Effect of myrtle fruit syrup on abnormal uterine bleeding: A randomized double-blind, placebo-controlled pilot study
Abstract and Figures
Background
Myrtle (Myrtus communis L.) has been used in the Iranian Traditional Medicine as a treatment for abnormal uterine bleeding-menometrorrhagia. The main aim of this study is to evaluate the effect of myrtle fruit syrup on abnormal uterine bleeding-menometrorrhagia.
Methods
A randomized, double-blind, placebo-controlled pilot study was conducted on 30 women suffering from abnormal uterine bleeding-menometrorrhagia. Treatment comprised of giving 15 ml oral myrtle syrup daily (5 ml three times a day) for 7 days starting from the onset of bleeding. The myrtle syrup along with placebo was repeated for 3 consecutive menstrual periods. Menstrual duration and number of used pads were recorded by the Pictorial Blood loss Assessment Chart at the end of each menstrual period. The quality of life was also evaluated using the menorrhagia questionnaire.
Results
The mean number of bleeding days significantly declined from 10.6 ± 2.7 days to 8.2 ± 1.9 days after 3 months treatment with the syrup (p = 0.01) and consequently the participants in the intervention group used fewer pads after 3 months (16.4 ± 10.7) compared with the number of pads used at the beginning of the treatment (22.7 ± 12.0, p = 0.01). Bleeding days and number of pads used by the participants in the placebo group did not change significantly. Also significant changes of quality of life scores were observed in the intervention group after 3 months compared to the baseline.
Conclusion
Myrtle syrup is introduced as a potential remedy for abnormal uterine bleeding-menometrorrhagia.
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... Tese efects may be due to the presence of astringent agents such as tannins and triterpenoids and antioxidant and antiinfammatory compounds that suppress the synthesis of prostaglandins [22]. In addition, it has been shown that myrtle (Myrtus communis L.), which is an evergreen shrub that grows in Iran, has antiseptic, antioxidant, antiinfammatory, ulcer protective, and astringent properties [23]. ...
... Tey concluded that intervention with TA or pomegranate fower in the frst 5 days of the menstrual cycle for three sequential months could equally mitigate the PBAC score. In addition, a trial by Qaraaty et al. [23] indicated that a 15 ml intake of myrtle syrup at the frst 7 days of the cycle for three consecutive menstrual periods declined bleeding compared to a placebo. Te hypothesis was that coadministration of pomegranate fower and myrtle which are components of Golnar product with longer duration can induce more therapeutic efects. ...
... Terefore, it seems that treatment of heavy menstrual bleeding could improve quality of life. Several studies have reported an improvement in quality of life after consumption of Golnar product and its components [18,20,21,23,29]. Other studies also demonstrated that pomegranate peel extract or supplements could improve the quality of life of hemodialysis patients and menopausal women [32,33]. ...
Introduction:
Abnormal uterine bleeding (AUB) is a major healthcare problem in females of reproductive age and impacts women's health and quality of life (QoL). This study aimed to test the equivalence of Persian Golnar (PG) and tranexamic acid (TA) for the treatment of excessive menstrual bleeding.
Method:
A triple-blind randomized equivalence trial with parallel design and block randomization technique was performed. A total of 80 patients with AUB were randomly allocated to receive either PG or TA for three consecutive menstrual cycles. Blood loss was measured by the Pictorial Blood Loss Assessment Chart (PBAC). Hematological evaluations were done before the intervention and after treatment. QoL and premenstrual dysphoric disorder (PMDD) as secondary outcomes were assessed using the menorrhagia questionnaire (MQ) and Premenstrual Symptoms Screening Tool (PSST). Statistical analysis was performed using an independent t-test, paired t-test, χ2 test, Mann-Whitney test, and Wilcoxon signed-rank test.
Results:
Seventy-six women completed the 12-week follow-up. Both PG and TA groups experienced a significant reduction in blood loss. Furthermore, the serum level of hemoglobin in the PG group enhanced significantly (P < 0.001). QoL and PMDD scores were significantly improved in both groups (P< 0.001).
Conclusion:
The findings of the current trial supposed that the Golnar product is as effective as tranexamic acid in controlling bleeding and enhancing the quality of life and premenstrual symptoms.
... Its small shrubs normally range in size from 1 to 3 m. Some studies have suggested Myrtle extract as a potential remedy for excessive bleeding (15,16). ...
... In other words, the herbal extract decreased B.T. in the rats treated with the herbal extracts. According to another study, three months of consuming Myrtle extract significantly reduced the number of bleeding days in women with abnormal menorrhagia compared to the control group (15). Also, Pomegranate flower extract could significantly control menstrual bleeding and reduce the volume of bleeding in women, improving relevant clinical indices and their life quality (27). ...
... Myrtle. They found that Myrtle syrup could be used as a potential drug to control excessive uterine bleeding (menorrhagia) (15). The results of these studies on the coagulant effects of Myrtle were consistent with our findings. ...
Background: Management of bleeding is among the major issues in medicine, particularly during surgery. Objectives: This study investigated the effects of Pomegranate peel and flower, Myrtle, Quercus fruit, and Rhus coriaria L extracts on bleeding control in rats. Methods: In this experimental study, 32 male Wistar rats (weighing 200 - 250 g, 8-10-month-old) with free access to sufficient water and food, were randomly divided into four groups: (a) the topical application of the extracts on tail wounds (bleeding time (B.T.) measurement); (b) intraperitoneal injection of the extracts (measurement of prothrombin time (P.T.) and partial thromboplastin time (PTT) in the blood taken from the heart); (c) control group 1 (B.T. measurement on tail wounds without the topical application of the extracts); and (d) control group 2 (no intraperitoneal injection of the extracts, P.T. and PTT measurement in blood drawn from the heart). The animals in all groups received the same care and were kept under standard laboratory conditions, 12:12 h light/dark cycles, and a temperature of 23 ± 2.0°C. The data were analyzed by the one-way ANOVA and Tukey's post-hoc tests. Results: The mean of B.T. in the control group, 3.57 ± 0.20 s, was significantly higher than that in the intervention group (1.56 ± 0.13 s) (P < 0.001). The mean of P.T. in the control group was not significantly different from that in the intervention group (P = 0.499). The mean of PTT in the control group (18.2 ± 24.82 s) was significantly shorter than that in the intervention group (38.00 ± 14.49 s) (P = 0.006). Conclusions: Considering the acceptable coagulant effects of the extracts of Pomegranate peel & flower, Myrtle, Quercus fruit, and Rhus coriaria L. compared to the control group, it can be concluded that these extracts can be suitable adjuvant drugs for controlling bleeding. Although the coagulant effects of these extracts have been mentioned in many traditional medicine texts, human tests are required to reject or confirm their clinical effects.
... and "d" is the accuracy of estimate or how close it is to the true mean (d = 900.40). Given the pioneering nature of this study, the above two data were collected from a previous work including women suffering from abnormal uterine bleeding-menometrorrhagia, conducted by Qaraaty et al., 18 where the mean number of bleeding days was 10.6 AE 2.7 and 8.2 AE 1.9, respectively, before and after the consumption of myrtle syrup. "Zα/2" is the normal deviate for a two-tailed alternative hypothesis at a level of significance (Zα/2 equal to 1.44 at an error rate of 0.20%). ...
... 23 The most interesting effects of sinapic acid are its capacity to influence steroid hormone metabolism and its anti-inflammatory properties. 24 The results of this study were similar to the results of Qaraaty et al. 18 in the management of abnormal uterine bleeding-menometrorrhagia by myrtle fruit syrup. ...
Background : Abnormal uterine bleeding-menometrorrhagia due to uterine myomas is a health problem affecting women’s quality of life and it is considered a frequent cause of emergency visits for women. If first line medication fails to treat symptoms, surgical procedures, such as hysterectomy could be indicated, which could interfere with women's physical, social, emotional, and material quality of life. The purpose of this pilot study was to investigate the effect of a mixture of two medicinal plants, Mentha pulegium L and Artemisia abrotanum L, on 13 women with menometrorrhagia, who were candidates for hysterectomy.
Methods: The herbs were taken as a tea infusion by the oral route. A total of 5 g of the dried aerial parts of the mixture were added to 100 ml of boiling water and the tea infusion was taken three times a day starting from the onset of menstruation for three consecutive days, and it was repeated for three consecutive months.
Results: The study results showed that 10 out of the 13 women involved avoided the surgical procedures. The mean number of bleeding days declined from 11.50 (±3.77) at baseline to 7.60 (±2.11) ( p=0.01 ). Participants confirmed a change in the bleeding intensity, regularization of their menstrual cycle, and improvement in their quality of life.
Conclusions: This preliminary study explores a new approach to treat abnormal uterine bleeding- menometrorrhagia, based on tea infusion consumption of a mixture of two medicinal herbs, and it paves the way for future studies.
Trial registration: This study is registered with ClinicalTrials.gov NCT05406960 (07/06/2022).
... Increasing the quality of life in healthy people (21) and reducing the cost of diseases [22] are the major priorities in PM. Some interesting results of the studies inspired by the opinion of ancient scholars indicate that PM in the feld of gynecology also has the ability to provide efective treatments [23,24]. ...
Introduction:
Infertility is an important issue with a high social and psychological burden. From the perspective of Persian Medicine (PM), uterine cold temperament is one of the important causes of female infertility.
Aim:
The aim of this study was to study the effect of PM or Iranian traditional medicine on improving ovulation and fertility.
Methods:
From January 2017 to August 2017, sixty infertile women with eugonadotropic ovulation disorder were randomly divided into two groups. Both groups were treated with clomiphene citrate, except that the intervention group also received metabolic Persian diet (MPD). In each cycle, the dominant follicles and endometrium were investigated with ultrasound. At the end of the cycle, beta human chorionic gonadotropin (β-HCG) was evaluated and if positive, another ultrasound was performed two weeks later to confirm early pregnancy.
Results:
The number of dominant follicles from the first to third cycle increased from 2.15 ± 1.14 to 2.28 ± 0.61 in the intervention group and decreased from 1.86 ± 0.79 to 1.30 ± 0.47 in the control group. The dominant follicle size changed from 16.00 ± 4.08 to 18.78 ± 2.78 and from 15.05 ± 3.11 to 15.80 ± 3.89 in the intervention and control groups, respectively. But endometrial thickness did not change significantly in the intervention group. Pregnancy results based on β-HCG and ultrasound findings were positive in 19 and 16 patients in the intervention group and in 10 and 7 patients in the control group, implying significantly higher numbers in the first group.
Conclusion:
It seems that MPD may be effective in the success of ovulation induction.
... Traditional Persian Medicine (TPM) with a comprehensive view on etiology, and considering several variables, has been effective in the treatment of diseases. These variables include part of human nature (mizaj), sex, age, racial/ethnic, season, region, profession [25]. TPM provides valuable preparations (phytopharmaceuticals) which are proposed as putative therapeutic medications in numerous health complications [26]. ...
Vaginal atrophy is one of the most common complaints in postmenopausal women. Symptoms of vaginal atrophy include dryness, itching, bleeding, and dyspareunia. According to Traditional Persian Medicine (TPM), the using of moisturizing plants can treat dry mucous membranes. TPM suggests the use of marshmallow (Alcea angulata) to moisturize dry mucus with its mucilage. The aim of this study was to evaluate the effect of Alcea on the treatment of vaginal atrophy. This double-blind, clinical trial was conducted on 60 postmenopausal women with vaginal atrophy (40 – 65 years of age). The patients were randomly assigned into two groups of treatment and control (n = 30). The treatment group received Alcea vaginal suppository 5% (125 mg), and the control group received placebo. Both groups used suppositories every night for two weeks and every other night for six weeks. Vaginal Maturation Value (VMV), symptoms of vaginal atrophy, and pH were compared before and after the intervention. Data were analyzed using SPSS 16. VMV was increased in the treatment group, from 40.30 ±13.27 to 46.40 ± 11.27, (p ˂ 0.0001) compared to the control group, in which the change of VMV was not significant (p ˂ 0.122). The vaginal pH was significantly decreased in the treatment group, from 6.45 ± 0.92 to 5.52 ± 0.62, (p ˂ 0.0001) compared to the control group, in which the change of pH was not significant (p ˂ 0.257). The symptoms were significantly reduced in the treatment group. It seems that Alcea vaginal suppository can be useful as a natural product to relieve the symptoms of vaginal atrophy.
... Aqueous extract of fruit of the plant MC for one month 38 patients (18 -68) age Double-blinded randomized placebocontrolled trial ---------According to the SNOT-22 parameters, symptoms improved in the treatment group after treatment in most parameters [69] 5. --------------Significant reductions of bleeding duration and intensity of bleeding [73] 8. ...
Myrtus communis Linn. (MC) is an important medicinal shrub being used in Unani Medicine for the
treatment of diarrhoea, peptic ulcers, leucorrhoea, urethritis, haemorrhoids, conjunctivitis, palpitation,
pulmonary and skin disease. This review provides data on the botany, phytochemical, Preclinical &
Clinical Studies and Unani traditional uses of MC, with an aim to make update of the current information
and obtain opportunities for further therapeutic potential. The information was obtained from scientific
literature databases including PubMed, Research Gate, Google Scholar, Web of Science and Science
Direct. Additional information was gathered from classical Unani text books, and published materials.
MC are used traditionally for the treatment so many diseases. The Anti-inflammatory, Antimicrobial,
Antioxidant, Hypoglycaemic, Anticancer, Analgesic, Antidiarrheal properties have been widely
investigated. More than 50 active ingredients have been isolated from this plant including monoterpene,
sesquiterpene, oxygenated sesquiterpenes, tannins and flavonoids. The present review verifies the real
identity of Myrtle, summarizes its valuable description in Unani literature, and its medicinal efficacy in
haemorrhoid, aphthous stomatitis, chronic rhinosinusitis, bacterial vaginosis (BV) and other disorders.
Phytochemical and pharmacological studies and clinical investigations on the crude drug and isolated
principles proved the multipotent action of Myrtle.
... As a holistic school of medicine, PM is based on the theory of humoral medicine and temperaments considering both physical and non-physical aspects of a human being (Atarzadeh, Daneshfard, Dastgheib, Jaladat, & Amin, 2016;Nimrouzi, Daneshfard, Tafazoli, & Akrami, 2019). It has a great potential for solving some of the medical problems, as demonstrated in some recent researches in these fields (Ahmadi et al., 2010;Khodaei et al., 2017;Nozad, Naseri, Safari, Al Ahadi, & Ghaffari, 2016;Qaraaty et al., 2014). According to the most famous PM textbooks, marshmallow (Althaea officinalis L.) is a good candidate for the treatment of AD (Avicenna, 2005;Shirazi, 2009 soothing, and antitussive effects (Shah et al., 2011). ...
Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease, which primarily affects infants and young children. Due to the side effects of commonly used drugs for its treatment, the development of safer therapeutic strategies is needed. There are many reports on the topical use of marshmallow (Althaea officinalis) for a range of skin diseases in Persian medicine. The main aim of the present investigation was evaluating the efficacy of marshmallow in children with mild-to-moderate atopic dermati-tis. Another aim of the study was screening the anti-allergic and anti-inflammatory potential of phytocomponents against target proteins, including TNF-alpha, IL6, and PDEs A, B, and D enzymes with PDB IDs: 2AZ5, 1P9M, 3I8V, 4KP6, and 1Y2K, respectively, along with their respective standard ligands using computational docking analysis. A pilot clinical trial was designed to investigate the safety and efficacy of Althaea officinalis in children with AD. The diagnosis of AD was made according to the criteria of Hanifin and Rajka. Children between 3 months and 12 years old were participated in this trial and randomly allocated into two parallel intervention and control groups. The intervention group used Althaea officinalis 1% ointment while the positive control group used Hydrocortisone 1% ointment twice a day for a week and after that, three times per week for a period of 3 weeks. The severity of AD was measured using the SCORAD score at the end of each assessment visits. A total number
of 22 patients completed the study. A significant decrease of the SCORAD score
was observed in both groups. At the end of the study, this score change, which indicates
the improvement of the patients was significantly higher in the intervention
group in comparison to the baseline (p-value = .015) and week 1 (p-value = .018). In
the docking analysis of the study, 33 phytochemical compounds were identified,
which were docked into the active site of IL6, TNF-alpha, and human PDE4 isoenzymes.
Affinity toward the selected enzymes was significantly higher in glycosylated
compounds. The results of this pilot study showed that the efficacy of Althaea officinalis
1% ointment in a decrease of disease severity is more than Hydrocortisone
1% in children with AD. However, further studies are needed to confirm this finding.
Moreover, the docking analysis revealed that the inhibitory activity of compounds
with free hydroxyl groups such as glycosylated compounds was better than others,
probably due to the hydrogen bond interaction of hydroxyl groups of the ligands with
the enzymes.
Background: Heavy menstrual bleeding during menstruation or hypermenorrhea or menorrhagia, which is
called "Efrate Tams" in Traditional Iranian Medicine, is one of the most common causes of visiting health
centers by women. The present study aimed to provide nutritional guidelines recommended in the Traditional
Iranian Medicine for this complaint which their effects on bleeding regulatory pathways are also proven in
conventional medicine.
Methods: In first phase of this study, we conducted a review with a focus on the sources of Traditional Iranian
Medicine; in second phase, electronic databases of PubMed, Scopus, and Magiran were studied with the key
words of "Menorrhagia", "Hypermenorrhea", "Efrate Tams", "Heavy Menstrual Bleeding", "Nutrition", and
“Food supplements”. Similarities and differences of our search results were extracted and classified, and the
resulting data were analyzed.
Findings: From the perspective of Traditional Iranian Medicine, foods such as egg yolk, lentils, meat extracts,
pomegranate, quinceand, and Sumac are prescribed to reduce bleeding in patients with menorrhagia, and new
studies have demonstrated anti-inflammatory, anti-oxidant, hematopoietic, and anti-fibrinolytic effects of some
of these foods.
Conclusion: Designing an appropriate diet for women with menorrhagia, along with common treatments, may
help promoting health states of these patients.
Objectives
Menorrhagia can be defined as heavy uterine bleeding which comes at regular intervals or uterine bleeding extending more than seven days during menses which has become a considerable problem for females, causing discomfort, anxiety, and poor quality of life. In this study we aimed to compare the effect of Myrtus communis fruits with tranexamic acid in the treatment of menorrhagia.
Methods
In this prospective patient blinded standard controlled study, 40 patients of menorrhagia were randomly assigned to receive either test drug (powdered M. communis fruits) or active control drug (tranexamic acid) for first five days of menstrual cycle consecutively for two cycles. The primary outcome measure was reduction in heavy flow during menses determined by pictorial blood loss assessment chart (PBAC), while improvements in quality of life (QOL) by using short form-36 questionnaire and increase in hemoglobin percentage were kept as secondary outcome measures.
Results
Both the groups were similar at baseline. Test and control drugs significantly reduced the PBAC score during treatment cycles with p-value <0.001 and these changes were not significantly different between the groups. During second treatment cycle significant difference was found in PBAC score (p = 0.024) between the groups. After treatment significant improvement in hemoglobin percentage was noted and marked improvement in overall quality of life was observed in both the groups.
Conclusion
These data suggest that M. communis fruits can be an effective alternate in reducing heavy menstrual bleeding. There is need to confirm these results by designing a trial on large number of patients.
Trial Registration No
CTRI/2017/09/009937 .
Myrtle (Myrtus communis L.) is a typical plant of the coasts of Mediterranean area, which grows spontaneously as a shrub or a small tree. Myrtle berries, leaves, seeds, and essential oils are natural sources of several nutrients and bioactive compounds with marked health effects. In the ancient medicine, it has been indeed used for treating several common diseases, including gastrointestinal, urinary, and skin disorders, whereas currently it is widely employed in food, cosmetic, and pharmaceutical industries. This review aims to describe the nutritional and the phytochemical compositions of different parts of myrtle plant, as well as their antioxidant activities. In addition, several in vitro, in vivo, and ex vivo studies are also presented to give a general overview of the potential effects of myrtle on human health. Finally, a critical analysis of the limitations related to the current research on myrtle is given.
Herbal combination of Itrifal Saghir (triphala) has been widely used in traditional medicine. And brings health benefits such as antioxidant effect and scavenger of hydroxyl radicals and nitric oxide radicals activity and substantiated in traditional medicine a anti-obesity.
In this study we aimed to assess the efficacy of this herbal medicinal on reduction of weight and body mass index (BMI) of simple obese subjects in comparison with placebo. Obese subjects aged between 16 and 60 years were selected for 12-week, double-blind, randomized, placebo-controlled trial using a parallel design. Subjects were randomly assigned to take 5 grams of either the Itrifal Saghir (n = 31) or placebo (n = 31), 2 times daily for 12 weeks. Measures of body weight, BMI, waist circumference (WC), hip circumference (HC), were assessed at baseline and once every four weeks during the 12 week treatment period. The safety was evaluated by means of measuring the liver and kidney function. Homeostasis model of insulin resistance (HOMA-IR) was calculated as [fasting insulin (μU/mL) × fasting glucose (mmol/L)/22.5].
Compared to placebo group, in treatment group the mean difference of effective weight loss was 4.82Kg (CI95% 3.52 - 6.11, ρ < 0.001), the mean of decrease in waist circumference was 4.01 cm (CI 95% 2.13 - 5.90, ρ < 0.001), and the mean decrease in hip circumference was 3. 21 cm (CI 95% 1.96 - 4.45, ρ < 0.001) in treated subjects. No adverse effects or significant changes in liver and kidney function tests were observed in both placebo and treated groups.
Itrifal Saghir appears to produce a positive effect on weight loss in obese subjects.
Amenorrhea is defined as the cessation of menses. Hormone therapy is the most common treatment. Due to the contraindications and side effects of it and the increasing demand for alternative medicine substitutes, Mentha longifolia L. was used in this study. Mentha longifolia L. is a known medication in Iranian traditional medicine to induce menstrual bleeding in women with secondary amenorrhea and oligomenorrhea.
A double-blind, randomized, placebo-controlled, multicenter study was conducted in 120 women with secondary amenorrhea and oligomenorrhea. Treatment consisted of sequential oral syrup, 45 ml (15 ml three times a day) for 2 weeks. If the patients did not have menstruation after 2 weeks of taking the medication, we would wait for two more weeks. If the patients had menstruation at each stage of using the drug, we started it one week after the end of menstruation. But if the patients had not menstruate after four weeks (two-week using of drug and waiting for two more weeks), the previous steps were repeated. The drug and placebo were repeated in three cycles of menstruation. Bleeding was documented by the patient on diary cards. The primary outcome variable was the occurrence (yes/no) of bleeding during the first treatment cycle. The secondary efficacy outcome was the regularity of bleeding pattern during the three cycles of the study.
The number of women with bleeding during the first cycle were higher in the drug group as in the placebo group (68.3% vs. 13.6%; p < 0.001). The regularity of bleeding throughout the study was markedly better in the drug group compared with those given placebo (33.3% vs. 3.3%; p < 0.001). No notable complication or side effect was reported in relation to Mentha longifolia L. syrup.
In conclusion, Mentha longifolia L. syrup is a safe, well-tolerated, and effective choice in inducing bleeding and maintaining regular bleeding in women with secondary amenorrhea and oligomenorrhea.
Tranexamic acid has proven to be an effective treatment for heavy menstrual bleeding (HMB). It reduces menstrual blood loss (MBL) by 26%-60% and is significantly more effective than placebo, nonsteroidal anti-inflammatory drugs, oral cyclical luteal phase progestins, or oral etamsylate, while the levonorgestrel-releasing intrauterine system reduces MBL more than tranexamic acid. Other treatments used for HMB are oral contraceptives, danazol, and surgical interventions (endometrial ablation and hysterectomy). Medical therapy is usually considered a first-line treatment for idiopathic HMB. Tranexamic acid significantly improves the quality of life of women treated for HMB. The recommended oral dosage is 3.9-4 g/day for 4-5 days starting from the first day of the menstrual cycle. Adverse effects are few and mainly mild. No evidence exists of an increase in the incidence of thrombotic events associated with its use. An active thromboembolic disease is a contraindication. In the US, a history of thrombosis or thromboembolism, or an intrinsic risk for thrombosis or thromboembolism are considered contraindications as well. This review focuses on the efficacy and safety of tranexamic acid in the treatment of idiopathic HMB. We searched for medical literature published in English on tranexamic acid from Ovid Medline, PubMed, and Cinahl. Additional references were identified from the reference lists of articles. Ovid Medline, PubMed, and Cinahl search terms were "tranexamic acid" and "menorrhagia" or "heavy menstrual bleeding." Searches were last updated on March 25, 2012. Studies with women receiving tranexamic acid for HMB were included; randomized controlled studies with a description of appropriate statistical methodology were preferred. Relevant data on the physiology of menstruation and the pharmacodynamics and pharmacokinetics of tranexamic acid are also included.
AimTo evaluate the efficacy and safety of Safoof Habis in Kasrate Tams (menorrhagia) with validated menstrual pictogram.Materials and methodsA single blind, randomized, standard controlled trial was conducted in the gynaecological outpatient of National Institute of Unani Medicine Hospital. Clinically diagnosed patients (n = 52) were randomized to the test (n = 35) and control (n = 17) groups. In the test group, Safoof Habis (Ingredient are Silicate of alumina and Iron oxide, Hydrated magnesium silicate and Vateria indica L.) 5 g twice daily and in the control group, tranexamic acid 500 mg, thrice daily were administered from day 1 to day 5 of menstrual cycle and Qurs Kushta Faulad, one tablet twice daily was administered in both the groups for three consecutive months. The primary outcome measure was to assess the efficacy and safety of this Unani formulation in menorrhagia with menstrual pictogram. The secondary outcome measures were to assess the effectiveness of test drug formulation on dysmenorrhea and hemoglobin concentration. The results were analyzed by Student's ‘t’ test and Fisher exact test.ResultsThe groups were homogenous in the terms of age, parity, socioeconomic status, marital status and biochemical parameters (P > 0.05). Post treatment when compared to baseline in same group showed significant reduction in menstrual blood loss in both the groups (P < 0.001). The comparison between test and control group showed that both groups were equally effective (P = 0.265). There was improvement in hemoglobin concentration in the test group (P = 0.04) and dysmenorrhea was reduced in both groups (P < 0.001).Conclusion
Safoof Habis was found to be effective in reducing menstrual blood loss in menorrhagia.
Myrtle (Myrtus communis L.) berries extracts were prepared with solvents at different polarity (water,
ethanol, and ethyl acetate) and analysed using different in vitro tests in order to evaluate their antioxidant
properties. Antiradical and total antioxidant activities were measured with DPPH and FRAP tests, respectively. Their ability to protect biological molecules was assessed using the cholesterol and LDL oxidation assays. In addition, phenolic compounds and unsaturated fatty acids composition was analysed by HPLC–DAD and HPLC–MS/MS. Ethanol and water extracts showed the highest amount of extracted compounds, but the highest antiradical and antioxidant activities were found in ethanol and ethyl acetate extracts. These extracts were also the ones with the highest content of phenolic compounds. In addition, our
results showed a highly significant correlation between the amount of total phenols and antiradical
(R2 = 0.9993) or antioxidant activities (R2 = 0.9985) in these extracts. HPLC–DAD and HPLC–MS analyses
showed significant quantitative and qualitative differences among these three extracts. The ethyl acetate
extract had the highest protective effect in assays of thermal (140 �C) cholesterol degradation and Cu2+-
mediated LDL oxidation, inhibiting the reduction of polyunsaturated fatty acids and cholesterol, and the
increase of their oxidative products. These results suggest that because of these properties, myrtle berries
could be used in dietary supplements preparations or as food additives.
Women today may reasonably anticipate in the order of some 400 menstrual cycles over their reproductive lifespan. The endometrium is thus subject to repeat cycles of shedding and repair and notably healing of the endometrium post menses is "scarless". The local molecular and cellular mechanisms involved in post menstrual resolution of the inflammatory events associated with menstruation and endometrial repair remain to be fully determined. Menstrual complaints are common. It is highly likely that unrestrained local inflammatory events and/ or deficient repair processes within the endometrium contribute to the women's experience of heavy menstrual bleeding (HMB). The management of women with HMB may need to utilize therapeutic approaches that optimize endometrial repair processes, post menses. These approaches may be necessary in addition to current therapies that hitherto have focused on limiting the local inflammation associated with menstruation. Research endeavors thus need to focus upon the molecular and cellular causes of problematic uterine bleeding. Herein the events associated with pre-menstrual progesterone withdrawal, limitation of blood loss, the expression of vasoactive mediators and factors that may modulate vascular morphology are described. Such lines of enquiry and knowledge will be essential if novel targets for treatment of menstrual bleeding complaints, such as HMB, are to be identified.
To estimate the efficacy of a fixed estrogen step-down and progestin step-up 28-day estradiol (E2) valerate and dienogest oral contraceptive regimen in women with heavy menstrual bleeding, prolonged menstrual bleeding, or heavy and prolonged menstrual bleeding without organic pathology.
This double-blind, placebo-controlled study randomized women aged 18 years or older with prolonged, frequent, or heavy menstrual bleeding, objectively confirmed during a 90-day run-in phase, to treatment with E2 valerate and dienogest or placebo (2:1) for 196 days. Data from the last 90 days of treatment and the run-in phase were compared. The primary variable was the "complete response" rate (complete resolution of qualifying abnormal menstrual symptoms, including a 50% or greater reduction in pretreatment menstrual blood loss volume in women with heavy menstrual bleeding). Secondary variables included objective changes in menstrual blood loss volume (alkaline hematin methodology) and iron metabolism parameters. Overall, 180 women were needed to provide 90% power.
There were no marked differences in the characteristics of E2 valerate and dienogest (n=120) and placebo (n=70) recipients. The proportion of "complete responders" in the evaluable group was significantly higher in E2 valerate and dienogest (35/80; 43.8%) compared with placebo (2/48, 4.2%, P<.001) recipients. The mean [standard deviation] reduction in menstrual blood loss with E2 valerate and dienogest from the run-in phase to the efficacy phase was substantial (-353 mL [309 mL]; mean -64.2%; median -70.6%) and significantly greater than that in placebo recipients (-130 mL [338 mL]; mean -7.8%; median -18.7%; P<.001). Significant improvements in hemoglobin, hematocrit, and ferritin were seen with E2 valerate and dienogest, but not with placebo.
Oral E2 valerate and dienogest was highly effective compared with placebo in the treatment of women with heavy menstrual bleeding, prolonged menstrual bleeding, or heavy and prolonged menstrual bleeding without organic pathology.
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00293059.
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