Traditional herbal medicine and the decreased risk of uterine surgery among women with uterine fibroid in Taiwan

Introduction: The gynecological symptoms treated with Chinese herbal medicines containing phytoestrogen are similar to fibroid-related symptoms. The objective of this study is to estimate the risk of herbs and formulas in relation to surgeries of the uterine. Methods: A case-control study with propensity score matching was conducted to estimate the risk of uterine surgeries among women with fibroids. In all, 34 435 women with fibroids (over 20 years of age) were recruited from a nationwide 1-million-person representative sample of those covered by National Health Insurance in Taiwan and were followed from January 1, 2000, to December 31, 2012. The age-specific hazard ratios of subsequent fibroid-related surgeries in connection with either phytoestrogens or herbs having estrogen activity were calculated with multivariate Cox proportional hazard regression. Results: Nearly 67% of the women with uterine fibroid eventually used traditional Chinese medicine. The adjusted hazard ratios for subsequent fibroid-related surgery were 0.29 (95% confidence interval [CI]: 0.26–0.32), 0.30 (95% CI: 0.27–0.32), and 0.30 (95% CI: 0.28–0.32) in women consuming phytoestrogen, Panax ginseng, and Angelica Sinensis, respectively. Phytoestrogen, Panax ginseng, and Angelica sinensis appear to decrease the risk of subsequent fibroid-related surgeries. Conclusions: Although the mechanism of action of phytoestrogen, Panax ginseng, and Angelica sinensis is uncertain, their use in accordance to traditional Chinese medicine theory as a pre-emptive agent for subsequent fibroid-related surgeries might be taken into account.