2023 International Journal of Environmental Research and Public Health

Dark chocolate, with its high cocoa content, may possess pain-relieving properties comparable to Ibuprofen.

In this research, a randomized controlled trial with a quantitative design was conducted, involving 45 participants randomly assigned to receive 330 mL of green coconut water, 35 g of 70% dark chocolate, or 400 mg Ibuprofen.

After the intervention, there was a noticeable change in the reported pain intensities. Among the women, 48.9% reported experiencing mild pain, indicating a reduction in pain intensity. Furthermore, 17.8% of the women still reported moderate pain, suggesting some improvement but not a complete alleviation of pain. It is noteworthy that none of the women reported severe pain after the intervention. Additionally, 33.3% of the women reported being pain-free, indicating a significant decrease in pain intensity.

These findings demonstrate the effectiveness of the interventions in reducing pain intensity among women. The results suggest that the treatments, including Ibuprofen, coconut water, and dark chocolate, were successful in providing pain relief, with the majority of women experiencing either mild pain or no pain after the intervention.

Single-Blind Randomized Controlled Trial: Comparative Efficacy of Dark Chocolate, Coconut Water, and Ibuprofen in Managing Primary Dysmenorrhea Nuha K, Rusmil K, Ganiem AR, Permadi W, Diah Herawati DM

2023 Metabolites

Consuming bicarbonate-calcium mineral water, low in sodium, can help manage calcium imbalance and support bone health in perimenopausal women.

The study involved 120 perimenopausal women who consumed 2 liters of a specific bicarbonate-calcium mineral water (Lete) daily for six months. This water was chosen because it is rich in calcium and bicarbonate but low in sodium. The study aimed to determine the impact of this water on bone health and overall metabolism. The participants’ urine and blood serum were analyzed using NMR-based metabolomic procedures. These analyses were conducted to assess the effects of the water not only on calcium metabolism but also on the broader systemic metabolism.

The findings indicated that the Lete water effectively compensated for calcium dysmetabolism and supported bone health and integrity in perimenopausal women. While the study primarily focused on bone metabolism, it also provided insights into the potential system-wide metabolic effects of this specific type of mineral water. This suggests that such water could be a valuable dietary supplement for addressing calcium-related metabolic issues, particularly in perimenopausal women.

Supplementing Low-Sodium Bicarbonate–Calcic (Lete)® Water: Effects in Women on Bone and Systemic Metabolism Marino C, Pagano I, Castaldo G, Grimaldi M, D’Elia M, Santoro A, Conte A, Molettieri P, Parisella C, Buonocore M, D’Ursi AM, Rastrelli L

2023 Journal of Global Research in Public Health

Young coconut water has been found to be more effective than carrot juice in reducing the severity of dysmenorrhea in teenage girls.

In this experimental study, research was conducted using a pre-experimental research design with a two group comparison pre-test and post-test. The research population was compiled of teenage girls from a school in the City of Kediri. The investigators selected a sample of 32 respondents using purposive sampling methods, and utilized observation sheets and pain scale measurements from the Femoralis Rectus Sheath as their primary data collection tools.

The results of the study highlighted a significant difference in the effectiveness of the two tested interventions, young coconut water and carrot juice, for the alleviation of dysmenorrhea symptoms. In this comparison, it was found that young coconut water showed higher effectiveness in reducing the pain severity in teenage girls than carrot juice.

Effectiveness of Young Coconut Water And carrots Juice Against the Scale of Dysmenorrhea on The Teenage Princess Candra Wahyuni

2023 Food Research International

Fermented soy milk significantly improves lipid profiles and fertility in a model of premenopausal mice, due to increased bioavailability and action of beneficial compounds.

In this study, non-fermented soy beverage (SB) and soy beverage fermented with Bifidobacterium pseudocatenulatum INIA P815 (FSB) were tested on both cyclic and acyclic C57BL/6J aged female mice which mimic premenopause and menopause conditions respectively. Over a period of 36 days, the beverages were given to the mice and the variables measured included body weight, lipid and inflammatory profile and fertility. In addition, hepatic gene expressions were examined and the faecal microbiota composition was assessed to further understand the effects of the two beverages.

In the results, FSB displayed a higher concentration of the aglycones daidzein and genistein as well as increased antioxidant activity due to the fermentation process. The cyclic mice that were given FSB experienced a significant rise in the number of oocytes and zygotes retrieved. It was also noticed that the triglycerides were lower in the groups that were given FSB compared to the SB groups. However, it was found that neither of the treatments significantly influenced the inflammatory profile or caused a major shift in intestinal microbiota or hepatic gene expressions in either of the groups. Still, it was observed that FSB had more health benefits than SB with regards to the lipid profile and fertility in the cyclic mice, likely due to the increased bioavailability and bioactivity of compounds due to fermentation.

Effect of fermented soy beverage in aged female mice model Ruiz de la Bastida A, Langa S, Peirotén , Fernández-Gonzalez R, Sánchez-Jiménez A, Maroto M, Antonio Curiel J, Guillamon E, Arqués JL, Gutiérrez-Adán A, Landete JM

2023 Modern Care Journal

Saffron shows promising improvements in dealing with women's health issues related to labor, childbirth, premenstrual syndrome and menopause.

For the methodology, the investigators implemented a systematic review by utilizing the PICO process to explore various databases like PubMed, Scopus, Cochrane, among others, until February 2023. A strategically designed search was conducted using a set of keywords related to saffron and women's health conditions. From a pool of 164 articles, 20 randomized controlled trials that met the minimum score based on the Jadad scale were included in the study.

In terms of results, the investigation revealed that saffron holds positive impacts on labor and childbirth, such as enhancing Bishop's score, fostering labor progression, and reducing labor pain intensity and fatigue. Moreover, it helps with episiotomy healing and ameliorates mood swings and psychological symptoms associated with menopause and premenstrual syndrome. The study also acknowledges some influence of saffron on postpartum depression.

Efficacy of Saffron (Crocus sativus L.) in Premenstrual Syndrome, Labor, Childbirth, and Menopause: A Systematic Review of Clinical Trials Irani M, Rahmanian A, Soltani N

2022 Medicine

High prevalence of insomnia, anxiety, and depression among perimenopausal women, emphasizing the importance of exploring acupuncture as a potential green therapy for effectively addressing these interconnected issues.

This passage discusses the prevalence of insomnia among perimenopausal women, its association with anxiety and depression, and the potential of acupuncture as a green therapy for treating these issues. The passage outlines the objectives and methods of a systematic review aiming to evaluate the efficacy of acupuncture in improving sleep quality and alleviating anxiety and depression in perimenopausal women, highlighting the need for safer alternatives to conventional medications and the significance of such a study.

Can acupuncture improve sleep quality and anxiety among women during perimenopause? Ping Y, Liang C, Fan X, Zhang L, Ying D, Wang Z

2022 Journal of Integrative Medicine

Acupuncture, when used in conjunction with medicine or alone, appears to improve certain PCOS outcomes such as ovulation rate and recovery of menstrual cycle.

This overview consolidates existing systematic reviews (SRs) on the efficacy and safety of acupuncture for treating Polycystic Ovary Syndrome (PCOS). Methodological quality, risk of bias, and confidence in evidence were assessed from these SRs to guide clinical practice and future research directions. However, due to the inconsistency and low quality of evidence, a definitive conclusion regarding the benefits of acupuncture for PCOS remains elusive. Notably, though all included SRs suggest potential benefits, their conclusions are undermined by defects in individual SRs and the limited reliability of evidence. Acupuncture, when used in conjunction with medicine or alone, appears to improve certain PCOS outcomes such as ovulation rate and recovery of menstrual cycle. Adverse events are mild, and while some evidence points to favorable effects on various outcomes, confidence remains too low to draw firm conclusions. The review highlights methodological shortcomings in SRs' assessments and calls for robust future studies. These studies should feature pre-registered protocols, comprehensive literature retrieval, detailed statistical methods, thorough reporting of trial characteristics and funding sources, and strategies to address bias and heterogeneity. In spite of potential benefits, the current evidence's poor quality and inconsistencies necessitate further high-quality research to establish acupuncture's effectiveness and safety for PCOS definitively.

Efficacy and safety of acupuncture for polycystic ovary syndrome: An overview of systematic reviews Yang H, Xiao Z, Yin Z, Yu Z, Liu J, Xiao Y, Zhou Y, Li J, Yang J, Liang F

2022 Frontiers in Endocrinology

PCOS patients suggests that combining acupuncture with metformin might enhance pregnancy and ovulation rates, as well as improve insulin resistance.

The study initially screened 330 relevant articles, eventually including nine randomized controlled trials (RCTs) that met the inclusion criteria. These trials encompassed 1,159 patients with PCOS who underwent acupuncture or acupuncture combined with metformin treatment. Using the GRADE method, a "Summary of Findings" table was employed to evaluate the quality of evidence for various outcome measures. The main results indicated that acupuncture combined with metformin exhibited superiority over metformin alone in terms of pregnancy rate, ovulation rate, and HOMA-IR (insulin resistance). Subgroup analysis highlighted that diagnostic criteria and random methods contributed to heterogeneity in results.

However, the evidence's quality was predominantly low or very low due to study limitations, inconsistencies, and imprecisions. The intervention measures, such as acupuncture methods and treatment parameters, varied substantially among studies. Challenges in contacting original authors and incomplete information posed further limitations. The study suggested potential improvements in pregnancy rate, ovulation rate, and HOMA-IR with acupuncture combined with metformin, but these findings were subject to uncertainties related to diagnostic criteria and overall evidence quality. Consequently, the conclusive efficacy of acupuncture combined with metformin for treating PCOS remains uncertain due to the dearth of high-quality research. The study called for well-designed and well-executed RCTs to address this question under standardized diagnostic criteria and treatment protocols for acupuncture and metformin.

Acupuncture combined with metformin versus metformin alone to improve pregnancy rate in polycystic ovary syndrome: A systematic review and meta-analysis Chen X, Lan Y, Yang L, Liu Y, Li H, Zhu X, Zhao Y, Long C, Wang M, Xie Q, Li Z, Wu J

2022 Journal of Asian Multicultural Research for Medical and Health Science Study

Honey, combined with Iron (Fe), effectively enhances hemoglobin levels and reduces oxidative stress markers in anemic expectant mothers.

This quasi-experimental study with a pretest-posttest design involved 30 pregnant women divided into two groups: one receiving Fe (Control Group) and the other Honey + Fe (Intervention Group) for 60 days. Blood and urine analyses revealed a remarkable increase in hemoglobin levels in the Honey + Fe group (2.80 ± 0.26 g/dl), surpassing the Fe control group (0.80 ± 0.13 g/dl). Moreover, the Intervention Group demonstrated a notable decrease in 8-Ohdg levels (-4.23 ± 1.32 nmol/ml, p = 0.031), indicating reduced oxidative stress, while the Fe control group exhibited less significant changes (2.98 ± 1.30 nmol/ml, p = 0.322). Independent T Test confirmed the Honey + Fe group's superior effectiveness in increasing hemoglobin levels and decreasing 8-Ohdg levels in anemic pregnant women (p = 0.001 and p = 0.002, respectively).

The study underscores the synergistic benefits of honey and iron supplementation in enhancing hemoglobin levels and mitigating oxidative stress among anemic pregnant women. The robust findings, supported by statistical significance, emphasize the potential clinical relevance of incorporating honey into anemia management strategies, offering a more effective approach compared to iron supplementation alone.

Effect of Honey to Levels Hemoglobin and Levels of 8-Hydroxy-2-Deoxyguanosin (8-Ohdg) in Pregnant Women with Anemia A A, Astuti A, Leli L, Saad R

2021 Evidence-Based Complementary and Alternative Medicine

Acupuncture therapy on patients with recurrent implantation failure can improve the pregnancy outcome of patients. It is a relatively effective treatment with satisfactory safety and suitable for clinical application.

The aim of this analysis was to identify the efficacy and safety of acupoint stimulation therapy for RIF patients. The results of meta-analysis show that for the outcome measurements including clinical pregnancy rate, biochemical pregnancy rate, embryo implantation rate, and endometrial thickness, the use of acupuncture in the treatment group is higher than the sham or nonacupuncture group, in which the difference is statistically significant. These results are believable and reliable. The included studies are highly homogeneous and there is no obvious publication bias. However, large heterogeneity appears in the statistical analysis of the endometrial thickness. Moreover, there was no statistical significance in the number of embryo transfers and the type of endometrium.

The Effects of Acupuncture on Pregnancy Outcomes of Recurrent Implantation Failure: A Systematic Review and Meta-Analysis Li, M., Liu, Y., Wang, H., Zheng, S., Deng, Y., & Li, Y.

2021 Medicine

Acupuncture can effectively improve the post voided residual urine, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy.

There is insufficient evidence that acupuncture can increase the patient's MFR, BR, and UIR. However, acupuncture can effectively improve the PVR, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy. Although limited due to the quality and methodological limitations of the included studies, acupuncture can still be used as an effective and safe treatment for women with urinary retention after hysterectomy.

Efficacy and safety of acupuncture for urinary retention after hysterectomy Zhao Q, Yan C, Dan M, Jia H

2021 Reproductive BioMedicine & Society Online

Women receiving IVF perceived that acupuncture or sham acupuncture gave them a psychological advantage through increased relaxation, reduced psychological stress, and enhanced well-being and self-efficacy.

In this qualitative study, participants reported that compassionate care and an opportunity to rest during IVF, and especially following embryo transfer, had an emotionally important effect. All women in the trial underwent the same procedural practices which involved bed rest during needling, among other comforts. Some women described benefitting purely from this opportunity to rest quietly in a supportive environment amidst the maelstrom of IVF. There was also recognition that this ‘oasis’, albeit brief, was an important time for allowing the meaning of having an embryo transferred to ‘soak in’, and presented an oppportunity to ‘be in the moment’.

IVF, acupuncture and mental health: a qualitative study of perceptions and experiences of women participating in a randomized controlled trial of acupuncture during IVF treatment de Lacey S, Sanderman E, Smith CA

2021 Frontiers in Medicine

Adding acupuncture to conventional therapy may decrease the subsequent endometriosis risk in female rheumatoid arthritis patients.

Between 1998 and 2010, female subjects with RA were recruited from a nationwide database (5,736 patients; age ≥20 years). Enrolled patients included 2,407 acupuncture users and 2,407 nonusers randomly selected using propensity scores. The occurrence of endometriosis was recorded through the end of 2012. Cox proportional hazards regression was used to estimate the adjusted hazard ratio (HR) associated with acupuncture use.

Results: During the follow-up period, 35 acupuncture users and 94 non-users developed endometriosis, with incidence rates of 2.36 and 4.91 per 1,000 person-years, respectively. Acupuncture use was associated with a 55% lower endometriosis risk. Those who received high intensity acupuncture (≥15 packages) had the greatest benefit.

The results of multivariable analysis demonstrated that the use of acupuncture was related to a significantly reduced risk of endometriosis. In the subgroup analysis, the medium- to high-level intensity acupuncture use was found to possibly lessen the risk of having endometriosis for more than 70%. We discovered that the post-rheumatoid arthritis acupuncture use would significantly reduce the risk of endometriosis in a dose-dependent manner.

The Relationship of Acupuncture Use to the Endometriosis Risk in Females With Rheumatoid Arthritis: Real-World Evidence From Population-Based Health Claims Chen Wei-Jen, Livneh Hanoch, Hsu Chien-Hui, Hu Ying-To, Lai Ning-Sheng, Guo How-Ran, Tsai Tzung-Yi

2021 Evidence-Based Complementary and Alternative Medicine

Acupuncture alone or traditional Chinese medicines (taken orally) in combination with western medicine significantly increased the pregnancy rate of PCOS patients and CAM was more effective than western medicine alone for improving hormone levels.

This review identified 13 RCTs involving 1,297 PCOS patients with abnormal endometrial status. This systematic review suggests that CAM has potential for improving endometrial thickness, endometrial type, serum hormone level, and pregnancy rate in PCOS patients. However, due to the limited quantity and the general low quality of the methodology of the included trials, more in-depth research is required before CAM can be applied more widely in clinical practice. Thus more rigorous double-blind, placebo-controlled trials should be conducted to confirm the efficacy of CAM in improving endometrial condition in PCOS patients.

Complementary and Alternative Medicine for the Treatment of Abnormal Endometrial Conditions in Women with PCOS: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Jiayu Hu, Wenhua Shi, Jiayue Xu, Shaoxuan Liu, Siya Hu, Wenjing Fu, Jing Wang and Fengjuan Han

2021 Molecules

In reproductive health, honey can improve infertility, protect the postmenopausal reproductive tract, prevent toxic effects, maintain sperm quality by restoring testosterone levels and treat vulvovaginal candidiasis infections.

Honey has a highly complex chemical and biological composition that consists of various essential bioactive compounds, enzymes, amino and organic acids, acid phosphorylase, phytochemicals, carotenoid-like substances, vitamins and minerals. Reproductive health and fertility rates have declined in the last 30 years. Therefore, this review aimed to highlight the protective role of honey as a potential therapeutic in maintaining reproductive health.

The main role of honey is to enhance fertility and treat infertility problems by acting as an alternative to hormone replacement therapy for protecting the vagina and uterus from atrophy, protecting against the toxic effects of xeno-oestrogenic agents on female reproductive functions and helping in the treatment of gynaecological disorders, such as vulvovaginal candidiasis infection, that affect women’s lives.

Protective Roles of Honey in Reproductive Health: A Review Zaid SSM, Ruslee SS, Mokhtar MH

2021 Complementary Therapies in Medicine

The Licorice and Jujube formula is seen as commonly used and potentially effective for treating menopausal symptoms as per classical Chinese medicine.

The methodology of this study involved exploring classical Chinese medicine textbooks to find the most frequent herbal mix used for symptoms similar to menopause. The approach taken was to sort and identify the formulas from the Encyclopedia of Traditional Chinese Medicine, a comprehensive resource in this field. Following this, a thorough review of randomized controlled trials was performed in order to determine the efficacy of the most common formula.

In terms of results, it was discovered that the Licorice and Jujube formula (LJF) was the most commonly found, mentioned in 36% of the analyzed references. The review of controlled trials revealed that the LJF might be effectively utilized for the improvement of sleep-related symptoms. Additionally, experimental studies hinted at potential benefits of the LJF, including sedative, antidepressant-like, estrogenic, and antiprogestogenic effects.

Licorice (Glycyrrhiza spp.) and jujube (Ziziphus jujuba Mill.) formula for menopausal symptoms: Classical records, clinical evidence and experimental data Coyle ME, Liu J, Yang H, Wang K, Zhang AL, Guo X, Lu C, Xue CC

2021 European Journal of Obstetrics & Gynecology and Reproductive Biology

Phytoestrogens, used in various forms, have shown improvement in urogenital menopause symptoms and improved women's sexual function, promoting overall quality of life.

A thorough and systematic review was conducted on databases including PubMed, EMBASE, Web of Science, Cochrane library, Scopus and ProQuest, spanning from the years 2000-2020. The focus was solely on randomized clinical trials. An evaluation of the quality of selected papers was carried out using the CONSORT checklist. In total, 33 high-quality papers were reviewed which discussed the different forms and uses of phytoestrogens.

The results of this systematic review reveal that phytoestrogens including Pueraria Mirifica, fennel, Hop plant, Glycine Max, soy, red clover, black cohosh, ginsing, cimicifugaracemosa, genistein, diadzein, glycitein and isoflavone, used as various products such as oral capsules, pills, food supplements, enriched powders, vaginal gels, creams and suppositories, improved menopausal urogenital symptoms. Particularly, the recovery rate was found to be higher when these were applied vaginally. Further implication of these findings is the enhancement of women's sexual function following treatment, validating the use of phytoestrogens as a safe, low-risk and accessible method to alleviate urogenital symptoms.

Impact of phytoestrogens on treatment of urogenital menopause symptoms: A systematic review of randomized clinical trials Abdi F, Rahnemaei FA, Roozbeh N, Pakzad R

2021 Phytotherapy Research

Curcumin supplements have comparable effects to placebos in alleviating symptoms of Premenstrual Syndrome and dysmenorrhea in young women.

In the methodology of this study, a randomized, triple-blinded, placebo-controlled trial was carried out. Women who were affected by both Premenstrual Syndrome and dysmenorrhea were enrolled and randomly assigned to either the curcumin or placebo group. Participants were given a capsule, containing either 500mg of curcuminoid or a placebo, once daily, starting from 7 days before menstruation and continuing till three days after menstruation. This was maintained for three continuous menstrual cycles.

As per the results, upon the completion of the trial, both the curcumin and placebo groups witnessed a significant decrease in the severity of Premenstrual Syndrome and dysmenorrhea symptoms, as evident by a decrease in the scores of the Premenstrual Syndrome Screening Tool and the visual analog scale. Therefore, curcumin was found to have similar effects to the placebo, in terms of relieving symptoms of both Premenstrual Syndrome and dysmenorrhea.

Effects of curcumin on menstrual pattern, premenstrual syndrome, and dysmenorrhea: A triple‐blind, placebo‐controlled clinical trial Bahrami A, Zarban A, Rezapour H, Agha Amini Fashami A, Ferns GA

2021 Phytotherapy Research

Curcumin supplements have comparable effects to placebos in alleviating symptoms of Premenstrual Syndrome and dysmenorrhea in young women.

In the methodology of this study, a randomized, triple-blinded, placebo-controlled trial was carried out. Women who were affected by both Premenstrual Syndrome and dysmenorrhea were enrolled and randomly assigned to either the curcumin or placebo group. Participants were given a capsule, containing either 500mg of curcuminoid or a placebo, once daily, starting from 7 days before menstruation and continuing till three days after menstruation. This was maintained for three continuous menstrual cycles.

As per the results, upon the completion of the trial, both the curcumin and placebo groups witnessed a significant decrease in the severity of Premenstrual Syndrome and dysmenorrhea symptoms, as evident by a decrease in the scores of the Premenstrual Syndrome Screening Tool and the visual analog scale. Therefore, curcumin was found to have similar effects to the placebo, in terms of relieving symptoms of both Premenstrual Syndrome and dysmenorrhea.

Effects of curcumin on menstrual pattern, premenstrual syndrome, and dysmenorrhea: A triple‐blind, placebo‐controlled clinical trial Bahrami A, Zarban A, Rezapour H, Agha Amini Fashami A, Ferns GA

2021 Nutrients

Moderate daily consumption of beer, both with and without alcohol, can significantly alleviate menopause-related symptoms and improve cardiovascular health in postmenopausal women.

In the research, 37 postmenopausal women were voluntarily put through a parallel controlled intervention trial, involving three study groups. The trial involved 16 women consuming beer with alcohol (330 mL/day), 7 women consuming non-alcoholic beer (660 mL/day), and 14 women as control.

In assessing the results, it was found that both interventions, beer with and without alcohol, substantially reduced the severity of menopause-associated symptoms. Specifically, beer with alcohol positively contributed to reducing psychological discomforts linked to menopause when compared to the control group. It was additionally noted that these beneficial effects could be traced to the non-alcoholic section of the beer, as the sex hormone profile remained largely unchanged across the different study groups. In addition, the group that consumed non-alcoholic beer conveyed improvements in their lipid profiles and exhibited lower blood pressure levels, indicating better cardiovascular health.

Moderate Consumption of Beer (with and without Ethanol) and Menopausal Symptoms: Results from a Parallel Clinical Trial in Postmenopausal Women Trius-Soler M, Marhuenda-Muñoz M, Laveriano-Santos EP, Martínez-Huélamo M, Sasot G, Storniolo CE, Estruch R, Lamuela-Raventós RM, Tresserra-Rimbau A

2020 Journal of Acupuncture and Tuina Science

The present study indicated that acupuncture had an advantage over hormone replacement therapy in reducing serum FSH level and increasing serum E2 level in women with premature ovarian insufficiency.

Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level and a remarkable elevation in the basal E2 level in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone and acupuncture plus HRT, while a remarkable elevation of E2 was only found in acupuncture plus HRT. There was no significant difference in the LH level between acupuncture and HRT, only one trial reported AMH, and no significant difference was found between acupuncture and HRT.

Acupuncture for premature ovarian insufficiency: a systematic review and meta-analysis Yin, Yq., Xu, Hf., Fang, Yg. et al.

2020 European Journal of Integrative Medicine

Compared with western medicine, acupuncture significantly increased the pregnancy and ovulation rates, as well as reducing the rate of miscarriages among Chinese women with infertility.

Twenty-four eligible RCTs (n=2095) were included in this review. The NMA data showed that warm acupuncture had the highest chances of increasing the rate of pregnancy while acupuncture most positively affected the ovulation rate. On the other hand, a combination of acupuncture and moxibustion had the most significant improvement in endometrial thickness and could reduce the rate of pregnancy loss.

Effectiveness of different acupuncture for infertility: Overview of systematic reviews and network meta-analysis Zhang, J., He, Y., Liu, Y., Huang, X., & Yu, H.

2020 Deutsches Arzteblatt International

Acupuncture may be considered in patients with persistent, idiopathic vulvar pruritus.

Vulvar pruritus is a complex symptom of multifactorial origin, frequently affecting the patient’s quality of life. The treatment of patients with chronic pruritus (>6 weeks) is particularly challenging and often requires a multimodal strategy with an interdisciplinary approach. Besides the elimination of potential triggers and continuous lipid-replenishing basic care, antifungal agents and glucocorticoids are paramount. Medical professionals not specialized in the field should refer patients with refractory and/or suspicious lesions to an experienced gynecologist. A specimen should be obtained by punch biopsy for histological evaluation to rule out (pre-) malignant lesions.

It is central to the management of vulvar pruritus to offer a detailed discussion of the condition and treat patients with empathy. Their complaints should be taken seriously and patients should be informed about what could cause their symptoms and which treatment options are available for them.

Vulvar pruritus-Causes, Diagnosis and Therapeutic Approach Woelber L, Prieske K, Mendling W, Schmalfeldt B, Tietz HJ, Jaeger A.

2020 Explore: The Journal of Science & Healing

Modified Tao-Hong Siwu Tang (MTST) appears more effective than non-steroidal anti-inflammatory drugs (NSAIDs), and a combination of Tao-Hong Siwu Tang with oral contraceptives (OCs) offers benefits over OCs alone for treating primary dysmenorrhea.

This systematic review aimed to assess the efficacy and safety of Tao-Hong Siwu Tang (TST) in treating primary dysmenorrhea. Conducted across various databases, the review identified five randomized controlled trials (RCTs) meeting inclusion criteria. The meta-analysis revealed suggestive evidence that modified TST (MTST) might have a favorable effect compared to non-steroidal anti-inflammatory drugs (NSAIDs) in managing primary dysmenorrhea (RR = 1.53, 95% CI = 1.37–1.72), with one RCT indicating MTST's superiority in reducing recurrence rates (RR = 0.31, 95% CI = 0.15–0.63, P = 0.001). Furthermore, combining TST with oral contraceptives (OCs) appeared beneficial compared to OCs alone (RR = 1.35, 95% CI = 1.02–1.79, P = 0.04). However, moderate evidence quality due to bias uncertainties and limited RCTs highlighted the need for cautious interpretation. The study emphasized the demand for alternative treatments, given NSAID and OC limitations, while stressing the need for rigorous large-scale trials to clarify TST's role in primary dysmenorrhea management.

Herbal medicine (Taohong Siwu Tang) for the treatment of primary dysmenorrhea: A systematic review and meta-analysis Ji HR, Park KS, Woo HL, Lee MJ, Yoon JG, Lee HJ, Hwang DS, Lee CH, Jang JB, Lee JM

2020 BioMed Research International

Endometriosis and Adenomyosis can have impact on miscarriage risk in pregnancy.

The study analyzed 39 publications involving 697,984 women to assess the impact of endometriosis (EMS) and adenomyosis (AD) on miscarriage risk. Women with EMS showed increased miscarriage risk in spontaneous conception (SC), but similar risk in assisted reproductive technology (ART) compared to tubal infertility. AD was associated with higher miscarriage risk in ART. Sensitivity analyses supported these conclusions. EMS staging did not significantly alter miscarriage risk. Early-stage EMS showed higher early abortion risk. No significant associations were found between EMS and low birthweight, placental abruption, intrauterine growth restriction, or preeclampsia. EMS correlated with higher odds of antepartum hemorrhage, postpartum hemorrhage, preterm birth, placenta praevia, and stillbirth. SUP and DIE were linked to increased miscarriage risk, while OMA showed no significant association. The findings suggest the need for closer monitoring and follow-up for pregnant women with EMS or AD, particularly in early pregnancy. Standardized recording of EMS types, stages, and miscarriage timing is recommended for future studies.

Miscarriage on Endometriosis and Adenomyosis in Women by Assisted Reproductive Technology or with Spontaneous Conception: A Systematic Review and Meta-Analysis Yangxue Huang, Xianhong Zhao, Yiyuan Chen, Jie Wang, Weilin Zheng, Lixing Cao

2020 Jurnal Kedokteran Brawijaya

Consuming 330 ml of green coconut water can be an effective non-pharmacological approach to alleviate dysmenorrhea pain.

The study used a non-pharmacological, randomized controlled trial to identify the optimal dosage of green coconut water as a magnesium source for reducing dysmenorrhea pain. A group of 21 participants was evenly divided into three groups. Treatment group 1 received 330 ml of green coconut water, treatment group 2 received 165 ml of green coconut water, and the control group was given 330 ml of mineral water. Each dosage was repeated three times every 4 hours. The study relied on the Visual Analogue Scale questionnaire to assess the severity of pain experienced by the participants both before and after the administration of the assigned drinks.

In the results discussion, it was identified that the group that ingested 330 ml of green coconut water experienced the most significant decrease in pain compared to the other two groups. Conversely, treatment group 2 showed only a minor reduction in dysmenorrhea pain. Meanwhile, the control group, which only consumed mineral water, did not display any notable changes in their levels of pain intensity. From these findings, it was concluded that a 330 ml dosage of green coconut water is an effective non-pharmacological treatment alternative for dysmenorrhea pain.

Non-pharmacological Randomised Control Trial: Green Coconut (Cocos nucifera L.) Water to Reduce Dysmenorrhea Pain Nugroho FA, Putri OM, Sariati Y

2020 Phytotherapy Research

Concentrated pomegranate juice consumption can potentially lower cardiovascular disease risk factors in women with polycystic ovary syndrome.

The study used a randomized clinical approach, enrolling 44 women identified with polycystic ovary syndrome, aged 18 to 40 years and above a certain body weight index. These participants were randomly divided into two groups: one group was given concentrated pomegranate juice (CPJ), while the other served as a control. Both groups were monitored over a period of 8 weeks, with baseline measurements taken for anthropometric measures, blood pressure, and biochemical parameters set at the onset and then compared at the end of the trial.

Upon completion, the group that consumed CPJ showed reductions in blood pressure and serum triglyceride levels — a known risk factor for cardiovascular diseases. There was also an increase in the amount of high density lipoprotein-cholesterol (good cholesterol) and a decrease in the triglyceride to high-density lipoprotein-cholesterol ratio. However, an increase was observed in levels of low-density lipoprotein-cholesterol (bad cholesterol). No adverse events or complications arose from CPJ consumption during the study period.

The effect of concentrated pomegranate juice consumption on risk factors of cardiovascular diseases in women with polycystic ovary syndrome: A randomized controlled trial Abedini M, Ghasemi‐Tehrani H, Tarrahi MJ, Amani R

2020 Current Women s Health Reviews

The use of ginger, chamomile, and honey significantly diminished the intensity of dysmenorrhea pain as compared to the use of mefenamic acid.

Methodology: The research involved 200 female students from Arak universities, suffering from primary dysmenorrhea. These participants were randomly divided into two groups. Initially, one cycle without any intervention was evaluated for all students. Following this, group A was administered 250mg of mefenamic acid while group B received a combination of 1000mg ginger, 5000mg chamomile along with a teaspoonful of honey. This regimen was followed for two days prior and for the first three days of menstruation, administered three times daily and was carried out over two consecutive cycles. To measure the pain severity, associated symptoms of dysmenorrhea and bleeding, tools such as a visual analogue scale, Andersch-Milsom Verbal Scale, and Higham chart were used.

Discussion of Results: Following the intervention, the pain intensity experienced by the group treated with ginger, chamomile, and honey was found to decrease significantly when compared to the group that was administered mefenamic acid.

The Effect of Ginger-chamomile Sachet with Honey on Primary Dysmenorrhea and Associated Symptoms: A Randomized, Double-Blind, Controlled Trial Shabani F, Chabra A, Vakilian K, Bioos S, Bozorgi M, Ayati MH, Nejatbakhsh F

2020 Complementary Therapies in Medicine

Clinical trials categorize botanical parts of date palm as being most effective in eight different areas such as obstetrics, oncology, and endocrinology.

In the study, a comprehensive review was conducted on all types of clinical trials (including randomized, pilot, quasi-experimental, cross-over, and non-randomized) assessing the clinical impacts of date palm for the period between 2000 to August 2019. These trials were sourced from both English and Persian language papers. The methodological quality of these trials was scrutinized based on the risk of bias assessment laid out by the Cochrane handbook of systematic reviews and subsequently, results were reported via the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

The study saw twenty-six research works fitting the criteria set for inclusion. These studies spanned across eight categories based on the varied botanical derivatives of the date palm. These categories consisted of fields like obstetrics, gynecology, oncology, dermatology, hematology, gastroenterology, endocrinology, metabolism, and infertility. However, there were concerns raised regarding existing biases in trial conduction, with about 80% of the studies indicating performance and detection bias, roughly half indicating selection bias, and about 20% indicating attrition and reporting bias. Regardless, these clinical trials provide useful insights into the possible health benefits of various date palm components.

Clinical effects of date palm (Phoenix dactylifera L.): A systematic review on clinical trials Bagherzadeh karimi A, Elmi A, Zargaran A, Mirghafourvand M, Fazljou SMB, araj-Khodaei M, Baghervand Navid R

2019 Evidence-Based Complementary and Alternative Medicine

This systematic review shows that the overall effectiveness of acupuncture treatment of premenstrual syndrome is superior to that of sham acupuncture and related medications.

Results. A total of 15 studies, comprising of 1103 cases, were included. Overall, acupuncture significantly increased the effective rate of PMS compared with medicine and sham acupuncture. Subgroup analyses showed no significant difference among different intervention time to start acupuncture treatment. Among the acupoints involved in the treatment of PMS, SP6, LR3, and RN4 were the most commonly used.

The current meta-analysis reveals that acupuncture leads to better effective rate, but the intervention time has no significant effect on the efficacy of acupuncture treatment for PMS. SP6, LR3, and RN4 are the most commonly used acupoints in treating PMS. However, large-scale, case-control studies with rigorous designs are required to provide more accurate evidence.

Acupuncture for Premenstrual Syndrome at Different Intervention Time: A Systemic Review and Meta-Analysis Zhang J, Cao L, Wang Y, Jin Y, Xiao X, Zhang Q

2019 Medicine

Acupuncture and its combined therapy may be effective for treating female infertility, however, the included studies are not robust enough to draw a firm conclusion.

Current evidence identified from this review suggested that acupuncture may be effective in the treatment of female infertility. The conclusion of this present review is limited by the low quality of the included studies. Future multicenter RCTs with rigorous methodological quality are needed to clarify the role of acupuncture in female infertility.

Acupuncture for infertile women without undergoing assisted reproductive techniques (ART) Yun L, Liqun W, Shuqi Y, Chunxiao W, Liming L, Wei Y

2019 Reproductive BioMedicine Online

Acupuncture may have a significant effect on clinical pregnancy rates, independent of comparator group, when used in women who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate.

Evidence suggests acupuncture may be effective when compared with no adjunctive treatment, with increased clinical pregnancies and live births, but is not an efficacious treatment when compared with sham controls. Future research should focus on different dosing acupuncture regimens, and exploration of the components of acupuncture that are contributing to improved reproductive outcomes. Increased understanding of these components may have broader application to the care and treatment modalities provided to women undergoing IVF. Further exploration of the effects of acupuncture for women with poorer IVF outcomes is warranted.

Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis Smith, C. A., Armour, M., Shewamene, Z., Tan, H. Y., Norman, R. J., & Johnson, N. P.

2019 Reproductive BioMedicine Online

Acupuncture may have a significant effect on clinical pregnancy rates, independent of comparator group, when used in women who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate.

Evidence suggests acupuncture may be effective when compared with no adjunctive treatment, with increased clinical pregnancies and live births, but is not an efficacious treatment when compared with sham controls. Future research should focus on different dosing acupuncture regimens, and exploration of the components of acupuncture that are contributing to improved reproductive outcomes. Increased understanding of these components may have broader application to the care and treatment modalities provided to women undergoing IVF. Further exploration of the effects of acupuncture for women with poorer IVF outcomes is warranted.

Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis Smith, C. A., Armour, M., Shewamene, Z., Tan, H. Y., Norman, R. J., & Johnson, N. P.

2019 Acupuncture in Medicine

The use of acupuncture as a monotherapy significantly improved the rate of pregnancy among the study participants compared with the use of clomiphene citrate alone.

The use of acupuncture in the treatment of infertility may be an appropriate alternative for some patients. To our knowledge, this is the first meta-analysis available to date that compares the use of acupuncture alone or together with clomiphene citrate versus clomiphene citrate alone in the treatment of anovulatory infertility. While some results were promising, their validity is limited by questionable methodological designs, lack of sufficient allocation concealment, inadequate sample sizes and limited long-term follow-up. As such, any results drawn from these studies should be interpreted with caution and applied with care to clinical practice.

Acupuncture and clomiphene citrate for anovulatory infertility: a systematic review and meta-analysis Gao R, Guo B, Bai J, Wu Y, Wu K

2019 BMC Complementary Medicine and Therapies

Acupuncture shows promise in improving endometrial receptivity and fertility outcomes in infertile women, but further high-quality research is needed to establish its effectiveness definitively.

This systematic review aimed to assess the effectiveness of acupuncture in improving endometrial receptivity (ER) based on randomized controlled trials (RCTs). The review included RCTs of infertile women with low ER and excluded other causes of infertility or non-RCTs. The researchers conducted an extensive search through various databases up to August 2018 without language restrictions. After analyzing the collected data, they found evidence indicating that acupuncture may enhance pregnancy rate, embryo transfer rate, trilinear endometrium, endometrial thickness, and decrease resistive index, pulse index, and peak systolic velocity/end-diastolic blood velocity when compared with medication, sham acupuncture, or physiotherapy. However, the overall level of evidence was mostly very low or low. Despite the statistically significant results, the authors emphasize the need for more large-scale, long-term RCTs with robust methodologies to further validate the efficacy and safety of acupuncture for women with low ER

Acupuncture in improving endometrial receptivity: a systematic review and meta-analysis Zhong, Y., Zeng, F., Liu, W. et al.

2019 Frontiers in Pharmacology

Gui Zhi Fu Ling Wan can potentially reduce and induce apoptosis in uterine leiomyomas cells.

In the study, human uterine myoma cells (hUtMCs) were collected from patients who had undergone surgery for this condition. The viability of these cells was tested when exposed to various doses of Gyejibongnyeong-hwan (GBH). Determination of adequate concentration for the treatment was also performed, ensuring that it did not affect normal cells adversely. Western blotting was employed to identify the expression levels of certain proteins that indicate cellular apoptosis, while the levels of reactive oxygen species were evaluated through fluorescence microscopy. Finally, the researchers looked into the time-dependent anti-neoplastic effect of GBH in order to establish an appropriate treatment duration under a non-harmful concentration of the medication.

The results showed that Gyejibongnyeong-hwan (GBH) drastically reduced the viability and number of hUtMCs within 48 hours in a dose-dependent manner. It was identified that the ratio of certain proteins and the expression of other apoptosis-related ones increased, suggesting that GBH induced cellular self-destruction in uterine leiomyomas. Moreover, it was shown that GBH noticeably increased the mitochondrial concentration of reactive oxygen species. Conversely, by using certain inhibitors along with GBH, the apoptotic effect mediated by GBH was mitigated. This evidence suggests that GBH could potentially trigger apoptosis of leiomyomas and hence, presents a promising therapeutic agent in managing uterine leiomyomas.

Gyejibongnyeong-Hwan (Gui Zhi Fu Ling Wan) Ameliorates Human Uterine Myomas via Apoptosis Lee SM, Choi ES, Ha E, Ji KY, Shin SJ, Jung J

2019 Biomedicines

Guizhi Fuling Wan, a traditional herbal formula, can improve peripheral blood flow in menopausal hot flush sufferers, despite not changing the frequency or severity of the flushes.

The methodology used in this study involved a comprehensive literature search across 20 English and Chinese databases for relative clinical and experimental studies. From the nearly 13,000 studies identified, only 46 were evaluated as relevant and thus included in the review. These articles were comprised of seven clinical studies detailing Guizhi Fuling Wan's effects on menopausal hot flushes and 35 phytochemical analysis studies that identified the 169 chemical compounds in the herbal formula. Four experimental studies were also utilized to discover the potential therapeutic effects and target proteins/cytokines related to these hot flushes.

The findings indicate that Guizhi Fuling Wan, despite exhibiting no significant impact on the frequency or severity of menopausal hot flushes, may have positive effects on peripheral blood flow. The blood flow improvements were specifically noted in the fingertips, jaw, and toes. Additionally, the analysis of the herbal formula revealed 169 distinct chemical compounds. Through experimental studies, potential therapeutic effects on target proteins/cytokines - including estrogen receptor beta with genetic variation, the calcitonin gene-related peptide receptor, and interleukin-8, were further highlighted. However, these therapeutic effects were inconsistent across different studies, which may be due to dosage differences and genotype variation.

A Classic Herbal Formula Guizhi Fuling Wan for Menopausal Hot Flushes: From Experimental Findings to Clinical Applications Li , Hung , Li , Yang

2018 Acupuncture in Medicine

Acupuncture appears to be effective for postpartum depression with respect to certain outcomes.

Nine trials involving 653 women were selected. The result of this meta-analysis demonstrated that the acupuncture group had a significantly greater overall effective rate compared with the control group. Moreover, acupuncture significantly increased oestradiol levels compared with the control group. Regarding the Hamilton Rating Scale for Depression (HAMD) and Edinburgh Postnatal Depression Scale (EPDS) scores, no difference was found between the two groups.

Effectiveness of Acupuncture in Postpartum Depression: A Systematic Review and Meta-Analysis Li S, Zhong W, Peng W, Jiang G

2018 Evidence-Based Complementary and Alternative Medicine

There is potential of acupuncture combined with conventional treatment for treating female chronic pelvic pain.

This review suggests the potential of acupuncture combined with conventional treatment compared to conventional treatment alone for treating female chronic pelvic pain. However, there is insufficient evidence to conclude that acupuncture can be recommended as a complementary and alternative (CAM) treatment for women with CPP. To draw a firm conclusion, future studies should require not only lager, more rigorously designed RCTs but also research on different acupuncture treatment types.

Acupuncture Treatment for Chronic Pelvic Pain in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Sung SH, Sung ADM, Sung HK, An TEB, Kim KH, Park JK

2018 British Journal of Midwifery

Acupuncture in postpartum depression was at least as effective as fluoxetine hydrochloride, supporting the notion that acupuncture may be a safe and effective option.

Of the 1592 studies reviewed, three met the inclusion criteria for quantitative analysis. Two studies reported no significant differences between acupuncture and fluoxetine for depression, while the third reported significant improvements.

Acupuncture versus antidepressants in the management of postpartum depression: A systematic review Akari Komori, David Arthur, Samara Radford, Hsiewe Ying Tan, Li Zheng, Mira An, Rika Umeda, and Zhen Zheng

2018 Reproductive Health

Endometriosis, often seen as benign, is linked to infertility and metastatic cancer, and shows different risk factors and treatment responses in Asian and European-American women.

The research studied endometriosis in Chinese women, thoroughly examining genetic and environmental risk factors, diagnosis strategies, treatment methods and their effects. It particularly focused on the presence and impact of various genetic mutations and polymorphisms that may increase endometriosis risk in this demographic. Comparison was drawn between the data from Asian and European-American women, studying the contrast in risk factors and how each group responds to treatment.

In analysing their results, researchers discovered endometriosis, while largely viewed as a benign condition, may in fact be a significant cause of infertility and metastatic cancer and has links with immune system function. Furthermore, the comparative study revealed clear distinctions in risk factors and treatment responses between Asian and European-American female populations. Additionally, when examining the efficacy of Western medicine compared to traditional Chinese medicine for treating endometriosis in the Chinese population, noteworthy data were highlighted.

A review of the risk factors, genetics and treatment of endometriosis in Chinese women: a comparative update Dai Y, Li X, Shi J, Leng J

2018 Evidence-Based Complementary and Alternative Medicine

Despite some indications of improved clinical pregnancy rates, the overall effectiveness of acupuncture as a treatment for couples with subfertility undergoing assisted reproduction therapy remains inconclusive and requires further high-quality research.

This abstract summarizes the findings of systematic reviews and meta-analyses assessing the effectiveness of acupuncture in treating couples with subfertility undergoing assisted reproduction therapy (ART). The review included eleven studies published between 2009 and 2017 and examined primary outcomes of live birth and clinical pregnancy, and secondary outcomes of ongoing pregnancy, miscarriage, and adverse events. The results suggest that acupuncture may improve the clinical pregnancy rate in ART patients. However, there was insufficient evidence to support its impact on live birth rate, ongoing pregnancy rates, or miscarriage, mainly due to the low quality of the included studies. The overall effectiveness of acupuncture in treating subfertility during ART remains uncertain, emphasizing the need for further high-quality research and well-reported trials.

Effects of Acupuncture on the Outcomes of Assisted Reproductive Technology: An Overview of Systematic Reviews Xi, J., Chen, H., Peng, Z., Tang, Z., Song, X., & Xia, Y.

2018 Molecules

(-)-Epigallocatechingallate (EGCG), a natural product, has potent anti-proliferation, anti-metastasis, and pro-apoptosis effects on cervical cancer cells, enhancing the effects of conventional drugs.

This research paper discusses the potential of (-)-epigallocatechingallate (EGCG), a naturally occurring compound, as an anti-cancer treatment for cervical cancer. Traditional treatment methods involve the use of chemotherapy, but these have high toxicity and numerous side effects. The inherent low toxicity of EGCG makes it a promising alternative for treatment. The paper reviews the mechanisms by which EGCG inhibits the growth and spread of cervical cancer cells and promotes their apoptosis. Furthermore, the synergistic pharmaceutical effects of EGCG with conventional agents including cisplatin and bleomycin, have been evaluated.

For the discussion of results, the research shows significant evidence of EGCG's abilities to inhibit growth and spread of cervical cancer cells as well as initiate programmed cell death, or apoptosis. The compound's synergistic properties when paired with conventional chemotherapy drugs such as cisplatin and bleomycin, further enhance its potential as a treatment method. The review also explains the underlying processes by which EGCG performs these roles, providing a comprehensive view on its potential applications in cervical cancer treatment.

Suppressive Effects of EGCG on Cervical Cancer Wang YQ, Lu JL, Liang YR, Li QS

2018 Journal of Clinical Medicine

Traditional Chinese Medicine, particularly Jia Wei Xiao Yao San and Xiang Fu, is widely utilized in Taiwan for managing Polycystic ovary syndrome symptoms.

The study administered a comprehensive survey through the Taiwan National Health Insurance Program database to scrutinize the use of TCM in women diagnosed with PCOS between 1997 and 2010. Single herbs and herbal formulas, their utilization patterns, and the top commonly prescribed items among them, were analyzed to gauge the extent and pattern of TCM usage.

The analysis of the survey results revealed that a significant majority, around 89.22%, of women who were newly diagnosed with PCOS, sought TCM therapy. The single herb, Xiang-Fu, and the herbal formula, Jia-Wei-Xiao-Yao-San, emerged as the most commonly used TCM treatments. Furthermore, it was observed that the top five commonly prescribed single herbs and herbal formulas showed potential in treating symptoms associated with PCOS.

Investigation on the Use of Traditional Chinese Medicine for Polycystic Ovary Syndrome in a Nationwide Prescription Database in Taiwan Liao WT, Chiang JH, Li CJ, Lee MT, Su CC, Yen HR

2018 Journal of Clinical Medicine

Aromatherapy (via inhalation, massage, or oral use) appears to be more effective than a placebo for pain reduction in primary dysmenorrhea.

The methodology of the study involved a comprehensive search for relevant data in eleven international databases, including some dedicated to Korean medical literature, until August 2018, with no restrictions on the language of publication. The focus was directed on randomized controlled trials holding aromatherapy as a potential treatment for pain reduction in primary dysmenorrhea, a common condition characterized by menstrual pain. Data mining and the evaluation of potential biases were handled by two independent reviewers.

The results indicated a consistent trend across trials: aromatherapy, whether applied through inhalation, massage, or oral intake, tended to have a positive effect on pain reduction when compared to a placebo control. It was also observed that the efficacy remained noticeable across different modes of implementation (inhalation, massage, or oral), suggesting that the therapeutic potential of essential oils was not necessarily restricted to one specific form of application. It is important to state that individual results varied; nevertheless, the general direction of the results remained consistent.

Aromatherapy for Managing Pain in Primary Dysmenorrhea: A Systematic Review of Randomized Placebo-Controlled Trials Lee MS, Lee HW, Khalil M, Lim HS, Lim HJ

2017 PLOS One

Acupuncture is non-inferior to hormone therapy or other applied relaxation therapies in alleviating the symptoms of menopause for its safety, non-invasive and especially considering the side effect of hormone therapy.

This meta-analysis of women with breast cancer confirms that acupuncture had no significant effect on the severity of hot flush, but did significantly alleviate the symptoms of menopause. We conclude that acupuncture is non-inferior to hormone therapy or other applied relaxation therapies in alleviating the symptoms of menopause for its safety, non-invasive and especially considering the side effect of hormone therapy. Recent studies show that use of acupuncture does not correlate with increased levels of plasma estradiol. Considering the safety and lack of serious adverse effects associated with acupuncture, in contrast to hormone therapy, acupuncture should be considered for treating hot flush and menopause syndrome in women with breast cancer.

Effect of acupuncture on hot flush and menopause symptoms in breast cancer- A systematic review and meta-analysis Chien TJ, Hsu CH, Liu CY, Fang CJ.

2017 Complementary Medicine Research

Both the total score and the subgroup analysis strongly indicated that acupuncture can alleviate menopause-related symptoms.

Six studies were included. Our analysis found that acupuncture can reduce the MRS score in menopausal women by the end of the treating period (2-3 months, on average) and even in the follow-up period (1-3 months), not only in the total score but also in each subscale score. But the grade of evidence is very low.

Both the total score and the subgroup analysis strongly indicated that acupuncture can alleviate menopause-related symptoms. However, the evidence is not very strong. Thus, further studies about the efficiency of acupuncture on menopausal symptoms based on well-designed trials are needed.

Acupuncture May Improve Quality of Life in Menopausal Women: A Meta-Analysis of Randomized Controlled Trials Li W, Luo Y, Fu W, Lei R.

2017 BMC Complementary Medicine and Therapies

Acupoint-stimulation can relieve pain effectively in the treatment of primary dysmenorrhea and offers advantages compared with treatment by NSAIDs.

The current evidence reveals that acupoint-stimulation in the treatment of primary dysmenorrhea has some obvious advantages compared with treatment by NSAIDs. The advantages are that acupoint-stimulation can alleviate the symptoms of dysmenorrhoea, reduce the level of peripheral blood PGF2α and has fewer side effect, so it can be used to treat primary dysmenorrhea patients, especially individuals with NSAIDs contraindication.

Effects of acupoint-stimulation for the treatment of primary dysmenorrhoea compared with NSAIDs: a systematic review and meta-analysis of 19 RCTs Xu, Y., Zhao, W., Li, T. et al.

2017 Oxidative Medicine and Cellular Longevity

Moderate beer consumption could potentially alleviate menopausal symptoms by influencing the internal estrogen receptors through the phenolic compounds present in beer.

The study used the developments in food analysis techniques over the past two decades to explore the correlation between the intake of polyphenols from moderate beer consumption and the relief of vasomotor symptoms often experienced during menopause. The focus was on phenolic compounds present in beer like 8-prenylnaringenin, 6-prenylnaringenin, and isoxanthohumol and how they interact directly with intracellular estrogen receptors to influence gene expression and sex hormone plasma concentrations.

The observed results pointed to the potential positive effects of moderate beer consumption on menopausal symptoms. It was inferred that phenolic compounds in beer could interact directly with intracellular estrogen receptors, leading to a modulation of gene expression, thereby balancing physiological hormone imbalance in menopausal women. This alternative could serve as a safer option for alleviating menopausal symptoms as traditional hormone replacement therapies have known health risks. However, these findings need to be viewed keeping in mind the implications of beer consumption on overall health.

Beer Polyphenols and Menopause: Effects and Mechanisms—A Review of Current Knowledge Sandoval-Ramírez BA, Lamuela-Raventós RM, Estruch R, Sasot G, Doménech M, Tresserra-Rimbau A

2016 BMC Pregnancy and Childbirth

Acupuncture was a feasible intervention and reduced threatened miscarriage symptoms when compared to a touch intervention.

Threatened miscarriage is a common complication of early pregnancy increasing the risk of miscarriage or premature labour. Currently there is limited evidence to recommend any biomedical pharmacological or self-care management, resulting in a ‘watchful waiting’ approach. The objective of this study was to examine the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage.

Acupuncture was a feasible intervention and reduced threatened miscarriage symptoms when compared to a touch intervention. Further research is required to further explore acupuncture use for this common complication and whether it can reduce the incidence of miscarriage.

Does acupuncture have a role in the treatment of threatened miscarriage? Findings from a feasibility randomised trial and semi-structured participant interviews Betts D, Smith CA, Dahlen HG.

2016 Evidence-Based Complementary and Alternative Medicine

Oral ginger could be an effective treatment for menstrual pain in dysmenorrhea.

Ginger appeared more effective for reducing pain severity than placebo. The weighted mean difference on a 10 cm visual analogue scale was 1.55 cm (favoring ginger). No significant difference was found between ginger and mefenamic acid (an NSAID). The standardized mean difference was 0 (95% CI -0.40 to 0.41). Available data suggest that oral ginger could be an effective treatment for menstrual pain in dysmenorrhea. Findings, however, need to be interpreted with caution because of the small number of studies, poor methodological quality of the studies, and high heterogeneity across trials. The review highlights the need for future trials with high methodological quality.

Efficacy of Oral Ginger (Zingiber officinale) for Dysmenorrhea: A Systematic Review and Meta-Analysis Chen X. Chen, Bruce Barrett, Kristine L. Kwekkeboom,

2016 Journal of Pain Research

Acupuncture could be tried as a complement in the treatment of pain in endometriosis as it is an overall safe treatment.

Based on the analysis in the presented review, there are grounds to believe that acupuncture can relieve pain in some patients. The effects of acupuncture as a pain-relieving treatment has in various studies been presented as an overall safe alternative treatment with very few and small (harmless) side effects, and furthermore with no effect on the environment. It could therefore also be regarded as a ‘sustainable’ treatment. In the future, studies designed for evaluating effectiveness between different types of treatment strategies, rather than efficacy design would be preferred to analyze treatment effects in individual patients.

Is acupuncture effective in the treatment of pain in endometriosis? Lund I, Lundeberg T

2016 Maturitas

Meta-analysis showed that Danggui Shaoyao San had superior effects compared to analgesics for treating primary dysmenorrhea.

A total of 746 potentially relevant studies were identified, and four RCTs met our inclusion criteria. All of the included RCTs had a high risk of bias across their domains. Three RCTs showed favourable effects of DSS on response rate compared with conventional medicine, and a meta-analysis showed that DSS had superior effects compared to analgesics. One RCT showed a beneficial effect of DSS on pain compared with placebo control. Our systematic review and meta-analysis provided suggestive evidence of the superiority of DSS over analgesics or placebo for dysmenorrhea. The quality of evidence for this finding was low to moderate because of a high risk of bias.

Herbal medicine (Danggui Shaoyao San) for treating primary dysmenorrhea: A systematic review and meta-analysis of randomized controlled trials Hye Won Lee, Ji Hee Jun, Ki-Jung Kil, Byong-Seob Ko, Choong Hwan Lee, Myeong Soo Lee

2016 Revista Latino-Americana de Enfermagem

The study's analysis of 272 articles comparing Traditional Chinese Acupuncture (TCA) and Sham Acupuncture (SA) for managing hot flashes in menopausal breast cancer patients indicates that while 3 studies leaned towards TCA's effectiveness, 2 showed both interventions to be beneficial.

The study encompassed the analysis of 272 articles from five selected databases, resulting in the inclusion of five manuscripts meeting the eligibility criteria. The primary focus was on comparing the efficacy of Traditional Chinese Acupuncture (TCA) to Sham Acupuncture (SA) in managing hot flashes among menopausal women with breast cancer. Among the selected studies, three indicated that TCA was more effective in reducing the frequency and intensity of hot flashes, while two found both interventions to be beneficial, though not significantly distinct. These studies exhibited considerable diversity in their designs, sample sizes, treatment durations, and acupuncture protocols. TCA appeared to hold promise in mitigating hot flashes, yet several methodological limitations and potential biases within the reviewed studies were noted. Consequently, there's a call for further comprehensive, large-scale, and long-term trials to elucidate TCA's true potential and overcome the limitations observed in the current body of research.

Effectiveness of Traditional Chinese Acupuncture versus Sham Acupuncture: a Systematic Review Carlos, Luís et al.

2016 Complementary Therapies in Medicine

SP6 acupressure's effectiveness for primary dysmenorrhea relief, indicating trained personnel-administered acupressure reduced pain immediately and up to 3 hours post-intervention

The review initially identified 72 potential studies, but after eliminating duplicates and conducting screenings, only 13 studies were considered for inclusion. The review is the most extensive to date on SP6 acupressure for primary dysmenorrhea (PD), indicating its effectiveness when administered by trained personnel for immediate pain relief, reduction of anxiety, and potential general health improvement. However, the evidence remains limited and mostly consists of low-quality trials. Patient-administered acupressure might be beneficial with extended monthly application, though high-quality trials are required for such recommendations. The study highlights the need for future trials to specify diagnostic criteria for PD, given the lack of clarity in the included studies. Despite limitations, the findings suggest that self-administered acupressure holds promise for relieving PD symptoms.

Effectiveness of SP6 (Sanyinjiao) acupressure for relief of primary dysmenorrhea symptoms: A systematic review with meta- and sensitivity analyses Abaraogu UO, Igwe SE, Tabansi-Ochiogu CS

2016 Journal of Herbal Medicine

Peppermint capsules can effectively reduce the severity of painful menstrual cramps in young women without causing any apparent change in pain duration.

This research was a double-blind clinical trial with 102 female students, who reported experiencing primary dysmenorrhea. Participants were evenly divided into two groups: one receiving three 330mg peppermint capsules per day and the other receiving identical placebo capsules filled with starch. The participants used their respective capsules from the first to the third day of their menstrual cycle. The assessment of pain level was done before the test run and over two successive menstrual cycles using a visual analog scale.

In the results, no substantial differences were seen between the two experimental groups in terms of pain duration and severity before the intervention. However, after the intervention, a significant reduction was found in the severity of pain among the group treated with peppermint capsules, while the placebo group showed no such change. The duration of pain did not present any significant differences between the two groups after the trial.

The effect of peppermint (Mentha piperita) capsules on the severity of primary dysmenorrhea Heshmati A, Dolatian M, Mojab F, shakeri N, Nikkhah S, Mahmoodi Z

2015 The Journal of Sexual Medicine

Acupuncture appeared to reduce vulvar pain and dyspareunia with an increase in overall sexual function for women with vulvodynia.

This was the first randomized controlled pilot study to examine the use of acupuncture for the treatment of vulvodynia. The acupuncture protocol was feasible and in this small sample appeared to reduce vulvar pain and dyspareunia with an increase in overall sexual function for women with vulvodynia. This study should be replicated in a larger double-blinded randomized controlled trial.

Acupuncture for the Treatment of Vulvodynia: A Randomized Wait-List Controlled Pilot Study Schlaeger JM, Xu N, Mejta CL, Park CG, Wilkie DJ

2014 Acupuncture in Medicine

Acupuncture during pregnancy appears to be associated with few adverse events when correctly applied.

Of 105 included studies, detailed adverse events (AE) were reported only in 25 studies represented by 27 articles (25.7%). AEs evaluated as certain, probable or possible in the causality assessment were all mild/moderate in severity, with needling pain being the most frequent. Severe AEs or deaths were few and all considered unlikely to have been caused by acupuncture. Total AE incidence was 1.9%, and the incidence of AEs evaluated as certainly, probably or possibly causally related to acupuncture was 1.3%.

The Safety of Acupuncture during Pregnancy: A Systematic Review Park J, Sohn Y, White AR, Lee H.

2014 BMC Complementary Medicine and Therapies

Acupuncture and herbal medicine show promise in alleviating premenstrual syndrome and premenstrual dysphoric disorder symptoms, with over 50% relief and proven safety.

The passage discusses a review of studies focusing on the efficacy of acupuncture and herbal medicine in treating premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). The review identified and analyzed 19 randomized controlled trials (RCTs) involving acupuncture and herbal interventions. Acupuncture treatments encompassed various techniques, including traditional acupuncture, hand acupuncture, and moxibustion, while herbal interventions included Vitex Agnus castus, Hypericum perforatum, and other herbal remedies. Results showed that both acupuncture and herbal treatments led to a 50% or greater reduction in symptoms compared to baseline. The studies suggested that acupuncture and herbal treatments could alleviate physical and psychological symptoms of PMS/PMDD. The safety of acupuncture and herbal interventions was generally established, with minimal reported adverse events. However, the review emphasized the need for larger-scale, well-controlled trials to further validate these findings and guide clinical recommendations for specific symptom relief.

Effects and treatment methods of acupuncture and herbal medicine for premenstrual syndrome/premenstrual dysphoric disorder: systematic review Jang SH, Kim DI, Choi MS

2013 Cochrane Database of Systematic Reviews

Despite its widespread use during assisted reproductive technology (ART) cycles, acupuncture does not appear to improve live birth or pregnancy rates in couples dealing with subfertility.

This passage discusses a meta-analysis that aimed to determine the effectiveness and safety of acupuncture as an adjunct to assisted reproductive technology (ART) cycles for couples dealing with subfertility. The review included 20 randomized controlled trials, analyzing the impact of acupuncture on live birth rate, ongoing pregnancy rate, miscarriage rate, and side effects. The findings indicate that acupuncture did not show any overall benefit in improving live birth or pregnancy rates during ART cycles, regardless of whether it was performed around oocyte retrieval or embryo transfer. Additionally, acupuncture did not have significant side effects. The authors conclude that there is no evidence supporting the use of acupuncture to enhance live birth or pregnancy rates in assisted conception.

Acupuncture and assisted reproductive technology Cheong YC, Dix S, Hung Yu Ng E, Ledger WL, Farquhar C

2013 Cochrane Database of Systematic Reviews

Despite its widespread use during assisted reproductive technology (ART) cycles, acupuncture does not appear to improve live birth or pregnancy rates in couples dealing with subfertility.

This passage discusses a meta-analysis that aimed to determine the effectiveness and safety of acupuncture as an adjunct to assisted reproductive technology (ART) cycles for couples dealing with subfertility. The review included 20 randomized controlled trials, analyzing the impact of acupuncture on live birth rate, ongoing pregnancy rate, miscarriage rate, and side effects. The findings indicate that acupuncture did not show any overall benefit in improving live birth or pregnancy rates during ART cycles, regardless of whether it was performed around oocyte retrieval or embryo transfer. Additionally, acupuncture did not have significant side effects. The authors conclude that there is no evidence supporting the use of acupuncture to enhance live birth or pregnancy rates in assisted conception.

Acupuncture and assisted reproductive technology Cheong YC, Dix S, Hung Yu Ng E, Ledger WL, Farquhar C

2013 Human Reproduction Update

The meta-analysis indicates that while adjuvant acupuncture does not show a pooled benefit for in vitro fertilization (IVF) across all trials, it appears to have a more significant effect in trials with lower baseline pregnancy rates, warranting further investigation and confirmation in additional studies.

This passage presents a meta-analysis that aimed to assess the overall pooled effects of adjuvant acupuncture on in vitro fertilization (IVF) clinical pregnancy success rates, as well as identify factors that might explain the heterogeneity of results across trials. The analysis included 16 trials with 4021 participants and found no statistically significant difference between acupuncture and control groups when combining all trials or analyzing sham-controlled and no adjuvant treatment-controlled trials separately. However, the study identified baseline pregnancy rate as a significant effect modifier, with trials having lower control group pregnancy rates showing larger effects of adjuvant acupuncture. Overall, the meta-analysis did not find a pooled benefit of adjuvant acupuncture for IVF, but the potential benefit in trials with lower baseline pregnancy rates requires further exploration and confirmation in additional studies due to potential confounders and publication bias.

The effects of acupuncture on rates of clinical pregnancy among women undergoing in vitro fertilization: a systematic review and meta-analysis Manheimer, E. ., van der Windt, D., Cheng, K., Stafford, K., Liu, J. ., Tierney, J., Lao, L. ., Berman, B. ., Langenberg, P., & Bouter, L.

2013 Evidence-Based Complementary and Alternative Medicine

Limited evidence supporting the benefit of acupressure in alleviating menstrual pain and reducing symptoms.

The passage presents the results of a systematic review on the effectiveness of acupressure in treating primary dysmenorrhea, a condition characterized by painful menstrual cramps. The review started with 224 potentially relevant records, ultimately including 8 trials involving 800 participants. All trials used a parallel design with varying control interventions. Six trials employed no treatment controls, while two were single-blind clinical trials using placebo acupressure. The research locations varied, with the largest trial conducted in China, and the smallest in Iran. The analysis was performed individually for each trial using special software. The trials used fixed sets of acupressure points and administered acupressure for different durations (one, two, or three menstrual cycles). Pain relief was assessed using Visual Analogue Scale (VAS) in six trials. The risk of bias assessment indicated high risks in various domains across the studies. In terms of effects, acupressure demonstrated an improvement in pain relief compared to placebo or rest control, and it was also more effective than Ibuprofen in one aspect. However, for improvement in symptoms, acupressure did not consistently outperform placebo acupressure or rest control, with mixed results across different time points. Overall, the evidence for the effectiveness of acupuncture in treating primary dysmenorrhea is considered limited due to methodological flaws in the trials, necessitating well-designed RCTs for more conclusive results.

Systematic Review of Randomized Clinical Trials of Acupressure Therapy for Primary Dysmenorrhea Jiang H, Ni S, Li J, Liu M, Li J, Cui X, Zhang B

2013 Medical Acupuncture

Acupuncture's efficacy in treating gynecologic and obstetric disorders

This comprehensive review evaluates acupuncture's efficacy and safety in treating gynecologic and obstetric disorders. Examining systematic reviews and randomized controlled trials, the study addresses conditions like pregnancy-related pelvic and low-back pain, labor pain, primary dysmenorrhea, and menopausal symptoms. The results are inconclusive, with some evidence supporting acupuncture's potential in reducing pelvic and back pain during pregnancy and alleviating climacteric vasomotor symptoms. However, more rigorous research is necessary for definitive conclusions. Adverse effects were minimal. The review emphasizes the need for well-designed studies to enhance the precision and reliability of findings regarding acupuncture's therapeutic benefits in these disorders.

Efficacy and Safety of Needle Acupuncture for Treating Gynecologic and Obstetric Disorders: An Overview Selva Olid A, Martinez Zapata MJ, Sola I, Stojanovic Z, Uriona Tuma SM, Bonfill Cosp X.

2013 Neuropediatrics

Hop extract, particularly its component 8-Prenylnaringenin (8-PN), demonstrates potential in alleviating symptoms common in menopause such as osteoporosis, vasomotoric disturbances, and sexual motivation.

The methodology of this research involved identifying the major constituents of hop extract, with a focus on 8-Prenylnaringenin (8-PN) due to its estrogenic qualities. Several in vivo studies were conducted to explore the potential of hop extract and 8-PN in mitigating climacteric symptoms. Clinical studies conducted have mainly centered around menopausal discomforts, still, these studies provided broad results.

In the discussion of the results, it was found that hop extract, and more prominently, 8-PN, show promise in alleviating menopausal symptoms such as osteoporosis, vasomotoric issues, and sexual desire. Although 8-PN primarily activates the estrogen receptor α and presents only slight uterotrophic attributes, it also brings about estrogenic effects on the mammary gland. The results indicate potential application of 8-PN and hop extract in alleviating symptoms commonly associated with menopause.

Hop Extracts and Hop Substances in Treatment of Menopausal Complaints Keiler A, Zierau O, Kretzschmar G

2012 The Journal of Alternative and Complementary Medicine

The meta-analysis suggests that acupuncture does not provide significant benefits in improving the outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments.

The article conducted a systematic review with a meta-analysis of trials on acupuncture during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. The pooled analysis of 17 trials showed that acupuncture did not significantly impact clinical pregnancy, biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, or miscarriage outcomes. Therefore, the study concludes that there are no significant benefits of acupuncture in improving IVF or ICSI outcomes.

Effects of Acupuncture on the Outcomes of In Vitro Fertilization: A Systematic Review and Meta-Analysis Qu, F., Zhou, J., & Ren, R.-X.

2012 The Journal of Alternative and Complementary Medicine

The meta-analysis suggests that acupuncture does not provide significant benefits in improving the outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments.

The article conducted a systematic review with a meta-analysis of trials on acupuncture during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. The pooled analysis of 17 trials showed that acupuncture did not significantly impact clinical pregnancy, biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, or miscarriage outcomes. Therefore, the study concludes that there are no significant benefits of acupuncture in improving IVF or ICSI outcomes.

Effects of Acupuncture on the Outcomes of In Vitro Fertilization: A Systematic Review and Meta-Analysis Qu, F., Zhou, J., & Ren, R.-X.

2011 BJOG: An International Journal of Obstetrics & Gynaecology

Acupuncture shows promise for alleviating PMS symptoms.

This review assesses acupuncture's effectiveness in treating premenstrual syndrome (PMS). Ten randomized controlled trials (RCTs) involving women with PMS were analyzed. The results indicate that acupuncture outperforms controls, showing significant symptom improvement (pooled RR 1.55, 95% CI 1.33–1.80, p < 0.00001). A comparison with progestin and/or anxiolytics also favored acupuncture (RR 1.49, 95% CI 1.27–1.74, p < 0.00001). Acupuncture demonstrated superiority over sham acupuncture (RR 5.99, 95% CI 2.84–12.66, p < 0.00001), with no observed harm. However, the studies displayed notable methodological flaws, highlighting the need for further rigorous research to solidify acupuncture's potential in alleviating PMS symptoms.

Acupuncture for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials S-Y Kim, H-J Park, H Lee, H Lee

2011 Climacteric

Pumpkin seed oil supplementation may increase good cholesterol levels, lower diastolic blood pressure, and alleviate menopausal symptoms in postmenopausal women.

In this pilot study employing a randomized, double-blinded and placebo-controlled design, 35 women that were either naturally menopausal or had prematurely entered menopause due to benign surgical intervention partook. Over the span of 12 weeks, participants received either pumpkin seed oil or wheat germ oil (serving as the placebo) at a dosage of 2 grams daily. Measurements of serum lipids, fasting plasma glucose, blood pressure and completion of a questionnaire regarding menopausal symptoms were taken before and after the supplementation period, and changes across these factors were evaluated.

Following supplementation, women who received pumpkin seed oil displayed increased concentrations of high density lipoprotein cholesterol (commonly known as good cholesterol) and a reduction in diastolic blood pressure. Additionally, there was a notable decline in the severity of menopausal symptoms, including hot flushes, headaches, and joint pain, thanks to this supplementation. Contrarily, symptoms of depression and feelings of being unloved heightened among women in the group that received wheat germ oil.

Improvement in HDL cholesterol in postmenopausal women supplemented with pumpkin seed oil: pilot study Gossell-Williams M, Hyde C, Hunter T, Simms-Stewart D, Fletcher H, McGrowder D, Walters CA