Herbal preparations for uterine fibroids

Area of Science:

• Integrative Medicine
• Gynecology
• Pharmacology

Background:

• Uterine fibroids are common benign tumors in women of reproductive age.
• They often cause heavy menstrual bleeding and subfertility.
• Herbal remedies are frequently sought as alternatives to surgery.

Purpose of the Study:

• To assess the efficacy and safety of Chinese herbal medicine for treating uterine fibroids.
• To review randomized controlled trials comparing herbal treatments with other interventions.

Main Methods:

• Searched multiple databases including Cochrane, MEDLINE, EMBASE, and specialized Chinese medical literature databases up to September 2012.
• Included randomized controlled trials (RCTs) of herbal preparations for uterine fibroids, with or without conventional therapy.
• Assessed risk of bias and analyzed data using risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI).

Main Results:

• 21 RCTs with 2222 women were included; most had unclear or high risk of bias.
• Primary outcomes (symptoms) were not reported; fibroid/uterine volume was commonly measured.
• Tripterygium wilfordii extract and Guizhi Fuling formula combined with mifepristone showed greater fibroid volume reduction than controls; no significant difference for Nona Roguy.
• Adverse events were reported in 13/21 trials, with no serious side effects noted.

Conclusions:

• Insufficient high-quality evidence exists to support or refute the use of herbal preparations for uterine fibroids.
• Further rigorous trials with large sample sizes and clinically relevant outcomes are necessary.
• The current evidence base requires strengthening to guide clinical practice regarding herbal treatments for uterine fibroids.