Herbal medicine and climacteric: a systematic review of the main clinical outcomes

Introduction: The climacteric is the stage of life in which the transition from the productive or fertile period to the non-reproductive period occurs. Climacteric and menopause are intrinsically linked and may bring about various psychological and physiological changes. The use of medicinal plants (Herbal Medicine) is an important tool in an attempt to relieve symptoms. Objective: It was to develop a systematic review to present the main considerations and scientific evidence of the use of herbal medicines in climacteric and menopause to the reduction of symptoms and improvement of quality of life. Methods: The systematic review rules (PRISMA) were followed. The research was carried out from September to October 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, covering scientific articles from various eras to the present day. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 121 articles were found. A total of 32 articles were fully evaluated and 23 were included in this systematic review. Most studies showed homogeneity in their results, with I2 =96.7% >50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 37 studies that did not meet GRADE. An asymmetrical funnel plot does not suggest a risk of bias among small sample-size studies. In search of symptom relief and based on knowledge of the side effects of hormone replacement therapy, many women resort to alternative therapy with herbal medicines. The main results support that supplementation with soy isoflavones as a natural source of phytohormones is associated with a reduction in the frequency and intensity of hot flashes, a recurrent symptom in the climacteric. The formulated blend of four herbal extracts (Glycine max, Cimicifuga racemosa, Vitex agnus-castus, and Oenothera biennis) supports skin health and antioxidant status in women of menopausal age. Furthermore, purified pollen cytoplasm can be considered an effective non-hormonal treatment alternative for the treatment of vasomotor symptoms, as well as mood and sleep disturbances in peri and post-menopause. Three clinical trials using the Danggui Buxue Tang herbal formula have been shown to alleviate menopausal syndrome, providing solid scientific evidence of its effectiveness.