Modified Tao-Hong Siwu Tang (MTST) appears more effective than non-steroidal anti-inflammatory drugs (NSAIDs), and a combination of Tao-Hong Siwu Tang with oral contraceptives (OCs) offers benefits over OCs alone for treating primary dysmenorrhea.
This systematic review aimed to assess the efficacy and safety of Tao-Hong Siwu Tang (TST) in treating primary dysmenorrhea. Conducted across various databases, the review identified five randomized controlled trials (RCTs) meeting inclusion criteria. The meta-analysis revealed suggestive evidence that modified TST (MTST) might have a favorable effect compared to non-steroidal anti-inflammatory drugs (NSAIDs) in managing primary dysmenorrhea (RR = 1.53, 95% CI = 1.37–1.72), with one RCT indicating MTST's superiority in reducing recurrence rates (RR = 0.31, 95% CI = 0.15–0.63, P = 0.001). Furthermore, combining TST with oral contraceptives (OCs) appeared beneficial compared to OCs alone (RR = 1.35, 95% CI = 1.02–1.79, P = 0.04). However, moderate evidence quality due to bias uncertainties and limited RCTs highlighted the need for cautious interpretation. The study emphasized the demand for alternative treatments, given NSAID and OC limitations, while stressing the need for rigorous large-scale trials to clarify TST's role in primary dysmenorrhea management.