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Effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women
Abstract
Many women seek alternatives to hormonal therapies for the management of menopausal symptoms. Among the treatments currently popular are extracts of wild yam (Dioscorea villosa), which are applied topically in the form of a cream. These preparations are known to contain steroidal saponins, including diosgenin, which has been claimed to influence endogenous steroidogenesis. However, there have been no studies of the safety or efficacy of these preparations in the management of menopausal symptoms.
We therefore conducted a double-blind, placebo-controlled, cross-over study of the effects of a wild yam cream in 23 healthy women suffering from troublesome symptoms of the menopause. After a 4-week baseline period, each woman was given active cream and matching placebo for 3 months in random order. Diaries were completed over the baseline period and for 1 week each month thereafter, and blood and saliva samples were collected at baseline and at 3 and 6 months, for measurement of lipids and hormones.
The average age of the subjects was 53.3 +/- 1.1 (SEM) years and average time since last period 4.3 +/- 0.9 years. At baseline, the average body mass index was 27.3 +/- 0.8, cholesterol level 5.7 +/- 0.2 mmol/l and follicle stimulating hormone (FSH) level 74.2 +/- 5.1 IU/l; estradiol levels were undetectable in the majority of cases. After 3 months of treatment, no significant side-effects were reported with either active treatment or placebo, and there were no changes in weight, systolic or diastolic blood pressure, or levels of total serum cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, FSH, glucose, estradiol, or serum or salivary progesterone. Symptom scores showed a minor effect of both placebo and active treatment on diurnal flushing number and severity and total non-flushing symptom scores, and on nocturnal sweating after placebo, but no statistical difference between placebo and active creams.
This study suggests that short-term treatment with topical wild yam extract in women suffering from menopausal symptoms is free of side-effects, but appears to have little effect on menopausal symptoms. It emphasizes the importance of careful study of treatments for menopausal symptoms if women are to be adequately informed about the choices available to them.
... Many studies suggest that natural bioactive compounds from plants resemble estrogen in structure and biological functions and can relieve the symptoms of menopause [16]. Estrogenic compounds have been identified in flax and sesame seeds [17], wild yam [18], and soybean [19]. Genistein extracted from soybean has been extensively studied and known to relieve menopausal symptoms [20,21]. ...
... Among these compounds, vitexicarpin is known to exhibit different pharmacological properties, including anti-proliferative, antiinflammatory, neuroprotective, and analgesic activities [24]. Many studies have been conducted to show that flavonoids act similar to female hormones and are beneficial to menopausal women [17][18][19][20][21]. V. rotundifolia is known to contain many flavonoids, which may be beneficial to menopausal women. ...
... Flavonoids act similar to female hormones and are beneficial to menopausal women [17][18][19][20][21]. V. rotundifolia is known to contain many flavonoids, which may be beneficial to menopausal women. ...
Estrogen replacement therapy is a treatment to relieve the symptoms of menopause. Many studies suggest that natural bioactive ingredients from plants resemble estrogen in structure and biological functions and can relieve symptoms of menopause. The fruit of V. rotundifolia, called “Man HyungJa” in Korean, is a traditional medicine used to treat headache, migraine, eye pain, neuralgia, and premenstrual syndrome in Korea and China. The aim of the present study was to confirm that V. rotundifolia fruit extract (VFE) exerts biological functions similar to those of estrogen in menopausal syndrome. We investigated its in vitro effects on MCF-7 cells and in vivo estrogen-like effects on weight gain and uterine contraction in ovariectomized rats. Using the polar extract, the active constituents of VFE (artemetin, vitexicarpin, hesperidin, luteolin, vitexin, and vanillic acid) with estrogen-like activity were identified in MCF-7 cells. In animal experiments, the efficacy of VFE in ameliorating body weight gain was similar to that of estrogen, as evidenced from improvements in uterine atrophy. Vitexin and vitexicarpin are suggested as the active constituents of V. rotundifolia fruits.
... Clinical trials of DSG reported the effectiveness of this drug in the management of premature ejaculation and erectile dysfunction as well [94,95]. Moreover, patients taking doses of DSG also showed an improved cognitive function, menopausal symptoms, and embryo quality [96][97][98]. It is also noteworthy that the newly synthesized DSG derivatives and DSG nano-drug delivery systems have proved to be extremely significant and efficient strategies for improving oral bioavailability, pharmacokinetic characteristics, anti-thrombotic property, and other activities of the compound [89,99]. ...
... Per 1 g of the cream preparation consists of Dioscorea villosa extract (100 mg), Linum usitatissmum oil (2 g), Perlargonium graveolens oil (100 mg), Salvia officinalis oil (100 mg) and α-tocopheryl acetate (10 mg). The results stated that the preparation did not show any significant benefits on the management of the symptoms, however, it did not impart any adverse effects as well [98]. ...
... However, the synthesis of DSG-CD complexes met with several limitations; the manufacturing method was time consuming and it needed huge number of excipients. In addition, the DSG complexes showed low drug-loading Menopausal symptoms -23 BioGest 1 g D Little effect with no side effects [98] Components capacity. Therefore, further investigations were carried out to find alternative drug delivery systems and this led to the development of nanocrystals of DSG which showed enhanced dissolution rate and increased oral bioavailability [99]. ...
Background
Chronic diseases are a major cause of mortality worldwide and despite the recent development in treatment modalities, synthetic drugs have continued to show toxic side effects and development of chemoresistance, thereby limiting their application. The use of phytochemicals has gained attention as they show minimal side effects. Diosgenin is one such phytochemical which has gained importance for its efficacy against the life-threatening diseases such as cardiovascular diseases, cancer, nervous system disorders, asthma, arthritis, diabetes and many more.
Aim
To evaluate the literature available on the potential of diosgenin and its analogues in modulating different molecular targets leading to the prevention and treatment of chronic diseases.
Method
A detailed literature search has been carried out on PubMed for gathering information related to the sources, biosynthesis, physicochemical properties, biological activities, pharmacokinetics, bioavailability and toxicity of diosgenin and its analogues.
Key findings
The literature search resulted in many in vitro, in vivo and clinical trials that reported the efficacy of diosgenin and its analogues in modulating important molecular targets and signaling pathways such as PI3K/AKT/mTOR, JAK/STAT, NF-κB, MAPK, etc., which play a crucial role in the development of most of the diseases. Reports have also revealed the safety of the compound and the adaptation of nanotechnological approaches for enhancing its bioavailability and pharmacokinetic properties.
Significance
Thus, the review summarises the efficacy of diosgenin and its analogues for developing as a potent drug against several chronic diseases.
... [66] Low impact on menopausal symptoms. [67] Clinical trial study. [66] Randomized double-blind, placebo-controlled. ...
... [66] Randomized double-blind, placebo-controlled. [67] [ [65][66][67] Gin seng Contains Phytoestrogenic properties. [68] Ginsenosides in ginseng have various biological and pharmacological activities. ...
... [66] Randomized double-blind, placebo-controlled. [67] [ [65][66][67] Gin seng Contains Phytoestrogenic properties. [68] Ginsenosides in ginseng have various biological and pharmacological activities. ...
Background:
Menopause is an important physiological phenomenon in women's lives. Women's concern about taking the hormone treatment to ease menopausal symptoms is increasing. Over the past decade, the use of complementary and alternative medicine for the treatment of menopausal problems instead of hormone therapy has increased.
Objective:
This study aimed to investigate the role of herbal medicine, acupressure, and acupuncture in the menopausal symptoms.
Methods:
Data source: related articles were searched from internal scientific databases and external databases of "Web of Scopus, Cochrane, PubMed, Science Direct, Ovid, and Google scholar."
Study eligibility criteria:
The keywords such as menopause, menopausal symptoms, complementary menopausal medicine, acupuncture in menopause, herbal medicine in menopause, and acupuncture in menopause were searched in the studies from 1987 to 2019. Exclusion criteria were inadequate information in the study, lack of access to full-text articles, animal studies, and reports. At the end of the search, 145 articles out of a total of 400 articles were reviewed.
Results:
In various studies, different herbs such as licorice, valerian, soy, sage, ginseng, etc., were used to improve menopausal symptoms. In addition, acupuncture and acupressure were used to reduce menopausal symptoms.
Conclusion:
The efficacy and use of complementary and alternative medicine, along with other classical medicine care, can be a new model for improving menopausal symptoms in women. It is recommended that further clinical and review studies be conducted to develop complementary and alternative medicine.
... La glándula pituitaria es esencial y a su vez está regulada por la FSH en un asa de retroalimentación específica en la que LH regula la expresión de la 17β-hidroxiesteroide deshidrogenasa, que es la enzima encargada de transformar androstenediona en testosterona (Figura 5). Asimismo, la testosterona es la principal molécula precursora de estradiol, ya que, por medio de la actividad de las aromatasas del retículo endoplásmico rugoso, se forma el anillo A de la molécula (proceso mediante el cual se generan tres dobles enlaces, creando un anillo bencénico), donde posteriormente se elimina un grupo metilo en el C10 y el grupo ceto presente en el C3 se reduce para la formación de un grupo hidroxilo (Komesaroff, et al., 2001). ...
... La progesterona también actúa sobre las glándulas mamarias estimulando su crecimiento y diferenciación celular, preparando las mamas para la lactación (Obr y Edwards, 2012;Hilton, et al., 2018); asimismo, actúa en el sistema digestivo generando un efecto miorrelajante causante de diarreas. Las fuentes principales de producción de progesterona son el ovario (específicamente el cuerpo lúteo) y la placenta, aunque también puede sintetizarse en las glándulas suprarrenales y es almacenada en el tejido adiposo (Komesaroff, et al., 2001). ...
El desarrollo de cualquier organismo es un evento jerárquico y secuencial que ocurre a través de la comunicación celular. Estos procesos de comunicación en eucariontes se llevan a cabo por medio de moléculas diversas, incluidas las hormonas. Las hormonas esteroideas participan en el desarrollo de los vertebrados, para controlar los rasgos distintivos de género, y que con ello pueda ocurrir la reproducción. Los andrógenos, estrógenos y progestágenos son fundamentales en el desarrollo del nuevo ser vivo, porque marcan a las diferentes células, de la madre gestante y del producto. Estas hormonas al ser mensajeros de flujos metabólicos son percibidas por los receptores celulares del vertebrado en desarrollo, aunque también pueden ser detectadas por algunos microorganismos circundantes que forman parte del microbioma. Así, estos microorganismos reconocen: i) el momento de desarrollo del hospedero, ii) el vigor o la debilidad del hospedador y iii) los sistemas de defensa contra las infecciones incluyendo la formación de biopelícula. La comunidad microbiana percibe la fortaleza del sistema inmune, por medio de la concentración de hormonas, y se mantiene contenida en las biopelículas o se dispersa a otros tejidos al detectar un sistema inmune débil, dañando al hospedero. Los cambios en la concentración de hormonas también provocan cambios en concentraciones de moléculas como glucosa y aminoácidos, que modifican el crecimiento microbiano, dificultando más el control de una infección. Comprender la importancia de las hormonas en la susceptibilidad a las infecciones es intrincado y desafiante; en este texto se muestra un panorama del tema.
... The standardized multinutrient supplement including folic acid, selenium, vitamin E, catechins, glycyrrhizin, dios-genin, damiana, and omega-3-fatty acids showed beneficial effects on in vitro fertilization/intracytoplasmic sperm injection in terms of embryo quality [159]. The curative effects of Dioscorea villosa extract on menopausal systems, lipids, and sex hormones were evaluated [160]. ...
... All candidates were treated with wild yam cream or placebo for up to three months, and no significant adverse effects were observed in both the treatments. Additionally, no changes were also recorded in weight, systolic or diastolic blood pressure, total serum cholesterol, triglyceride, high-density lipoprotein cholesterol, glucose, estradiol, or serum [160]. ...
Plants including Rhizoma polgonati, Smilax china, and Trigonella foenum-graecum contain a lot of diosgenin, a steroidal sapogenin. This bioactive phytochemical has shown high potential and interest in the treatment of various disorders such as cancer, diabetes, arthritis, asthma, and cardiovascular disease, in addition to being an important starting material for the preparation of several steroidal drugs in the pharmaceutical industry. This review aims to provide an overview of the in vitro, in vivo, and clinical studies reporting the diosgenin’s pharmacological effects and to discuss the safety issues. Preclinical studies
have shown promising effects on cancer, neuroprotection, atherosclerosis, asthma, bone health, and other pathologies. Clinical investigations have demonstrated diosgenin’s nontoxic nature and promising benefits on cognitive function and menopause. However, further well-designed clinical trials are needed to address the other effects seen in preclinical studies, as well as a better knowledge of the diosgenin’s safety profile.
... To overcome muscle wasting in sarcopenia, it is necessary to stimulate the myogenesis pathway or inhibit the muscle wasting process. Satellite cells such as C2C12 myoblasts undergo expansion and migration and differentiate into multinucleated fibers, myotubes via myoblasts fusion [31]. Myoblast differentiation is orchestrated by myogenic regulatory factors (MRFs) such as myoblast determination protein (MyoD), MRF4, myogenic factor 5 (Myf5) and myogenin [31]. ...
... Satellite cells such as C2C12 myoblasts undergo expansion and migration and differentiate into multinucleated fibers, myotubes via myoblasts fusion [31]. Myoblast differentiation is orchestrated by myogenic regulatory factors (MRFs) such as myoblast determination protein (MyoD), MRF4, myogenic factor 5 (Myf5) and myogenin [31]. Mature myotubes also express structural muscle proteins such as tropomyosin and MyHC, which is the motor protein of muscle thick filaments and a specific mature marker protein [32]. ...
With the aging process, a loss of skeletal muscle mass and dysfunction related to metabolic syndrome is observed in older people. Yams are commonly use in functional foods and medications with various effects. The present study was conducted to investigate the effects of rhizome extract of Dioscorea batatas (Dioscoreae Rhizoma, Chinese yam) and its bioactive compound, allantoin, on myoblast differentiation and mitochondrial biogenesis in skeletal muscle cells. Yams were extracted in water and allantoin was analyzed by high performance liquid chromatography (HPLC). The expression of myosin heavy chain (MyHC) and mitochondrial biogenesis-regulating factors, peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), sirtuin-1 (Sirt-1), nuclear respiratory factor-1 (NRF-1) and transcription factor A, mitochondrial (TFAM), and the phosphorylation of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) were determined in C2C12 myotubes by reverse transcriptase (RT)-polymerase chain reaction (RT-PCR) or western blot. The glucose levels and total ATP contents were measured by glucose consumption, glucose uptake and ATP assays, respectively. Treatment with yam extract (1 mg/mL) and allantoin (0.2 and 0.5 mM) significantly increased MyHC expression compared with non-treated myotubes. Yam extract and allantoin significantly increased the expression of PGC-1α, Sirt-1, NRF-1 and TFAM, as well as the phosphorylation of AMPK and ACC in C2C12 myotubes. Furthermore, yam extract and allantoin significantly increased glucose uptake levels and ATP contents. Finally, HPLC analysis revealed that the yam water extract contained 1.53% of allantoin. Yam extract and allantoin stimulated myoblast differentiation into myotubes and increased energy production through the upregulation of mitochondrial biogenesis regulators. These findings indicate that yam extract and allantoin can help to prevent skeletal muscle dysfunction through the stimulation of the energy metabolism.
... This was sufficient to cause infertility in mice. A previous study has shown that the application of a wild yam (Dioscorea villosa) ointment on the skin is safe and does not affect hormone levels (Komesaroff et al., 2001). It is popularly used to treat menopausal symptoms. ...
... Plasma DHEA levels gradually decrease with age, and it was reported that they were also lower in individuals with obesity and type 2 diabetes. Studies have demonstrated that D. esculenta administration alleviates allergies, inflammation (Mollica et al., 2013), hyperlipidemia (Komesaroff et al., 2001), and osteoporosis (Chiang et al., 2011). It has also been shown to improve neuroimmunological function (Ying et al., 2007). ...
Background Diosgenin, extracted from Dioscorea esculenta, has been reported to decrease prostaglandin E2 (PGE2) levels and any other inflammatory cytokine in rodents. However, it is still unclear whether D. esculenta intake suppressed PGE2 production and menstrual pain and premenstrual syndrome (PMS) in younger female. Aim This study aims to investigate the effect of D. esculenta intake on PGE2 and cytochrome c oxidase subunit 2 (COX-2) levels and on menstrual pain and PMS in young women. This is a randomized, double-blind, placebo-controlled, crossover study. Methods Ten healthy young females were administered either a placebo or D. esculenta (300 mg/day) for 4 weeks, followed by a 4-week washout period. Fasting blood sample was taken from the fingertips on the second day of menstrual cycle began and obtained 24h before the last D. esculenta to avoid acute effects. Participants then switched treatments for 4 weeks as a second trial. Plasma PGE2 and COX-2 levels were measured before and after each trial. The visual analogue scale (VAS), McGill pain questionnaire (MPQ), and Daily Record of Severity of Problems (DRSP) were also evaluated. The study was set and conducted from 2019 to 2020. Results PGE2 and COX-2 levels significantly decreased after D. esculenta intake compared to placebo (p = 0.038, p = 0.042 each). The VAS and DRSP scores were also significantly lower after D. esculenta intake (p = 0.046, p = 0.035 each). Conclusion Four-week D. esculenta intake suppressed PGE2 and COX-2 levels resulting in an improvement in PMS symptoms and menstrual pain in young women.
... Parallel comparisons of biological activities, pharmacodynamic properties, and content differences between species among multiple structural analogs are also necessary. What's more, although some clinical trials show that extractive preparations rich in diosgenin and its analogs, such as wild yam, 159 fenugreek, 160,161 Di'ao Xin Xue Kang capsule, 162 etc., have a positive effect on atherosclerosis, clinical trials diosgenin and its analogs are still lacking. In addition, it should be noted that whether these drugs exert their effects through diosgenin or other monomeric analogs alone or drug-drug interactions needs to be further explored. ...
Atherosclerosis is a chronic inflammatory disease of the artery wall associated with lipid metabolism imbalance and maladaptive immune response, which mediates most cardiovascular events. First-line drugs such as statins and antiplatelet drug aspirin have shown good effects against atherosclerosis but may lead to certain side effects. Thus, the development of new, safer, and less toxic agents for atherosclerosis is urgently needed. Diosgenin and its analogs have gained importance for their efficacy against life-threatening diseases, including cardiovascular, endocrine, nervous system diseases, and cancer. Diosgenin and its analogs are widely found in the rhizomes of Dioscore, Solanum, and other species and share similar chemical structures and pharmacological effects. Recent data suggested diosgenin plays an anti-atherosclerosis role through its anti-inflammatory, antioxidant, plasma cholesterol-lowering, anti-proliferation, and anti-thrombotic effects. However, a review of the effects of diosgenin and its natural structure analogs on AS is still lacking. This review summarizes the effects of diosgenin and its analogs on vascular endothelial dysfunction, vascular smooth muscle cell (VSMC) proliferation, migration and calcification, lipid metabolism, and inflammation, and provides a new overview of its anti-atherosclerosis mechanism. Besides, the structures, sources, safety, pharmacokinetic characteristics, and biological availability are introduced to reveal the limitations and challenges of current studies, hoping to provide a theoretical basis for the clinical application of diosgenin and its analogs and provide a new idea for developing new agents for atherosclerosis.
... Currently, its demand is increasing day by day in pharmaceutical industries due to its immense therapeutic activities such as anti-cancer [8,9], anti-diabetic [10,11], anti-fungal [12], anti-viral [13], anti-microbial [14], anti-tumour [15], anti-oxidant [16,17], anti-coagulant and anti-thrombosis [18,19] activities. In addition, it also shows effects on skin aging [20,21], menopausal symptoms [22,23], CNS [24], lipid system [25] and blood pressure. ...
Introduction
Dioscorea deltoidea var. deltoidea (Dioscoreaceae) is a valuable endangered plant of great medicinal and economic importance due to the presence of the bioactive compound diosgenin. In the present study, response surface methodology (RSM) and artificial neural network (ANN) modelling have been implemented to evaluate the diosgenin content from D. deltoidea. In addition, different extraction parameters have been also optimized and developed.
Materials and methods
Firstly, Plackett-Burman design (PBD) was applied for screening the significant variables among the selected extraction parameters i.e. solvent composition, solid: solvent ratio, particle size, time, temperature, pH and extraction cycles on diosgenin yield. Among seven tested parameters only four parameters (particle size, solid: solvent ratio, time and temperature) were found to exert significant effect on the diosgenin extraction. Moreover, Box-Behnken design (BBD) was employed to optimize the significant extraction parameters for maximum diosgenin yield.
Results
The most suitable condition for diosgenin extraction was found to be solid: solvent ratio (1:45), particle size (1.25 mm), time (45 min) and temperature (45°C). The maximum experimental yield of diosgenin (1.204% dry weight) was observed close to the predicted value (1.202% dry weight) on the basis of the chosen optimal extraction factors. The developed mathematical model fitted well with experimental data for diosgenin extraction.
Conclusions
Experimental validation revealed that a well trained ANN model has superior performance compared to a RSM model.
... Progestogens can be administered in combination with estrogens in a transdermal patch and are able to provide endometrial protection. Transdermal cream application of progestogens, however, is not effective given the lack of adequate systemic levels achieved; its use is not FDA approved, nor is its use advised (189)(190)(191)(192)(193)(194)(195)(196). Lastly, as mentioned earlier, oral progestogens-unlike vaginal progesterone-are effective for VMS. ...
Hormone therapy (HT) is an effective treatment for menopausal symptoms, including vasomotor symptoms and genitourinary syndrome of menopause. Randomized trials also demonstrate positive effects on bone health, and age-stratified analyses indicate more favorable effects on coronary heart disease and all-cause mortality in younger women (close proximity to menopause) than in women more than a decade past menopause. In the absence of contraindications or other major comorbidities, recently menopausal women with moderate or severe symptoms are appropriate candidates for HT. The WHI hormone therapy trials— estrogen and progestin (E+P) trial and the estrogen-alone (E-alone) trial— clarified the benefits and risks of HT, including how the results differed by age. A key lesson from the WHI trials, which was unfortunately lost in the post-trial cacophony, was that the risk:benefit ratio and safety profile of HT differed markedly by clinical characteristics of the participants, especially age, time since menopause, and comorbidity status. In the present review of the WHI and other recent HT trials, we aim to provide readers with an improved understanding of the importance of the timing of HT initiation, type and route of administration, and of patient-specific considerations that should be weighed when prescribing HT.
... Many traditional systems have implemented treatment plans with a number of plant species for the management of physiological changes associated with menstruation, conception, pregnancy, birth, lactation and menopause [321]. There is reported evidence that Dioscorea species, while serving as nutritional supplements, proffer medicinal properties and relief of menopausal symptoms [322]. A Taiwanese study examined the efficacy of D. alata in the treatment of menopausal symptoms on 50 women [323]. ...
The quest for a food secure and safe world has led to continuous effort toward improvements of global food and health systems. While the developed countries seem to have these systems stabilized, some parts of the world still face enormous challenges. Yam (Dioscorea species) is an orphan crop, widely distributed globally; and has contributed enormously to food security especially in sub-Saharan Africa because of its role in providing nutritional benefits and income. Additionally, yam has non-nutritional components called bioactive compounds, which offer numerous health benefits ranging from prevention to treatment of degenerative diseases. Pharmaceutical application of diosgenin and dioscorin, among other compounds isolated from yam, has shown more prospects recently. Despite the benefits embedded in yam, reports on the nutritional and therapeutic potentials of yam have been fragmented and the diversity within the genus has led to much confusion. An overview of the nutritional and health importance of yam will harness the crop to meet its potential towards combating hunger and malnutrition, while improving global health. This review makes a conscious attempt to provide an overview regarding the nutritional, bioactive compositions and therapeutic potentials of yam diversity. Insights on how to increase its utilization for a greater impact are elucidated.
... Saponins are known to have stimulating effects on androgen synthesis (Kostova & Dinchev, 2005). Diosgenin is structurally similar to dehydroepiandrosterone (DHEA) and is thought to replenish DHEA in vivo in rats (Raju et al., 2004;Sato et al., 2014) and regulate sex hormones in humans (Komesaroff, Black, Cable, & Sudhir, 2001;Wu, Liu, Chung, Jou, & Wang, 2005). The generated DHEA is then converted to other sex steroid hormones including testosterone and oestradiol (Norton, 1998;Raju et al., 2004;Sato et al., 2014). ...
This review attempts to collate existing data and provide the perspectives for future studies on the effects of plants on the male gonads. For many of these medicinal plants such as Lepidium meyenii, Rupus coreanus, Tribulus terrestres, Panax ginseng, Petasites japonicas, Apium graveolens, Eurycoma longifólia, Pedalium murex, Corchorus depressus, Mucuna pruriens, Astragalus membranaceus, Nigella sativa, Crataegus monogyna, Fagara tessmannii, Phaleria macrocarpa, Anacyclus pyrethrum, Cynomorium songaricum and Morinda officinalis, the mechanism of actions of their active principles and crude extracts has been shown in both laboratory animals, in vitro, and human studies, and includes their antioxidant, anti‐inflammatory, spermatogenesis‐inducing, aphrodisiac, smooth muscle relaxing and androgenic properties. Several active chemical leads including glucosinolates, anthocyanins, protodioscin, ginsenosides, sesquiterpenes, phyto‐oestrogens, quassinoids, diosgenin, thymoquinone, proanthocyanidins and bajijiasu isolated from these plants are known to have target effects on the testis, but efforts have been limited in their application at the clinical level. There still appear to be many more extracts of medicinal plants that have not been characterised to determine the phytochemicals unique to them that have target effects on the gonads. Further, collaborative efforts at isolating pro‐drug candidates from medicinal plants for studies at the molecular, cellular and clinical level towards elucidating their mechanisms of action on the testes are therefore warranted in the light of the current male fertility crisis.
... However, the enzymes responsible for the transformation of DSG into diverse metabolites are yet to be reported. Thus, there is no evidence to validate the claim of DSG-associated oestrogenic potency in humans (Marker, 1940;Komesaroff et al., 2001), although the benefists of its consumption by humans has been established (Yan et al., 2015). To date, the beneficial effects of DSG on human health has been limited to its efficacy in preventing metabolic diseases, such as hypercholesterolaemia (Juarez-Oropeza et al., 1987). ...
... In a double blind, placebo controlled, cross-over study, wild yam cream was no better than placebo in reducing menopause symptoms, or improving levels of estrogen or progesterone. 81 In contrast, a RCT of 50 women consuming 12 mg of Dioscorea alata (ie, purple yam) extract twice daily reported significant improvements (90%) in menopause symptoms (primarily psychological) compared with the placebo group (70%) as measured by the Greene Climacteric Scale. 82 The authors note that sexual functioning symptoms did not show the same levels of improvement. ...
Menopause is associated with problematic symptoms, including hot flashes, sleep problems, mood disorders, sexual dysfunction, weight gain, and declines in cognitive functioning. Many women seek complementary and alternative medicine (CAM) for symptom management. This article critically reviews the existing literature on CAM treatments most commonly used for menopausal symptoms. Electronic searches were conducted to identify relevant, English-language literature published through March 2017. Results indicate that mind and body practices may be of benefit in reducing stress and bothersomeness of some menopausal symptoms. In particular, hypnosis is a mind-body intervention that has consistently shown to have a clinically significant effect on reducing hot flashes. Evidence is mixed in regard to the efficacy of natural products and there are some safety concerns. Health care providers should consider the evidence on CAM in providing an integrative health approach to menopausal symptom management.
... [21] discovered that Dioscorea villosa (wild yam) induces chronic kidney injury via pro-fibrotic pathways, [22] worked on the characterization of steroidal saponins from Dioscorea villosa while [23] isolated steroidal saponins and flavan-3-ol glycosides from Dioscorea villosa. Furthermore, [24] studied the effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women while [25] worked on bioassay-guided evaluation of Dioscorea villosa -an acute and subchronic toxicity, antinoceptive and anti-inflammatory approach. Despite all these studies and purported use of the tuber, there has not been any information in the open scientific literature that has specifically addressed its contraceptive activity in animal model. ...
The contraceptive effect of oral administration of ethanolic extract of Dioscorea villosa tuber for thirty days on reproductive hormones of female albino rats was investigated. Twenty four female albino rats weighing 150-220g were completely randomized into four groups (A-D) comprising six rats each. Animals in Group A (control) were administered 0.5ml of distilled water. Animals in groups B, C and D received 100, 200 and 400mg/kg body weight of ethanolic extract of Dioscorea villosa tuber respectively for 30 consecutive days. Preliminary phytochemical screening of ethanolic extract of ioscorea villosa tuber revealed the presence of alkaloids, saponins, flavonoids and cardiac glycosides. The extract at all tested doses decreased serum luteinizing hormone (LH) levels, although this effect was statistically significant only at 100mg/kg body weight (p<0.05). The extract at all doses significantly (p<0.05) decreased the concentration of progesterone in the serum of the animals. A decrease in serum estradiol levels was observed only in animals that received 100 and 200mg/kg body weight of the extract while the 400mg/kg body weight of the extract did not significantly (p>0.05) affect the serum estradiol concentration when compared with the distilled water treated control animals. Serum levels of follicle stimulating hormone (FSH) increased following treatment in a dose-dependent manner, and this effect was statistically significant only at 400mg/kg body weight (p<0.05). These alterations in female rat reproductive hormones by the extract are hormonal imbalance and would have adverse effect on maturation and ovulation of follicles. Consequently, the extract may impair fertility and pregnancy in female rats. Therefore, the ethanolic extract of Dioscorea villosa tuber may be explored as a female contraceptive.
... Dioscorea villosa L. (Family: Dioscoreaceae), a tuber vegetable commonly known as "Wild Yam, " is native to North America and has been recommended for menopausal symptoms and menstrual complaints (Komesaroff et al., 2001). Dioscorea plants are rich in steroidal saponins and sapogenins. ...
Dioscorea villosa, commonly known as “Wild Yam” and native to North America, is well documented for its pharmacological properties due to the presence of steroidal glycosides. However, the hepatoprotective potential of these compounds has not been studied so far. The present investigation was aimed to study the hepatoprotective effect of the steroidal glycosides from D. villosa against H2O2, a known hepatotoxin, in human liver cell line (HepG2). Cytotoxicity assessment was carried out in cells exposed to various concentrations (10–50 μM) of compounds for 24 h using MTT assay and morphological changes. All tested compounds were known and among them, spirostans (zingiberensis saponin I, dioscin, deltonin and progenin III) were found to be cytotoxic whereas, furostans (huangjiangsu A, pseudoprotodioscin, methyl protobioside, protodioscin, and protodeltonin) were non-cytotoxic. Further, HepG2 cells were pretreated with biologically safe concentrations (10, 30, and 50 μM) of non-cytotoxic compounds and then cytotoxic (0.25 mM) concentration of H2O2. After 24 h, cell viability was assessed by MTT and NRU assays, while morphological changes were observed under the microscope. The results showed that treatment of HepG2 cells with compounds prior to H2O2 exposure effectively increased cell viability in a concentration-dependent manner. Furthermore, huangjiangsu A, pseudoprotodioscin, methyl protobioside, protodioscin, and protodeltonin at 50 μM increased GSH level and decreased intracellular ROS generation against H2O2-induced damages. The results from this study revealed that compounds isolated from D. villosa have hepatoprotective potential against H2O2-induced cytotoxicity and ROS generation and could be promising as potential therapeutic agents for liver diseases.
... In traditional medicine, yams are known as a nourishing herb that alleviates yin deficiency in the spleen, lung, and kidney by providing a supplementary energy, qi, therefore, it is used to treat metabolic syndromes such as obesity, diabetes, and hypothyroidism [27]. In addition, yams have been used to prevent the aging process (e.g., muscle weakness) because they control muscle function by spleen control [28]. However, there is little known about the medicinal effects of yams on muscle function. ...
The present study was conducted to investigate the effects of rhizome extract of Dioscorea batatas (Dioscoreae Rhizoma, Chinese Yam) and its bioactive compound, allantoin, on myoblast differentiation and mitochondrial biogenesis in skeletal muscle cells. Yams were extracted in water and the extract was analyzed by HPLC. The expression of C2C12 myotubes differentiation and mitochondrial biogenesis regulators were determined by reverse transcriptase (RT)-PCR or Western blot. The glucose levels and total ATP contents were determined by glucose consumption, glucose uptake and ATP assays, respectively. Treatment with yam extract (1 mg/mL) and allantoin (0.2 and 0.5 mM) significantly increased of MyHC expression compared with non-treated myotubes. Yam extract and allantoin significantly increased the expression of mitochondrial biogenesis regulating proteins, PGC1?, Sirt-1, NRF-1, and TFAM, as well as the phosphorylation of AMPK and ACC in C2C12 myotubes. Furthermore, yam extract and allantoin significantly increased the glucose uptake levels and the ATP contents. Finally, HPLC analysis revealed that the yam extract contained 1.53% of allantoin. Yam extract and allantoin, stimulated myoblast differentiation into myotubes and increased energy production through upregulation of mitochondrial biogenesis regulators. These findings indicate that yam extract and allantoin can help to prevent the skeletal muscle dysfunction through stimulation of energy metabolism.
... Popular in historic Singapore was Penis soup and Snake meat (Figure 2), whilst Surabaya was known for Cobra meat and Cobra blood ( Figure 3) which had claims of improving erectogenic prowess-the myths and realities concerning these and other Village doctor remedies are what they are-myths! Chinese yam, (Dioscorea sp): used often as a tonic to the reproductive system (3). ...
In the East, many herbal tonics and preparations are used to assist the aging male improve his sexual drive or ability to perform penetrative sex by increasing sexual stimulation, erectile, ejaculatory, orgasmic and other responses for sexual function and satisfaction. The herbs and tonics act as or as “pick-me-ups” and energizing tonics which help the tired and fatigued male and those with sexual asthenia. The myths and realities concerning Tongkat Ali, sea horse, cobra meat and blood, animal penises and testicles amongst many other herbs and portions for oral intake or local application used by traditional “medical” practitioners and village doctors will be discussed.
... However, mammals are unable to convert 1 into important steroidal metabolites, such as cholesterol, pregnanes, androstanes, etc., due to the lack of the appropriate enzymes involved in steroid hormone biosynthesis. In that sense, there is no evidence to validate the claim of an estrogenic potency of diosgenin in humans [24,25,27]. The trustworthiness of its consumption by humans has been established [28]. ...
Steroidal sapogenins have shown antiproliferative effects against several tumor cell lines; and their effects on human cancer cells are currently under study. Changes in the functionality on the steroidal structure make it possible to modify the biological activity of compounds. Herein, we report the synthesis and in vitro antitumor activity of two steroidal oxime compounds on cervical cancer cells. These derivatives were synthesized from the steroidal sapogenin diosgenin in good yields. The in vitro assays show that the steroidal oximes show significant antiproliferative activity compared to the one observed for diosgenin. Cell proliferation, cell death, and the cytotoxic effects were determined in both cervical cancer cells and human lymphocytes. The cancer cells showed apoptotic morphology and an increased presence of active caspase-3, providing the notion of a death pathway in the cell. Significantly, the steroidal oximes did not exert a cytotoxic effect on lymphocytes.
... Diosgenin can be chemically converted to progesterone, although there is no biological pathway for the conversion in vivo (Fig. 20). When given as a cream, there was no significant effect on menopausal symptoms in 23 women after 3 months compared with placebo (Komesaroff et al., 2001). No significant adverse effects were reported. ...
Botanical dietary supplements are increasingly popular for women's health, particularly for older women. The specific botanicals women take vary as a function of age. Younger women will use botanicals for urinary tract infections, especially Vaccinium macrocarpon (cranberry), where there is evidence for efficacy. Botanical dietary supplements for premenstrual syndrome (PMS) are less commonly used, and rigorous clinical trials have not been done. Some examples include Vitex agnus-castus (chasteberry), Angelica sinensis (dong quai), Viburnum opulus/prunifolium (cramp bark and black haw), and Zingiber officinale (ginger). Pregnant women have also used ginger for relief from nausea. Natural galactagogues for lactating women include Trigonella foenum-graecum (fenugreek) and Silybum marianum (milk thistle); however, rigorous safety and efficacy studies are lacking. Older women suffering menopausal symptoms are increasingly likely to use botanicals, especially since the Women's Health Initiative showed an increased risk for breast cancer associated with traditional hormone therapy. Serotonergic mechanisms similar to antidepressants have been proposed for Actaea/Cimicifuga racemosa (black cohosh) and Valeriana officinalis (valerian). Plant extracts with estrogenic activities for menopausal symptom relief include Glycine max (soy), Trifolium pratense (red clover), Pueraria lobata (kudzu), Humulus lupulus (hops), Glycyrrhiza species (licorice), Rheum rhaponticum (rhubarb), Vitex agnus-castus (chasteberry), Linum usitatissimum (flaxseed), Epimedium species (herba Epimedii, horny goat weed), and Medicago sativa (alfalfa). Some of the estrogenic botanicals have also been shown to have protective effects against osteoporosis. Several of these botanicals could have additional breast cancer preventive effects linked to hormonal, chemical, inflammatory, and/or epigenetic pathways. Finally, although botanicals are perceived as natural safe remedies, it is important for women and their healthcare providers to realize that they have not been rigorously tested for potential toxic effects and/or drug/botanical interactions. Understanding the mechanism of action of these supplements used for women's health will ultimately lead to standardized botanical products with higher efficacy, safety, and chemopreventive properties.
... The main ingredients, DSG and 5-MOP, were chosen as the objectives in our study with the method of component compatibility [16]. In previous studies, DSG and 5-MOP showed multiple activities against glycometabolism disorder [17,18]. Several studies attributed DSG's hypoglycemic effect to its regulation of metabolismrelated enzymes [19,20], its interaction with various target molecules, and the related signaling pathways [21,22]. ...
To determine the effects and the underlying mechanism of diosgenin (DSG) and 5-methoxypsoralen (5-MOP), two main active components in the classical Chinese prescription Hu-Lu-Ba-Wan (HLBW), on insulin resistance, HepG2 cells were incubated in medium containing insulin. Treatments with DSG, 5-MOP, and their combination were performed, respectively. The result showed that the incubation of HepG2 cells with high concentration insulin markedly decreased glucose consumption and glycogen synthesis. However, treatment with DSG, 5-MOP, or their combination significantly reversed the condition and increased the phosphorylated expression of estrogen receptor- α (ER α ), sarcoma (Src), Akt/protein kinase B, glycogen synthase kinase-3 β (GSK-3 β ), and the p85 regulatory subunit of phosphatidylinositol 3-kinase p85 (PI3Kp85). At the transcriptional level, expression of the genes mentioned above also increased except for the negative regulation of GSK-3 β mRNA. The increased expression of glucose transport-4 (GLUT-4) was meanwhile observed through immunofluorescence. Nevertheless, the synergistic effect of DSG and 5-MOP on improving glycometabolism was not obvious in the present study. These results suggested that DSG and 5-MOP may improve insulin resistance through an ER-mediated PI3K/Akt activation pathway which may be a new strategy for type 2 diabetes mellitus, especially for women in an estrogen-deficient condition.
... Angeng Recipe is an anti-menopausal Chinese medicine formula with DO, which could also significantly increase the serum estrogen level of climacteric female SD rats [17]. Besides, extracts from Dioscorea species as nutritional supplements have been reported for relieving the menopausal symptoms [18]. Although rhizome of D. oppositifolia L. (DO) is the one used in the Chinese Pharmacopoeia [19] for female aging disorder, rhizomes of D. alata L. (DA) and D. zingiberensis C. H. Wright (DZ) are popularly used to regulate aging disorders and rhixomes of D. collettii var. ...
Rhizomes of Dioscorea species are traditionally used for relieving menopausal syndromes in Chinese medicine. The estrogen-stimulating bioactive principles have been demonstrated in our previous study. In this study, the estrogen-stimulating effects of proteins isolated from four Dioscorea species [D. alata L. (DA), D. zingiberensis C.H. Wright (DH), D. collettii var. hypoglauca (Palib.) S.J. Pei & C.T. Ting (DH), and D. oppositifolia L. (DO)] have been investigated and compared. Microscopic authentication of four Dioscorea species was performed by using paraffin and powder sections of the rhizomes. The potential bioactive proteins of four Dioscorea species have been rapidly isolated by using a DOI-antibody affinity column chromatography on immobilized antibodies against on estradiol-stimulating protein from DO (DOI), and their bioactivity has been rapidly confirmed and compared by phenotypic (i.e., estradiol-stimulating effect) and target-based (i.e., STAR, aromatase, estrogen receptors) screening approaches. The estrogen-stimulating activity of bioactive proteins from DO is the highest. In addition, bioactive proteins from DO upregulated the estradiol-metabolizing enzymes (aromatase and steroidogenic acute regulatory protein). Meanwhile, bioactive proteins from DA, DH and DO upregulated estrogen receptor beta (ER beta). All bioactive proteins did not change the expression of estrogen receptor beta (ER alpha). The estrogen-stimulating bioactive proteins isolated from DO increased biosynthesis of estradiol and upregulated the protein expression of aromatase, steroidogenic acute regulatory protein, and ER beta. The results scientifically support the traditional use of DO in Chinese medicine for relieving menopausal syndrome. Besides, proteins from DA and DZ could also upregulate the translational levels of ER beta, and potentially reducing the risk of ovarian cancer, which also support the clinical use of them for treating female aging disorder.
... [13] Diosgenin is the primary furostanol saponin [ Figure 1] found in several plants, including Dioscorea species (yams), fenugreek, and Costus speciosus. Th s compound has been shown to be useful for the maintenance of healthy blood cholesterol levels, [14] it has been reported that diosgenin retarded the progression of osteoporosis [15] and possessed anti-inflammatory effects in rats. [15] Also, diosgenin glycosides altered myocardial mechanical activities, probably, through the modulation of extracellular calcium (Ca 2+ ) flux across the plasma membrane. ...
Background:
Diosgenin, a steroidal saponin from plants, exhibits many biological potentials. Herein, the cardioprotective role of diosgenin is studied.
Materials and methods:
The effect of diosgenin, isolated from Dioscorea bulbifera, was studied on hypoxia-reoxygenation (HR) in H9c2 cardiomyoblast cells. The amount of diosgenin in the plant extract was analyzed by high-performance thin layer chromatography using a solvent system comprising of chloroform:methanol:acetic acid:formic acid (13:4.5:1.5:1). Cardioprotection was checked by (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Further, the release of lactate dehydrogenase, an enzyme released during cell death was checked. The proteins responsible for cell death (Bax) and cell survival (Bcl-2, hemeoxygenase-1 and Akt) were analyzed using Western blot to check the cardioprotective role of diosgenin.
Conclusion:
Supplementation of diosgenin mitigates HR injury, thereby exhibiting cardioprotective potential.
Summary:
The cardioprotective effect of Diosgenin was evidenced from the improved cell survival after hypoxia-reoxygenation injury demonstrated through MTT cell survival assay.The release of lactate dehydrogenase, an enzyme released during cell death was decreased by Diosgenin.Diosgenin upregulated the pro-survival molecules like B-cell lymphoma 2 (Bcl-2), heme oxygenase-1 and the phosphorylation of ATK (at serine 473); and at the same time pro-.death molecules like Bax was downregulated.Thus, Diosgenin as a plant based steroidal saponin is confirmed to mitigate ischemic reperfusion injury. Figure.
... Besides their use as food, yams have been symbolically associated with culture and ritualism. In addition, certain wild yam species are used for their medicinal properties, particularly as an alternative to hormonal therapies because of their high content in steroidal saponins, primarily diosgenin (Bhandari and Kawabata, 2004;Komesaroff et al., 2001). ...
Kurzzusammenfassung:
Die vorliegende Dissertation wurde durchgeführt, um die Diversität der von der Bevölkerung des Mahafaly Plateaus genutzten Pflanzenressourcen zu erfassen, die sozialen, ökologischen und biophysiologischen Bedingungen, die deren Nutzung und Verfügbarkeit bestimmen, zu verstehen und mögliche Alternativen für deren nachhaltige Nutzung in der Region aufzuzeigen. Das Untersuchungsgebiet, die Mahafaly Region, liegt im Südwesten von Madagaskar. Es ist eine der ökonomisch, klimatisch und in Hinblick auf das Bildungswesen am meisten benachteiligten Regionen des Landes. In dem ariden Steppenklima wird die landwirtschaftliche Produktion durch die begrenzte Wasserverfügbarkeit und den geringen Gehalt an Bodennährstoffen und organischer Substanz limitiert. Teil der Region ist der in jüngerer Vergangenheit erweiterten Nationalpark Tsimanampetsotsa mit einer Vielzahl an der lokalen Bevölkerung heiligen Waldflächen ebenso wie von ihr gemeinschaftlich genutzten Waldflächen, die jedoch durch Brandrodung und Raubbau der Waldressourcen zunehmend gefährdet sind. Um die Verwendung von wilden Yams und Heilpflanzen zu untersuchen, wurde eine ethnobotanische Erhebung in fünf Dörfern in der Mahafaly Region durchgeführt und die Diversität, das lokale Wissen sowie die Verwendung dieser Pflanzen erfasst. 250 Haushalte wurden zufällig ausgewählt, um anhand von teilstrukturierten Interviews deren sozio-ökonomischen Merkmale zu ermitteln. Die erhobenen Daten erlaubten die Charakterisierung der soziokulturellen und sozioökonomischen Faktoren, welche die Intensität der Verwendung von wilden Yams und Heilpflanzen beeinflussen. Hierbei wurde die jeweilige Rolle in der Sicherung des Lebensunterhaltes der Bevölkerung identifiziert. Die Art-Umwelt-Beziehung und die gegenwärtige räumliche Verteilung des wilden Yams wurde basierend auf abiotischen und biotischen Faktoren untersucht und mit Hilfe von Ordinationsverfahren und eines Nischen-basierten Habitat-Modells vorhergesagt. Darüber hinaus wurden Art-Wirkungskurven entlang von Bodengradienten erstellt. Die Auswertungen ermöglichten es, die Umwelt- und Habitatansprüche verschiedener Yams-Arten sowie die Bedeutung der durch den Menschen induzierten Veränderungen auf die Artverfügbarkeit zu verstehen. Vor diesem Hintergrund wurden verschiedene alternative Methoden zur Verbesserung der Regeneration von wildem Yams für die örtliche Bestandserhaltung und die nachhaltige Nutzung in der Mahafaly Region untersucht. Insgesamt wurden sechs wilde Yams-Arten und 214 Heilpflanzenarten aus 68 Familien und 163 Gattungen im Untersuchungsgebiet identifiziert. Die Ergebnisse der Cluster- und Diskriminanzanalyse deuteten ein klares Muster in der Ressourcen-Nutzung an und ergaben zwei Gruppen von Haushalten, die sich in der Intensität der Sammlung von wilden Yams und Heilpflanzen, dem Wissen über deren Nutzung und ihrem Wohlstand unterschieden. Letzteres wurde durch den örtlichen Viehbestand, nichtlandwirtschaftliche Haushaltsaktivitäten, die verfügbare landwirtschaftlichen Nutzfläche sowie Ernteerträgen bestimmt. Ein generalisiertes lineares Modell stellte heraus, dass ökonomische Faktoren die Sammelintensität von wilden Yams signifikant beeinflussten, wohingegen die Nutzung von Heilpflanzen stärker von soziokulturellen Faktoren abhängt. Die Redundanzanalyse zeigte ein klares Muster in der Verbreitung von wilden Yams-Arten in den verschiedenen Lebensräumen. Mit Hilfe eines nichtparametrischen multiplikativen Regressionsmodells konnten 37-88% der Variation in der Häufigkeit der Arten erklärt werden. Die Ergebnisse deuteten zudem auf die Bedeutung der Vegetationsstruktur, Nutzungsintensität sowie der Bodeneigenschaften bei der Bestimmung der Vorkommen wilder Yams-Arten hin. Die Vorhersage der Verbreitung dieser Ressourcen zeigte, dass reichhaltige Vorkommen selten und meist begrenzt in offenen Dornwäldern und Dorndickichten vorkommen, wo die Ernte sehr arbeitsintensiv ist. Feldversuche zum Yams-Anbau zeigten darüber hinaus, dass die Keimfähigkeit durch Vorbehandlung des Saatgutes verbessert werden konnte und die vegetative Regeneration der oberen Knollenteile (Kormus) eine höhere Keimrate hatte als die Minisetts der Knollen. Die in-situ Regeneration aus den oberen Teilen von wilden Knollen war möglich, wobei der Erfolg signifikant vom Bodentyp abhing. Die Verwendung von Dünger (10-20 t ha-1) erhöhte die Erträge von D. alata und D. alatipes um 40%. Der Anbau von weiteren heimischen D. alata-Sorten aus benachbarten Regionen sollte daher gefördert werden.
... One clinical trial employing a yam cream to treat menopausal symptoms reported no significant benefit. 75 Yam creams that have been tested often do not contain any yam extract, and many have been adulterated with undisclosed steroids, including estrogens, progesterone, and medroxyprogesterone acetate (MPA). Because of the potential harm that might result from adulterants and lack of efficacy data, yam creams are not recommended for VMS. ...
Objective: To update and expand The North American Menopause Society's evidence-based position on nonhormonal management of menopause-Associated vasomotor symptoms (VMS), previously a portion of the position statement on the management of VMS. Methods: NAMS enlisted clinical and research experts in the field and a reference librarian to identify and review available evidence. Five different electronic search engines were used to cull relevant literature. Using the literature, experts created a document for final approval by the NAMS Board of Trustees. Results: Nonhormonal management of VMS is an important consideration when hormone therapy is not an option, either because of medical contraindications or a woman's personal choice. Nonhormonal therapies include lifestyle changes, mind-body techniques, dietary management and supplements, prescription therapies, and others. The costs, time, and effort involved as well as adverse effects, lack of long-Term studies, and potential interactions with medications all need to be carefully weighed against potential effectiveness during decision making. Conclusions: Clinicians need to be well informed about the level of evidence available for the wide array of nonhormonal management options currently available to midlife women to help prevent underuse of effective therapies or use of inappropriate or ineffective therapies. Recommended: Cognitive-behavioral therapy and, to a lesser extent, clinical hypnosis have been shown to be effective in reducing VMS. Paroxetine salt is the only nonhormonal medication approved by the US Food and Drug Administration for the management ofVMS, although other selective serotonin reuptake/norepinephrine reuptake inhibitors, gabapentinoids, and clonidine show evidence of efficacy. Recommend with caution: Some therapies that may be beneficial for alleviating VMS are weight loss, mindfulness-based stress reduction, the S-equol derivatives of soy isoflavones, and stellate ganglion block, but additional studies of these therapies are warranted. Do not recommend at this time: There are negative, insufficient, or inconclusive data suggesting the following should not be recommended as proven therapies for managing VMS: cooling techniques, avoidance of triggers, exercise, yoga, paced respiration, relaxation, over-The-counter supplements and herbal therapies, acupuncture, calibration of neural oscillations, and chiropractic interventions. Incorporating the available evidence into clinical practice will help ensure that women receive evidence-based recommendations along with appropriate cautions for appropriate and timely management of VMS.
... Dioscorea could theoretically be given to women who have been treated for breast cancer, but safety data are required. When given as a cream, the effect on menopausal symptoms was not statistically significant compared to placebo [9]. Dioscorea was found to increase bone mineral density in ovariectomised rats [10], but studies in humans are lacking. ...
Many women develop vasomotor complaints and psychological problems in their menopause. Hormonal substitution is the most efficient treatment to alleviate these symptoms. Some women are reluctant to take hormones or are not allowed to use them for medical reasons. Therefore, they request natural alternatives. Controlled trials indicate that soy or its supplements are hardly more efficient than a placebo in the treatment of menopausal symptoms. It has been demonstrated in studies among Flemish women that the gut bacteria play an important role in the metabolisation of soy isoflavones into equol. Women with the adequate gut flora to produce a sufficient amount of equol may experience a reduction of their vasomotor complaints. Other herbal preparations, such as Cimicifuga racemosa (black cohosh), Vitex agnus-castus and flax seed, exert little or no proven beneficial effects on vasomotor complaints. Hop flavonoids contain 8-prenylnaringenin (8-PN). This molecule exerts an estrogenic effect many times stronger than that of soy isoflavones. However, hop extracts show an inconsistent influence on menopausal complaints. The extract of the bark of the Mediterranean pine tree (Pycnogenol), rich in anthocyanidins, has been shown to reduce menopausal symptoms. The saponin of the Dioscorea villosa (wild yam) does not bind to the human estrogen receptor. It reduces the metabolisation of estradiol into the genotoxic 16-hydroxy-oestrone (16-OH-oestrone). Trials with dehydroepiandrosterone (DHEA) come to contradictory conclusions regarding the alleviation of menopausal symptoms. It may induce androgenic side effects when given in a high dose. Whereas judiciously composed nutriceuticals, containing a low dose of minerals, natural vitamins, antioxidants and herbal preparations, may exert a favourable effect, high-dose vitamins or synthetic vitamin analogues may cause health damage.
... One trial of yam cream yielded nonsignificant improvements in symptoms. 46 ...
Given the persistent confusion about the risks and benefits of hormone therapy since 2002 and the first publication from the Women's Health Initiative's primary findings, women and health care providers are increasingly motivated to find effective, nonhormonal approaches to treat menopause-related symptoms. Complementary and alternative medicine has grown increasingly popular in the last decade. A wide array of botanic medicines is offered as an alternative approach to hormone therapy for menopause, but data documenting efficacy and safety are limited. None of the available botanicals is as effective as hormone therapy in the management of vasomotor symptoms.
Copyright © 2015 Elsevier Inc. All rights reserved.
Introduction: Early symptoms of menopause are very common and often very bothersome. Considering the increasing number of women experiencing these symptoms in the world and Iran, there is a growing need to use methods to reduce these symptoms. Therefore, this study was performed with aim to determine the effect of the combined herbal capsules (Menohelp) on reducing the early symptoms of menopause, number and intensity of hot flashes (primary outcomes), and improving sleep quality and quality of life (secondary outcomes) in menopausal women.
Methods: In this double-blind trial in Tabriz, 100 women aged 50 to 59 years suffering from early symptoms of menopause were randomly assigned into two groups of receiving capsules of either Menohelp or placebo. The randomization was done using blocked randomization stratifying by duration of menopause with allocation ratio of 1:1. The outcomes were assessed using the Green Climacteric Scale, a checklist including the number and severity of hot flashes, Pittsburgh sleep quality and the Menopause-Specific Quality of Life (MENQOL). Data were analyzed by SPSS statistical software (version 21) and repeated measures ANOVA, ANCOVA and Mann-Whitney U. P<0.05 was considered statistically significant.
Results: There were no statistically significant differences between the two groups in terms of mean score of Green at 4 and 12 weeks of intervention (adjusted mean difference 0.60, 95% CI -2.9 to 4.0), but, mean rank number (p = 0.003 and p = 0.008, respectively) and mean intensity (0.59, 0.3 to 0.9) of hot flashes were higher in the Menohelp group than the placebo group. The mean rank score of Pittsburgh (p = 0.29) at 4 weeks and mean score of MENQOL (p = 0.64) at 12 weeks of intervention were not significantly different between the two groups.
Conclusion: The results of the present study could show the positive effects of Menohelp herbal capsule on improving the early symptoms of menopause.
Background: Hot flashing is the most common symptoms experienced by women around the menopause time. The most common therapy for relief of menopausal symptoms is Hormone Replacement Therapy (HRT), but it has side effects. So, many women are interested in herbal medicines because of fear of side effect of hormone therapy.
Objective: The aim of this study was assess the effectiveness of different herbal medicine on the hot flash in menopausal women in clinical trial.
Methods: The database of Medline, Scopus, and Web of Science were searched to investigate randomized controlled clinical trials on the efficacy of herbal medicines on hot flash from Feb 1994 to Feb 2017.
Results: Fifty nine randomized controlled trials found according to the inclusion criteria. The results demonstrating that different herbal medicines such as Glycine max, Cimicifuga racemose, Vitex agnus-castus, Glycyrrhiza glabra, Trigonella foenum-graecum, Humulus lupulus, Valeriana officinalis, Linum usitatissimum, Salvia officinalis, Pimpinella anisum, Trifolium pretense, Hypericum perforatum and Ginkgo biloba can have role in reduction of the hot flashes.
Conclusion: Our study show that many herbal medicines can reduce the frequency and number of hot Flash but it needs more future studies to find reliable result.
Up to one-third of a woman’s lifetime will take place in menopause. This chapter will discuss the physiological changes and symptoms associated with menopause. The clinical management of menopausal symptoms with hormone therapy, nonhormonal medications, and nonmedical treatments will be reviewed. Additionally, we will discuss key clinical trials that examine treatment efficacy and the risks and benefits of various treatment approaches. Lastly, preventive approaches, lifestyle modifications, and national recommendations for supplements such as calcium and vitamin D will be reviewed.
Yam (Dioscorea species), a member of the monocotyledonous family Dioscoreaceae, is a nutritious food in West Africa, Southeast Asia, and the Caribbean. Yam has a deciduous perennial vine climbing to twenty feet with heart-shaped leaves and tiny green flowers. The tuberous rhizome of yam is pale brown, cylindrical, and twisted.
Up to one-third of a woman’s lifetime will take place in menopause. This chapter will discuss the physiological changes and symptoms associated with menopause. The clinical management of menopausal symptoms with hormone therapy, nonhormonal medications, and nonmedical treatments will be reviewed. Additionally, we will discuss key clinical trials that examine treatment efficacy and the risks and benefits of various treatment approaches. Lastly, preventive approaches, lifestyle modifications, and national recommendations for supplements such as calcium and vitamin D will be reviewed.
Parts used - root and rhizome Indications - diverticulosis, gall bladder colic, PMS, cramps, gestational nausea, rheumatoid arthritis Pharmacology - traditionally a cholagogue, anti-spasmodic, anti-inflammatory, autonomic nervous system relaxant; anti-oxidant, weak anti-oestrogenic and/or anti-androgenic activity Constituents - diosgenin, dioscin, dioscorin, vitamins and minerals, polyphenols Products used - decoction, tincture, liquid extract, creams Therapeutic doses decoction: 2-4 g tid tincture (1:5): 2-10 mL tid liquid extract (1:2): 3-6 mL/day Precautions - may cause GI upset in Large doses. Safety in large amounts in pregnancy not established Interactions - insufficient data available.
Objective: To create an evidence-based position statement regarding the treatment of vasomotor symptoms associated with menopause. Design: The North American Menopause Society (NAMS) enlisted clinicians and researchers acknowledged to be experts in the field of menopause-associated vasomotor symptoms to review the evidence obtained from the medical literature and develop a document for final approval by the NAMS Board of Trustees. Results: For mild hot flashes, lifestyle-related strategies such as keeping the core body temperature cool, participating in regular exercise, and using paced respiration have shown some efficacy without adverse effects. Among nonprescription remedies, clinical trial results are insufficient to either support or refute efficacy for soy foods and isoflavone supplements (from either soy or red clover), black cohosh, or vitamin E; however, no serious side effects have been associated with short-term use of these therapies. Single clinical trials have found no benefit for dong quai, evening primrose oil, ginseng, a Chinese herbal mixture, acupuncture, or magnet therapy. Few data support the efficacy of topical progesterone cream; safety concerns should be the same as for other progestogen preparations. No clinical trials have been conducted on the use of licorice for hot flashes. Among nonhormonal prescription options, the antidepressants venlafaxine, paroxetine, and fluoxetine and the anticonvulsant gabapentin have demonstrated some efficacy for treating hot flashes and were well tolerated. Two antihypertensive agents, clonidine and methyldopa, have shown modest efficacy but with a relatively high rate of adverse effects. For moderate to severe hot flashes, systemic estrogen therapy, either alone (ET) or combined with progestogen (EPT) or in the form of estrogen-progestinoral contraceptives, has been shown to significantly reduce hot flash frequency and severity. Clinical trials have associated ET/EPT with adverse effects, including breast cancer, stroke, and thromboembolism. Several progestogens (both oral and intramuscular formulations) have shown efficacy in treating hot flashes, including women with a history of breast cancer, although no definitive data are available on long-term safety in these women. Conclusions: In women who need relief for mild vasomotor symptoms, NAMS recommends first considering lifestyle changes, either alone or combined with a nonprescription remedy, such as dietary isoflavones, black cohosh, or vitamin E. Prescription systemic estrogen-containing products remain the therapeutic standard for moderate to severe menopause-related hot flashes. Recommended options for women with concerns or contraindications relating to estrogen-containing treatments include prescription progestogens, venlafaxine, paroxetine, fluoxetine, or gabapentin. Clinicians are advised to enlist women's participation in decision making when weighing the benefits, harms, and scientific uncertainties of therapeutic options. Regardless of the management strategy adopted, treatment should be periodically reassessed as menopause-related vasomotor symptoms will abate over time without any intervention in most women.
Evidence for the phytoestrogen containing plants for the treatment of menopausal symptoms was examined in part 1 of this review. Phytotherapeutic agents that may exert estrogenic effects via different mechanisms, and non-hormonally-acting remedies administered for menopause-related complaints in the Anglo-American tradition are reviewed here. The evidence presented is derived from pharmacological and clinical studies.
The midlife transition is associated with many changes in hormonal and physiological function, some of which are sex related. In women, one of the most dramatic hormonal changes is the striking reduction in estrogen production that accompanies menopause. The word menopause is derived from two Greek roots: mens, meaning monthly, and pause, meaning to stop. It refers specifically to the cessation of menstruation and the termination of fertility, two events which may not happen at the same time.
The aim of the present study was to evaluate the anti bacterial activity of the ethanolic extract of Dioscorea villosa (wild yam) tubers. Dioscorea villosa (dioscoraceae) is used for centuries as a medicinal herb for a wide range of ailments. It is a tuberous, twining vine with pale- brown, knotty, wood and cylindrical tubers. Wild yam is sometimes suggested as an alternative to hormone replacement therapy. The ethanolic extract of Dioscorea villosa tubers was screened for its antibacterial activity against Shigella dysenteriae, E.coli, Vibrio cholera, Klebsiella pneumonia, Psuedomonas aerugenosa, Staphylococcus aureus, using disc diffusion technique.The results of this study showed good anti bacterial activity against the bacterial species tested, at different concentrations of the extract.
Many women are interested to use complementary and alternative medicines for relief from their menopausal symptoms. The prevalence of herbal medicinal product use among menopausal women highlights the need for investigation into these interventions. The goal of this study was to evaluate the benefit of herbal medicinal products for the treatment of menopausal symptoms by performing a systematic review of clinical trials. Literature searches of four computerized databases were done to identify randomized clinical trials of herbal medicinal products for the treatment of menopausal symptoms. Manufacturers of herbal products were contacted, and our own files were also searched. There were no restrictions on the language of publication. Trials were considered if the outcome measures related to the physical or psychological impact of menopause, whether by compendium scores, questionnaires, or women's symptom diaries, excluding studies describing artificially induced menopause. This review was not concerned with biochemical or pathological data. Eighteen randomized clinical trials that fit our criteria were identified. These studies investigated black cohosh (n = 4), red clover (n = 4), kava (n = 3), dong quai (n = 1), evening primrose oil (n = 1), ginseng (n = 1), and combination products (n = 4). Trial quality was generally good, with 16 of 18 studies scoring 3 or more (maximum 5) on the Jadad Scale. There is no enough evidence for any herbal medical product in the treatment of menopausal symptoms. However, the evidence for black cohosh is promising. The studies involving red clover show it may be of benefit for more severe menopausal symptoms. There is some document for the use of kava, but safety concerns mean this herbal product is not a therapeutic option at present.
Every year, millions of women begin the menopausal transition. By the year 2030, the World Health Organization estimates 1.2 billion women will be age 50 or over, which is nearly triple the number of women in that age bracket in 1990.1 The vast majority of women will experience some symptoms during the menopausal transition. This is also a time when many women begin to experience the signs and symptoms of midlife and aging.2,3 During this phase, many women turn to some form of therapy, either hormonal or nonhormonal, to treat menopausal symptoms and prevent or treat chronic disease.
Diosgenin, a well-known steroid sapogenin derived from plants, has been used as a starting material for production of steroidal hormones. The present review will summarize published literature concerning pharmacological potential of diosgenin, and the underlying mechanisms of actions. Diosgenin has shown a vast range of pharmacological activities in preclinical studies. It exhibits anticancer, cardiovascular protective, anti-diabetes, neuroprotective, immunomodulatory, estrogenic, and skin protective effects, mainly by inducing apoptosis, suppressing malignant transformation, decreasing oxidative stress, preventing inflammatory events, promoting cellular differentiation/proliferation, and regulating T-cell immune response, etc. It interferes with cell death pathways and their regulators to induce apoptosis. Diosgenin antagonizes tumor metastasis by modulating epithelial-mesenchymal transition and actin cytoskeleton to change cellular motility, suppressing degradation of matrix barrier, and inhibiting angiogenesis. Additionally, diosgenin improves antioxidant status and inhibits lipid peroxidation. Its anti-inflammatory activity is through inhibiting production of pro-inflammatory cytokines, enzymes and adhesion molecules. Furthermore, diosgenin drives cellular growth/differentiation through the estrogen receptor (ER) cascade and transcriptional factor PPARγ. In summary, these mechanistic studies provide a basis for further development of this compound for pharmacotherapy of various diseases.
Copyright © 2015 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.
IntroductionThe Food and Drug Administration defines an aphrodisiac drug product as “any product that bears labeling claims that it will arouse or increase sexual desire, or that it will improve sexual performance.” Presently, there are no approved medications for the treatment of lowered desire for women, and many opt for “natural” products.AimThe aim of this article was to review the most popular and currently used aphrodisiac products marketed in the United States. The safety and efficacy of animal- and plant-based aphrodisiacs, vitamins and minerals, and popular over-the-counter combination supplements have been reviewed.Methods
An English PubMed literature search was performed using the key words “sexuality,” “sex,” “aphrodisiac,” and “sexual enhancer.” Approximately 50 articles were reviewed by the authors. The authors used relevant case series, case-controlled, and randomized clinical trial data.Main Outcome MeasuresProducts were evaluated based on the quality of research, and their known efficacy and safety considerations. Products with low risk and potential benefit for sexual response based on prior research studies were highlighted.ResultsResearch has demonstrated that the risks of yohimbine, Spanish fly, mad honey, and Bufo toad may outweigh any benefit, and these products should be avoided. Other products, such as Maca, Tribulus, Ginkgo, and ginseng, have limited but emerging data. Randomized clinical trial data are often lacking, but future research should be performed to further elucidate the efficacy and safety of these products.Conclusion
Future randomized clinical trials are warranted before health care practitioners can recommend most aphrodisiac products. There remain some medical concerns with drug interactions, purity, reliability, and safety. West E and Krychman M. Natural aphrodisiacs—A review of selected sexual enhancers. Sex Med Rev **;**:**–**.
Diabetes mellitus is a condition in which a person has a high blood sugar/glucose level. This is because the body does not produce enough insulin, or because the body cells do not properly respond to the insulin that is produced. Herbal treatment for diabetes has been a part of traditional medicine for thousands of years. The natural herbs for diabetes treatment focus on lowering blood sugar, reducing the damaging effects of the disease and maintaining of a safe, healthy level of blood glucose. Many diabetic patients seeking an alternative treatment to traditional drugs turn to natural herbs for help. This review article provides very useful information of officially-approved antidiabetic natural ingredients [Table 1] by KFDA, thereby providing consumers with a wise decision when they purchase the effective nutraceuticals for diabetes. Therefore, medicinal herbs may be used to prevent and treat diabetes reliably and safely when the government approves the ingredients or products officially.
This study was undertaken to investigate the effect of various forms of hormone replacement therapy (HRT) upon postmenopausal women while controlling as many variables as possible. It was felt that the age, duration of amenorrhoea and the general health of the patients should be as comparable as possible and that each patient should provide her own pretherapy and post-therapy control data. In addition, it was felt that any placebo effect should be investigated and the patients were therefore randomly allocated to placebo tablets or one of six available forms of HRT. The age/sex registers of two large general practices were scrutinized and all women between 49 and 54 years of age were asked to cooperate; for a variety of reasons only 56 women were suitable and willing to take part in the project, yielding 8 women for each of the seven possible therapy groups. Blood samples were taken at 7-day intervals three times before therapy was given and the mean of the three values was used as the control value. The women returned on day 21 of each subsequent therapy cycle for six consecutive months and finally three months after discontinuing therapy. From the data the following broad conclusions can be drawn: (i) some women have classic symptoms of hot flushes and sweating despite high endogenous oestrogen concentrations; (ii) vaginal cytology is a relatively poor indicator of endogenous oestrogen status; (iii) while follicle stimulating hormone (FSH) and luteinizing hormone (LH) concentrations are reduced on HRT neither is decreased to anywhere near premenopausal values while prolactin is unaffected; (iv) plasma cholesterol levels are reduced on HRT, the pulse rate is slower and both systolic and diastolic blood pressure are reduced to a small but significant extent; (v) there is no adverse effect upon blood clotting; and (vi) most women experience significant or complete relief of symptoms on all forms of HRT as do some women taking a placebo. The combined preparations containing an oestrogen and progestogen produced vaginal bleeding in only 80 per cent of the women. Thus protection by regular endometrical shedding may not be afforded to all women. As vaginal bleeding is unacceptable to most women if they can achieve the same symptomatic relief without inducing menstruation, it is suggested that women have a low dose oestrogen preparation prescribed cyclically for 6 to 12 months. If therapy is to be maintained for a longer time, uterine curretage should be undertaken at regular intervals to exclude the possibility of endometrial carcinoma developing.
Thin-layer chromatography was employed to separate diosgenin from other plant constituents present in Dioscorea tuber extracts. The diosgenin was rendered visible by antimony trichloride and the colored spot estimated by scanning with a photoelectric densitometer attached to an integrating logarithmic recorder. Diosgenin could be estimated with an experimental error of approximately 7 per cent when applied in concentrations between 10 and 75 mcg. Assay results obtained for diosgenin by this method were slightly lower than those obtained by conventional infrared spectrophotometry, since the 25 D-spirosta-3, 5-diene formed during the extraction of diosgenin was not estimated in the chromatographic procedure.