Chinese herbal medicine Ding Kun Dan for menopausal syndrome: A systematic review and meta-analysis of randomized controlled trials.

Background: Menopausal syndrome is a common condition in women during menopause, characterized by hormonal imbalances and various symptoms that negatively impact quality of life. Ding Kun Dan (DKD), a traditional Chinese herbal medicine, has been used to alleviate these symptoms, but its clinical efficacy and safety require further evaluation. Methods: A systematic search of eight databases was conducted through March 15, 2025. Randomized controlled trials (RCTs) were included if DKD was used alone or with conventional Western treatments. The primary outcome was the Kupperman Index; secondary outcomes included the Pittsburgh Sleep Quality Index, SF-36, Self-Rating Anxiety Scale, Self-Rating Depression Scale, estradiol, follicle-stimulating hormone, luteinizing hormone, and adverse events. Meta-analysis was performed using RevMan 5.4.1 and Stata 17. Results: A total of 21 RCTs involving 1981 participants were included. DKD combined with menopause hormone therapy (MHT) demonstrated superior efficacy in improving overall symptoms, sleep quality, quality of life, and reducing anxiety and depression, with a positive impact on hormone levels and fewer adverse events. DKD alone also showed comparable effects to MHT in improving symptoms and hormone levels. Additionally, DKD combined with oryzanol positively impacted hormone levels. Conclusions: DKD, both alone and in combination with MHT or oryzanol, demonstrates potential therapeutic effects for managing menopausal symptoms, but due to the low quality of included studies, results should be interpreted cautiously. Larger, high-quality RCTs are needed to confirm these findings. Protocol registration: PROSPERO, CRD42024621022.