“…Our literature search identified 31 RCTs. Twenty-two studies were excluded because of lack of indices of interest (Agnusdei et al, 1997a, b;Gambacciani et al, 1997a, b;Potter et al, 1998;Alekel et al, 2000;Wangen et al, 2000;Clifton-Bligh et al, 2001;Katase et al, 2001;Anderson et al, 2002;Chiechi et al, 2002;Lucas et al, 2002;Chen et al, 2003Chen et al, , 2004Jones et al, 2003;Schult et al, 2003;Atkinson et al, 2004;Harkness et al, 2004;Olsen et al, 2004;Mori et al, 2004a, b), non-randomization (Dalais et al, 1998), lack of a control group (Agnusdei et al, 1997a, b), insufficient original data or baseline values (Gambacciani et al, 1997a, b;Khalil et al, 2002). Thus, nine studies with a total of 432 subjects were included in this meta-analysis, in which five studies had quality score of five; three studies had quality score of four and one study had quality score of three (Morabito et al, 2002;Uesugi et al, 2002;Yamori et al, 2002;Arjmandi et al, 2003Arjmandi et al, , 2005Dalais et al, 2003;Brooks et al, 2004;Mori et al, 2004a, b;Nikander et al, 2004) (Table 1).…”