Effectiveness of Herbal Medicines Containing Phytoestrogens to Treat Cyclic Mastalgia: A Systematic Review and Meta-Analysis

Background: Despite the high prevalence of cyclic mastalgia (cyclic breast pain), and disagreement about its therapeutic methods, there is a lot of ambiguity about breast pain yet. We aimed to assess the effectiveness of phytoestrogens to treat cyclic mastalgia, based on the available evidences.Materials and Methods: In this systematic review and meta-analysis, systemic search of online databases (Scopus, Cochrane Central Register of Controlled Trials, EMBASE-Ovid, and Medline complete) for randomized control trial and non-randomized prospective or retrospective clinical studies published up to December ۲۰۲۱ that use oral appliances for the treatment of cyclic mastalgia in women was conducted. Study selection was done by two reviewers.Results: Totally, eight studies were included. Results of the meta-analysis showed that Isoflavones, Nigella sativa, Cinnamon Chamomile tea, Vitagnus and Flax seeds, reduce mastalgia pain; also phytoestrogens (SMD:-۱.۴۰; ۹۵%CI: -۱.۹۳ to -۰.۸۹), and its sub-groups such as Flaxseed (SMD:-۱.۴۸; ۹۵% CI: -۲.۴۶ to -۰.۵۱۲), and Vitex agnus-castus (SMD:-۱.۷۸; ۹۵%CI: -۲.۸۸ to -۰.۶۸; p<۰.۰۰۱) were found significantly effective on the severity of cyclic mastalgia. However, heterogeneity index of all studies was at a significantly high level and was estimated in the range of moderate to high. Also, Nigella sativa, Chamomile, Red clover, and Cinnamon significantly reduced the severity of cyclic mastalgia. Conclusion: Phytoestrogens may have effective and helpful effects on improving cyclic breast mastalgia. Findings of the present study should be interpreted carefully because of existing high heterogeneity between studies, few numbers of studies and small sample size.