Tabriz University of Medical Sciences Journal of Caring Sciences 2251-9920 14 4 2025 12 28 The Effect of Evening Primrose Oil on Menopausal Symptoms Management: A Systematic Review and Meta-Analysis 293 302 10.34172/jcs.025.33570 EN Mona Larki https://orcid.org/0000-0001-6026-7995 Solmaz Mohammadi https://orcid.org/0000-0002-8124-8600 Somayeh Makvandi https://orcid.org/0000-0002-6351-1372 Journal Article 10.34172/jcs.025.33570 2024 06 06 2025 10 05 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 Risk of Bias 2 (ROB2) tool. The GRADEpro evaluated the quality of the evidence, and the RevMan 5.4 performed the data analysis. Results: Six randomized controlled trials (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. Women who received EPO also experienced a significant reduction in the duration of hot flashes compared to those who did not supplement. The EPO group experienced a 0.19 reduction in hot flash intensity, but this reduction was not statistically significant. 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.