P05.09
Purpose: Oligomenorrhoea and amenorrhoea are cardinal symptoms of polycystic ovary syndrome (PCOS), a common female endocrine disorder affecting 6–18% of women of reproductive age. Although randomized controlled trials (RCTs) have explored the use of Chinese herbal medicine (CHM) for PCOS, this requires rigorous investigation. Our aim was to evaluate the evidence on CHM for PCOS-related oligomenorrhoea and amenorrhoea by conducting a systematic review and meta-analysis.
Methods: We conducted a comprehensive search using international and Chinese language electronic databases from their date of inception to June 2011 and grey literature search. RCTs were assessed for eligibility and data extracted independently by two reviewers. Study authors were contacted where eligibility remained unclear.
Results: 4 RCTs involving 246 participants were eligible. Pooled analysis was not possible for our primary measure of menstrual cyclicity, reported in one study to show a significantly greater number of responders with CHM plus Diane-35 (n=13), compared with Diane-35 only (n=5) (RR2.60, 95%CI 1.06 to 6.39, p=0.04). Pooled analysis showed significant reduction in total testosterone favoring CHM plus Diane-35 over Diane-35 alone (MD−0.69, 95%CI −0.72 to −0.66, p<0.00001), and in luteinising hormone (LH) (MD-2.24, 95%CI −3.03 to −1.46, p<0.00001). Compared with conventional medicine alone, CHM alone showed significantly greater reduction in total testosterone (MD-0.45, 95%CI −0.63 to −0.28, p<0.0001) and no significant between-group difference in LH reduction (MD-0.62, 95%CI −1.80 to −0.55, p=0.30). Two studies reported fewer adverse events with CHM. One study reported no change in liver function with CHM plus Diane-35 or Diane-35 alone. All studies were rated as being at high risk of bias.
Conclusion: Although preliminary evidence suggests CHM may help regulate menses and correct endocrine abnormalities in PCOS, these results should be interpreted with caution owing to the small number of studies and high risk of bias found. Further research with more methodologically robust RCTs is required.
Contact: George Lewith, glewith@scmrt.org.uk
