Avicenna J Phytomed., 2016., May-Jun;6(3):273-83.

Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis.

Ghazanfarpour M, Sadeghi R, Latifnejad Roudsari R, Khadivzadeh T, et al.

Key Findings

The aim of this systematic review was to assess the effect of flaxseed and H. perforatum on hot flashes, vaginal atrophy and estrogen-dependent cancers. Flaxseed was more effective than placebo or soy on decreasing the frequency of hot flashes. Night sweats were found to decrease more efficiently in the flaxseed group as compared to the placebo. Studies have found a greater decline in follicle stimulating hormone (FSH) levels in flaxseed groups as compared to placebo. Standardized difference in means of estradiol change showed more increase in flaxseed group as compared to placebo. There is evidence for protective effect of flaxseed on breast cancer. This systematic review showed beneficial effects of flaxseed on vasomotor symptoms of post-menopausal women. However no consistent conclusion can be reached regarding estrogen dependent cancer and vaginal maturation value. Further high quality trials are still needed to address these issues.

Abstract

OBJECTIVE: In this study, we aimed at evaluation of the efficacy of Hypericum perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women. MATERIALS AND METHODS: We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials (RCT) to explore trials that assessed the effectiveness of H. perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers. In this regard, the following terms were used “menopause AND H. perforatum OR flaxseed OR Linum usitatissimum. Only randomized controlled trials were included in the study. RESULTS: Nine RCTs were included in this systematic review. Based on the literature, flaxseed showed beneficial effect on hot flash frequency and intensity, which was not statistically significant. According to two trials, flaxseed showed estrogenic effects; however, no conclusion regarding cancer promoting or protecting effects can be made. The evidence of the efficacy of the flaxseed on alleviating vaginal atrophy was also limited due to inconsistent findings in this regard. One trial declared that Vitex agnus-castus and H. perforatum showed comparable decrease in the frequency of hot flashes. CONCLUSION: The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review.

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