Abstract
Introduction: Many women avoid hormone therapy due to the health risks, deciding to pursue herbal alternatives. This meta-analysis aimed to determine the effectiveness of Evening Primrose Oil (EPO) in managing menopausal symptoms. Methods: A comprehensive literature review was conducted until February 7,2024, without any limitations on language or time, using electronic databases such as PubMed, Web of Science, Scopus, and the Cochrane Library to collect randomized clinical trials. The methodological quality of the included trials was assessed using the Cochrane ROB2 tool. The GRADEpro evaluated the quality of the evidence, and the RevMan 5.4 performed the data analysis. Results: Six RCTs were included in this study. The meta-analysis of 450 women revealed, however, that the women in the EPO group experienced a mean decrease of 2.13 in the number of hot flashes per day compared to the control group. Still, it was not statistically significant(MD=-2.13, 95%CI -4.26 to 0.001, P=0.05, I2=84%). Women who received EPO also experienced a significant reduction in the duration of hot flashes compared to those who did not supplement(SMD=-0.39, 95%CI -0.76 to -0.02, P=0.04, I2=69%). The EPO group experienced a 0.19 reduction in hot flash intensity, but this reduction was not statistically significant(SMD=-0.19, 95%CI -0.45 to 0.08, P=0.16, I2=0%). The evidence grading was moderate to low. Conclusion: EPO reduces menopausal symptoms, but to understand the effectiveness of this option, we need to conduct further research with rigorous methodological standards so that menopausal women can make decisions that improve their quality of life in the menopause period.