Scolaris Content Display Scolaris Content Display

Comparison 1 Promensil versus placebo, Outcome 1 Incidence of hot flushes (number/day).
Figures and Tables -
Analysis 1.1

Comparison 1 Promensil versus placebo, Outcome 1 Incidence of hot flushes (number/day).

Comparison 1 Promensil versus placebo, Outcome 2 Change in frequency of hot flushes (% reduction).
Figures and Tables -
Analysis 1.2

Comparison 1 Promensil versus placebo, Outcome 2 Change in frequency of hot flushes (% reduction).

Comparison 1 Promensil versus placebo, Outcome 3 Proportion with improvement in hot flush severity.
Figures and Tables -
Analysis 1.3

Comparison 1 Promensil versus placebo, Outcome 3 Proportion with improvement in hot flush severity.

Comparison 1 Promensil versus placebo, Outcome 4 Change in vasomotor score from baseline to end of study.
Figures and Tables -
Analysis 1.4

Comparison 1 Promensil versus placebo, Outcome 4 Change in vasomotor score from baseline to end of study.

Comparison 1 Promensil versus placebo, Outcome 5 Proportion with any adverse events.
Figures and Tables -
Analysis 1.5

Comparison 1 Promensil versus placebo, Outcome 5 Proportion with any adverse events.

Comparison 1 Promensil versus placebo, Outcome 6 Incidence of specific adverse events.
Figures and Tables -
Analysis 1.6

Comparison 1 Promensil versus placebo, Outcome 6 Incidence of specific adverse events.

Comparison 1 Promensil versus placebo, Outcome 7 Endometrial thickness after treatment.
Figures and Tables -
Analysis 1.7

Comparison 1 Promensil versus placebo, Outcome 7 Endometrial thickness after treatment.

Table 1. Quality assessment of included trials

Trial

Design

Randomisation proced

Allocation concealmt

Blinding

Power calc

ITT analysis

Dropouts

B'line comparability

Albertazzi 1998

Parallel

adequate

A

double

Yes

No

24% by end of 1st month

Yes

Baber 1999

Crossover

not reported

B

double

not reported

No

16% (8/51). 7 for personal reasons, 1 for medical reason not related to study

not reported

Balk 2002

Parallel

adequate

A

double

Yes, but insufficient

No

30% (8/27). 6 in soy grp (2 family, 2 medical, 1 ineffective, 1 lost to follow up); 2 in placebo grp (1 lack of efficacy, 1 bad taste of cereal)

Yes

Bica 2004

Parallel

adequate

A

triple

not reported

No

5% (4/75). 1 in soy grp (l follow up), 3 in placebo grp (2 adverse events, 1 other)

No

Brzezinski 1997

Parallel

not reported

B

none

Yes

No

21% (31/145). 17 in soy grp (4 taste, 2 symptoms, 11 personal), 14 control grp (7 symptoms, 7 personal)

Yes

Burke 2003

Parallel

not reported

B

double

not reported

No

12% (30/241). Not clear which grp ‐ data were missing

No, did not include missing participants

Campagnoli 2005

Crossover

adequate

A

double

Yes

No

19% (7/36). Not clear which grp. 3 medical, 4 family

Yes

Crisafulli 2004

Parallel

adequate

B

double

Yes

Yes

8% (7/90). Reason or grp not given

Yes

Dalais 1998

Crossover

adequate

B

double

Yes

No

15% (8/52). Not clear which grp. 7 personal, 1 non compliant

Yes

Dodin 2005

Parallel

adequate

B

double

Yes

No

10% (20/199). 16 in flaxseed grp (7 medical, 3 non compliance, 4 personal, 1 symptomatic, 1 HRT); 4 in placebo grp (2 medical, 2 non compliant)

No, did not include dropouts

Duffy 2003

Parallel

not reported

B

double

not reported

No

8% (3/36). All from placebo grp ‐ concurrent Rx.

No, did not include dropouts

Faure 2002

Parallel

not reported

B

double

Yes

No

27% (20/75). 6 in soy grp (4 inefficacy, 1 l follow up, 1 other), 14 in placebo grp (11 inefficacy, 2 adverse events, 1 l follow up)

Yes

Han 2002

Parallel

adequate

B

double

not reported

No

2% (2/82). Not clear which grp. 1 inefficacy, 1 adverse event

No, did not include 2 dropouts

Heyerick 2006

Parallel

adequate

A

double

not reported

No

18% (12/67). 4 in hi phyto grp (3 no efficacy, 1 other), 1 in low phyto grp (no efficacy), 7 in placebo grp (all no efficacy)

No, did not include dropouts

Hidalgo 2005

Crossover

adequate

A

double

Yes, but insufficient

No

12% (7/60). Not clear which grp. 5 no reason, 2 adverse events

No, did not include dropouts

Imhof 2006

Crossover

not reported

B

double

not reported

No

4% (4/113) excluded post randomisation because they started ERT

not reported

Jeri 2002

Parallel

not reported

B

double

not reported

No

10% (3/30). All from placebo grp ‐ no reasons.

Yes, but no table provided

Kaari 2006

Parallel

adequate

B

double

not reported

No

14% (11/79). 7 from soy grp (3 medical, 4 personal), 4 from E grp (1 medical, 1 no reason, 1 scared of biopsy, 1 personal)

No, did not include dropouts

Khaodhiar 2007

Parallel

not reported

B

double

not reported

No

20% (41/207) (not clear from which group, mostly for inability to follow protocol)

No, did not include dropouts

Knight 1999

Parallel

adequate

A

double

not reported

No

3% (1/37) for personal reason but replaced. 5% (2/37) withdrawn by GP.

Yes

Knight 2001

Parallel

adequate

A

double

not reported

No

17% (4/24). 3 from soy grp (taste), 1 from placebo grp ( l follow up)

Yes

Kotsopoulos 2000

Parallel

not reported

B

double

not reported

No

20% (19/94). 10 in soy grp (7 could not accept Rx, 2 adverse events, 1 not known), 9 in placebo grp (6 could not accept Rx, 3 adverse events)

Yes

Lewis 2006

Parallel

adequate

A

double

not reported

No

12% (12/99). 2 in soy grp (1 could not accept Rx, 1 adverse event), 5 in flaxseed grp (2 could not accept Rx, 1 adverse event, 1 medical, 1 personal), 5 in placebo grp (1 could not accept Rx, 1 adverse event, 2 medical, 1 protocol violation).

Penotti 2003

Parallel

adequate

B

double

done retrospectively

No

21% (13/62). 6 in soy grp (1 medical, 5 no efficacy), 7 in placebo grp (all no efficacy).

Yes

Sammartino 2003

Parallel

adequate

B

no

not reported

No

10% (7/70). 3 in genistin grp (2 no compliance, 1 personal), 4 in calcium grp (3 no compliance, 1 personal)

No, did not include dropouts

St Germain 2001

Parallel

not reported

B

double

Not reported

No

14% (11/80). Not clear which grp. 6 could not accept Rx, 1 died, 1 family member died, 2 medical, 1 non compliance.

No, did not include dropouts

Tice 2003

Parallel

adequate

A

double

Yes

Yes

2% (6/252). 2 in Promensil grp (1 no efficacy, 1 personal), 2 in Rimostil grp (1 adverse event, 1 physician advice), 2 in placebo grp (both personal)

Yes

Upmalis 2000

Parallel

not reported

B

double

not reported

No

31% (55/177). 31 in soy grp (9 did not meet inclusion, 11 protocol violation, 10 no reason, 1 adverse event), 24 in placebo grp (4 did not meet inclusion, 13 protocol violation, 7 no reason)

No, did not include dropouts

Van de Weijer 2002

Parallel

adequate

A

double

not reported

No

13% (4/30). All from lack of efficacy (1 in Promensil grp, 3 in placebo grp)

Yes

Woo 2003

Parallel

not reported

B

single (assessors)

Yes

No

7% (9/136). HRT 5 (adverse events, personal), 2 in phyto grp (1 medical, 1 personal), 2 in control grp (both personal)

No, did not include dropouts

Figures and Tables -
Table 1. Quality assessment of included trials
Table 2. Summary of findings: efficacy outcomes

Trial

No

Intervention

Comparison

Duration

Efficacy outcomes

Results(btwn grp cp)

SOY DIETARY SUPPLEMENTS

Albertazzi 1998

104

60 g soy powder (76 mg isoflavones)

Placebo (60 g casein)

12 weeks

No flushes/day after treatment; %age decrease in number of flushes

At end of study, a significant difference between placebo and soy: ‐1.59 (‐1.95 to ‐1.2), p<0.01 representing a mean reduction of 1.6 flushes per day in soy group compared to placebo. 45% reduction in flushes with soy vs 30% reduction with placebo; p<0.01.

Balk 2002

27

Soy and corn flour cereal (100 mg/d isoflavones)

Placebo (wheat cereal)

24 weeks

Hot flush and night sweat symptom score after Rx (1‐4)

NS all outcomes

Brzezinski 1997

145

Phytoestrogen enriched diet (individualized by dietician) (isoflavone amount not given)

Control ‐ regular diet (avoiding phytoestrogens)

12 weeks

MSQ hot flush severity reduction sub score (0‐3)

Greater reduction with PE rich diet, p=0.004 (no CI given)

Burke 2003

241

(1) soy drink 1 (42 mg/d isoflavones); (2) soy drink 2 (58 mg/d isoflavones)

Placebo (soy drink with isoflavones removed)

2 years

No and severity of flushes/sweats per day after Rx (symptom diary); also subgroup analysis in women with 4+ symptoms/d at baseline

NS all outcomes

Dalais 1998

52

(1) soy diet (53 mg/d isoflavones); (2) linseed diet (high in isoflavones ‐ amount not given)

Placebo (wheat diet (low isoflavones))

12 weeks + 12 weeks

%age decrease in no of hot flushes

NS. 22% reduction with soy; 41% reduction with linseed; 51% reduction with wheat.

Knight 2001

24

Soy powder 60 g/d for beverage (134.4 mg/d isoflavones)

Placebo (casein powder for beverage)

12 weeks

No flushes/wk after Rx

NS. 29 flushes/wk in soy group; 46 flushes/wk in placebo group (reduction in both from baseline)

Kotsopoulos 2000

94

Soy powder for beverage (118 mg/d isoflavones)

Placebo (casein powder for beverage)

12 weeks

Hot flush symptom score (severity) (0‐3) after Rx

NS. 0.77 score with soy; 0.83 score with placebo

Lewis 2006

99

(1) Soy flour muffins (42 mg/d isoflavones); (2) flaxseed muffins (50 mg/d lignans)

Placebo (wheat flour muffins (low lignans and no isoflavones))

16 weeks

Menoquol vasomotor score; no flushes per day; severity of flushes (1‐7 scale) after Rx

NS all outcomes

St Germain 2001

69

(1) Soy protein + (80.4 mg/d isoflavones); (2) soy protein ‐ (4.4 mg/d isoflavones) in muffins and powder for cooking

Placebo (whey protein)

24 weeks

%age of participants perceiving a decrease in (1) frequency, (2) duration and (3) severity of flushes; no of flushes/wk after Rx; no of sweats/wk after Rx

NS

SOY EXTRACT

Bica 2004

75

Standardized soy extract (33 mg/d isoflavones)

Placebo capsule

25 weeks

Greene vasomotor sub scale (intensity); %age who experienced a decrease in frequency of flushes and sweats from baseline

NS Greene vasomotor scale; 74% with soy vs 43% with placebo had decrease in no of hot flushes; p=0.007; 68% with soy vs 46% with placebo had decrease in no of night sweats; p=0.049. NS: severity of symptoms.

Campagnoli 2005

36

Standardized soy extract (Soy select) (60 mg/d isoflavones)

Placebo capsules

12 weeks + 12 weeks

No flushes/week after Rx

NS

Duffy 2003

36

Soy supplement capsules (Solgen) (60 mg/d isoflavones)

Placebo capsules

12 weeks

Greene vasomotor symptom score (severity)

NS

Faure 2002

75

Standardized soy extract capsules (70 mg/d isoflavones)

Placebo capsules

16 weeks

%age decrease in flushes/day; %age of 'responders' (participants who had reduction of at least 50%)

61% decrease with soy vs 21% reduction with placebo (p value not reported); 66% of soy group were responders vs 34% in placebo group; p<0.005. Repeated measures analysis confirmed the soy‐placebo treatment effect.

Han 2002

80

Soy capsules (100 mg/d isoflavones)

Placebo capsules

16 weeks

Kupperman vasomotor symptom score (severity)

Vasomotor score 8.2 in soy group vs 9.9 in placebo group; p<0.01

Kaari 2006

79

Soy extract capsules (S40/Ach‐1)(120 mg/d isoflavones)

Estrogen + placebo capsules

24 weeks

%age of participants reporting reduction (subgroup)

NS

Khaodhiar 2007

207

Soy extract capsule (isoflavone quantity not known) (1) 40 mg/d, (2) 60 mg/d

Placebo

12 weeks

%age reduction in frequency of hot flushes (from daily diary), %age reduction in severity of hot flushes (daily diary)

50% reduction in hot flush frequency in both soy groups at 12 weeks compared to 38% reduction with placebo (NS). When both treatment groups were combined, there was an average reduction of 1.2 more flushes per day in women on soy compared to women on placebo (p=0.016). NS for hot flush severity score (p=0.07)

Penotti 2003

62

Soy tablets (72 mg/d isoflavones)

Placebo tablets

24 weeks

No flushes per day after Rx

NS

Upmalis 2000

177

Standardized soy extract tablets (50 mg/d of genistin and daidzin)

Placebo tablets

12 weeks

%age change in flush severity/wk; %age change in flush frequency/wk; %age change in sweat frequency/wk

34% change in severity with soy vs 21% change in severity with placebo: p=0.01); NS for %age change in frequency (p=0.078 repeated measures analysis); NS for change in reduction of night sweats.

RED CLOVER EXTRACTS

Baber 1999

51

Promensil (standardised red clover extract) (40 mg/d isoflavones)

Placebo tablet

12 weeks + 12 weeks

No flushes per day after Rx; %age flush reduction

NS

Hidalgo 2005

60

Red clover supplement capsules (80 mg/d isoflavones)

Placebo capsules

12 weeks + 12 weeks

Kupperman Index score for hot flushes and sweats (severity) (expressed as percentage)

Hot flushes: 15% with red clover vs 98% with placebo; night sweats: 30% with red clover vs 93% with placebo; p value not given

Jeri 2002

30

Promensil (standardized red clover extract) (40 mg/d isoflavones)

Placebo tablet

16 weeks

%age reduction in no flushes per day; severity of flushes per day (scale)

Frequency: 49% reduction with red clover vs 11% reduction with placebo: p<0.001); severity: reduction from 2.53 to 1.33 with red clover vs no reduction with placebo: p<0.001.

Knight 1999

37

Promensil (standardized red clover extract) (40 mg/d isoflavones)

Placebo tablet

12 weeks

No flushes per day

NS

Tice 2003

252

(1) Promensil (standardized red clover extract) (82 mg/d isoflavones ‐ 2 tablets); (2) Rimostil (standardized red clover extract) (57 mg/d isoflavones ‐ 2 tablets)

Placebo tablets

12 weeks

No flushes per day; %age reduction in flushes; rate of reduction over time

No flushes per day NS; %age reductions NS; Promensil had faster reduction over time vs placebo (p=0.03)

Van de Weijer 2002

30

Promensil (standardized red clover extract) (80 mg/d isoflavones ‐ 2 tablets)

Placebo tablets

12 weeks

No flushes per day; median %age change in no of flushes

3.4 flushes per day with Promensil vs 6 flushes per day with placebo (p value not reported); 44% reduction with Promensil vs 0% reduction with placebo: p=0.01 (variation not reported)

OTHER PHYTOESTROGENS

Crisafulli 2004

90

(1) Genistein extract (54 mg/d isoflavones); (2) continuous HRT (17B estradiol 1mg/d + norethisterone acetate)

Placebo tablets

1 year

%age change in no of flushes per day

24% reduction with genistein when compared with placebo: p<0.01; 30% reduction with HRT when compared with genistein: p<0.05

Dodin 2005

112

Flaxseed dietary supplement (in bread and ground grain) (21,071ug lignans)

Placebo (wheat germ) (196ug lignans)

1 year

Menoquol hot flush and sweat scores (severity)

NS

Heyerick 2006

67

(1) hop extract 1 (100ug 8‐prenylnaringenin); (2) hop extract 2 (250ug 8‐prenylnaringenin) (Menohop)

Placebo capsule

12 weeks

Kupperman hot flush score (severity)

NS at the end of the study period

Woo 2003

136

Sachets of Pueraria lobata (Chinese medicinal herb) (100 mg/d isoflavones)

(1) Sequential HRT (CEE 0.625 mg/d continuously + MPA 5mg/d for 14 days of cycle), (2) no treatment

12 weeks

Vasomotor symptom score; mean change in score (menopause questionnaire)

NS

Dalais 1998

see above for results in the flaxseed arm

Lewis 2006

see above for results in the flaxseed arm

Figures and Tables -
Table 2. Summary of findings: efficacy outcomes
Table 3. Summary of findings: safety outcomes

Trial

No

Intervention

Comparison

Duration

Safety outcomes

Results(btwn grp cp)

SOY DIETARY SUPPLEMENTS

Albertazzi 1998

104

60g soy powder (76 mg isoflavones)

Placebo (60g casein)

12 wks

Adverse events

NS

Balk 2002

27

Soy and corn flour cereal (100 mg/d isoflavones)

Placebo (wheat cereal)

24 wks

Endometrial stimulation; adverse events

Endometrial stimulation: NS (all participants had atrophic endometrium). Adverse events: NS

Dalais 1998

52

(1) soy diet (53 mg/d isoflavones), (2) linseed diet (high in isoflavones ‐ amount not given)

Placebo (wheat diet ‐ low isoflavones)

12 wks + 12 weeks

Vaginal maturation index (%age increase from baseline)

Increase of 103% with soy diet (p=0.03), 6% increase with linseed (NS), 11% increase with placebo (NS)

Knight 2001

24

Soy powder 60g/d for beverage (134.4 mg/d isoflavones)

Placebo (casein powder for beverage)

12 wks

Adverse events; vaginal maturation index

Total adverse events: 75% with soy vs 17% with placebo, p<0.001; vaginal maturation index NS

Kotsopoulos 2000

94

Soy powder for beverage (118 mg/d isoflavones)

Placebo (casein powder for beverage)

12 wks

Adverse events

Total adverse events NS

SOY EXTRACTS

Bica 2004

75

Standardized soy extract (33 mg/d isoflavones)

Placebo capsule

25 wks

Vaginal maturation index; vaginal pH (% with improvement)

Maturation: NS; pH: 21% with soy vs 11% with placebo had improvement in pH, p=0.008

Campagnoli 2005

36

Standardized soy extract (Soyselect) (60 mg/d isoflavones)

Placebo capsules

12 wks + 12 weeks

Vaginal maturation index

NS

Faure 2002

75

Standardized soy extract capsules (7mg/d isoflavones)

Placebo capsules

16 wks

Adverse events

NS

Han 2002

80

Soy capsules (100 mg/d isoflavones)

Placebo capsules

16 wks

Endometrial thickness

NS

Kaari 2006

79

Soy extract capsules (S40/Ach‐1) (120 mg/d isoflavones)

Estrogen + placebo capsules

24 wks

Vaginal pH; vaginal maturation index; endometrial thickness; endometrial stimulation; adverse events

pH: 5.5 in soy grp vs 4.8 in ERT grp: p=0.0012; maturation index: significant difference in intermediate and superficial cells frequency in ERT grp when compared with soy grp (p value not given); endometrial thickness: 5.9 mm in ERT grp vs 3.0 mm in soy grp (significant, p value not given); non atrophic endometrium: 54% in ERT grp vs 88% in soy grp, p<0.01; adverse events: 17% genital bleeding in ERT grp vs 0% in soy grp.

Khaodhiar 2007

207

Soy extract capsules (isoflavone quantity not known) ‐ 2 different doses: 40 mg/d and 60 mg/d

Placebo

12 wks

Adverse events

Very few events reported ‐ no group comparisons reported

Penotti 2003

62

Soy tablets (72 mg/d isoflavones)

Placebo tablets

24 wks

Endometrial thickness

NS

Upmalis 2000

177

Standardized soy extract tablets (50 mg/d of genistin and daidzin)

Placebo tablets

12 wks

Adverse effects; vaginal pH; vaginal maturation index; endometrial thickness

Adverse events: 34% (30/89) of soy grp reported 70 events vs 45% (39/86) in placebo grp reported 79 events (no p value); pH: NS; maturation index NS; endometrial thickness: NS

RED CLOVER EXTRACTS

Baber 1999

51

Promensil

Placebo

12 wks + 12 weeks

Endometrial thickness

NS

Hidalgo 2005

60

Red clover supplement capsules (80 mg/d isoflavones)

Placebo

12 wks + 12 weeks

Vaginal cytology (karyopyknotic index, cornification index, maturation index)

Significant changes (p<0.05) in all indexes when compared with placebo.

Imhof 2006

113

Red clover extract capsules (80 mg/d isoflavones)

Placebo

12 wks + 12 weeks

Endometrial thickness

Significant decrease in thickness with red clover (15%) but not with placebo (placebo values not given), p<0.001

Tice 2003

252

(1) Promensil (standardized red clover extract) (82 mg/d isoflavones ‐ 2 tablets); (2) Rimostil (standardized red clover extract) (57 mg/d isoflavones ‐ 2 tablets)

Placebo

12 wks

Adverse events

NS

OTHER PHYTOESTROGENS

Crisafulli 2004

90

(1) Genistein extract (54 mg/d isoflavones); (2) continuous HRT (17B estradiol 1mg/d + norethisterone acetate)

Placebo

1 year

Endometrial thickness

NS

Sammartino 2003

70

Genistin extract tablets (amount of isoflavones not given)

Placebo tablets

1 year

Endometrial thickness

NS

Dalais 1998

see above for results in the flaxseed arm

Figures and Tables -
Table 3. Summary of findings: safety outcomes
Table 4. Summary of findings: acceptability outcomes

Trial

No

Intervention

Comparison

Duration

Outcomes

Results(btwn grp cp)

Albertazzi 1998

104

60g soy powder (76 mg/d isoflavones)

Placebo

12 wks

Withdrawal because of adverse events

20% in soy grp vs 23% in placebo grp (p value not reported

Knight 2001

24

Soy powder 60g/d for beverage (134.4 mg/d isoflavones)

Placebo

12 wks

Withdrawal because of adverse events

25% in soy grp vs 8% in placebo grp (p value not reported)

Kotsopoulos 2000

94

Soy powder for beverage (118 mg/d isoflavones)

Placebo

12 wks

Withdrawal because of adverse events or inability to tolerate the treatment

20% in soy grp vs 18% in placebo grp (p value not given)

Figures and Tables -
Table 4. Summary of findings: acceptability outcomes
Comparison 1. Promensil versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Incidence of hot flushes (number/day) Show forest plot

5

300

Mean Difference (IV, Random, 95% CI)

‐0.57 [‐1.76, 0.62]

1.1 40mg/day

3

105

Mean Difference (IV, Random, 95% CI)

‐0.54 [‐2.34, 1.27]

1.2 80mg/day

2

195

Mean Difference (IV, Random, 95% CI)

‐0.76 [‐3.28, 1.77]

2 Change in frequency of hot flushes (% reduction) Show forest plot

2

199

Mean Difference (IV, Random, 95% CI)

20.15 [‐12.08, 52.38]

3 Proportion with improvement in hot flush severity Show forest plot

1

27

Odds Ratio (M‐H, Fixed, 95% CI)

47.73 [2.35, 967.37]

4 Change in vasomotor score from baseline to end of study Show forest plot

1

165

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐1.54, 1.74]

5 Proportion with any adverse events Show forest plot

1

169

Odds Ratio (M‐H, Fixed, 95% CI)

0.92 [0.49, 1.72]

6 Incidence of specific adverse events Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 Cold or upper respiratory tract infection (URTI)

1

169

Odds Ratio (M‐H, Fixed, 95% CI)

0.61 [0.25, 1.49]

6.2 Headache

1

169

Odds Ratio (M‐H, Fixed, 95% CI)

0.43 [0.14, 1.28]

6.3 Myalgia

1

169

Odds Ratio (M‐H, Fixed, 95% CI)

1.51 [0.54, 4.16]

6.4 Nausea

1

169

Odds Ratio (M‐H, Fixed, 95% CI)

1.01 [0.24, 4.19]

6.5 Arthralgia

1

169

Odds Ratio (M‐H, Fixed, 95% CI)

0.83 [0.24, 2.84]

6.6 Diarrhea

1

169

Odds Ratio (M‐H, Fixed, 95% CI)

0.67 [0.11, 4.09]

6.7 Vaginal spotting

1

169

Odds Ratio (M‐H, Fixed, 95% CI)

1.54 [0.25, 9.44]

7 Endometrial thickness after treatment Show forest plot

1

51

Mean Difference (IV, Fixed, 95% CI)

0.06 [‐4.94, 5.06]

Figures and Tables -
Comparison 1. Promensil versus placebo