Efficacy of Prasaplai for Treatment of Primary Dysmenorrhea: a Meta-Analysis

Prasaplai is used in Thai traditional medicine for treatment of primary dysmenorrhea; however, clinical evidence is limited regarding the efficacy of Prasaplai for primary dysmenorrheal outcomes. This study has constituted a systematic review and meta-analysis to evaluate Prasaplai as an effective treatment for primary dysmenorrhea. Randomized controlled trials were retrieved and identified through electronic searches (PubMed, CINAHL, Cochrane Central Register of Controlled Trials, SCOPUS, Science Direct, and ThaiLis publications until May 2017). A hand search for relevant trials was also conducted. Quality of the selected trials was assessed using Jadad’s scoring and A Cochrane Risk of Bias Assessment Tool. Studies were recruited for the meta-analysis if 1) they were randomized controlled trials, 2) participants were diagnosed with primary dysmenorrhea, and 3) a pain score was included. Related outcomes and adverse events were also evaluated for all groups. Four randomized controlled trials met the criteria, totaling 460 participants. Results revealed that Prasaplai significantly improved pain scores. The pooled mean difference was -1.24 (95% CI -1.90 to -0.59; p = 0.0002). The results did not indicate significant effects of Prasaplai on menstrual characteristics and associated symptoms, compared with NSAIDs; however, participants receiving Prasaplai reported a low frequency of adverse effects compared to the NSAID group. Current evidence suggests that Prasaplai improved pain associated with primary dysmenorrhea. Prasaplai had no effect on menstrual characteristics and associated symptoms. Additional rigorously-designed trials with larger sample sizes are warranted to confirm the effects of Prasaplai on primary dysmenorrhea and related outcomes.