How we grade evidence

In health publishing, bold claims are easy to make but difficult to prove. We evaluate treatments, supplements, and lifestyle interventions against a rigorous hierarchy of scientific evidence.

The evidence hierarchy

When reviewing options, we prioritize sources in the following order:

1. Regulatory approvals and prescribing labels: FDA, EMA, and MHRA evaluations based on pivotal Phase 3 trials.
2. Society consensus guidelines: The Menopause Society (formerly NAMS), the International Menopause Society (IMS), and the National Institute for Health and Care Excellence (NICE).
3. Systematic reviews and meta-analyses: Cochrane reviews and independent pooled analyses of randomized controlled trials.
4. Individual randomized controlled trials (RCTs): Well-powered, placebo-controlled human studies.
5. Observational and preliminary research: Cohort and animal studies (clearly labelled as exploratory).

Our evidence grades explained

• Strong evidence: Proven efficacy replicated across multiple randomized controlled trials or adopted into formal clinical guidelines.
• Moderate evidence: Supported by at least one high-quality randomized trial or consistent observational data, but with minor limitations in sample size or duration.
• Limited evidence: Conflicting findings, small study populations, or benefits restricted to subjective self-reports without objective physiological changes.
• Not supported: Robust clinical trials demonstrate no significant benefit compared to placebo.
• Harm concern: Credible evidence indicates that potential adverse effects (e.g., hepatotoxicity, increased thrombosis risk) outweigh potential benefits.
• Per option: Used on symptom hub pages where multiple treatment choices are compared side-by-side in a graded summary table.

Where to use these grades on MenoVerdict

• Look up any treatment or supplement by symptom and evidence grade in our interactive Does it work? evidence checker.
• Browse our full Does It Work? evidence directory and editorial policy.
• Read how our medical review process and commercial independence rules keep commissions separate from evidence grades.