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Chinese Medicine, 2012, 3, 116-123
http://dx.doi.org/10.4236/cm.2012.33019 Published Online September 2012 (http://www.SciRP.org/journal/cm)
Mugwort (Artemisia vulgaris, Artemisia douglasiana,
Artemisia argyi) in the Treatment of Menopause,
Premenstrual Syndrome, Dysmenorrhea and Attention
Deficit Hyperactivity Disorder
James David Adams, Cecilia Garcia, Garima Garg
University of Southern California, School of Pharmacy, Los Angeles, USA
Email: jadams@pharmacy.usc.edu
Received June 19, 2012; revised July 16, 2012; accepted July 30, 2012
ABSTRACT
Mugwort has many traditional uses around the world. The Chumash Indians of California use it to treat imbalances that
women may suffer such as premenstrual syndrome, dysmenorrhea and menopausal symptoms. The plant contains a
sesquiterpene that appears to work through a serotonergic mechanism and may be beneficial for women. Mugwort
therapy is safer for menopausal women than hormone replacement therapy. Children affected by attention deficit hy-
peractivity disorder benefit from mugwort therapy. There is no doubt that mugwort therapy is safer for these children
than methylphenidate or amphetamine.
Keywords: Mugwort; Artemisia vulgaris; Artemisia argyi; Artemisia douglasiana; Menopause; Attention
Deficit Hyperactivity Disorder
1. Introduction
Mugwort is found in Europe (Artemisia vulgaris), Africa
(Artemisia vulgaris), India (Artemisia vulgaris), Asia
(Artemisia argyi) and America (Artemisia douglasiana).
This plant may have been transported throughout the
world by early humans who needed it for its medicinal
and food value. It can be easily transported as seeds. The
meaning of mugwort may be marsh root since it grows
near permanent sources of water. In Chinese, mugwort is
lou hao. In Chumash Indian, mugwort is molush. The
scientific name Artemisia comes from Artemis, Greek
Goddess of the hunt, wild animals, wilderness, childbirth
and virginity. Artemis is capable of bringing or relieving
disease in women.
The three species of mugwort differ somewhat in ap-
pearance, perhaps the result of growing in different habi-
tats for thousands of years. Mugwort is easy to grow
from seeds and likes shade. The perennial plants grow to
2.5 meters high and have variably lobed oblanceolate
leaves with 1 to 7 lobes. The leaves can be up to 15 cm
long, are green on top and white, tomentose on the un-
derside. The stem and roots are woody. The flowers grow
in panicles as small disciform heads, less than 5 mm in
diameter, contain 5 - 9 pistillate flowers and 6 - 25 disk
flowers.
2. European Traditional Uses
Mugwort, Artemisia vulgaris, is used in Europe as a bit-
ter aromatic and is rarely used [1]. It is intended to
stimulate gastric secretions in patients with poor appetite,
is used against flatulence, distention, colic, diarrhea, consti-
pation, cramps, worm infestations, hysteria, epilepsy, vom-
iting, menstrual problems, irregular periods, to promote
circulation and as a sedative. This sedative effect may be
responsible for internet reports of the use of A. vulgaris
to induce dreams. The root has different uses, as a tonic,
for psychoneuroses, neurasthenia, depression, autonomic
neuroses, irritability, restlessness, insomnia and anxiety.
A. vulgaris is described as an abortifacient without dis-
cussion of the preparation used [1].
The plant contains many active compounds including
the monoterpenes, eucalyptol, camphor, linalool, thujone,
4-terpineol, borneol, α-cadinol, spathulenol and 21 others
[1]. These monoterpenes are present in the essential oil
that makes up 0.03% - 0.3% of the plant. The plant also
contains sesquiterpenes and sesquiterpene lactones such
as eudesmane, vulgarin, psilostachyin and psilostachyin
C [1]. Flavonol glycosides are present including quercitin
3-O-glucoside, rutin and isorhamnetin 3-O-glucoside [1].
Coumarins are found such as aesculetin, aesculin, um-
belliferone, scopoletin, coumarin and 6-methoxy-7,8-
C
opyright © 2012 SciRes. CM
J. D. ADAMS ET AL. 117
methylene-dioxycoumarin [1]. Polyacetylenes, carote-
noids and pentacyclic triterpenes are present such as si-
tosterol and stigmasterol [1].
3. Pharmacology of Artemisia Plants
Many monoterpenoids are pain and anxiety relievers due
to inhibition of transient receptor potential cation chan-
nels [2]. These channels are found on sensory afferent
neurons of the skin and are usually responsive to heat or
cold. They are also found in the brain, spinal cord and
lungs [2]. The involvement of the brain transient receptor
potential channels in anxiety has not been investigated.
Most of these channels have six transmembrane spanning
units and large intracellular amino and carboxy terminal
portions [2]. Most of them allow sodium and calcium to
enter the cell. The vanilloid receptors (TRPV) have
amino terminal ankyrin repeat domains and a carboxy
terminal TRP box. The TRPA channels (ankyrin) have
many ankyrin repeats in the amino terminal. The TRPM
channels (melastatin) have a TRP box in the carboxy ter-
minal. Several drugs are available that act on these chan-
nels, such as capsaicin (TRPV1) and menthol (TRPM8).
More than a dozen drug candidates are in clinical trials
that act on these channels to relieve pain. Typically an
agonist at these channels causes transient channel open-
ing that is followed by long term channel closing and
pain relief [2].
Several monoterpenoids have reported pain relieving
activity such as camphor [3-5], eucalyptol [4-6, also
called 1,8-cineole], camphene [4,5], β-pinene [4-6], bor-
neol [4,5,7] and thujone [8]. Most of the pain relieving
monoterpenoids found in A. vulgaris are agonists for
TRPV3 (heat sensing) including camphor [3,9,10], bor-
neol, thujone and eucalyptol [10]. Camphor is also an
antagonist for the TRPA1 (TRP ankyrin-repeat1, cold-
sensitive) receptor and an agonist for the TRPV1 (heat-
sensitive) receptor [3]. Eucalyptol has been shown to also
be a TRPM8 (cold-sensitive) receptor agonist and to ex-
hibit an antinociceptive activity comparable to or greater
than that of morphine [11].
Some monoterpenoids have reported anti-inflamma-
tory properties such as camphene and β-pinene [12,13].
The monoterpene, borneol has been shown to have high
anti-inflammatory activity [14], which results from the
inhibition of nitric oxide (NO) and prostaglandin E2
(PGE2) production due to inhibition of NF-κB activation
(nuclear factor κB). The NF-κB mechanism involves
increasing the expression of IKK (inhibitor of NF-κB
kinase), iNOS (inducible nitric oxide synthase) and de-
creasing IκBα (inhibitor of NF-κBα) expression in
dose-dependent manners [13,14].
Some sesquiterpenoids are anti-inflammatory agents
[12]. In fact, a sesquiterpene from Artemisia pallens is
reported to have strong anti-inflammatory activity and is
topically active [15]. In other words, it penetrates the
skin after topical administration and relieves inflamma-
tion. The mechanism of anti-inflammatory action of a
sesquiterpene, 7-hydroxyfrullanolide, appears to be inhi-
bition of an NF-κB pathway [16]. IKKβ phosphorylation
was shown to be inhibited by 7-hydroxyfrullanolide,
which resulted in inhibition of NF-κB translocation into
the nucleus. Several sesquiterpenes inhibit the production
of inflammatory cytokines and adipokines. 7-Hydroxy-
frullanolide inhibits the production of inflammatory ad-
hesion proteins such as ICAM-1, VCAM-1 and E-se-
lectin [16]. This inhibits monocyte induced inflammation.
Patchouli alcohol, a tricyclic sequiterpene, inhibits tumor
necrosis factor-α, IL-1β (interleukin-1β), cyclooxyge-
nase-2, and iNOS production [17]. This results in less
NO and PGE2 production, less inflammation and less
edema. Parthenolide, a sesquiterpene lactone present in
several plants, inhibits inflammation in the brain and
other organs by decreasing IL-6, tumor necrosis factor-α
and cyclooxygenase-2 production [18]. This results in
lowered body temperature and occurs through an NF-κB
inhibition mechanism. NF-κB activation is inhibited,
especially in the hypothalamus. Alpha-bisabolol is an-
other anti-inflammatory sesquiterpene that is found in
several plants. Alpha-bisabolol has been shown to de-
crease iNOS and cyclooxygenase-2 production by inhib-
iting NF-κB activation [19]. A plant used by Native
Americans, Eupatorium perfoliatum, has been found to
be anti-inflammatory due to the presence of sesquiter-
penes [20]. A structure-activity study of 26 sesquiterpene
lactones was conducted to elucidate the structural re-
quirements for inhibition of iNOS production and found
potent inhibition down to micromolar levels [21]. This
clearly indicates that sesquiterpenes are very useful
anti-inflammatory and fever decreasing agents that have
been used for centuries in plant medicines around the
world.
Flavonols can be anti-inflammatory agents. For in-
stance, women who have higher intake of flavonol rich
foods, especially citrus fruits, have lower blood levels of
inflammatory proteins, including VCAM, C-reactive pro-
tein, soluble tumor necrosis factor receptor-2 and IL-18
[22]. Kaempferol, kaempferol
3-O-alpha-L-rhamnopyranosyl-(1-6)-beta-D-glucopyrano
side and quercetin 3-O-alpha-L-rhamnopyranosyl-(1-6)-
beta-D-glucopyranoside have been found to be anti-in-
flammatory agents and can be topically active in paw
edema tests [23]. These flavonols inhibit production of
iNOS [23]. Some flavonols, such as papyriflavonol A,
are phospholipase A2 inhibitors and potently inhibit the
enzyme with IC50 values of 4 micromolar [24]. Inhibi-
tion of phospholipase A2 decreases leukotriene C4 pro-
duction, decreases allergic reactions and results in less
Copyright © 2012 SciRes. CM
J. D. ADAMS ET AL.
118
inflammation [24]. A nasal spray made from Artemisia
abrotanum is anti-inflammatory, contains monoterpenes
and flavonols [25]. This spray was tested in a clinical
trial and found to relieve bronchoconstriction in 50% of
patients [25]. Allergic rhinitis was relieved by the nasal
spray in 100% of patients [25].
Coumarins are pharmacologically important agents
found in Artemisia plants. Umbelliferone, also called
7-hydroxycoumarin, is a pain relieving agent, relieves in-
flammation and relieves fever in animal tests [26]. It is
also topically active. Umbelliferone also inhibits inflam-
matory cytokine production, such as IL-12 and inter-
feron-gamma, produced by viral infections [27]. Um-
belliferone is antihyperglycemic in rats and has activity
comparable to glibenclamide [28]. It also decreases blood
levels of total cholesterol, triglycerides, phospholipids,
free fatty acids, LDL-C, VLDL-C and increases HDL-C
in diabetic rats [29]. Aesculetin, also called 6,7-dihy-
droxycoumarin, is a lipoxygenase inhibitor that inhibits
the proliferation of vascular smooth muscle cells in a
model of atherosclerosis [30]. Aesculetin inhibits the
activation of p42/44 mitogen activated protein kinase by
inhibiting c-fos and c-jun transcription [30]. Aesculetin
also inhibits activation of NF-κB, activator protein-1 and
phosphoinositide 3-kinase [30]. Coumarin, umbelliferone
and esculetin have antitumor activity [31,32] even in hu-
man clinical trials [32].
It may be important that Artemisia plants contain high
amounts of both monoterpenoids and sesquiterpenes.
Both classes of agents have anti-inflammatory activity
due to inhibition of NF-κB activation. It is not known
how monoterpenoids and sesquiterpenes may interact in
this mechanism, perhaps to enhance anti-inflammatory
activity and decrease fevers. This may involve decreas-
ing cyclooxygenase-2 synthesis. The presence of flavo-
nols may add to the anti-inflammatory effects of Ar-
temisia plants due to inhibition of iNOS production and
phospholipase A2 inhibition. Coumarins may increase
the anti-inflammatory activity of the plants by inhibition
of lipoxygenase. Artemisia plants may be potent pain
relieving and anti-inflammatory medicines due to these
compounds. Each class of compound may enhance the
activity of the other classes through additive or synergis-
tic mechanisms.
4. Traditional Recipes for the Use of
Mugwort in Europe and India
In Europe a tea is made from 150 ml of boiling water
poured over 1.2 g of dried A. vulgaris leaves, stems and
flowers [1]. This is allowed to steep in a covered vessel
for 5 min before it is strained and consumed. Two or
three cups of this strong tea are drunk daily before meals.
The German Commission E has not substantiated the
efficacy of this preparation.
In India, mugwort (Artemisia vulgaris, nagadamni in
Sanskrit) is used as an antispasmodic, expectorant, sto-
machic, tonic, laxative, antihysteric and anthelmintic [33].
It is used for menstrual problems, metorrhagia and to
prevent abortion. In children it is used as a decoction
against measles and as a leaf juice against whooping
cough. Leaf powder is used against hemorrhage, dysen-
tery, intestinal complaints, urinary tract problems and
skin diseases. A strong tea is made from 14 - 28 ml of
boiling water and 0.5 - 1 g of powdered leaves.
5. Chinese Traditional Uses
In China, mugwort (Artemisia argyi) is used mostly for
moxibustion [34,35]. Moxibustion is direct or indirect.
For direct moxibustion, a cone of dried A. argyi leaf pow-
der is placed on the skin and burned. The cone can be
taken off before the skin burns or can be allowed to burn
and scar the skin. Indirect moxibustion involves using a
cigar of A. argyi leaves to heat the skin. A. argyi is used
to stimulate blood flow and qi at specific points on the
skin, sometimes acupuncture points. This can be benefi-
cial in pain, weakness, fatigue associated with aging and
in turning fetuses for head down delivery. The dried
leaves are also used as a tea for analgesia, excessive men-
struation and bleeding during pregnancy.
A. argyi contains carveol, α-phellandrene, α-terpineol,
4-terpineol, eucalyptol, borneol, spathulenol, camphor, ca-
mazulene, β-caryophyllene, β-caryophyllene alcohol,
chrysartemin A, chrystemin B, arteminolides, and mox-
artenolide. Triterpenes include glutinone, fernenone, lu-
penone, simiarenol, α-amyrin acetate and β-amyrin ace-
tate. Flavones present are scopoletin, isoscopoletin, eu-
patilin, jaceosidin, apigenin, chrysoeriol and naringenin
[35]. Several of these compounds have antiasthmatic
effects including carveol, α-terpineol, 4-terpineol and
β-caryophyllene alcohol [35]. Several compounds are
analgesics including 4-terpineol, several of the monoter-
penes, α-amyrin and β-amyrin as discussed in the phar-
macology section [35]. Anxiolytic effects have been re-
ported for β-amyrin and several monoterpenes [35].
6. Chumash Indian Traditional Uses
Mugwort, Artemisia douglasiana, is a traditional medi-
cine of the Chumash Indians of California and is used in
the treatment of menopausal symptoms, premenstrual
syndrome and dysmenorrhea [36,37]. The traditional
treatment for menopause is a mild, A. douglasiana tea.
This tea is much milder than the European A. vulgaris tea
above. A. douglasiana tea is made by placing a fresh or
dried leaf in 300 ml of water. The mixture is warmed
until it starts to boil at which time it is removed from the
heat. The tea is allowed to steep for a few minutes prior
Copyright © 2012 SciRes. CM
J. D. ADAMS ET AL. 119
to drinking. Sugar, honey or other sweeteners are not
added.
Anxiety is a learned disorder that must be unlearned
[38]. It is treated, in part, with A. douglasiana. People
with anxiety attacks are treated once with sagebrush tea
in the evening. California sagebrush, Artemisia califor-
nica, leaves and stems are collected and put into a cloth
sack. The patient sleeps with this sack for one week.
During this time, meat must not be eaten. The sagebrush
leaves are measured in the palm of the hand. About a half
teaspoon of the dried leaves from the sack are mixed
with 300 ml of water and allowed to sit in the sun for 2
hours. This is heated with a stick of cinnamon (Cinna-
momum species) until it simmers. The patient drinks this
tea and does not add sugar or honey. Overweight people
should use a quarter of a teaspoon of sagebrush leaves,
since sagebrush can produce a strong reaction in them.
At the same time, four to six yerba santa leaves, Eriodic-
tyon crassifolium, seven flowers and seven leaves of
California jimson weed, Datura wrightii, and about ten
leaves of white sage, Salvia apiana, are put in 1.5 l of
water and allowed to boil moderately until the entire
house smells of the preparation. The patient drinks the
sagebrush tea while vaporizing over the E. crassifolium,
D. wrightii and S. apiana steam.
The next step, that evening, is a massage. The massage
oil is prepared by making a sun tea of four to six tobacco
leaves, Nicotiana quadrivalvis or Nicotiana glauca, and
four to seven leaves of S. apiana in 1.5 l of sea water.
This is brewed in the sun for a few hours, then put on the
stove to boil moderately until the entire house smells of
the preparation. Some of the tea is cooled, strained and
mixed with olive oil or baby oil to make a massage oil.
The massage should especially treat the areas under the
arms and below the butt.
For the next several weeks, the patient drinks 300 ml
of hot chocolate containing a S. apiana leaf and an A.
douglasiana leaf, every night before bed. It is best to use
a traditional chocolate such as Chocolate Ibarra that is
high in flavonols. Heat 300 ml of water to boiling. Re-
move it from the heat. Melt two or three tablespoons, 55
g, of the chocolate in the water with a whisk. Add the S.
apiana leaf and A. douglasiana leaf to this and steep for
a few minutes. Remove the leaves and drink the tea.
When the anxiety attacks decrease, the patient puts a
stick of cinnamon in 300 ml of water and heats it to a
simmer. The patient removes this from the heat and adds
a leaf of S. apiana. The tea is allowed to steep for five
min before drinking. This continues until the anxiety is
no longer a problem. One month or more of treatment is
needed to relieve anxiety attacks. Overweight people
may need to be treated longer than a month.
Attention deficit hyperactivity disorder is treated by
stuffing dried A. douglasiana leaves into a cloth 5 pointed
star. The star should be the size of the palm and fingers
of the adult making the star. The child should play with
the star daily, especially during times of excessive activ-
ity. The child should also sleep with the star. After a few
weeks, the child will respond and become less active.
A. douglasiana is also called dream sage (sagebrush)
by Chumash Healers [36]. To induce dreams, place the
stems and leaves, under a pillow and sleep on the pillow.
The fragrance helps with dreaming. When the plant dries,
strip the leaves and stuff them into a small pillow. Place
this under the regular pillow and continue sleeping on
both pillows. This is a traditional use of A. douglasiana
especially in very ill or aged people who cannot dream.
Dreaming is considered an essential part of life and
healing.
American A. douglasiana contains a variety of phar-
macologically active compounds including many ses-
quiterpene lactones such as vulgarin and psilostachyin
[39-50], and probably monoterpenoids such as thujone
and alpha-pinene [51]. Of course, the very lipophilic mo-
noterpenoids, such as thujone, will not extract into an
aqueous tea. However, the sesquiterpene lactones can be
extracted into hot water [52]. A sesquiterpene lactone
isolated from A. douglasiana, dehydroleucodine, inhibits
the release of serotonin from gastroduodenal and other
cells [39-41]. It is possible that A. douglasiana may have
a serotonergic mechanism of action in decreasing meno-
pausal symptoms and attention deficit hyperactivity dis-
order. On the other hand, if dehydroleucodine inhibits
NF-κB activation, like other sesquiterpenes, it may de-
crease body temperature and inflammation. This is dis-
cussed in the pharmacology section.
Many of the monoterpenes found in A. douglasiana
are pain relievers and anxiolytic [53-60]. Pain relief
comes from inhibition of transient receptor potential ca-
tion channels [53,57,58]. The mechanism of relief of
anxiety is not known but may involve brain transient
receptor potential cation channel inhibition. The monoter-
pene thujone, found in A. douglasiana, has been found to
be safe in European medicines and foods [61].
The biochemical imbalance that results in attention
deficit hyperactivity disorder is not known. The fact that
amphetamine like compounds are used to treat the disor-
der, suggests that inadequate neurotransmitter release
may be involved in the disorder. Amphetamine is known
to enhance the release of dopamine, norepinephrine and
serotonin in the brain and neuronal synapses. Recent
evidence suggests that aberrant kinase activity is in-
volved in attention deficit hyperactivity disorder. An
aberrant deactivation of striatal dopamine (D1) receptor
cAMP protein kinase A DARP32 may be important [62].
DARP32 is dopamine and cAMP regulated neuronal
phosphoprotein 32. G-Protein coupled receptor kinase
interacting protein-1 (GIT1) has also been implicated in
Copyright © 2012 SciRes. CM
J. D. ADAMS ET AL.
120
the disorder [63]. In addition, guanylyl cyclase-C may be
involved in attention deficit hyperactivity disorder [64].
Of course, guanylyl cyclase-C makes cGMP that acti-
vates several kinases. It is interesting that a recent meta
analysis suggests that several drugs that do not act
through an amphetamine like mechanism are effective in
the disorder [65]. These drugs include clonidine, desip-
ramine, guanfacine and atomoxetine. Clearly, the disor-
der is more complex and less well understood than some
reviews suggest.
A. douglasiana has been reported to induce abortion
[36]. It is not clear what preparation of A. douglasiana
was used or the mechanism of induction of abortion.
Estragole has been found in some species of Artemisia
(Artemisia dracunculus, tarragon). Estragole induces
cancer, especially in female mice. However, A. dracun-
culus is on the FDA list of GRAS agents and is not
known to induce cancer in humans. Mugwort (A. doug-
lasiana) has not been reported to contain estragole.
Desvenlafaxine has been found to effectively decrease
the incidence of hot flashes in menopausal women [66].
Desvenlafaxine is a serotonin and norepinephrine reup-
take inhibitor [67]. It is not known how this mechanism
relates to the relief of menopausal hot flashes. Desvenla-
faxine has adverse drug effects including increased sui-
cidality, serotonin syndrome, increased blood pressure,
and increased blood cholesterol [68]. Gabapentin also
appears to decrease the incidence of hot flashes [69] and
has an off label indication for hot flashes. Gabapentin
activates presynaptic GABAB heteroreceptors on gluta-
matergic neurons resulting in less release of glutamate
[70]. How this mechanism decreases hot flashes is not
known. Gabapentin has adverse drug effects including
seizures and sudden unexplained death [66]. A. doug-
lasiana is much safer therapy for menopausal symptoms
than these drugs.
Hormone replacement therapy was used until the about
10 years ago for menopausal symptoms when it was
found that hormone replacement therapy is hazardous to
women. The hazards may include increased heart attack,
stroke, breast cancer and Alzheimer’s disease [71-75]. A.
douglasiana is much safer than hormone replacement
therapy.
There are several medicines, such as antimalarials and
drugs used against AIDS, which induce vivid dreams and
nightmares. Dreaming is not considered essential to the
clinical uses of these drugs. A. douglasiana is a safe and
effective way to produce dreams, even in cancer chemo-
therapy patients. Patients find these dreams comforting.
Attention deficit hyperactivity disorder is normally
treated with amphetamine and methylphenidate. Both of
these drugs are addictive and can cause seizures. A.
douglasiana is much safer and should be the therapy of
choice in this condition.
The essential oil of mugwort (A. vulgaris) is available
from several sources. Some people have tried to use the
essential oil in place of mugwort leaves (A. douglasiana)
to make a tea. The essential oil of mugwort is made by
steam distillation of the leaves, flowers and stems of
mugwort. It contains only those compounds in mugwort
that vaporize below 100˚, especially the monoterpenoids
α-thujone, β-thujone, cineole, camphene and camphone.
Vendors of mugwort essential oil (armoise, A. vulgaris)
recommend using it for aromatherapy, massage therapy
and other external uses, not internally. The authors know
of people who have suffered seizures and kidney damage
from drinking A. douglasiana essential oil tea. Several
internet sites claim the essential oil causes abortions.
7. Conclusion
Mugwort is used similarly wherever it is found, espe-
cially for menstrual concerns, such as premenstrual syn-
drome and dysmenorrhea. Mugwort should be tested in
clinical trials for menopausal symptoms. Abortions or
protection against miscarriage are both uses of mugwort.
It is likely that high dose mugwort is used for abortions
and lower doses are used to prevent miscarriage. It is also
likely that other plants are added to mugwort in the in-
duction of abortions. Mugwort should be tested in clini-
cal trials for use in attention deficit, hyperactivity disor-
der. The sedative, antianxiety and dreaming effects of
mugwort should be tested in clinical trials. Medicine
frequently neglects dreaming as an essential part of heal-
ing.
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