Chinese Herbs as Good as NSAIDs for Menstrual Pain

Scientists at the University of Western Sydney, Australia, have done a meta-analysis of available evidence for safety and effectiveness of Chinese herbs in treating menstrual cramps. They report their findings in the Cochrane Database of Systematic Reviews 2007, concluding that it is probable that these herbs are effective, but there is only limited evidence of their safety.

The search for evidence revealed 39 randomized controlled clinical studies, the bulk of which were conducted in China, with a few done in Taiwan, Japan, and the Netherlands. The 3,475 women in the studies were randomly allocated to take herbal formulations, placebo, acupuncture, heat, or conventional ‘Western’ therapy (non-steroid anti-inflammatory drugs - NSAIDs - or oral contraceptives). The herbal formulations usually used contained one or more of the following herbs: Danggui (Chinese angelica root), Chuanxiong (Szechuan lovage root), Chishao (red peony root), and Baishao (white peony root). The herbs were usually begun 5-7 days before menstruation and continued for 10-15 days.

In 3 trials where the comparison was a placebo results were unclear and could not be used.

In 14 trials, when compared with pharmaceutical drugs - NSAIDs or contraceptives - herbal formulations were superior in pain relief, overall symptoms, and the need for additional medications.

In 18 trials, one herbal mixture was compared with an over-the-counter herbal health product. The ‘designed’ herbal medicine mixtures were superior to the health products in pain relief, symptoms, and use of additional medication.

4 trials covered acupuncture (2), placebo, and hot compresses. The herbal formulations were superior in all 4 trials.

The authors of this meta-analysis found “promising evidence supporting the use of Chinese herbal medicine for primary dysmenorrhea . . .” But they specify that poor methodology limits the value of this evidence; and no mention is made of side effects. And no single herb was identified as being better than the others.

This report may be encouraging to women who suffer from painful menstruation and wish to avoid taking conventional painkillers (NSAIDs). However, the herbal medicine mixtures studied were formulated specifically for the patients, and it might take some effort to find such therapy in the USA . And remember, there were no reports – good or bad – about ill-effects beyond a remark that no significant side effects were identified . . . I would advise my daughter to stick with Advil® (ibuprofen) or another NSAID.