Determining the Ease of Cervical Dilation in Patients Given Evening Primrose Oil (Eveprim®) Intravaginally before Hysteroscopy in Postmenopausal and Nulliparous, Premenopausal Women Ages 37-77 Years Old: A Pilot Study

Evening Primrose versus Misoprostol for Cervical Dilatation before Gynecologic Surgeries; a Double–blind Randomized Clinical Trial

“…Considering the effect of evening primrose oil (EPO) on cervical ripening during labor, Journal of Obstetrics, Gynecology and Cancer Research some studies have shown the efficacy of EPO (10), EPO plus misoprostol vs. misoprostol plus placebo (11), as well as EPO vs. placebo (12) in women with post-term pregnancy, while such efficacy has been rejected for oral EPO capsules (1000 mg for 14 days)(13) and oral EPO capsules (2 capsules of 1000 mg for 7 days) (14), compared to placebo. Considering the effect of EPO on cervical dilatation before hysteroscopy procedure, studies comparing vaginal soft gels of EPO with placebo have confirmed the efficacy of vaginal EPO for cervical ripening and have suggested it as an appropriate cervical priming agent to be used prior to gynecologic procedures (15,16). Also, 1000 mg oral EPO was found to be as effective as 500 mcg intracervical dinoprostone gel for cervical priming before hysteroscopy (17).…”

“…Also, 1000 mg oral EPO was found to be as effective as 500 mcg intracervical dinoprostone gel for cervical priming before hysteroscopy (17). Several studies (11,12,(15)(16)(17) have confirmed the effectives of vaginal EPO on cervical ripening/dilatation; however, this herbal plant has not been validated as an appropriate alternative to misoprostol. Considering the adverse events and complications of misoprostol (6), this issue is worth studying.…”

The effect of evening primrose oil on cervical ripening and birth outcomes: A systematic review and meta-analysis

“…Several studies have indicated the effectiveness of EPO in the improvement of Bishop score during pregnancy, and even before gynecologic procedures [ 19 , 26 , 31 , 32 ], but some have not shown any positive effect of this herbal oil on cervical priming of pregnant women [ 17 , 27 , 29 ].The contradictory results of these studies could be attributed to differences in route or frequency of EPO administration, EPO dosage, initiation time and length of using EPO during pregnancy, complete or incomplete use of EPO capsules by the intervention group and combination of EPO with other medications like misoprostol or oxytocin, which provides greater effect than EPO or these medications alone [ 11 , 13 , 26 , 30 ]. Hence, this lack of homogeneity among studies caused that despite performing subgroup analysis, the I square did not decrease significantly.…”

Comparison of the Effect of Vaginal Capsule of Evening Primrose Oil and Misoprostol on Cervical Ripening of Nulliparous Women with Post-term Pregnancy

“…In the end, it was concluded that receiving 4 capsules of evening primrose oil before applying genecology could be effective in improving the cervical profile and its achievement. Aquino et al [26] study investigated the ease of cervical dilatation in postmenopausal women and nulliparous premenopausal women who received vaginal evening primrose oil prior to hysteroscopy operation. In this study, 2 capsules (1000 mg) of evening primrose oil were inserted into the posterior fornix of the vagina at 4-6 hours prior to hysteroscopy operation, and the cervical dilatation rate was assessed using a Hegar dilator.…”