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

Affiliation
Department of Ilmul Qabalat wa Amraze Niswan, National Institute of Unani Medicine, Ministry of AYUSH, Bengaluru 560091, Karnataka, India
Sultana, Arshiya;
ORCID
0000-0001-5307-9582
Affiliation
IoT Research Center, College of Computer Science and Software Engineering, Shenzhen University, Shenzhen 518060, China
Heyat, Md Belal Bin;
ORCID
0000-0002-0920-9631
Affiliation
Department of Ilmul Saidla, National Institute of Unani Medicine, Ministry of AYUSH, Bengaluru 560091, Karnataka, India
Rahman, Khaleequr;
ORCID
0000-0002-2066-7836
Affiliation
Department of Biostatistics, National Institute of Unani Medicine, Ministry of AYUSH, Bengaluru 560091, Karnataka, India
Kunnavil, Radhika;
Affiliation
Department of Ilmul Qabalat wa Amraze Niswan, National Institute of Unani Medicine, Ministry of AYUSH, Bengaluru 560091, Karnataka, India
Fazmiya, Mohamed Joonus Aynul;
Affiliation
School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China
Akhtar, Faijan;
Affiliation
Department of Ilmul Qabalat wa Amraze Niswan, National Institute of Unani Medicine, Ministry of AYUSH, Bengaluru 560091, Karnataka, India
Sumbul;
ORCID
0000-0002-0982-815X
Affiliation
Higher Polytechnic School, Universidad Europea Del Atlántico, Isabel Torres 21, 39011 Santander, Spain
Vidal Mazón, Juan Luis;
Affiliation
Department of Project Management, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
Rodríguez, Carmen Lili;
ORCID
0000-0003-3134-7720
Affiliation
Department of Signal Theory and Communications and Telematic Engineering, University of Valladolid, Paseo de Belén 15, 47011 Valladolid, Spain
De La Torre Díez, Isabel

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 to 0.35) 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.

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