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Review
. 2022 Nov 8;15(11):1371.
doi: 10.3390/ph15111371.

A Systematic Review and Meta-Analysis of Premenstrual Syndrome with Special Emphasis on Herbal Medicine and Nutritional Supplements

Arshiya Sultana  1 , Md Belal Bin Heyat  2   3   4 , Khaleequr Rahman  5 , Radhika Kunnavil  6 , Mohamed Joonus Aynul Fazmiya  1 , Faijan Akhtar  7 , Sumbul  1 , Juan Luis Vidal Mazón  8   9   10 , Carmen Lili Rodríguez  9   10 , Isabel De La Torre Díez  11
Affiliations
Review

A Systematic Review and Meta-Analysis of Premenstrual Syndrome with Special Emphasis on Herbal Medicine and Nutritional Supplements

Arshiya Sultana et al. Pharmaceuticals (Basel). .

Abstract

Herbal medicine and nutritional supplements are suggested to treat premenstrual somatic and psycho-behavioural symptoms in clinical guidelines; nonetheless, this is at present based on poor-quality trial evidence. Hence, we aimed to design a systematic review and meta-analysis for their effectiveness in alleviating premenstrual symptoms. The published randomized controlled trials (RCTs) were extracted from Google scholar, PubMed, Scopus and PROSPERO databases. The risk of bias in randomized trials was assessed by Cochrane risk-of-bias tool. The main outcome parameters were analysed separately based on the Premenstrual Symptom Screening Tool and PMTS and DRSP scores. Secondary parameters of somatic, psychological, and behavioural subscale symptoms of PSST were also analysed. Data synthesis was performed assuming a random-effects model, and standardized mean difference (SMDs) was analysed using SPSS version 28.0.0 (IBM, Armonk, NY, USA). A total of 754 articles were screened, and 15 RCTs were included (n = 1211 patients). Primary results for participants randomized to an intervention reported reduced PSST (n = 9), PMTS (n = 2), and DSR (n = 4) scores with (SMD = -1.44; 95% CI: -1.72 to -1.17), (SMD = -1.69; 95% CI: -3.80 to 0.42) and (SMD = 2.86; 95% CI: 1.02 to 4.69) verses comparator with substantial heterogeneity. Physical (SMD = -1.61; 95% CI = -2.56 to -0.66), behavioural (SMD = -0.60; 95% CI = -1.55 to0.35) and mood (SMD = 0.57; 95% CI = -0.96 to 2.11) subscale symptom groupings of PSST displayed similar findings. Fifty-three studies (n = 8) were considered at low risk of bias with high quality. Mild adverse events were reported by four RCTs. Based on the existing evidence, herbal medicine and nutritional supplements may be effective and safe for PMS.

Keywords: PMS; PRISMA; Web of Science; dietary supplements; female health; herbal medicine; reproductive health; software; unani medicine.

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Conflict of interest statement

The authors declare that there are no conflict of interest regarding the publication of this study.

Figures

Figure 1
Figure 1
PRISMA flow chart of included publications.
Figure 2
Figure 2
Traffic light plot of randomized controlled trials showing the risk of bias assessment [5,7,43,44,45,46,47,48,49,50,51,52,53,54,55].
Figure 3
Figure 3
Summary plot of RCTs showing risk of bias.
Figure 4
Figure 4
Forest plot for premenstrual screening tool (PSST) [5,7,45,47,49,50,51,54,55].
Figure 5
Figure 5
Funnel plot for PSST [5,7,45,47,49,50,51,54,55].
Figure 6
Figure 6
Forest plot for premenstrual screening tool using DSR [43,44,48,53].
Figure 7
Figure 7
Forest plot for premenstrual screening tool using PMTS [46,52].
Figure 8
Figure 8
Forest plot for subgroup physical symptoms of PSST scale [1,5,45,51].
Figure 9
Figure 9
Forest plot for subgroup behavioural symptoms of PSST scale [1,5,49,51].
Figure 10
Figure 10
Forest plot for subgroup mood symptoms of PSST scale [5,45,51].
Figure 11
Figure 11
Country-wise and author-wise publications related to RCTs on nutritional supplements and herbal medicine in PMS.
Figure 12
Figure 12
Author distribution as per university-wise related to published RCTs on nutritional supplements and herbal medicine in PMS.
Figure 13
Figure 13
Research area-wise authors in a publication on nutritional supplements and herbal medicine in PMS.
Figure 14
Figure 14
Network visualization based on previously published studies for the collection of the closest terms.
Figure 15
Figure 15
Word clouds of the present study for the collection of the closest terms.
See this image and copyright information in PMC

References

    1. Arabnezhad L., Mohammadifard M., Rahmani L., Majidi Z., Ferns G.A., Bahrami A. Effects of curcumin supplementation on vitamin D levels in women with premenstrual syndrome and dysmenorrhea: A randomized controlled study. BMC Complement. Med. Ther. 2022;22:19. doi: 10.1186/s12906-022-03515-2. - DOI - PMC - PubMed
    1. Purnawati J., Sinrang A.W., Jusuf E.C., Limoa E., Ahmad M., Usman A.N. Nutrition, mental status and level of 8-hydroxy-2-deoxyguanosine (OHDG) urine as predictors of premenstrual syndrome (PMS) in adolescent girls. Int. J. Curr. Res. Rev. 2020;12:7–13. doi: 10.31782/IJCRR.2020.122315. - DOI
    1. Abay H., Kaplan S. Current approaches in premenstrual syndrome management. Bezmialem Sci. 2019;7:150–156. doi: 10.14235/bas.galenos.2018.2358. - DOI
    1. Masoumi S.Z., Ataollahi M., Oshvandi K. Effect of combined use of calcium and vitamin B6 on premenstrual syndrome symptoms: A randomized clinical trial. J. Caring Sci. 2016;5:67–73. doi: 10.15171/jcs.2016.007. - DOI - PMC - PubMed
    1. Jafari F., Tabarrai M., Abbassian A., Jafari F., Ayati M.H. Effect of garlic (Allium sativum) supplementation on premenstrual disorders: A randomized, double-blind, placebo-controlled trial. Evid. Based Complement. Altern. Med. 2021;2021:9965064. doi: 10.1155/2021/9965064. - DOI - PMC - PubMed

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