evidence-based medicine Archives - Revista Brasileira de Ginecologia e Obstetrícia
, , , , , Summary
Rev Bras Ginecol Obstet. 2020;42(7):427-435
, , , , , We performed a systematic review to assess the effectiveness and safety of Tribulus terrestris to treat female sexual dysfunction (FSD).
We performed unrestricted electronic searches in the MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, PsycINFO,WHO-ICTR, Clinicaltrials.gov and OpenGrey databases. Selection of studies We included any randomized controlled trials (RCTs) that compared T. terrestris versus inactive/active interventions. After the selection process, conducted by two reviewers, 5 RCTs (n = 279 participants) were included.
Data extraction was performed by two reviewers with a preestablished data collection formulary.
Due to lack of data and clinical heterogeneity, we could not perform meta-analyses. The risk of bias was assessed by the Cochrane Risk of Bias (RoB) tool, and the certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluations (GRADE).
After 1 to 3 months of treatment, premenopausal and postmenopausal women randomized to T. terrestris had a significant increase in sexual function scores. Three months of treatment with T. terrestris showed a significant increase in the serum testosterone levels of premenopausal women. There was no report of serious adverse events, and none of the studies assessed health-related quality of life. The certainty of the evidence was very low, whichmeans that we have very little confidence in the effect estimates, and future studies are likely to change these estimates.
MoreRCTs are needed to supportor refute the use of T. terrestris. The decision to use this intervention should be shared with the patients, and the uncertainties around its effects should be discussed in the clinical decision-making process. Number of Protocol registration in PROSPERO database: CRD42019121130
Summary
Rev Bras Ginecol Obstet. 2020;42(7):427-435
, , , , , We performed a systematic review to assess the effectiveness and safety of Tribulus terrestris to treat female sexual dysfunction (FSD).
We performed unrestricted electronic searches in the MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, PsycINFO,WHO-ICTR, Clinicaltrials.gov and OpenGrey databases. Selection of studies We included any randomized controlled trials (RCTs) that compared T. terrestris versus inactive/active interventions. After the selection process, conducted by two reviewers, 5 RCTs (n = 279 participants) were included.
Data extraction was performed by two reviewers with a preestablished data collection formulary.
Due to lack of data and clinical heterogeneity, we could not perform meta-analyses. The risk of bias was assessed by the Cochrane Risk of Bias (RoB) tool, and the certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluations (GRADE).
After 1 to 3 months of treatment, premenopausal and postmenopausal women randomized to T. terrestris had a significant increase in sexual function scores. Three months of treatment with T. terrestris showed a significant increase in the serum testosterone levels of premenopausal women. There was no report of serious adverse events, and none of the studies assessed health-related quality of life. The certainty of the evidence was very low, whichmeans that we have very little confidence in the effect estimates, and future studies are likely to change these estimates.
MoreRCTs are needed to supportor refute the use of T. terrestris. The decision to use this intervention should be shared with the patients, and the uncertainties around its effects should be discussed in the clinical decision-making process. Number of Protocol registration in PROSPERO database: CRD42019121130
Summary
Rev Bras Ginecol Obstet. 2009;31(7):367-374
DOI 10.1590/S0100-72032009000700008
A good quality prenatal assistance is essential to warrant perinatal and maternal health. Nowadays, due to the evolution of diagnostic methods and the change in illness prevalence, such as the increase in diabetes and sexually transmitted diseases, several propedeutic procedures are available. This introduces further difficulty for clinicians to select the most adequate procedures and when to apply them during gestation, assuring the best results for both mother and infant. The present review aimed at evaluating the main prenatal routine tests on the basis of the best scientific evidence presently available.
Summary
Rev Bras Ginecol Obstet. 2009;31(7):367-374
DOI 10.1590/S0100-72032009000700008
A good quality prenatal assistance is essential to warrant perinatal and maternal health. Nowadays, due to the evolution of diagnostic methods and the change in illness prevalence, such as the increase in diabetes and sexually transmitted diseases, several propedeutic procedures are available. This introduces further difficulty for clinicians to select the most adequate procedures and when to apply them during gestation, assuring the best results for both mother and infant. The present review aimed at evaluating the main prenatal routine tests on the basis of the best scientific evidence presently available.
Summary
Rev Bras Ginecol Obstet. 2009;31(3):148-155
DOI 10.1590/S0100-72032009000300008
Good prenatal care is essential to guarantee maternal and perinatal health. Nowadays, with the constant progress on the diagnostic methods and changes in diseases panorama, like increased frequency of diabetes and sexually transmitted diseases, several diagnostic procedures have been studied. These challenges difficult the selection of prenatal exams by the clinicians, in order to improve maternal and perinatal outcome. This review aimed to evaluate the main prenatal routine exams, according to the best current scientific evidences.
Summary
Rev Bras Ginecol Obstet. 2009;31(3):148-155
DOI 10.1590/S0100-72032009000300008
Good prenatal care is essential to guarantee maternal and perinatal health. Nowadays, with the constant progress on the diagnostic methods and changes in diseases panorama, like increased frequency of diabetes and sexually transmitted diseases, several diagnostic procedures have been studied. These challenges difficult the selection of prenatal exams by the clinicians, in order to improve maternal and perinatal outcome. This review aimed to evaluate the main prenatal routine exams, according to the best current scientific evidences.
