This study evaluates 23 (9 Chinese and 14 non-Chinese) randomized controlled trials for efficacy and side effects of Chinese herbal medicine on menopausal symptoms. Menopause was diagnosed according to western medicine criteria in all studies while seven Chinese studies and one non-Chinese study further stratified the participants using traditional Chinese medical diagnosis “Zheng differentiation.” Efficacy was reported by all 9 Chinese and 9/14 non-Chinese papers. Side effects and adverse events were generally mild and infrequent. Only ten severe adverse events were reported, two with possible association with the therapy. CHM did not increase the endometrial thickness, a common side effect of hormone therapy. None of the studies investigated long-term side effects. Critical analysis revealed that (1) high-quality studies on efficacy of Chinese herbal medicine for menopausal syndrome are rare and have the drawback of lacking traditional Chinese medicine diagnosis (Zheng-differentiation). (2) Chinese herbal medicine may be effective for at least some menopausal symptoms while side effects are likely less than hormone therapy. (3) All these findings need to be confirmed in further well-designed comprehensive studies meeting the standard of evidence-based medicine and including Zheng-differentiation of traditional Chinese medicine.

Background:Perimenopausal insomnia (PI) is one of the most common complaints in women. Acupuncture is used to treat PI increasingly considering its less side effect. The subject of this study is to explore the effectiveness and safety of acupuncture for PI.Methods:All the randomized controlled trials(RCT) literatures of acupuncture for PI will be searched in the databases of MEDLINE, Cochrane Library, Web of Science, EMBASE, Springer, WHO International Clinical Trials Registry Platform (ICTRP), China National Knowledge Infrastructure (CNKI), Wan fang, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP), and other available resources using the subject terms of "acupuncture” and “perimenopausal insomnia” and their synonyms. The languages are limited as English and Chinese. Non-RCT literatures will be screened and relative information will be extracted. Sleep quality values is considered as the primary outcome. Secondary outcomes include biochemical indicators, such as hormone levels, side effects caused by acupuncture, total scores on the insomnia severity index and traditional Chinese medicine symptom changes.Results:This systematic review study will provide an evidence of acupuncture for PI.Conclusion:The study will give an explicit evidence to evaluate the effectiveness and side effects of acupuncture for PI.PROSPERO registration number:CRD42018092917.

No abstract