Frontiers in Medicine · Oct 31, 2026
Evidence Profile of Femoston Combined with Kuntai Capsule Across Estradiol Dose Backgrounds for Menopausal Syndrome: A Narrative Review
By Xiaolin Wang, Mingyang Lv, Ling Wang et al.
Menopausal syndrome (MPS) presents with heterogeneous vasomotor, sleep-related, mood, and somatic symptoms that can substantially impair women's health and quality of life. Femoston, an oral menopausal hormone therapy (MHT) combining 17β-estradiol (E2) with dydrogesterone, effectively relieves menopause-related symptoms, although dose-related tolerability considerations and long-term adherence may influence treatment decisions. Kuntai Capsule is a non-estrogen-containing Chinese patent medicine that may provide additional symptom relief, although monotherapy may not fully address the multidimensional symptom burden of MPS. This narrative review synthesizes clinical evidence on Femoston combined with Kuntai Capsule in naturally perimenopausal and postmenopausal women with MPS, with particular emphasis on the evidence profiles of 1 mg and 2 mg E2-containing regimens. PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang Data were searched for studies published from January 2016 to July 30, 2026. Relevant evidence from monotherapy studies, clinical guidelines, pharmacological studies, and analytical reports was also considered when appropriate. Across both E2 dose backgrounds, adjunctive Kuntai Capsule was associated with additional short-term improvements in overall menopausal symptoms, with benefits also reported for sleep, psychological outcomes, quality of life, and selected metabolic and endocrine measures. The 1 mg evidence base was more quantitatively developed and included meta-analytic support, whereas evidence for the 2 mg regimen was derived from fewer, smaller, and more heterogeneous studies. No head-to-head trials have directly compared the two combination regimens, and current evidence cannot establish dose superiority, a dose-response relationship, validated phenotype-dose matching, or a confirmed E2 dose-sparing effect. Interpretation of endocrine outcomes is further limited by the widespread use of immunoassays, which may be less reliable than liquid chromatography–tandem mass spectrometry at low E2 concentrations. Based on these findings, we propose a hypothesis-generating framework for future comparative studies to examine whether baseline patient characteristics modify the relative effects of the two combination regimens. Femoston combined with Kuntai Capsule may provide complementary short-term benefits for multidimensional MPS management; however, adequately powered multicenter randomized controlled trials with standardized outcomes, LC-MS/MS-based hormone measurements, longer follow-up, and prespecified phenotype-by-treatment interaction analyses are required before individualized dose recommendations can be established.