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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.
Archive of SID
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,
2- Iranian Academic Center for Education, Culture & Research (ACECR), Tehran,
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
Received: 21 Jan. 2015 Accepted: 17 March 2015
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
Archive of SID
Journal of Medicinal Plants, Volume 14,
No. 53, Winter 2015
Herbal Medicine in …
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.
Archive of SID
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
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].
Archive of SID
Journal of Medicinal Plants, Volume 14,
No. 53, Winter 2015
Herbal Medicine in …
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... 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]. ...
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). ...
Full-text available
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]. ...
Full-text available
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. ...
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). ...
Ethnopharmacological relevance: Endometriosis is a gynecological disorder characterized by the presence of endometrial tissue outside the uterine cavity. The fruits of Viburnum opulus L. have been used to treat gynecological disorders including primary and secondary dysmenorrhea and ovarian cysts. Materials and methods: Air-dried and powdered fruits of V. opulus were extracted sequentially with n-hexane, ethyl acetate (EtOAc), and methanol (MeOH), respectively for four days. Endometriosis was induced by suturing 15mm piece of endometrium into abdominal wall of Sprague Dawley rats. In second laparotomy, the dimensions of endometrial implants were measured and intra-abdominal adhesions were scored. The abdomen was closed. Extracts were daily administered to the rats. At the end of the experiment, rats were sacrified and endometriotic foci areas and intra-abdominal adhesions were re-evaluated. The tissues were also histopathologically investigated. Furthermore, tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) levels of peritoneal fluid were measured. HPLC analyses were conducted on the most potent EtOAc and MeOH extracts to determine the amount of the major compound, chlorogenic acid. Results: The endometriotic volumes were found to be reduced significantly in the EtOAc extract-administered group to 30.1mm(3) and in the MeOH extract-administered group to 34.7mm(3) as compared to the control group. No adhesion was observed in the reference and EtOAc groups. Histopathological data also supported the results. Both EtOAc and MeOH extract-administered groups displayed significant remission in the levels of TNF-α, VEGF and IL-6. When the active extracts were subjected to HPLC analysis, chlorogenic acid was found to be the major compound and the amount of this compound was calculated as 0.5112±0.0012mg and 1.7072±0.0277mg/100mg extract, repectively. Conclusions: The results of the present study indicate that the effectiveness of the fruit extract of V. opulus could be partially attributed chlorogenic acid. Other phenolic compounds could potentiate the activity due to their amount.
Objective menstrual pain is a common gynecological symptom at women on or near their menstrual period. Two third of them experienced moderate to severe pain. However, just several seek for medical help. This research aims to know the effect of ginger oil used on decreasing menstrual pain scale. Materials and methods this cross over experimental study was held from February until May 2020 on 64 grade XI high school students at Palu city. Participants were grouping cluster randomly into group A which applied 5 ml ginger oil five days before until the second day of the first menstrual period, and group B that given the same treatment in the next period. A visual pain scale measured the pain scale on the second day of the menstrual period. Result most participants were in the age of 17 years old. The study found a lowering of pain scale significantly at both groups after treatment. The main menstrual pain scale were 6.87 ± 1.817 and 6.46 ± 1.362 decreased to 3.48 ± 1.928 and 4.24 ± 2.010 after treatment (p = 0.0001). Differences between the two groups were significant in the first period (p = 0.0001) but not significant in the second period (p = 0.410). Conclusion the use of ginger oil several days before menstruation can reduce menstrual pain scale on students with primary dysmenorrhea; therefore, its use can be recommended to prevent the pain.
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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.
Full-text available
Conventional treatment for primary dysmenorrhoea has a failure rate of 20% to 25% and may be contraindicated or not tolerated by some women. Herbal medicine may be a suitable alternative. To determine the efficacy and safety of Iranian herbal medicine for primary dysmenorrhea when compared with placebo, no treatment, and other treatment. Electronic searches of the Cochrane Menstrual Disorders and Dysmenorrhoea Group Register of controlled trials, Scopus, Google Scholar, Medline, Pubmed were performed to identify relevant randomized controlled trials (RCTs). The study abstraction and quality assessment of all studies were undertaken following the detailed descriptions of these categories as described in the JADAD Criteria for Systematic Reviews of Interventions. 25 RCTs involving a total of women were included in the review. The review found promising evidence in the form of RCTs for the use of herbal medicine in the treatment of primary dysmenorrhoea compared with pharmacological treatment. However, the results were limited by methodological flaws. Further rigorous no penetrating placebo-controlled RCTs are warranted. The review found promising evidence supporting the use of herbal medicine for primary dysmenorrhoea; however, results are limited by the poor methodological quality of the included trials.
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Ethnopharmacological relevance: In Dominica, women offer dysmenorrhea, delayed menses, and menorrhagia as prevalent menstrual troubles. Dominican humoral theory considers menstruation to be "hot" such that menstrual problems are caused by the introduction of too much "cold" in the body. These conditions can be painful and may require herbal medicine. Our method finds the most culturally salient plants for these conditions-those which are of common knowledge across the population. We hypothesize that cultural agreement on ethnobotanical treatments (1) reflects their perceived ethnophysiological efficacy, and that (2) salient plants contain bioactive compounds appropriate for the menstrual conditions for which Dominicans employ the plants. Materials and methods: Qualitative data on local explanatory models and treatment of menstrual conditions were collected using participant-observation, focus groups, and informal key informant interviews. Quantitative ethnobotanical data come from freelist (or "free-list") tasks, conducted with 54 adults. Results: Mean salience values calculated from freelisted data reveal that the same four plants, Cinnamomum verum (synonym Cinnamomum zeylanicum) (Lauraceae), Mentha suaveolens (Lamiaceae), Pimenta racemosa (Myrtaceae) and Sphagneticola trilobata (synonym Wedelia trilobata) (Asteraceae) are used to treat dysmenorrhea and delayed menses. The only remedy reported for menorrhagia, Sphagneticola trilobata (Asteraceae), is also a treatment for dysmenorrhea and delayed menses. The Dominican humoral system views menstruation as a "hot" condition, yet these "bush medicines" are also "hot." Dominicans do not view menstruation as a problem, rather, they reckon that excess "cold" in a woman׳s menstruating body impedes menstrual function to cause problems thus requiring "hot" plants to alleviate their symptoms. A literature review revealed that all four plants contain analgesic, anti-nociceptive, and anti-inflammatory properties. Additionally, Mentha suaveolens is muscle-relaxing and anti-spasmodic, Cinnamomum verum has a mild anti-coagulant, and Sphagneticola trilobata has wound healing, anti-stress, and sedative properties. Conclusions: In Dominican menstrual problems there is correspondence between cultural consensus, bioactivity, and humoral theory. Examining the ethnophysiology of menstruation and its complications provides evidence for the expectations of actions and effectiveness of locally culturally salient medicinal plants.
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Dysmenorrhea is defined as symptoms associated with menstruation, such as abdominal pain, cramping and lumbago, that interfere with daily activity. Primary dysmenorrhea refers to menstrual pain without underlying pathology, whereas secondary dysmenorrhea is menstrual pain associated with underlying pathology. Endometriosis, one of the main causes of secondary dysmenorrhea, induces dysmenorrhea, pelvic pain and infertility, resulting in marked reduction of quality of life during reproductive age. This review article is a comprehensive overview of dysmenorrhea and endometriosis in young women.
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Dysmenorrhea is a common menstrual complaint with a major impact on women's quality of life, work productivity, and health-care utilization. A comprehensive review was performed on longitudinal or case-control or cross-sectional studies with large community-based samples to accurately determine the prevalence and/or incidence and risk factors of dysmenorrhea. Fifteen primary studies, published between 2002 and 2011, met the inclusion criteria. The prevalence of dysmenorrhea varies between 16% and 91% in women of reproductive age, with severe pain in 2%-29% of the women studied. Women's age, parity, and use of oral contraceptives were inversely associated with dysmenorrhea, and high stress increased the risk of dysmenorrhea. The effect sizes were generally modest to moderate, with odds ratios varying between 1 and 4. Family history of dysmenorrhea strongly increased its risk, with odds ratios between 3.8 and 20.7. Inconclusive evidence was found for modifiable factors such as cigarette smoking, diet, obesity, depression, and abuse. Dysmenorrhea is a significant symptom for a large proportion of women of reproductive age; however, severe pain limiting daily activities is less common. This review confirms that dysmenorrhea improves with increased age, parity, and use of oral contraceptives and is positively associated with stress and family history of dysmenorrhea.
Depression is a serious disorder in today's society. With estimates of lifetime prevalence as high as 21% of the general population in some developed countries. As a therapeutically plant, saffron it is considered an excellent stomach ailment and an antispasmodic, helps digestion and increases appetite. It is also used for depression in Persian traditional medicine. Our objective was to assess the efficacy of stigmas of Crocus sativus (saffron) in the treatment of mild to moderate depression in a 6-week double-blind, placebo controlled and randomized trial. Forty adult outpatients who met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition for major depression based on the structured clinical interview for DSM IV participated in the trial. Patients have a baseline Hamilton Rating Scale for Depression score of at least 18. In this double-blind, placebo controlled, single-center trial and randomized trial, patients were randomly assigned to receive capsule of saffron 30 mg/day (BD) (Group 1) and capsule of placebo (BD) (Group 2) for a 6-week study. At 6 weeks, Crocus sativus produced a significantly better outcome on Hamilton Depression Rating scale than placebo (d.f.=1, F= 18.89, p<0.001). There were no significant differences in the two groups in terms of observed side effects. The results of this study indicate the efficacy of Crocus sativus in the treatment of mild to moderate depression. A large- scale trial is justified.
: Primary dysmenorrhea is the most common gynecologic complaint among adolescents. Conventional treatments include nonsteroidal anti-inflammatory drugs and hormonal contraceptives, but complementary and alternative medicine is a growing area of interest. As patients seek such treatments, pediatric nurse practitioners should be aware of these options to offer the best advice to patients.
Purpose of review: The purpose of this review is to highlight the recent literature and emerging data describing clinical situations in which menstrual suppression may improve symptoms and quality of life for adolescents. A variety of conditions occurring frequently in adolescents and young adults, including heavy menstrual bleeding, and dysmenorrhea as well as gynecologic conditions such as endometriosis and pelvic pain, can safely be improved or alleviated with appropriate menstrual management. Recent findings: Recent publications have highlighted the efficacy and benefit of extended cycle or continuous combined oral contraceptives, the levonorgestrel intrauterine device, and progestin therapies for a variety of medical conditions. Summary: This review places menstrual suppression in an historical context, summarizes methods of hormonal therapy that can suppress menses, and reviews clinical conditions for which menstrual suppression may be helpful.
Primary dysmenorrhoea (PD) is highly prevalent among women of reproductive age and it can have significant short- and long-term consequences for both women and society as a whole. Validated symptom measures are fundamental for researchers to understand women's symptom experience of PD and to test symptom interventions. The objective of this paper was to critically review the content and psychometric properties of self-report tools to measure symptoms of PD. Databases including PubMed, PsychoINFO, Cumulative Index of Nursing and Allied Health Literature, and Health and Psychosocial Instruments were searched for self-report symptom measures that had been used among women with either PD or perimenstrual symptoms. A total of 15 measures met inclusion criteria and were included in the final analysis. The measures were categorized into generic pain measures, dysmenorrhoea-specific measures, and tools designed to measure perimenstrual symptoms. These measures had varying degrees of comprehensiveness of symptoms being measured, relevance to PD, multidimensionality and psychometric soundness. No single measure was found to be optimal for use, but some dysmenorrhoea-specific measures could be recommended if revised and further tested. Key issues in symptom measurement for PD are discussed. Future research needs to strengthen dysmenorrhoea-specific symptom measures by including a comprehensive list of symptoms based on the pathogenesis of PD, exploring relevant symptom dimensions beyond symptom severity (e.g., frequency, duration, symptom distress), and testing psychometric properties of the adapted tools using sound methodology and diverse samples.
Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients' quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the cause. Primary dysmenorrhea is menstrual pain in the absence of pelvic pathology. Abnormal uterine bleeding, dyspareunia, noncyclic pain, changes in intensity and duration of pain, and abnormal pelvic examination findings suggest underlying pathology (secondary dysmenorrhea) and require further investigation. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. Endometriosis is the most common cause of secondary dysmenorrhea. Symptoms and signs of adenomyosis include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Management options for primary dysmenorrhea include nonsteroidal anti-inflammatory drugs and hormonal contraceptives. Hormonal contraceptives are the first-line treatment for dysmenorrhea caused by endometriosis. Topical heat, exercise, and nutritional supplementation may be beneficial in patients who have dysmenorrhea; however, there is not enough evidence to support the use of yoga, acupuncture, or massage.