Evening primrose oil (EPO) is a supplement from the seeds of the evening primrose plant, rich in the omega-6 fat gamma-linolenic acid (GLA). Women take it for PMS, breast pain, menopause hot flushes and skin, but the evidence is weaker than most labels suggest: reviews found no clear benefit for PMS or eczema, it worked no better than placebo for breast pain overall, and one small trial found less severe hot flushes. EPO is safe for most adults, with mild stomach upset as the main side effect. Avoid it in pregnancy unless your doctor advises it, and check with a pharmacist if you take blood thinners, blood pressure medicines or HIV medicines.
Ringkasan: Evening primrose oil (minyak bunga primrose)
- Evening primrose oil (EPO) dibuat daripada biji bunga evening primrose dan kaya dengan GLA, sejenis lemak omega-6.
- Ramai wanita mengambilnya untuk PMS, sakit payudara, hot flush menopaus dan kulit. Namun bukti saintifiknya lemah atau bercampur.
- Kesan sampingan biasanya ringan: sakit perut, loya dan cirit-birit.
- Semasa mengandung: jangan ambil untuk "melembutkan servik" atau mempercepat bersalin kecuali dinasihatkan oleh doktor.
- Berhati-hati jika anda mengambil ubat pencair darah (warfarin, aspirin), ubat darah tinggi atau ubat HIV. Tanya ahli farmasi dahulu.
Sumber: NCCIH (NIH), Memorial Sloan Kettering Cancer Center, Cochrane, kajian Universiti Sains Malaysia (2021).
Apa itu evening primrose oil? (What is evening primrose oil?)
Evening primrose (Oenothera biennis) is a plant with yellow flowers that open at sunset. The oil pressed from its seeds contains omega-6 fatty acids, including gamma-linolenic acid (GLA) (NCCIH). EPO is about 10% GLA (MSKCC). The body can turn GLA into substances involved in inflammation and in prostaglandins, which is why EPO has been tried for hormonal, skin and inflammatory conditions (MSKCC).
- Forms: soft-gel capsules (often labelled 500 mg or 1,000 mg), liquids, and skin creams (MSKCC).
- Popular in Malaysia: in a study of Malay, Chinese and Indian women in Ipoh, EPO was the most popular alternative remedy for menopause symptoms, used by 18.1% of women (Ohn Mar 2015).
- Overall verdict: NCCIH, part of the US National Institutes of Health, says there is not enough evidence to support EPO for any health condition, although it is probably safe for most adults.
Kebaikan evening primrose oil: apa kata kajian (benefits: what the research shows)
Here is a summary of the main uses and the best available evidence:
| Use | What the research shows | Verdict |
|---|---|---|
| PMS (sindrom pramenstruasi) | Reviews found the best-controlled trials showed no benefit over placebo (Budeiri 1996; Dante 2011) | Not supported |
| Cyclical breast pain (sakit payudara sebelum haid) | A 2021 meta-analysis of 13 trials (1,752 women) by a Universiti Sains Malaysia team found EPO no better than placebo, vitamin E, NSAID gel or danazol for pain relief, but it was safe (Ahmad Adni 2021). A small 6-month pilot (3,000 mg a day) suggested less severe pain (Pruthi 2010) | Weak; may help some women |
| Menopause hot flushes | A 6-week trial of 56 women (500 mg twice daily) found hot flushes were less severe than with placebo, but not less frequent (Farzaneh 2013) | Small benefit possible |
| Eczema (atopic dermatitis) | A Cochrane review of 19 EPO trials found no improvement over placebo (Bamford 2013) | Not effective |
| Skin hydration | Studies in healthy adults found better skin hydration and barrier function (Sharifi 2024) | Small studies only |
| Acne | Not effective in available trials (Sharifi 2024) | Not supported |
| Softening the cervix / labour | Mixed results from small trials with risks of bias; not recommended (Hutcherson 2022; Moradi 2021) | Not recommended without a doctor |
| Rheumatoid arthritis, diabetic nerve pain | Mixed or early results (Sharifi 2024; MSKCC) | Unclear |
Sources: NCCIH; MSKCC; PubMed studies listed in the references.
A "not supported" verdict does not mean no woman ever feels better on EPO. It means that, in trials, women taking EPO did not improve more than women taking a dummy capsule. If you choose to try it, set a time limit and judge it honestly.
EPO untuk PMS dan sakit payudara (PMS and breast pain)
PMS: EPO has been used for PMS for decades, but a review of the placebo-controlled trials found that the two best-controlled studies showed no benefit, and concluded EPO is of little value for PMS (Budeiri 1996). A later review of herbal remedies also found EPO no better than placebo (Dante 2011). Our guide to PMS covers the lifestyle steps and treatments that do help, and senggugut covers period cramps.
Cyclical breast pain (mastalgia): many women feel sore, heavy or lumpy breasts before a period. A 2021 meta-analysis led by doctors at Universiti Sains Malaysia pooled 13 trials and found the number of women whose pain improved was no different with EPO than with placebo or other treatments, although EPO did not cause more side effects (Ahmad Adni 2021). A small Mayo Clinic pilot study using 3,000 mg a day for 6 months suggested the worst pain eased (Pruthi 2010). For simple first steps for breast pain, such as a well-fitted bra, see our guide to ketulan payudara.
Do not use EPO to treat a breast lump. See a doctor for any new lump, skin dimpling, nipple discharge or pain in one spot that does not go away. Our guides to ketulan payudara and kanser payudara explain what to check.
EPO untuk menopaus dan hot flush (menopause and hot flushes)
In a 6-week randomised trial of 56 women aged 45 to 59, those taking EPO 500 mg twice daily had hot flushes that were less severe than with placebo, and their social life and relationships were less affected; the number and length of hot flushes did not differ significantly (Farzaneh 2013). NCCIH still rates the evidence for menopause symptoms as insufficient.
Hormone replacement therapy (HRT) remains the most effective treatment for hot flushes for most women. If you want to try EPO, tell your doctor, especially if you are taking HRT or other medicines. See our guide to menopaus for all the options.
EPO untuk kulit dan ekzema (skin and eczema)
- Eczema: a Cochrane review of 19 trials found oral EPO did not improve eczema more than placebo, and concluded it is not an effective treatment (Bamford 2013). Moisturisers and treatments prescribed by your doctor work better; see our guide to ekzema.
- Dry skin: small studies in healthy adults found improved skin hydration and barrier function (Sharifi 2024). This is early evidence, and a good moisturiser is still the first step for kulit kering.
- Acne: EPO was not effective for acne in available trials (Sharifi 2024). For blackheads and breakouts, see our blackhead guide.
EPO semasa mengandung dan bersalin (pregnancy and labour)
Many pregnant women hear from friends or online that taking EPO in the last weeks of pregnancy, by mouth or inserted into the vagina, will "soften the cervix" and make labour faster or easier. The idea is that EPO may increase prostaglandins, which help the cervix ripen (NCCIH). Here is what the research says:
- Results are inconsistent. Some small trials and one meta-analysis found a higher Bishop score (a measure of cervical readiness) after EPO (Shahinfar 2023), while a randomised trial and another meta-analysis found no difference in cervical ripening or the length of labour (Kalati 2018; Moradi 2021).
- Possible problems: an older study of women taking EPO from 37 weeks found it did not shorten pregnancy or labour, and it was linked with more prolonged rupture of membranes, oxytocin augmentation, arrest of descent and vacuum delivery (Dove 1999).
- A case report described bleeding spots (petechiae) in a newborn whose mother had used EPO and raspberry leaf in the week before birth (Wedig 2008).
- Reviews do not recommend it. A 2022 systematic review of 11 studies concluded that EPO is not recommended to help labour, and NCCIH says its long-term safety for this use has not been established (Hutcherson 2022; NCCIH).
If you are pregnant: do not take EPO, by mouth or vaginally, unless your obstetrician advises it. Never insert capsules into the vagina on your own, especially if your waters have broken, you have bleeding, a low-lying placenta, a previous caesarean or any pregnancy complication.
Tell your doctor or midwife about any supplement you take. If labour does not start on its own, your hospital can offer a safe, monitored induction. See our guide to tanda bersalin.
Breastfeeding: NCCIH says EPO raises the GLA level in breast milk but has not been linked to harm in babies. Ask your doctor or pharmacist before taking it.
Keburukan dan kesan sampingan (side effects)
EPO is probably safe for most adults when taken by mouth, and it is generally well tolerated (NCCIH). In trials, side effects were no more common than with placebo (Ahmad Adni 2021). Possible side effects include (NCCIH; MSKCC):
- stomach pain, indigestion, nausea, soft stools or diarrhoea;
- headache;
- easier bleeding or bruising, especially with blood-thinning medicines;
- rarely, lipoid pneumonia (an oil-related lung problem) was reported in a woman after long-term use (MSKCC).
Less is known about its safety in children (NCCIH), so do not give EPO to a child without a doctor's advice.
Interaksi dengan ubat (drug interactions and who should be careful)
| If you take or have… | Why it matters | What to do |
|---|---|---|
| Blood thinners or antiplatelets (warfarin, aspirin, clopidogrel) | EPO may add to their effect and raise bleeding risk; GLA lengthened bleeding time in a small study (MSKCC) | Ask your doctor before taking EPO |
| Surgery or dental procedures planned | Possible effect on clotting (MSKCC) | Tell your surgeon or dentist; ask when to stop |
| Blood pressure medicines | EPO was among supplements linked with slightly higher blood pressure in a large population study (MSKCC) | Check your blood pressure; ask your doctor |
| HIV medicines (e.g. lopinavir) | EPO may raise levels of some antiretrovirals and their side effects (MSKCC) | Do not take without your HIV doctor's advice |
| Hormone-sensitive cancer (some breast cancers) | EPO itself is not oestrogenic, but some products add phytoestrogens (MSKCC) | Check the full ingredient list with your oncologist |
| Epilepsy | Older warnings about seizures came from two 1980s reports; a later review found the link was not supported (Puri 2007) | Tell your neurologist; do not stop your epilepsy medicine |
| Pregnancy | Safety not established; possible labour complications (NCCIH; MSKCC) | Avoid unless your doctor advises it |
Sources: MSKCC; NCCIH; Puri 2007.
If you take any regular medicine, show the EPO bottle to your pharmacist before you start.
Cara makan dan dos (how to take it)
- Dose: follow the label or your pharmacist. Studies used 1,000 mg a day (500 mg twice daily) for hot flushes and up to 3,000 mg a day for breast pain (Farzaneh 2013; Pruthi 2010).
- Morning or night: no study shows one time is better. Take it at the same time each day; taking it with a meal may reduce stomach upset.
- How long: trials ran for 6 weeks to 6 months. Give it 2 to 3 months, keep a symptom diary, and stop if there is no clear change.
- With other supplements: check the total dose if you take a combination product (for example, EPO with fish oil or a women's multivitamin).
Cara pilih produk EPO (choosing a product)
- In Malaysia, buy supplements that are registered with the National Pharmaceutical Regulatory Agency (NPRA) and show a MAL registration number on the label.
- Check the GLA content per capsule, not just the oil weight.
- Read the full ingredient list: some products add vitamin E, fish oil or plant oestrogens (phytoestrogens), which matters if you have a hormone-sensitive cancer (MSKCC).
- Avoid products that claim to "cure" PMS, cysts or infertility, or to guarantee an easy birth.
Frequently asked questions (FAQ)
Evening primrose oil untuk apa (what is evening primrose oil used for)?
Evening primrose oil (EPO) is a supplement made from the seeds of the evening primrose plant. It is rich in gamma-linolenic acid (GLA), an omega-6 fat. People take it mainly for PMS, cyclical breast pain, menopause hot flushes, dry skin and eczema, and some take it near the end of pregnancy hoping to "soften the cervix" (NCCIH). The evidence for most of these uses is weak or mixed.
Apa kebaikan evening primrose oil (what are the benefits)?
The best evidence is modest: one trial found EPO 500 mg twice daily for 6 weeks reduced the severity of menopausal hot flushes more than placebo (Farzaneh 2013), and small studies suggest it may help skin hydration in healthy adults (Sharifi 2024). Reviews have not found it better than placebo for PMS, eczema or breast pain overall (Budeiri 1996; Bamford 2013; Ahmad Adni 2021). It is generally well tolerated.
Apa keburukan evening primrose oil (side effects)?
Most people tolerate EPO well. The most common side effects are stomach pain, nausea, indigestion, soft stools or diarrhoea and headache (NCCIH; MSKCC). It may increase bleeding risk when taken with blood thinners, may raise blood pressure slightly, and can interact with some HIV medicines (MSKCC).
Boleh makan evening primrose oil semasa mengandung (in pregnancy)?
Do not take it in pregnancy unless your doctor advises it. NCCIH says the evidence on safety in pregnancy is not conclusive, and Memorial Sloan Kettering Cancer Center advises pregnant women not to take it because of possible complications. Studies on using EPO to start labour are mixed, one older study linked it with more labour problems (Dove 1999), and a 2022 systematic review concluded it is not recommended for this purpose (Hutcherson 2022).
Does evening primrose oil help to "soften the cervix" or induce labour?
The results are inconsistent. Some small trials, mostly from Iran, found a higher Bishop score (a measure of how ready the cervix is), while other trials and a 2021 meta-analysis found no difference (Moradi 2021; Kalati 2018). Because the studies are small, have important risks of bias and safety has not been established, do not use it for this purpose without your obstetrician's advice, and never insert capsules into the vagina on your own.
Bila waktu sesuai makan evening primrose oil, pagi atau malam (morning or night)?
No study shows that morning or night works better. Take it at the same time each day as the label directs. Because stomach upset is the most common side effect (NCCIH), taking it with a meal may be more comfortable.
Cara makan evening primrose oil 1000mg (how much should I take)?
Follow the dose on the label or from your pharmacist. In studies, doses ranged from 500 mg twice a day for hot flushes (Farzaneh 2013) to 3,000 mg a day for breast pain (Pruthi 2010). Any effect usually takes weeks to months, so give it at least 2 to 3 months and stop if nothing changes. Check with a pharmacist first if you take other medicines.
Can I take evening primrose oil with fish oil?
Many people do, and some products combine them. Both can affect blood clotting, so check with your doctor or pharmacist if you also take a blood thinner or aspirin, or have surgery planned. Fish oil gives omega-3 fats, while EPO gives the omega-6 fat GLA; see our minyak ikan guide.
Is evening primrose oil safe while breastfeeding?
NCCIH says taking EPO while breastfeeding raises the GLA level in breast milk but has not been linked to harm in babies. The evidence is limited, so talk to your doctor or pharmacist first.
Does evening primrose oil help with acne, pigmentation or hair loss?
There is no good evidence. A 2024 systematic review found it was not effective for acne in the trials available (Sharifi 2024), and there are no reliable trials for pigmentation or hair loss. For acne, ingredients such as topical retinoids and benzoyl peroxide have far stronger evidence.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor or pharmacist. Do not use evening primrose oil in pregnancy unless your doctor advises it. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Evening Primrose Oil — National Center for Complementary and Integrative Health (NCCIH), NIH
- Evening Primrose Oil — Memorial Sloan Kettering Cancer Center (MSKCC)
- Bamford JT, et al. Oral evening primrose oil and borage oil for eczema. Cochrane Database Syst Rev. 2013;(4):CD004416.
- Ahmad Adni LL, et al. A systematic review and meta-analysis of the efficacy of evening primrose oil for mastalgia treatment. Int J Environ Res Public Health. 2021;18(12):6295.
- Budeiri D, Li Wan Po A, Dornan JC. Is evening primrose oil of value in the treatment of premenstrual syndrome? Control Clin Trials. 1996;17(1):60-8.
- Dante G, Facchinetti F. Herbal treatments for alleviating premenstrual symptoms: a systematic review. J Psychosom Obstet Gynaecol. 2011;32(1):42-51.
- Pruthi S, et al. Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study. Altern Med Rev. 2010;15(1):59-67.
- Farzaneh F, et al. The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Arch Gynecol Obstet. 2013;288(5):1075-9.
- Ohn Mar S, et al. Use of alternative medications for menopause-related symptoms in three major ethnic groups of Ipoh, Perak, Malaysia. Asia Pac J Public Health. 2015;27(8 Suppl):19S-25S.
- Sharifi M, et al. The effect of Oenothera biennis (evening primrose) oil on inflammatory diseases: a systematic review of clinical trials. BMC Complement Med Ther. 2024;24(1):89.
- Hutcherson TC, et al. Systematic review of evening primrose (Oenothera biennis) preparations for the facilitation of parturition. Pharmacy (Basel). 2022;10(6):172.
- Moradi M, et al. The effect of evening primrose oil on labor induction and cervical ripening: a systematic review and meta-analysis. Phytother Res. 2021;35(10):5374-5383.
- Shahinfar S, et al. The effect of evening primrose oil on cervical ripening and birth outcomes: a systematic review and meta-analysis. Heliyon. 2023;9(2):e13414.
- Kalati M, et al. Evening primrose oil and labour, is it effective? A randomised clinical trial. J Obstet Gynaecol. 2018;38(4):488-492.
- Dove D, Johnson P. Oral evening primrose oil: its effect on length of pregnancy and selected intrapartum outcomes in low-risk nulliparous women. J Nurse Midwifery. 1999;44(3):320-4.
- Wedig KE, Whitsett JA. Down the primrose path: petechiae in a neonate exposed to herbal remedy for parturition. J Pediatr. 2008;152(1):140.
- Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukot Essent Fatty Acids. 2007;77(2):101-3.
