Med 2002; 137(10): 805-13.
[http://dx.doi.org/10.7326/0003-4819-137-10-200211190-00009] [PMID: 12435217]
[37]
Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010; 340: c332.
[http://dx.doi.org/10.1136/bmj.c332] [PMID: 20332509]
[38]
Vitale SG, Caruso S, Rapisarda AMC, Cianci S, Cianci A. Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study. Prz Menopauzalny 2018; 17(1): 32-8.
[http://dx.doi.org/10.5114/pm.2018.73791] [PMID: 29725283]
[39]
Cianci A, Colacurci N, Paoletti AM, et al. Soy isoflavones, inulin, calcium, and vitamin D3 in post-menopausal hot flushes: an observational study. Clin Exp Obstet Gynecol 2015; 42(6): 743-5.
[PMID: 26753476]
[40]
Chen LR, Ko NY, Chen KH. Isoflavone supplements for menopausal women: A systematic review. Nutrients 2019; 11(11): 2649.
[http://dx.doi.org/10.3390/nu11112649] [PMID: 31689947]
[41]
Lethaby A, Marjoribanks J, Kronenberg F, Roberts H, Eden J, Brown J. Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database Syst Rev 2013; 2013(12) CD001395
[PMID: 24323914]
[42]
Caruso S, Cianci S, Cariola M, Fava V, Rapisarda AM, Cianci A. Effects of nutraceuticals on quality of life and sexual function of perimenopausal women. J Endocrinol Invest 2017; 40(1): 27-32.
[http://dx.doi.org/10.1007/s40618-016-0500-2] [PMID: 27300032]

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