Complementary and alternative therapies in the management of menopausal symptoms: a systematic review and meta-analysis of randomised controlled trials
In brief
Complementary therapies modestly ease hot flashes but overall benefit varies
A meta-analysis of 24 recent randomized trials found that herbal and non-herbal complementary approaches produced a small, inconsistent reduction in menopausal symptoms, with the most reliable improvement seen for hot flashes. Effect sizes differed widely across studies, and larger trials showed weaker benefits, so clinicians should weigh these modest gains against the substantial uncertainty before routine adoption.
- Journal
- Archives of gynecology and obstetrics (Q1)
- Published
- 20 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Eda Yakit Ak, Zeynep Ogul
- PMID
- 42474537
- DOI
- 10.1007/s00404-026-08517-w
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (top studies of the week, 26 July 2026): Systematic review of CAM for menopausal symptoms
- Picked for Obstetrics and Gynecology (top studies of the week, 26 July 2026).
Abstract
OBJECTIVE: This meta-analysis evaluated the effects of complementary and alternative therapies on menopausal symptoms. MATERIALS AND METHODS: Relevant randomized controlled trials published after 2020 were systematically searched in the ASSIA, CENTRAL, CINAHL, LILACS, PubMed, Embase, and WOS databases. A total of 24 studies were included, and analyses were conducted using RevMan and JASP software. Heterogeneity and publication bias were assessed using various statistical methods. Results Twenty-four randomized controlled trials were synthesized. Evidence from the included studies indicates that complementary and traditional interventions may contribute to improvements in menopausal symptoms; however, effect estimates varied substantially across studies. A random-effects meta-analysis identified an average effect estimate, but substantial heterogeneity (τ2 = 0.362) and a wide 95% prediction interval (-0.228 to 2.340) suggest considerable uncertainty in the magnitude and direction of effects across different settings. Meta-regression analyses showed that larger sample sizes were associated with smaller observed effects (β = -0.005, p = .014), indicating potential small-study effects. Intervention duration significantly influenced outcomes, whereas intervention type, dose, and formulation were not significant moderators. Subgroup analyses suggested beneficial trends for both herbal and non-herbal interventions, although prediction intervals remained wide, reinforcing the variability of findings. CONCLUSION: Improvements were most consistent for hot flashes, while evidence for overall symptom severity and quality of life was less consistent. Although no statistically significant publication bias was detected, this finding should be interpreted with caution given the limited number of studies and observed heterogeneity. Integrating evidence-based complementary and alternative approaches into clinical guidelines could enhance holistic women's healthcare.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.