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Abstract

Dysmenorrhea is called "primary" when there is no specific abnormality and "secondary" when the pain is caused by an underlying gynecological problem. It is believed that primary dysmenorrhea occurs when hormone-like substances called "prostaglandins" produced by uterine tissue trigger strong muscle contractions in the uterus during menstruation. However, the level of prostaglandins does not seem to have anything to do with how strong a woman's cramps are. Some women have high levels of prostaglandins and no cramps, whereas other women with low levels have severe cramps. This is why experts assume that cramps must also be related to other things (such as genetics, stress, and different body types) in addition to prostaglandins. Secondary dysmenorrhea may be caused by endometriosis, fibroid tumors, or an infection in the pelvis. In this article we focus on herbal medicine in the treatment of primary dysmenorrheal.
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Volume 14, No. 53, Winter 2015
Journal of Medicinal Plants
Herbal Medicine in the Treatment of Primary Dysmenorrhea
Kashani L (M.D.)1, Mohammadi M (M.D.)1, Heidari M (M.D.)2, Akhondzadeh S (Ph.D.)3*
1- Infertility ward, Arash Hospital, Tehran University of Medical Sciences, Tehran,
Iran
2- Iranian Academic Center for Education, Culture & Research (ACECR), Tehran,
Iran
3- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical
Sciences, Tehran, Iran
* Corresponding author: Psychiatric Research Center, Roozbeh Hospital, South
Kargar Street, Tehran 13337, Iran
Tel: +98-21-88281866, Fax: +98-21-55419113
Email: s.akhond@neda.net
Received: 21 Jan. 2015 Accepted: 17 March 2015
Abstract
Dysmenorrhea is called "primary" when there is no specific abnormality and "secondary" when
the pain is caused by an underlying gynecological problem. It is believed that primary
dysmenorrhea occurs when hormone-like substances called "prostaglandins" produced by
uterine tissue trigger strong muscle contractions in the uterus during menstruation. However, the
level of prostaglandins does not seem to have anything to do with how strong a woman's cramps
are. Some women have high levels of prostaglandins and no cramps, whereas other women with
low levels have severe cramps. This is why experts assume that cramps must also be related to
other things (such as genetics, stress, and different body types) in addition to prostaglandins.
Secondary dysmenorrhea may be caused by endometriosis, fibroid tumors, or an infection in the
pelvis. In this article we focus on herbal medicine in the treatment of primary dysmenorrheal.
Keywords: Herbal Medicine, NSAIDs, Primary dysmenorrhea
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www.SID.ir
Archive of SID
Journal of Medicinal Plants, Volume 14,
No. 53, Winter 2015
Herbal Medicine in …
Introduction
Dysmenorrhea refers to the symptom of
painful menstruation. It can be divided into 2
broad categories: primary (occurring in the
absence of pelvic pathology) and secondary
(resulting from identifiable organic diseases)
[1]. Primary dysmenorrhea is common
menstrual cramps that are recurrent (come
back) and are not due to other diseases. Pain
usually begins 1 or 2 days before, or when
menstrual bleeding starts, and is felt in the
lower abdomen, back, or thighs. Pain can
range from mild to severe, can typically last 12
to 72 hours, and can be accompanied by
nausea, vomiting, fatigue, and even diarrhea
[2-4]. Common menstrual cramps usually
become less painful as a woman ages and may
stop entirely if the woman has a baby.
Secondary dysmenorrhea is pain that is caused
by a disorder in the woman's reproductive
organs, such as endometriosis, adenomyosis,
uterine fibroids, or infection. Pain from
secondary dysmenorrhea usually begins earlier
in the menstrual cycle and lasts longer than
common menstrual cramps. The pain is not
typically accompanied by nausea, vomiting,
fatigue, or diarrhea. Some of the risk factors
for primary dysmenorrhea include an early
onset of menstrual periods (before the age of
12), heavy or prolonged menstrual flow, a
prior family history of dysmenorrhea, obesity,
or a history of smoking [5, 6]. The risk factors
for secondary dysmenorrhea include the
presence of fibroid tumors, pelvic
inflammatory disease, tubo-ovarian abscesses,
endometriosis, IUD, or ovarian torsion.
Primary dysmenorrhea can affect up to 50
percent of all women who have menstrual
periods, and up to 15% of these women will
have a level of pain that interferes with their
daily lives. Typically, dysmenorrhea begins
during adolescence, although occasionally it
can begin later in a woman's life. The
prevalence of dysmenorrhea is estimated to be
up to 90% in adolescents, and, in fact, is the
most common reason for school absence.
Dysmenorrhea can be crippling, both
physically and psychologically [5, 6].
Several drugs can lessen or completely
eliminate the pain of primary dysmenorrhea.
The most popular choice is the nonsteroidal
anti-inflammatory drugs (NSAIDs), which
prevent or decrease the formation of
prostaglandins. These include aspirin,
ibuprofen, and naproxen. These drugs are
usually begun at the first sign of the period and
taken for a day or two. There are many
different types of NSAIDs, and women may
find that one works better for them than the
others [6-9].
If an NSAID is not available,
acetaminophen may also help ease the pain.
Heat applied to the painful area may bring
relief, and a warm bath twice a day also may
help. While birth control medications will ease
the pain of dysmenorrhea because they lead to
lower hormone levels, they are not usually
prescribed just for pain management unless the
woman also wants to use them as a birth
control method. This is because these
medications may carry other more significant
side effects and risks [6-9].
Dietary recommendations to ease cramps
include increasing fiber, calcium, and complex
carbohydrates, cutting fat, red meat, dairy
products, caffeine, salt, and sugar. Smoking
also has been found to worsen cramps. Recent
research suggests that vitamin B supplements,
primarily vitamin B6 in a complex,
magnesium, and fish oil supplements (omega-
3 fatty acids) also may help relieve cramps.
Other women find relief through visualization,
concentrating on the pain as a particular color
and gaining control of the sensations.
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Kashani et al.
Aromatherapy and massage may ease pain for
some women. Others find that imagining a
white light hovering over the painful area can
actually lessen the pain for brief periods [6-9].
Herbal medicine has an important role in
women health [10-14]. There are a number of
herbal remedies for treatment of depression
and PMS in women and the most famous one
is saffron. In addition, there are a number of
herbal remedies for treatment of primary
dysmenorrheal [15-21].
Ginger (Zingiber officinale Rosc.): Ginger
has been traditionally used to treat ailments
such as arthritis, colic, diarrhea, and heart
conditions. Ginger can be consumed by
boiling it in water and drinking the water at
least 3 times a day to get relief from
dysmenorrhea. Research and clinical trials
conducted by Ozgoli et al, from Iran, show
that ginger has the same effect on killing pain
as mefenamic acid or ibuprofen, so it can be
used as one of the home remedies for
dysmenorrheal [22].
Parsley (Pteroselenium hortense Hoffm.):
Parsley has menstrual cycle-regulating
properties and pain relieving properties.
Parsley can be consumed as a juice mixed with
various vegetables such as carrots, beetroots,
cucumbers, and tomatoes for good results [23].
Mint (Mentha longifolia L.): Mint has
been used to treat many ailments, including
stomach disorders, indigestion, nausea, and
vomiting. Consumption of mint tea helps in
alleviating the associated pain of
dysmenorrheal [24].
Coriander (Coriandrum sativum L.): The
use of coriander has been traditionally
mentioned by Ayurvedic practices in India as a
remedy for dysmenorrhea. It can be consumed
by boiling a few stems of fresh coriander in
water. This is known to reduce dysmenorrheal
[24].
Cinnamon (Cinnamum camphora (L.)
Nees & Eberm.): Cinnamon is one of the
oldest spicies known to man. This spice also
has medicinal properties which include pain
relieving during menstrual cramps, apart from
other remedies such as the reduction of LDL
cholesterol, blood sugar levels, heart disease,
and cancer fighting properties [22].
Cramp Bark & Black Haw (Viburnum
opulus L. and Viburnum pranifolium L.):
These are probably the most effective herbs
for reducing uterine spasm and cramping.
These sister herbs bring relief of pain and
muscle spasm in the uterus. Cramp bark and
Black haw have been shown safe for use for
several days prior to onset on menses in
anticipation and prevention of painful cramps.
I can attest to these plants wonderful pain
relieving action. I personally feel these herbs
are one of the best herbs to have on hand at all
times for any sort of menstrual pain, I prefer it
over NSAID’s. There is also no risk of liver
damage from this herb like there are with
NSAID use [8, 10].
Black Cohosh (Actea racemosa L.): This
plant is very anti-inflammatory and wonderful at
reducing spasm in both the smooth muscles, but
also the skeletal muscles associated with pain
that radiates to the lower back and down the
thighs [8, 10].
Chamomile (Matricaria chamomilla L.):
This sweet little flower is both anti-
inflammatory and antispasmodic. It is also
helpful for women with digestive constipation
contributing to pain. Because this herb is also
a nervine and mild sedative it may help to
reduce stress, relax the nervous system and
induce a restful state in the body. This can be
very useful when experiencing menstrual
cramping accompanied by anxiety and
irritability. Chamomile is best sipped as a tea
during menstruation [8, 10].
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References
1. Latthe PM, Champaneria R.
Dysmenorrhoea. BMJ Clinical Evidence.
2014; 2014. pii: 0813.
2. Chen CX, Kwekkeboom KL and Ward SE.
Self-report pain and symptom measures for
primary dysmenorrhoea: A critical review.
European Journal of Pain. 2015; 19 (3): 377 -
91.
3. Osayande AS and Mehulic S. Diagnosis and
initial management of dysmenorrhea.
American Journal of Family Physician 2014;
89 (5): 341 - 6.
4. Harada T. Dysmenorrhea and endometriosis
in young women. Yonago Acta Medica 2013;
56 (4): 81 - 4.
5. Ju H, Jones M and Mishra G. The
prevalence and risk factors of dysmenorrhea.
Epidemiological Review 2014; 36: 104 - 13.
6. Sultan C, Gaspari L and Paris F. Adolescent
dysmenorrhea. Endocrine Development. 2012;
22: 171 - 80.
7. Lethaby A, Duckitt Ka and Farquhar C.
Non-steroidal anti-inflammatory drugs for
heavy menstrual bleeding. Cochrane Database
Systematic Reviwew. 2013; 1: CD000400.
8. Yu A. Complementary and alternative
treatments for primary dysmenorrhea in
adolescents. Nurse Practice 2014; 39 (11): 1 -
12.
9. Altshuler AL and Hillard PJ. Menstrual
suppression for adolescents. Current Opinion
in Obstetrics and Gynecol. 2014; 26 (5): 323 -
31.
10. Park KS, Park KI, Hwang DS, Lee JM,
Jang JB and Lee CH. A review of in vitro and
in vivo studies on the efficacy of herbal
medicines for primary dysmenorrhea.
Evidence Based Complementary and
Alternative Medicine 2014; 2014: 296860.
11. Akhondzadeh S, Ahmadi-Abhari SA,
Assadi SM, Shabestari OL, Kashani AR and
Farzanehgan ZM. Double-blind randomized
controlled trial of baclofen vs. clonidine in the
treatment of opiates withdrawal. Journal of
Clinical Pharmacy and Therapeutics 2000; 25
(5): 347 - 53.
12. Akhondzadeh S, Malek-Hosseini M,
Ghoreishi A, Raznahan M and Rezazadeh SA.
Effect of ritanserin, a 5HT2A/2C antagonist,
on negative symptoms of schizophrenia: a
double-blind randomized placebo-controlled
study. Progress in Neuropsychopharmacology
and Biological Psychiatry 2008; 32 (8): 1879 -
83.
13. Akhondzadeh S. The 5-HT hypothesis of
schizophrenia. IDrugs. 2001; 4 (3): 295 - 300.
14. Rezaei V, Mohammadi MR, Ghanizadeh
A, Sahraian A, Tabrizi M, Rezazadeh SA and
Akhondzadeh S. Double-blind, placebo-
controlled trial of risperidone plus topiramate
in children with autistic disorder. Progress in
Neuropsychopharmacology and Biological
Psychiatry 34 (7): 1269 - 72.
15. Agha-Hosseini M, Kashani L, Aleyaseen
A, Ghoreishi A, Rahmanpour H, Zarrinara AR
and Akhondzadeh S. Crocus sativus L.
(saffron) in the treatment of premenstrual
syndrome: a double-blind, randomised and
placebo controlled trial. BJOG. 2008; 115 (4):
515 - 9.
16. Noorbala AA, Akhondzadeh S, Tamacebi-
pour N and Jamshidi AH. Hydro-alcoholic
extract of Crocus sativus L. versus fluoxetine
in the treatment of mild to moderate
4
www.SID.ir
Archive of SID
Kashani et al.
depression: A double-blind, randomized pilot
trial. Ethnopharmacol. 2005; 97: 281 - 4.
17. Akhondzadeh S, Fallah Pour H, Afkham K,
Jamshidi AH and Khalighi-Cigarodi F.
Comparison of Crocus sativus L. and
imipramine in the treatment of mild to
moderate depression: a pilot double-blind
randomized trial [ISRCTN45683816]. BMC
Complementary and Alternative Medicine
2004; 4: 12.
18. Akhondzadeh S, Tamacebi-pour N,
Noorbala AA, Amini H, Fallah Pour H,
Jamshidi AH and Khani M. Crocus sativus L.
in the treatment of mild to moderate
depression: A double-blind, randomized and
placebo controlled trial. Phytotherapy
Research 2005; 19: 25 - 9.
19. Akhondzadeh Basti A, Moshiri E,
Noorbala AA, Jamshidi AH, Abbasi SH and
Akhondzadeh S. Comparison of petal of
Crocus sativus L. and fluoxetine in the
treatment of depressed outpatients: a pilot
double-blind randomized trial. Progress in
Neuropsychopharmacology and Biological
Psychiatry 2007; 31: 439 - 42.
20. Modabbernia A, Sohrabi H, Nasehi AA,
Raisi F, Saroukhani S, Jamshidi A, Tabrizi M,
Ashrafi M and Akhondzadeh S. Effect of
saffron on fluoxetine-induced sexual
impairment in men: randomized double-blind
placebo controlled trial. Psychopharmacology
2012; 223 (4): 381 - 8.
21. Kashani L, Raisi F, Saroukhani S, Sohrabi
H, Modabbernia A, Nasehi AA, Jamshidi A,
Ashrafi M, Mansouri P, Ghaeli P and
Akhondzadeh S. Saffron for treatment of
fluoxetine-induced sexual dysfunction in
women: randomized double-blind placebo-
controlled study. Human Psychopharmacol.
2013; 28 (1): 54 - 60.
22. Ozgoli G, Goli M and Moattar F.
Comparison of effects of ginger, mefenamic
acid, and ibuprofen on pain in women with
primary dysmenorrhea. Journal of Alternative
and Complementary Medicine 2009; 15 (2):
129 - 32.
23. Mirabi P, Alamolhoda SH, Esmaeilzadeh S
and Mojab F. Effect of medicinal herbs on
primary dysmenorrhoea- a systematic review.
Iranian Journal of Pharmaceutical Research
2014; 13 (3): 757 - 67.
24. Flores KE and Quinlan MB.
Ethnomedicine of menstruation in rural
Dominica, West Indies. Journal of
Ethnopharmacol. 2014; 153 (3): 624 - 34.
5
... Dietary recommendation to get relief from dysmenorrhea include food rich in calcium, fiber, complex carbohydrate, red meat, dairy product, salt, sugar, caffeine, vitamin B supplement, fish oil supplement etc [5] . Natural antioxidants namely Vitamin B, vitamin C, B carotenoids are found to be useful in reducing pain of dysmenorrhea [6] . This ethnobotanical study report discloses that among 25 total species found, 10 species of plants were belong to herb & 3 species were belong to shrub & 6 plant species were belong to both climber & tree. ...
Experiment Findings
The present study report is an approach to enshrine the rich ancestral bio cultural knowledge of Ahom (Sivasagar district) & Matak community (Dibrugarh district) of Assam (India) to treat dysmenorrhea. This study report encompasses total 17 types of medicines prepared from 25 plant species belonging to 18 families. It also clearly exhibits the procedure of preparation of medicine along with the prescribed doses. The plant parts used for the purpose are bark, stem, root, shoot apex, leaf, seed, Fruit, whole plant. On accordance with the distribution of habits, the no. of herbs, shrubs, tree, Climber are found to be 10,3,6,6 respectively.
... During menstruation use chamomile as a tea, it may reduce the menstruation pain and cramps. Chamomile tea also help to reduce inflammation and digestive problems like, constipation [36]. Primary and secondary dysmenorrhea is the types of dysmenorrhea. ...
... Although the etiology of primary dysmenorrhea is not well known, an increase in uterine thickness and severe uterine contractions caused by excessive secretion of uterine prostaglandins (PGs) especially (PGE2, PGF2 α), is considered as the postulated etiology of PDM [7,8]. Furthermore, unhealthy lifestyle (smoking, stressfulness), family history, genetics and different body types may also intensify the symptoms [9,10]. ...
Article
Primary dysmenorrhea (PDM) is one of the common complaints in women. This study aimed to assess the effects of turmeric and mefenamic acid and a combination compared with placebo on PDM. This clinical trial was conducted on dormitory students with PDM. Subjects completed the visual analog scale (VAS) before randomization. One hundred twenty-eight patients, randomly assigned to one of following groups: Turmeric group (n = 32), mefenamic acid group (n = 32), turmeric and mefenamic acid group (n = 32), and placebo group (n = 32). Turmeric and mefenamic acid were administrated in 500 mg and 250 mg, respectively. Pain severity was assessed in the baseline and the end line by VAS. Statistical analysis was performed using SPSS software. The combination of turmeric and mefenamic acid, dramatically, alleviated pain in comparison to other groups. Our results illustrated that combination of turmeric and mefenamic acid would be better in pain alleviation in PDM.
... Many herbal plants have got significant activity in PCOS with fewer side effects (Bency Baby, et al. 2017). The aim of herbal treatment is to enable the body to readjust the excess levels of hormones to normal levels and loss weight, so that the menstrual cycle can occur in a normal manner (Kashani, Mohammadi, Heidari, Akhondzadeh, 2015). There are some herbs that are very helpful in treating PCOS, such as Green tea, jeera powder (cumin seed powder), black seed oil, Chia Seeds, Anise, Fenugreek Seeds, Fennel seeds, Cinnamon powder, Flax seed, Evening Primrose Oil, Curcuma turmeric etc., have been highly esteemed sources which have the advantages to reduce PCOS and also having hypoglycaemic and anti-obesity effect (Chitra, Dhivya, Derera, 2017). ...
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Polycystic ovary syndrome (PCOS) is a common, complex reproductive problem that affects women in reproductive age. It is characterized by menstrual irregularities, hyperandrogenism and polycystic ovaries. Lifestyle modification is a first-line intervention. Women often seek adjunct therapies including herbal remedies. So, the aim of this study was to compare the effectiveness of lifestyle modification plus herbal remedies, with lifestyle modification alone on minimizing PCOS symptoms and weight loss. One hundred twenty women with PCOS were recruited for the study (60 each group) from outpatient gynecological clinic at Al Kasr Alani hospital, workplaces, and colleges, Cairo, Egypt, utilizing quasi-experimental design. After 6 months interventions, women in the herbal group reported a reduction in oligomenorrhoea (30%) compared to (48.3%) in lifestyle alone group (p < 0.04) and regulation of menstruation (61.7%) compared to (41.7%) (p<0.02). Other significant improvements were found for body mass index (p< 0.01); waist circumference (p < 0.002); W/H circumference (p < 0.015); acne score (p <0.003); and Hirsutism score (p <0.01). This study provides evidence of effectiveness and safety of the combined herbal remedies and lifestyle modification on overweight and obese women with PCOS.
... Cinnamomum zeylanicum is one of the oldest spices known to man [45]. It contains mucilage, tannin, a pigment, calcium oxalate, sugar, essential oil and resin. ...
... The postulated etiology of PD is related to the combination of different factors, including increase of synthesis and secretion of prostaglandin F2α, raised vasopressin and oxytocin that subsequently enhance the secretion of prostaglandin and stimulation of the type C pain fibers [6]. Also, PD must also be related to genetics, stress, and different body types [7]. The first line treatment of PD is the use of NSAIDs that unfortunately has contraindication, side effects, and 20-25% failure to treatment [8,9]. ...
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Primary dysmenorrhea (PD) is defined as painful menstrual in the absence of any pelvic pathology. Nowadays, the first line treatment is the use of NSAIDs that unfortunately has contraindication and side effects. Persian Medicine has noted menstrual pain with the defined treatments by use of herbs and herbal formulations. The aim of this study is to introduce the medicinal plants used to treat menstrual and uterine pains (M & UP) in Persian Medicine for evaluating in field of PD. For this purpose, first the medicinal plants used to treat M & UP were listed using prominent Persian Medicine references. In the next step, data were collected in relation to treat PD by searching in ‘Google Scholar’, ‘Scopus’, ‘PubMed’ and ‘SID’ databases between 2000 and 2016. Finally, the plants from identified Persian Medicine list, whose effect on PD have been revealed in modern literatures were introduced. According to this review, more than 100 medicinal plants were recommended for the treatment of M & UP in Persian Medicine. They belong to 60 plant families, the most frequent of which are Asteraceae, Apiaceae, Fabaceae, Rosaceae and Lamiaceae, respectively. Also, only about 13% of the aforementioned medicinal plants have been evaluated for the treatment of PD. It seems that many plants have been introduced in Persian Medicine for the treatment of menstrual pain, which have not yet been evaluated for their therapeutic effects and precise mechanisms of action. Thus, the introduced plants could be suitable candidates for future investigations.
... One of the most important gynaecological disorders deserves attention. Dysmenorrhea is characterized by frequent muscle cramping during menstruation and lower abdominal pain but can spread to the lower back and thigh (Kashani et al., 2015). Dysmenorrhea may be primary, with no associated organic pathology, or secondary, with demonstrable pathology. ...
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Since time immemorial long before the beginning of human civilization, prehistoric men used plant parts traditionally to take care of various diseases and disorders. Primary Dysmenorrhea is a sort of painful menstrual disorder. By semi-structured questionnaires in the course of scheduled interviews with the local herbal practitioners (commonly known as Mahan, Ojha or Kabiraj), four herbal formulations (coded as DYS1, DYS2, DYS3 and DYS4) were recorded with their dosimetry and method of application. Several plants like Allium sativum L., Areca catechu L., Zingiber officinale Roscoe, Crinum amoenum Roxb. ex KerGawl., Cuscuta reflexa Roxb., Nymphaea pubescens Willd., Piper nigrum L., Citrus limon (L.) Osbeck are used in different ratio to make herbal formulation to cure primary dysmenorrheal pain by the traditional healers of the Rajbanshi community.
... Caffeine may also aggravate dysmenorrheal which may be primary or secondary. So, it is recommended to cut and limit the caffeine intake for relieving dysmenorrhea [13]. There is an increased risk of uterine fibroids if caffeine consumption is more than 7 cups a day [14]. ...
... Besides its antimicrobial, antioxidant, hepatoprotective, hypoglycemic, antinociceptive and anti-inflammatory activities (Altun et al., 2008(Altun et al., , 2010(Altun et al., , 2009Česonienė et al., 2014;Erdogan-Orhan et al., 2011;Eryılmaz et al., 2013;Rop et al., 2010;Yılmaz et al., 2008), V. opulus was reported to be one of the most effective and safe herbs used several days prior to onset on menses for the relief of pain and muscle spasm in the uterus (Kashani et al., 2015;Mayo, 1997). Active constituents of V. opulus were reported to be arbutin, valerianic acid, (+)-catechin and (−)-epicatechin, anthocyanins and quercetin glycosides (Kraujalytė et al., 2012;Mayo, 1997). ...
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Purpose. Primary dysmenorrhea (PD) is a common gynecological complaint among adolescent girls and women of reproductive age. This study aims to review the findings of published articles on the in vitro and in vivo efficacy of herbal medicines for PD. Methods. In vitro and in vivo studies of herbal compounds, individual herbal extracts, or herbal formula decoctions published from their inception to April 2014 were included in this review. Results. A total of 18 studies involving herbal medicines exhibited their inhibitory effect on PD. The majority of in vitro studies investigated the inhibition of uterine contractions. In vivo studies suggest that herbal medicines exert a peripheral analgesic effect and a possible anti-inflammatory activity via the inhibition of prostaglandin (PG) synthesis. The mechanisms of herbal medicines for PD are associated with PG level reduction, suppression of cyclooxygenase-2 expression, superoxide dismutase activation and malondialdehyde reduction, nitric oxide, inducible nitric oxide synthase, and nuclear factor-kappa B reduction, stimulation of somatostatin receptor, intracellular Ca(2+) reduction, and recovery of phospholipid metabolism. Conclusions. Herbal medicines are thought to be promising sources for the development of effective therapeutic agents for PD. Further investigations on the appropriate herbal formula and their constituents are recommended.
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