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 Nutrients

Green tea helps alleviate symptoms in multiple benign gynecological disorders, primarily due to a compound called Epigallocatechin-3-gallate.

The paper reviews the role of the compound Epigallocatechin-3-gallate found in green tea, and its effects on various benign gynecological conditions. The compound is noted for its antioxidant and prooxidant qualities, allowing it to interact with multiple cellular pathways that are crucial for disease pathogenesis. The studied conditions include uterine fibroids, endometriosis, dysmenorrhea, adenomyosis, menopause, and polycystic ovary syndrome. The research accounts for the specific mechanisms through which the compound might affect each condition, such as anti-fibrotic, anti-angiogenic, and pro-apoptotic mechanisms.

The results suggest that green tea consumption can lead to improved symptom management in these disorders. It was found to lessen the intensity of symptoms associated with uterine fibroids and endometriosis, by invoking anti-fibrotic, anti-angiogenic, and pro-apoptotic mechanisms. It also helped manage pain linked with dysmenorrhea and adenomyosis through reducing uterine contractility and widely felt pain. Additionally, it showed efficacy in weight and osteoporosis control during menopause, and showed potential benefits in managing polycystic ovary syndrome. However, claims regarding its influence on fertility were deemed controversial.

Green Tea and Benign Gynecologic Disorders: A New Trick for An Old Beverage? Hazimeh D, Massoud G, Parish M, Singh B, Segars J, Islam MS

2023 Nutrients

Green tea helps alleviate symptoms in multiple benign gynecological disorders, primarily due to a compound called Epigallocatechin-3-gallate.

The paper reviews the role of the compound Epigallocatechin-3-gallate found in green tea, and its effects on various benign gynecological conditions. The compound is noted for its antioxidant and prooxidant qualities, allowing it to interact with multiple cellular pathways that are crucial for disease pathogenesis. The studied conditions include uterine fibroids, endometriosis, dysmenorrhea, adenomyosis, menopause, and polycystic ovary syndrome. The research accounts for the specific mechanisms through which the compound might affect each condition, such as anti-fibrotic, anti-angiogenic, and pro-apoptotic mechanisms.

The results suggest that green tea consumption can lead to improved symptom management in these disorders. It was found to lessen the intensity of symptoms associated with uterine fibroids and endometriosis, by invoking anti-fibrotic, anti-angiogenic, and pro-apoptotic mechanisms. It also helped manage pain linked with dysmenorrhea and adenomyosis through reducing uterine contractility and widely felt pain. Additionally, it showed efficacy in weight and osteoporosis control during menopause, and showed potential benefits in managing polycystic ovary syndrome. However, claims regarding its influence on fertility were deemed controversial.

Green Tea and Benign Gynecologic Disorders: A New Trick for An Old Beverage? Hazimeh D, Massoud G, Parish M, Singh B, Segars J, Islam MS

2023 Nutrients

A combination of soybean germ extract and a probiotic significantly improved menopause-related conditions and mood in an ovariectomized rat model.

The study employed an ovariectomized rat model to understand the effects of a combination of soybean germ extract containing 30% isoflavone and a probiotic. The methodology included assessing the effects of this combination on several health markers including body weight, estrogen markers, uterine and bone health, vascular markers, and neurotransmitter levels in these rats.

Once implemented, the combination of soybean germ extract and the probiotic showcased significant improvement in body weight and uterine and bone health of the rats. There were also noticeable effects on the lipid profile, liver function, and vascular markers. Most interestingly, the combination had a positive impact on the levels of serotonin and norepinephrine, indicating potential mood-enhancing effects, which are crucial in managing symptoms post-menopause. This essentially shows the potential of a dietary approach towards menopausal management, especially given the observed benefits without the side effects typically associated with hormone replacement therapy.

Anti-Menopausal Effect of Soybean Germ Extract and Lactobacillus gasseri in the Ovariectomized Rat Model Lee SH, Lim TJ, Yun EJ, Kim KH, Lim S

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 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 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 International Journal of Molecular Sciences

Isoflavones found in soybeans can reduce risks of certain cancers and alleviate menopause-related symptoms among women, such as vasomotor syndromes, spinal bone loss, and hypertension.

The study overviewed soybeans' chemical composition and focused mainly on isoflavones. The research examined the processes of soybean preparation that includes cleaning, drying, crushing, and dehulling, and extraction methods to derive various soy products, particularly focusing on isoflavones - daidzein, genistein, and S-equol. Various soy products such as refined soy oil, soy lecithin, free fatty acids, glycerol, and soybean meal were discussed, along with the presence of the minor biological constituents in remaining components.

The study explored the relationship between isoflavone consumption and disease prevention, particularly in relation to heart disease, cancer incidence—of the breast, bladder, and endometrial and colorectal—and menopause-related symptoms. The therapeutic effects of isoflavones were studied in the context of vasomotor syndromes, spinal bone loss, hypertension regulation, depressive symptoms during pregnancy, and in vitro glycemic control. In contrast, it failed to find definitive effects of isoflavones on cognition improvement and urogenital symptoms. The inconsistencies in defining the ingredients, doses, study durations, and outcomes of isoflavone studies proved challenging for the research.

Utilization of Isoflavones in Soybeans for Women with Menopausal Syndrome: An Overview Chen LR, Chen KH

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 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 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 JBI Database of Systematic Reviews and Implementation Reports

Breast massage eases pain and symptoms in breastfeeding problems.

This systematic review assesses the effectiveness of breast massage as a treatment for breastfeeding problems. It focuses on outcomes like pain reduction, increased milk supply, and resolution of issues like blocked ducts and mastitis. While breastfeeding is crucial for infant health, rates drop, and complications like mastitis contribute. The review covers studies from 1980 to 2017, including six diverse studies. Although outcomes varied due to different interventions and small sample sizes, all reported reduced pain. However, lack of detailed technique explanation and training hinder replicability. This research is valuable for healthcare professionals, suggesting a need for standardized measurement tools and more robust trials.

Effectiveness of breast massage for the treatment of women with breastfeeding problems Anderson L, Kynoch K, Kildea S, Lee N

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 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 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 Acupuncture in Medicine

Acupuncture may increase the clinical pregnancy rate and ongoing pregnancy rate and decrease the risk of ovarian hyperstimulation syndrome in women with PCOS undergoing IVF or ICSI.

Acupuncture may increase the CPR and OPR and decrease the risk of OHSS in women with PCOS undergoing IVF or ICSI. Further studies are needed to confirm the efficacy and safety of acupuncture as an adjunct to assisted reproductive technology in this particular population.

Effectiveness of Acupuncture in Women with Polycystic Ovarian Syndrome Undergoing in Vitro Fertilisation Or Intracytoplasmic Sperm Injection: A Systematic Review and Meta-Analysis Jo J, Lee YJ

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.

2016 Neurourology and Urodynamics

Acupuncture has promising efficacy for patients with chronic prostatitis/chronic pelvic pain syndrome.

Three and four randomized controlled trials compared acupuncture with sham acupuncture (n = 101 vs. 103) and medical treatment (n = 156 vs. 138), respectively. The results revealed that acupuncture was superior to sham acupuncture as regards response rate, NIH-CPSI, and IPSS reductions, therefore, excluding the placebo effect. Compared to standard medical treatments, acupuncture had a significantly higher response rate.

Acupuncture has promising efficacy for patients with CP/CPPS. Compared to standard medical treatment, it has better efficacy. Thus, it may also serve as a standard treatment option when available.

The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome: A systemic review and meta-analysis Chang SC, Hsu CH, Hsu CK, Yang SSD, Chang SJ

2016 Archives of Gynecology and Obstetrics

Acupuncture improves the clinical pregnancy rate among women undergoing IVF and the IVF outcome results were significantly superior in the acupuncture group when acupuncture was conducted during controlled ovarian hyperstimulation.

When the studies were restricted to Asian or non-Asian area patients, compared with traditional acupuncture and other methods, electrical acupuncture yielded better IVF outcomes. Optimal positive effects could be expected using acupuncture in IVF during controlled ovarian hyperstimulation, especially in Asian area. However, as a limitation of this review, most of the included studies did not mention the number of embryos transferred.

Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis Qian, Y., Xia, X.-R., Ochin, H., Huang, C., Gao, C., Gao, L., Cui, Y.-G., Liu, J.-Y., & Meng, Y.

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 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

2016 Mansoura Nursing Journal

Cinnamon shows significant positive effects in reducing the severity of physical symptoms of premenstrual syndrome among adolescent girls at Mansoura University.

The methodology used in this study was a quasi-experimental research design conducted at the nursing School of Mansoura University. The purposive sample was 150 students suffering from premenstrual syndrome, over the course of September 2012 to May 2013. The data was collected using three tools: a structured questionnaire, an assessment tool to gauge the severity of physical PMS symptoms, and a Likert scale to measure the level of student satisfaction after using cinnamon to relieve physical symptoms.

The results showed a significant reduction in the severity of physical PMS symptoms after the students regularly used cinnamon. A notable correlation was found between the decrease in symptom severity and the regular use of cinnamon. Furthermore, the study found that about three-quarters of the sampled students were satisfied with the use of cinnamon for symptom relief. These findings demonstrated the potential benefits of cinnamon in alleviating PMS physical discomfort.

THE EFFECT OF CINNAMON ON PHYSICAL SYMPTOMS OF PREMENSTRUAL SYNDROME AMONG ADOLESCENT GIRLS Hashim S, El-Sayed H, Wasel S

2015 Journal of Acupuncture and Meridian Studies

Acupressure showed evidence of pain relief while acupuncture improved both the mental and the physical components of quality of life associated with primary dysmenorrhea.

This study involved three reviewers who dependently and independently performed study selection, quality assessment, and data extraction and management. Several interventions indicated statistical significance. Insights into the efficacies of the interventions were identified in correlation to themselves and with one another. The systematic review highlighted promising evidence in the form of studies done to establish the effectiveness of acupuncture and acupressure in the management of primary dysmenorrhea. However, the results were limited and had methodological flaws. The review and the meta-analysis indicated that acupressure significantly reduced the pain associated with primary dysmenorrhea and that acupuncture improved both the physical and the mental components of quality of life. The magnitude of these effects may or may not be clinically worthwhile, but as the costs and the risks of these interventions is low, these results may be clinically useful.

As Acupressure Decreases Pain, Acupuncture May Improve Some Aspects of Quality of Life for Women with Primary Dysmenorrhea: A Systematic Review with Meta-Analysis Abaraogu UO, Tabansi-Ochuogu CS

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

2015 Journal Of Medicine & Health

Consuming dark chocolate every day for two weeks before menstruation significantly reduced symptoms of premenstrual syndrome in women aged 18-22, showing improvements in anxiety, fatigue, abdominal cramps, bloating, and other related symptoms.

This research involved 30 women aged 18-22, using an experimental design with one group pre and post-test. Subjects consumed 20 grams of dark chocolate daily for two weeks before their menstruation period and reported their symptoms using a questionnaire. The data was analyzed using statistical tests to measure changes in individual PMS symptoms before and after eating dark chocolate.

The study found a highly significant decrease in anxiety symptoms and a statistically significant reduction in various PMS symptoms, including fatigue, abdominal cramps, bloating, diarrhea, headache, back pain, changes in appetite, muscle or joint pain, and concentration problems. However, there was a slight increase in acne complaints.

Black Chocolate Consumption Reduces Subjective Symptoms in 18-22 Years Old Females with Premenstrual Syndrome Nurazizah E, Tih F, Suwindere W

2013 Medical Acupuncture

There is high-level evidence to support the use of acupuncture for treating major depressive disorder in pregnancy.

Six articles used the desired inclusion and exclusion criteria. The quality of research varied heavily. Five studies were properly randomized. Three were double-blinded. Three used individualized acupuncture. Four studies were of at least reasonable quality. One was of marginal quality, and one was of poor quality. There was a significant difference between acupuncture and at least one control in all six trials.

Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review Sniezek DP, Siddiqui IJ.

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.

2012 BMC Complementary Medicine and Therapies

Complementary and alternative medicine (CAM) therapies have the potential to provide supportive care for women presenting with threatened miscarriage.

Within fertility research, acupuncture demonstrates beneficial hormonal responses with decreased miscarriage rates, raising the possibility acupuncture may promote specific beneficial effects in early pregnancy. With the lack of current medical options for women presenting with threatened miscarriage it is timely to examine the possible treatment benefits of providing CAM therapies such as acupuncture.

Acupuncture as a therapeutic treatment option for threatened miscarriage Betts D, Smith CA, Hannah DG.

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 seems promising for symptom improvement in women with premenstrual syndrome.

Ten RCTs were included in our review. The pooled results demonstrated that acupuncture is superior to all controls. A meta-analysis comparing the effects of acupuncture with different doses of progestin and/or anxiolytics supported the use of acupuncture. In addition, acupuncture significantly improved symptoms when compared with sham acupuncture. No evidence of harm resulting from acupuncture emerged. Most of the included studies demonstrated a high risk of bias in terms of random sequence generation, allocation concealment, and blinding.

Although acupuncture seems promising for symptom improvement in women with PMS, important methodological flaws in the included studies weaken the evidence. Considering the potential of acupuncture, further rigorous studies are needed.

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

2011 BJOG: An International Journal of Obstetrics & Gynaecology

Acupuncture seems promising for symptom improvement in women with premenstrual syndrome.

Ten RCTs were included in our review. The pooled results demonstrated that acupuncture is superior to all controls. A meta-analysis comparing the effects of acupuncture with different doses of progestin and/or anxiolytics supported the use of acupuncture. In addition, acupuncture significantly improved symptoms when compared with sham acupuncture. No evidence of harm resulting from acupuncture emerged. Most of the included studies demonstrated a high risk of bias in terms of random sequence generation, allocation concealment, and blinding.

Although acupuncture seems promising for symptom improvement in women with PMS, important methodological flaws in the included studies weaken the evidence. Considering the potential of acupuncture, further rigorous studies are needed.

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

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