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Menstrual Disorders: Causes and Natural Remedies

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J Pharm Chem B io l Sci, June-A ug us t 2016; 4(2): 307-320
Jo ur na l of P ha rmac eu ti ca l, Chemi cal and B io lo gi cal
Sciences
IS SN : 23 48 -7658
Im pa ct F ac to r (GIF ): 0 .6 15
Im pa ct F ac to r (SJI F): 2. 09 2
June-August 201 6; 4 (2 ): 307-320
Menstrual Disorders: Causes and Natural Remedies
Monawara Begum1, Sumit Das2*, H.K. Sharma1
1Department of Pharmaceutical Sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
2Girijananda Chowdhury Institute of Pharmaceutical Science, Azara, Hatkhowapara, NH-37,
Guwahati- 781017, Assam
*Corresponding Author: Sumit Das, Assistant Professor, Girijananda Chowdhury Institute of
Pharmaceutical Science, Azara, Hatkhowapara, NH-37, Guwahati- 781017, Assam
Received: 12 May 2016 Revise d: 29 Jul y 2016 A cc ep te d: 0 5 Au gu st 2016
INTRODUCTION
Menstruation, is the periodical flow of blood
from the uterus through the cervix and out
through the vagina, and it is also called a
"period". Menstruation occurs during the years
between puberty and menopause[1].Monthly
menstrual periods are a normal part of a
woman’s life. Menstruation is essential for the
renewal of the uterine lining in preparation for
pregnancy.The process of degeneration of
endometrial bed and removal of the same
though vagina occurs at regular interval andis
called the menstrual cycle. The menstrual cycle
provides important body chemicals, called
hormones, to keep healthy. It also prepares
body for pregnancy each month. A cycle is
counted from the first day of 1 period to the
Revi ew Arti cle
ABSTRACT
Menstruation often bring about a wide variety of uncomfortable symptoms Premenstrual
syndrome (PMS) encompasses the most common issues, such as mild cramping and fatigue, but the
symptoms usually go away when your period begins. However, other, more serious menstrual
problems may also arise. Menstruation that is too heavy or light, or a complete absence of a cycle, all
signal issues that can contribute to an abnormal menstrual cycle. Allopathic drugs have shown many
significant effect for the treatment of menstrual problem . Hence focus has been turned towards
home remedies. Medicinal plants play an important role in management of menstrual disorder like as
dysmenorrhea or Amenorrhea. The present review gives detailed information about various
medicinal plants and some home remedies used in the treatment of the disease.
Keyword: Menstruation; dysmenorrhea; amenorrhea; medicinal plants
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first day of the next period. The average
menstrual cycle is 28 days long. Cycles can
range anywhere from 21 to 35 days in adults
and from 21 to 45 days in young teen [2].
It is intended to discuss about this physiological
process and associated complications in detail
in the following sections including traditional
ways to get relief from such discomforts
highlighting the herbs and home remedies
commonly used.
Phases of Menstrual cycle
The entire duration of a Menstrual cycle can be
divided into four main phases (Fig. 1)such as -
Menstrual phase (From day 1 to 5) ,Follicular
phase (From day 1 to 13),Ovulation phase (Day
14) ,Luteal phase (From day 15 to 28).
Fig.1: Phases of menstrual cycle [3]
1. Menstrual phase (day 1-5)
Menstrual phase begins on the first day of
menstruation and lasts till the 5th day of the
menstrual cycle. The following events occur
during this phase [3]:
The uterus sheds its inner lining of soft
tissue and blood vessels which exits the
body from the vagina in the form of
menstrual fluid.
Blood loss of 10 ml to 80 ml is considered
normal.
During these phase cramps may occur due
to the contraction of the uterine and the
abdominal muscles to expel the menstrual
fluid.
2. Follicular phase (day 1-13)
This phase also begins on the first day of
menstruation, but it lasts till the 13th day of the
menstrual cycle. The following events occur
during this phase [4]:
The pituitary gland secretes a hormone that
stimulates the egg cells in the ovaries to
grow. One of these egg cells begins to
mature in a sac-like-structure called follicle.
It takes 13days for the egg cell to reach
maturity.
While the egg cell matures, its follicle
secretes a hormone that stimulates the
uterus to develop a lining of blood vessels
and soft tissue called endometrium.
3. Ovulation phase (day 14)
On the 14th day of the cycle, the pituitary gland
secretes a hormone that causes the ovary to
release the matured egg cell. The released egg
cell is swept into the fallopian tube by the cilia
of the fimbriae. Fimbriae are finger like
projections located at the end of the fallopian
tube close to the ovaries and cilia are slender
hair like projections on each Fimbria[3].
4. Luteal phase (day 15-28)
This phase begins on the 15th day and lasts
till the end of the cycle. The following events
occur during this phase[5]:
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The egg cell released during the ovulation
phase stays in the fallopian tube for 24
hours.
If a sperm cell does not impregnate the egg
cell within that time, the egg cell
disintegrates.
The hormone that causes the uterus to
retain its endometrium gets used up by the
end of the menstrual cycle. This causes the
menstrual phase of the next cycle to begin.
Menstrual Disorders
There are a number of different menstrual
disorders. Problems can range from heavy,
painful periods to no periods at all. There are
many variations in menstrual patterns, but in
general women should be concerned when
periods come fewer than 21 days or more than
3 months apart, or if they last more than 10
days. Such events may indicate ovulation
problems or other medical conditions.
Dysmenorrhea (Painful Cramps)
Dysmenorrhea is severe, frequent cramping
during menstruation. Pain occurs in the lower
abdomen but can spread to the lower back and
thighs. Dysmenorrhea is usually referred to as
primary or secondary.
Primary dysmenorrhea. Primary
dysmenorrhea is cramping pain caused by
menstruation. The cramps occur from
contractions in the uterus and are usually
more severe during heavy bleeding.
Secondary dysmenorrhea. Secondary
dysmenorrhea is menstrual-related pain
that accompanies another medical or
physical condition, such as endometriosis or
uterine fibroids [6].
Menorrhagia (Heavy Bleeding)
Menorrhagia is menstrual flow that lasts longer
and is heavier than normal. The bleeding occurs
at regular intervals (during periods). It usually
lasts more than 7 days and women lose an
excessive (more than 80 mL) amount of blood.
Menorrhagia is often accompanied by
dysmenorrhea because passing large clots can
cause painful cramping.
Amenorrhea (Absence of Menstruation)
Amenorrhea is the absence of menstruation.
There are two categories: primary amenorrhea
and secondary amenorrhea. These terms refer
to the time when menstruation stops:
Primary amenorrhea occurs when a girl
does not begin to menstruate by age 16.
Girls who show no signs of sexual
development (breast development and
pubic hair) by age 13 should be evaluated
by a doctor. Any girl who does not have
her period by age 15 should be evaluated
for primary amenorrhea.
Secondary amenorrhea occurs when
periods that were previously regular stop
for at least 3 months.
Oligomenorrhea
Oligomenorrhea (Light or Infrequent
Menstruation)is a condition in which menstrual
cycles are infrequent, greater than 35 days
apart. It is very common in early adolescence
and does not usually indicate a medical
problem [7].
Premenstrual Syndrome (PMS)
Premenstrual syndrome (PMS) is a set of
physical, emotional, and behavioral symptoms
that occur during the last week of the luteal
phase (a week before menstruation) in most
cycles. The symptoms typically do not start until
at least day 13 in the cycle, and resolve within 4
days after bleeding begins. Women may begin
to have premenstrual syndrome symptoms at
any time during their reproductive years, but it
usually occurs when they are in their late 20s to
early 40s.
Causes of Painful Menstrual Cramps
There could be some factors that lead to
menstrual cramps. Given below are a few of the
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health conditions that have been known to
cause severe menstrual pain and cramps:
Hormonal imbalance is one of the most
common causes for menstrual cramps.
The prostaglandins, which are hormone-
like substances, trigger off contractions in
the uterine muscles, which also leads to
pain. The higher the level of
prostaglandin, the more severe the
menstrual cramps are likely to be
occurred [8].
Pelvic Inflammatory Disease (PID), which
is a disease or rather an infection,
affecting the female reproductive organs
(Fig.2). PID is one of the most serious
complications of a sexually transmitted
disease in women: It can lead to
irreversible damage to the uterus,
ovaries, fallopian tubes, or other parts of
the female reproductive system, and is
the cause of cramps and also primary
preventable cause of infertility in women
[9].
Fig.2: Pelvic Inflammatory Diseases [9]
Uterine fibroids are very common non-
cancerous (benign) growths that develop in
the muscular wall of the uterus (Fig.3). They
can range in size from very tiny (a quarter
of an inch) to larger than a cantaloupe.
Occasionally, they can cause the uterus to
grow to the size of a five-month pregnancy.
In most cases, there is more than one
fibroid in the uterus. While fibroids do not
always cause symptoms, their size and
location can lead to problems for some
women, including pain and heavy bleeding
[10].
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Fig.3: Uterine fibroids [10]
Cervical Stenosis, where the opening of
the cervix is quite small because of which,
it impedes the flow of blood. This causes
the pressure in the uterus to increase,
along with the pain.
Adenomyosis is a condition in which the
inner lining of the uterus (the
endometrium) breaks through the muscle
wall of the uterus (Fig.4). Adenomyosis
can cause menstrual cramps, lower
abdominal pressure, and bloating before
menstrual periods and can result in heavy
periods [11].
Fig.4:Adenomyosis [11]
Endometriosis is a very painful health
condition, where the tissues that are
supposed to line the walls of the uterus
get implanted in other parts of the body,
mainly the fallopian tubes, pelvic tissues
and the ovaries (Fig.5) also cause
menstrual problem [12].
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Fig.5: Endometriosis [12]
Pregnancy-related conditions are the
most common causes of abnormal
bleeding amongst women from the age of
20 to 40. Pain may accompany the
abnormal bleeding. A late and/or painful,
heavy period may be an early miscarriage
or a ‘blighted ovum’ where the foetus
fails to develop normally.
Few Symptoms of Menstrual disorder
Three most common symptoms present on
both days, that is, the day before and first day
of menstruation were lethargy and tiredness
(first), depression (second), and inability to
concentrate on work (third), other possible
symptoms are Nausea or vomiting, Excess
perspiration, Loose stools, Increase in the
frequency of urination, Dizziness, Loss of
appetite, Mood swings,Uneasiness.
Complication associated with menstrual
problem
Anemia(reduction in red blood cells)
Menorrhagia is the most common cause of
anemia in premenopausal women. A blood loss
of more than 80mL (around three tablespoons)
per menstrual cycle can eventually lead to
anemia Most cases of anemia are mild.
Nevertheless, even mild anemia can reduce
oxygen transport in the blood, causing fatigue
and a diminished physical capacity. Moderate-
to-severe anemia can cause shortness of
breath, rapid heart rate, lightheadedness,
headaches, ringing in the ears (tinnitus),
irritability, pale skin, restless legs syndrome,
and mental confusion [13].
Osteopenia (loss of bone density)
Amenorrhea caused by reduced estrogen
levels is linked to osteopenia. Conditions
that are associated with low estrogen levels
include eating disorders, pituitary tumors,
and premature ovarian failure.
Osteoporosis (more severe bone loss that
increases fracture risk)
Osteoporosis is a condition characterized by
progressive loss of bone density, thinning of
bone tissue, and increased vulnerability to
fractures. Osteoporosis may result from
disease, dietary or hormonal deficiency.
Infertility
Some conditions associated with heavy
bleeding, such as ovulation abnormalities,
fibroids, or endometriosis, are important
contributors to infertility. Many conditions
that cause amenorrhea, such as ovulation
abnormalities and polycystic ovary
syndrome, can also cause infertility [14].
Ways to help treat Menstrual Cramping
1. Nutritional Considerations
Adequate nutrition is very important and since,
Dysmenorrhea is an inflammatory state in the
body, it is important to avoid foods that
increase inflammation response. High glycemic
foods are known to increase levels of
inflammatory chemicals in the body, including
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PGF2. Therefore, food containing an anti-
inflammatory activity or anti-inflammatory diet
is important.
The food habits that should be practiced to
avoid or to get relief from dysmenorrhea are
summarized in Table 1.
Table 1: Food habits or food supplement that should be practiced in case of dysmenorrhea
Avoid refined carbohydrates [15].
Stick to whole grains like oats, millet, brown rice,
quinoa, etc. Eat only 3 servings of grains at most a
day.
Eliminate sugary foods and processed sugar
[16].
Choose very limited amounts of honey or agave.
Choose Stevia as a sweetener when possible.
Consider eliminating dairy [17].
Dairy products are congesting to the body and
many doctors have seen a reduction in menstrual
cramp pain in women who eliminated dairy
products. If you choose dairy, try to purchase
organic or organic raw dairy only to avoid added
hormones
Reduce red meat and egg yolk consumption to
at most 2-3 times a week [18].
This is because both red meat and egg yolk are high
in arachidonic acid (AA). This has been found to
increase cellular inflammation
2. Important Nutritional Supplements:
Several studies have indicated that certain
vitamins are very effective in reducing the
severity of menstrual cramps. Following a
healthy diet is very important at all times and
not just during menstrual cycle. However,
healthy foods can help restore energy levels
and reduce lethargy, tiredness, weakness and
fatigue. Some of the foods that should be
included in a diet for menstrual cramps given in
Table 2.
Table 2: Daily requirement of nutritional supplements for menstrual disorders
Vitamin A
Vitamin A is an important nutrient in the growth and
development of adolescents and ensures healthy endometrial
growth. Women with normal menstrual loss appear to have
significantly better levels of vitamin A than women with
menorrhagia. When the women with heavy menstrual loss
were given vitamin A [19].
Magnesium
Magnesium supplements reduce PMS symptoms such as aches
and pains, depression, irritability, mood swings and fluid
retention. Magnesium helps to relax smooth muscle tissue. It
has been shown to reduce menstrual cramping greatly[20].
Omega-6 essential fatty acids
(EFAs)
Borage oil and Evening Primrose Oil are high in Omega-6 fatty
acids. Omega-6 fats can assist fertility by improving
reproductive cell structure, decrease risk of inflammation and
improve the condition of organs in the body. Borage and EPO
tone the uterus [21].
Fermented Cod Liver Oil
Provides many of the necessary building blocks for hormone
production including Vitamins A, D, and K. It also is a great
source of Omega-3s and beneficial fats [22].
Gelatin
Is a great source of calcium, magnesium and phosphate? It
supports hormone production and digestive health and helps
sooth inflammation, especially in joints [23].
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3. Herbal Support for Dysmennorhea:
Medicinal herbs are significant source of
dysmenorrheal drugs. Mono and poly-herbal
preparations have been used in various
disorders. According to one estimate, more
than 700 mono and poly-herbal preparations in
the form of decoction, tincture, tablets and
capsules from more than 100 plants are in
clinical use. A drug having beneficial effect on
the heavy bleeding during menstruation is
known as anti dysmenorrheal drug. There are a
number of herbs that can affect the activity of
the uterine muscle, someare listed in Table 3
Table 3: List of common herbs used in uterine disorder
Common
name
(English)
Parts
used
Method of use
Red raspberry
Leaf
Make a strong cup of raspberry leaf tea and
added into it the juice of an orange. Take 3 cups
of this mixture daily during menstruation if pain is
occured[24].
Basil
Leaf
Add 15 ml of basil leaves extract to one cup of
boiling water. Cover tightly and allow it to cool.
Drink this every few hours to relif cramps[25].
Cinnamon
Bark
Cinnamon is hot and aromatic herb, and it is
taken at a dose of up to 1 g three times per day as
an infusion, or as part of a herbal tea formula at a
dose of between 24 ml, three times daily[26].
Fennel
Seeds
Adding 4 gm of fennel seeds to a cup of boiling
water simmer the mixture on low heat for five
minutes then removed from heat and strain the
tea and add honey and mix well. Drink this herbal
tea two times daily beginning three days before
the expected start date[27].
Ginger
Rhizo
me,
ginger
root
Ginger can be taken as a fresh or decoction of
rhizome or as tincture. The extract (tincture) is
taken at a dose of 2.53 ml depending on
strength. During menstruation lower doses
preferable [28].
Valerian
Leaves
2 ml ofvaleriana tincture is taken every 3-4 hours
as needed for pain[29].
Cramps Bark
Bark
1ml of bark tincture takenevery 2-3 hours during
cramps [30].
Black haw
Bark
Tincture of black haw is taken at a dose of 1ml
every 2-4hoursduring menstruation[31].
Black Cohosh
Dried
root
The usual dose ofBlack cohoshis between 1ml2
ml of tincture, two to three times daily used
during menstruation [32].
Motherwort
Fresh
/dried
leaves
The fresh or dried leaves of Motherwort is used in
the infusion form and the recommended dosage
is 26 ml of 1 in 5 tincture or 24 ml of 1:1 fluid
extract, and taken three times daily before
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expected date of menstruation [33].
Jamaican
dogwood
Root
bark
It is a Cooling herb and it is used at a dose of
between 28 ml three times per day during
cramps [34]
St John’s wort
Leaf
The tincture of this herb is taken at a doses of
range from 28 ml per day during
menstruation[35].
Chamomile
Leaf
One cup of boiling water is poured into a cup
containing a chamomile tea bag.Cover and let it
steep for 10 to 15 minutes. Squeeze out the tea
bag and add some lemon juice or honey as
desired.then drink at least two cups ofchamomile
tea a day during the week before menstrual
period [36].
Parsley
Leaf
The fresh leaves of parsley is Pour in one cup of
boiling water and then it steep for five minutes.
Strain the solution and drink the tea
immediately.Drink this tea twice a day during
periods to minimize pain[37].
Pasque
Flower
Whole
herb
The herb pasque is as Warm with a Cooling
potential. The tincture (dried plant) is taken at a
standard dose of 12 ml of the daily during
periods[38].
Feverfew
Leaf
The effective dose of feverfew herb can use
quite low at 50100 mg per day if pain is
occured[39].
Cnidium
Rhizo
mes.
Cnidiumis acrid and warm herb and it is used as a
fluid extract it can be taken at doses of 26 ml,
one to three times per day during periods[40
Yarrow
Whole
Herb
Yarrow herb is taken by makeingtea and it is
prepared by covering 15 g of the dried herb with
boiling water and infusing overnight. After
straining, the tea is taken in divided doses over
the next day during times of heavy
menstruation[41].
Ladies’
mantle
Root
or
herb
This herb should be used at the high end ofthe
dose range: 1.52.5 ml three times daily to
reduce menorrhagia[42].
Golden seal
Rhizo
mes
The tincture of Golden Seal rhizome is used at a
dose of 1ml2 ml, three times dailyto reduce the
pain [43].
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4. Benefits of Aroma therapy for Painful
Menstrual Cramps
Essential Oil Massage blends or hot compress
are another form of pain relief for menstrual
cramps. The aromatherapy massage that should
be performed each day between periodslead
to a significant reduction in the number of days
of menstrual pain. Below are some of the best
aromatherapy for painful cramp.
Heat
Applying heat on the lower abdomen is
the easiest way to control menstrual
cramps. Heat helps relax the contracting
muscles in the uterus. Alternatively Place
a heating pad over the lower part of
abdomen and lower back or alternatively
use a plastic bottle filled with hot water
and apply the heat until the pain is
reduced [44].
German Chamomile
(MatricariachamomillaL; Asteraceae)
German chamomile oil is best known for
its ability to reduce inflammation. This oil
is a deep blue in color due to the
presence of azulene. It also has some pain
reducing effects, promotes calming of the
nerves, reduces anger, irritability and
depression which are very common
symptoms during menstruation [45].
Sweet Marjoram (OriganummarjoranaL;
Lamiaceae)
This is also a great oil for menstrual
cramps it reduces pain on all levels. For
better result it is use with a hot compress
on the abdomen when menstrual
crampsoccur[46].
Sweet Fennel (FoeniculumvulgareMill;
Apiaceae)
The essential oil of fennelhave the ability
to assist in promoting menstruation
(menses) and regulating the monthly
discharge, but although these oils are
very helpful in treating problems of pain
associated during menses.
Lavender oil (Lavandulalatifolial;
Lamiaceae)
This essential oil obtained by distillation
from the flower spikes of certain species
of lavenderi,eLavandulalatifolia can
relieve anxiety, depression and pain
during menstruation [47].
Clary Sage oil (Salvia SclareaL;Labiatae)
The Essential Oil of clary is extracted by
steam distillation from the buds and
leaves of the Clary Sage plant of Salvia
Sclarea, it regulated menstrual cycles, and
alleviated symptoms of menopause [48].
5. Physical activity for menstrual disorder:
Regular physical activity is very important for
promoting the flow of qi in the body. A lack of
exercise can increase the severity and
duration of symptoms associated with
dysmenorrhea. In addition to a regular
physical exercise regimen, a good moving
meditation can help balance the emotions,
reduce stress, strengthen the organs, and
regulate menstruation.Regular exercise,
including exercise right before and during
your menstrual cycle can and will help lessen
the severity of menstrual
cramping. Swimming can alsolessen
menstrual flow, and lessen cramps [49].
6. Self Acupressure for menstrual pain
Acupressure and reflexology are alternative
medicine techniques that are based on the
theory of holistic self-healing using solely
physical pressure. The pressure applied at
specific points helps in increasing the flow of
life energy through the meridians and clears the
blockages. PMS or premenstrual syndrome is a
batch of symptoms that are linked with the
menstrual it can surely disrupt normal life of a
woman for a few days. Acupressure therapy
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can be used to treat the symptoms of PMS
quite successfully. Below listed some of the
most important points ranging from various
parts of the body that are useful for
acupressure treatment of premenstrual
syndrome.
Points on Abdomen
The most important acupressure treatment
points for relieving PMS symptoms is located in
the abdomen like Mansion Cottage( In the
pelvic area, in the middle of the crease where
the leg joins the trunk of the body ), Rushing
Door(In the pelvic area, in the middle of the
crease where the leg joins the trunk of the body
), Sea of Energy( Two finger widths below the
belly button).stimulating these points by
applying soft pressure using palms and fingers
can help in relieving menstruation related
discomfort[50].
Points on the Back
A few of the acupressure points related to PMS
are located on the back of the body such as
Womb and Vitals (This pair of points are located
right outside the sacrum the bony area at the
base of the spice, midway between the hipbone
and the base of the buttocks), Sacral
Points(These points are located in the sacrum,
right at the base of the pelvis),and stimulating
these points not only helps in relieving
abdominal cramps, but also soothes lower back
pain[51].
Points on Legs
The reflexology points present on the legs
suchasThree Yin Crossing
(Four finger widths above the inner
anklebone close to the back of the
shinbone), Grandfather Grandson( In the
upper arch of the foot, one thumb width
from the ball of the foot ) are help in
improving blood flow to the lower part of
the body and helps in reducing bloating by
driving out excess fluid from the body[52].
Point on Arms
One of the most important points of
acupressure therapy the Union Valley
point, there stimulation of which helps in
treating a wide range of health
problems.Union Valley Point( This
acupressure point is located in the fleshy
joint between the thumb and index finger
on both hands). Stimulating this point by
applying pressure on the fleshy region helps
in normalizing delayed and irregular
periods, calms the uterine muscles and
treats infertility [53].
CONCLUSION
In this review we discussed about medicinal
plants and some alternative home remedies for
the treatment of menstrual disorder. Menstrual
problem (i.e Dysmenorrhea, Amenorrhea) is a
chronic disease which leads to various
complications on long standing. Allopathic
medicines are not effective in treating the
disease leading to various adverse effects.
Hence medicinal plants are the best alternative
for the treatment of menstrual problem. The
plant species have proved their efficacy in
reducing problem. Folklore medicinal plants are
mostly used for rural areas; because the
availability of lavish amount of medicinal plants
those areas.
CONFLICT OF INTEREST STATEMENT
The authors declare that they have no conflict
of interests.
REFERENCES
1. Biggs WS, Demuth RH. Premenstrual
syndrome and premenstrual dysphoric
disorder. Am Family Phys 2011; 84(8): 918-
924.
2. Casablanca Y. Management of
dysfunctional uterine bleeding. Obstet
Gynecol Clin North Am 2008; 35(2):219-
234.
Monawara et al 318
J Pharm Chem Biol Sci, June-Augu st 2016; 4(2):307 -320
3. Laufer A, Breech MR. Menstruation in girls
and adolescents: using the menstrual cycle
as a vital sign. Pediatrics 2006; 118(5):
22452250.
4. Silverthorn, Dee Unglaub. Human
Physiology: An Integrated Approach.
Glenview, IL: Pearson Education; 2013, p
850.
5. Menstruation and the menstrual cycle fact
sheet. USA: Office of Women's Health;
2014.
6. Osayande AS, Mehulic S .Diagnosis and
initial management of dysmenorrhea. Am
Family Phys 2014; 89 (5): 341346.
7. Cho SH, Hwang EW. Acupuncture for
primary dysmenorrhea: a systematic
review. BJOG 2010; 117(5):509-521.
8. Bhattacharya S, Middletone LJ, Tsourapas
A, Lee AJ, Champaneria R, Daniels JP.
Hysterectomy, endometrial ablation and
Mirena for heavy menstrual bleeding; a
systematic review of clinical effectiveness
and cost-effectiveness analysis, Health
Technol Assess 2011; 15 (19): 1-252.
9. Mitchell C, Prabhu M. Pelvic inflammatory
disease: current concepts in pathogenesid,
diagnosis and treatment. Infect Dis Clin
North Am 2010; 27 (4): 793-809.
10. Wallach EE, Vlahos NF. Uterine myomas: an
overview of development, clinical features,
and management. Obstet Gynecol 2004;
104 (2): 393406.
11. Matalliotakis I, Kourtis A, Panidis D.
Adenomyosis, Obst Gynecol Clin North
America 2003; 30(1): 63-82.
12. Bulletti C, Coccia ME, Battistoni S, Boini A.
Endometriosis and infertility. J Assist
Reprod Genet 27(8): 441447.
13. Kaunitz AM, Meredith S, Inki P, Kubba A,
Sanchez-Ramos L. Levonorgestrel-releasing
intrauterine system and endometrial
ablation in heavy menstrual bleeding. A
systematic review and meta-analysis.
Obstet Gynecol 2009; 113(5):1104-16.
14. Uriel H. History and trajectory of PMS
towards a balanced adaptation and a
biosocial homeostasis. J Repro Infant
Psychol 2006; 24(4): 336-346.
15. Usuki S, Nakauchi T, Higa S, Someya K. The
Improvement of luteal Insufficiency in
Fecund Women by Tokishakuyakusan
treatment. The Am J Chinese Med 2002; 30
(2,3): 327-338.
16. Balbi C, Musone R, Menditto A. Influence of
menstrual factors and dietary habits on
menstrual pain in adolescence age. Eur J
Obstet Gynecol Reprod Biol 2000; 91(2):
143-148
17. Penland JG, Johnson PE. Dietary calcium
and manganese effects on menstrual cycle
symptoms. Am J Obstet Gynecol 1993; 168:
1417-1423.
18. Dennehy CE. The use of herbs and dietary
supplements in gynecology: an evidence-
based review. J Midwifery Womens Health
2006; 51(6): 402-406.
19. Brabin L, Brabin BJ.The cost of successful
adolescent growth and development in
relation to iron and vitamin A status. Am J
Clin Nutr 1992; 55(5): 955-958.
20. Guerrera MP, Volpe SL, Mao JJ. Therapeutic
uses of magnesium. Am Fam Physician
2009; 80(2): 157-162.
21. Sohrabi N, Kashanian M, Ghafoori SS,
Malakout SK. Evaluation of the effect of
omega 3-fatty acids in the treatment of
premenstrual syndrome. Complement Ther
Med 2013;21(3);141-146
22. Bope and Kellerman: Conn Current Therapy
2013. 1st ed. Philadelphia, PA: Elsevier
Saunders; 2012.
23. Yuichiro I, Shuji I, Akira K, Eisuke K, Makiyo
H, Seiji K, Toyohiro O, Tsuneo I. Uterine
artery embolization by use of porous
gelatin particle for symptomatic uterine
leiomyomas. Japanese J Radiol 2015; 33(8):
461-470.
Monawara et al 319
J Pharm Chem Biol Sci, June-Augu st 2016; 4(2):307 -320
24. Burn JH, Withell ER. A principle in raspberry
leaves which relaxes uterin muscle. Lancet
1941; 2(6149): 13.
25. Khodayari N, Moatar F. Efficacy of
traditional medicine for the treatment of
primary dysmenorrhoea. Iran J Pharm Res
2004; 3:37-43.
26. Akhavan Amjadi M, Mojab F, Shahbaz-
Zadegan S. Effect of Cinnamomum
zeylanicum on the severity and systemic
manifestations of dysmennorhoea. Med J
Arak Uni 2009; 9: 204-209.
27. Ghodsi Z, Asltoghiri M. The effect of fennel
on pain quality, symptoms, and menstrual
duration in primary dysmenorrheal. J
Pediatr Adolesc Gynecol 2014; 27(5): 283-
286
28. Mascolo N, Jain R, Jain SC, Capasso F.
Ethnopharmacologic investigations of
ginger (Zingiber officinale). J Ethno-
pharmacol 1989; 27 (12):129140.
29. Mirabi P, Doulatian M, Mojab F, Alavimajid
H. Effect of Valeriana officinalis on the
systemic manifestations of dysmenorrhoea.
Int J Gynecol Obstet 2011;115:285-288.
30. Jarboe C, Schmidt C, Nicholson J and Zirvi K.
Uterine Relaxant Properties of Vibernum.
Nature 1966; 19:837-846.
31. Evans W, Harne W, Krantz J. Menstrual
cramps; An Herbal approach. 1942; 174-
177.
32. Jarry H, Harnischfeger G, Duker E. Studies
on the endocrine efficacy of the
constituents of Cimici fugaracemosa, In
vitro binding of constituents tooestrogen
receptors. Planta Med 1948; 4(9):94-98.
33. Weiss RF. Herbal Medicine, AB Arcanum.
London: Gothenburg, Sweden and
Beaconsfield; 1988, p 279.
34. Costello CH, Butler CL. An investigation of
Piscidiaerythrina (Jamacia dogwood). J Am
Pharm Assoc 1948; 37(3): 89-97.
35. Van Gurp G, Meterissian GB, Haiek LN. St
John’s wort or sertraline Randomized
controlled trial in primary care. Can Fam
Physician 2002; 48: 905-912.
36. Barene I, Daberte I, Zvirgzdina L, Iriste V,
The complex technology on products of
German chamomile. Medicina 2003; 39:
127-131.
37. Wang ZL, Sun PP, Li TX. Pulsatilla decoction
treat inflammatory bowel disease by
activating NLRP3. Zhong Yao 2012; 35 (8):
1280-1286.
38. Anil P, Manish S, Garvendra S, Vijay B.
Feverfew (Tanacetum parthenium).
Systemic Rev 2011; 5 (9): 103-110.
39. Hoffmann D. Thorson’s Guide to Medical
Herbalism. UK: Thorson’s; 1991, p146.
40. Chandler RF, Hooper SN. Ethnobotany and
phytochemistry of Yarrow, Achilleamille
folium, Compostitae. Econ Bot 1982; 36(2):
203-223.
41. Jonadet M, MeunierM, Villie T. Flavonoids
extracted from Ribiesnigrum L and
Alchemilla vulgaris L, I. In vitro inhibitory
activities on the enzyme elastase, trypsin
and α-chymotrypsin. II. Angio protective
activities compared in vivo, J Pharmacol
1986;17(1): 21-27.
42. Zargari A. Medicinal plants. 4th ed. Tehran:
Tehran Univ. Pub; 1982, p 651.
43. Jamieson DJ, Stegge JF. The prevalence of
dysmenorrheal, dyspareunia, pelvic pain
and irritable bowel syndrome in primary
care practices. Obstet Gynecol 1996; 87: 55-
58.
44. McIntyre A. The Complete Woman’s Herbal.
Rydalmere, NSW: Hodder Headline
Australia Pty Ltd.; 1995, p 110.
45. Graz B, Savoy M, Buclin T, Bonvin E.
Dysmenorrhea: patience, pills or hot-water
bottle. Rev Med Suisse 2014;10 (452):2285-
2288.
46. Ali-Shtayeh MS, Yaniv Z, Mahajna J.
Ethnobotanical survey in the Palestinian
area, a classification of the healing potential
of medicinal plants. J Ethnopharmacol
2000; 73(1-2):221-232.
Monawara et al 320
J Pharm Chem Biol Sci, June-Augu st 2016; 4(2):307 -320
47. Pimple BP, Patel AN, Kadam PV, Patil MJ.
Microscopic evaluation and
physicochemical analysis of Origanum
majorana Linn leaves. Asian Pacific J Trop
Dis 2013; 13(2):897-903.
48. Henley DV, Korach KS. Physiological effects
and mechanisms of action of endocrine
disrupting chemicals that alter estrogen
signaling. Hormones 2010; 9(3):191-205.
49. Smith CA, Zhu X, He L, Song J. Acupuncture
for primary dysmenorrhoea. Cochrane
Database Syst Rev 2011;19: 1-7.
50. Wayne PM, Kerr CE, Schnyer RN, Legedza
AT, Savetsk-German J, Shields MH, Buring
JE, Davis RB, Conboy LA, Highfield E, Parton
B, Thomas P, Laufer MR. Japanese-style
acupuncture for endometriosis-releated
pelvic pain in adolescents and young
women. J Pediatr Adolesc Gynecol 2008;21:
247-257.
51. Chen HM, Chen CH. Effects of acupressure
at the sanjinjiao point on primary
dysmenorrhoea. J Adv Nurs 2004; 48:380-
387.
52. Helms JM. Acupuncture for the
management of primary Dysmenorrhea.
Obstet, Gynecol 1986; 69(1):51-56.
53. Jonas WB, Jacobs J. Healing with
Homeopathy. The Doctors Guide. New
York: Warner; 1996, p 185.
Cite this article as:
Monawara Begum, Sumit Das, H.K. Sharma. Menstrual Disorders: Causes and Natural
Remedies. J Pharm Chem Biol Sci 2016; 4(2):307-320.
... Remaja yang tidak memberikan gejala perkembangan seksualnya (perkembangan payudara dan rambut pubis) pada umur 13 tahun harus dipantau oleh dokter. Setiap remaja putri yang tidak mendapatkan haid di umur 15 tahun harus dipantau sebagai amenorea primer 2) Amenorea sekunder terjadi di mana sebelumnya seorang wanita mengalami haid teratur namun terjadi keadaan selama minimal 3 bulan haidnya tidak terjadi (Begum, 2016). ...
... Menurut Kusmiran (2016) bahwa hipermenorea dapat juga diartikan menoragia yang merupakan keluarnya darah haid dengan jumlah yang banyak lebih dari umumnya (>80 ml/hari), dengan frekuensi mengganti pembalut lebih dari lima balutan per hari atau lebih lama dari umumnya (> 7 hari), biasanya saat haid disertai adanya gumpalan darah. Menoragia sering disertai terjadinya dismenorea karena melewati gumpalan besar yang bisa mengakibatkan kram yang sangat sakit (Begum, 2016). Wanita yang mengalami hal ini memiliki indikasi serta gejala sebagai berikut: 1) Lama haid yang tak teratur (>7 hari) maka diperlukan pembalut pengganti lebih dari 1 lapis bahkan pembalut tambahan/ganda untuk di malam hari. ...
... Dismenorea dapat dialami sekitar 30%-70% wanita dan terkadang memunculkan keluhan serta terganggunya kegiatan dan kenyamanan maka perlunya pengobatan secara farmakologi dan alamiah (Setyarini et al, 2022). Menurut Begum (Begum, 2016) Dismenorea yang parah bisa menyebabkan kram ketika haid. Nyeri terjadi di perut bagian bawah namun bisa merambat ke bagian punggung bawah dan paha. ...
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Penyusunan buku ini didorong oleh kebutuhan akan referensi yang lengkap dan mudah dipahami oleh berbagai kalangan, termasuk mahasiswa, praktisi kesehatan, serta masyarakat umum yang ingin memperdalam pengetahuannya tentang kesehatan reproduksi. Dalam buku ini, kami membahas secara mendalam berbagai gangguan dan masalah yang sering terjadi pada sistem reproduksi, mulai dari penyebab, gejala, diagnosis, hingga penanganan dan pencegahannya. Proses penyusunan buku ini melibatkan berbagai sumber literatur yang kredibel serta kontribusi dari para ahli di bidang kesehatan reproduksi. Kami berharap bahwa buku ini dapat menjadi referensi yang bermanfaat dan dapat membantu pembaca dalam memahami serta menangani masalah yang terkait dengan sistem reproduksi. Ucapan terima kasih kami sampaikan kepada semua pihak yang telah memberikan dukungan, baik berupa saran, kritik, maupun bantuan dalam bentuk lainnya, sehingga buku ini dapat diselesaikan tepat pada waktunya. Kami menyadari bahwa buku ini masih memiliki kekurangan, oleh karena itu, kami sangat mengharapkan masukan dan kritik yang membangun dari para pembaca untuk penyempurnaan di edisi-edisi berikutnya.
... It is generally accepted that the BMI is a useful tool for determining a healthy body mass index. [11] [12] A person is considered extremely underweight if their BMI is less than 16.5. If it falls between 16.5 and 18.4, it is deemed underweight; if it falls between 18.5-24.9, ...
... While 25-30 is considered overweight, class I obesity is defined as 30-35, class II obesity as 35-40, and class III obesity as over 40. [12] The study's goal is to assess the relationship between BMI and PMS symptoms, as well as to identify aggravating and mitigating factors. ...
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Premenstrual syndrome, or PMS, is a common issue that impairs the performance and quality of life of young women. It is characterized by the onset of cyclical emotional, psychological, and physical symptoms that subside once menstruation has ended and start during the luteal (premenstrual) phase of the menstrual cycle. The Body Mass Index (BMI) is a tool for identifying weight categories that could make medical conditions worse.
... This sometimes comes with pain and other discomforting experiences for women. This could be caused by many factors such as genetics, lifestyle, pregnancy related conditions and any other underlying health issues such as hormonal imbalance, uterine fibroids, and smallness of the cervix (Begum et al., 2016). This menstrual disorders could manifest in the form of tiredness, failure to concentrate on the given task, lethargy, depression, dizziness, loss of appetite, mood changes, uneasiness, nausea and vomiting, excessive perspiration and many others (Begum et al., 2016) . ...
... This could be caused by many factors such as genetics, lifestyle, pregnancy related conditions and any other underlying health issues such as hormonal imbalance, uterine fibroids, and smallness of the cervix (Begum et al., 2016). This menstrual disorders could manifest in the form of tiredness, failure to concentrate on the given task, lethargy, depression, dizziness, loss of appetite, mood changes, uneasiness, nausea and vomiting, excessive perspiration and many others (Begum et al., 2016) . Menstrual pattern vary among women. ...
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There is a growing concern about dysmenorrhea (menstrual pain among young female undergraduates of higher institutions because of its deleterious effect on their menstrual health and academic success. This study examined menstrual pattern and contraceptive use among female undergraduate student of Prince Abubakar Audu University, Anyigba. The study is descriptive in nature. The sample size was 330 derived through Krejcie and Morgan (1970) sample size formula based on the female population of the school. Multi-stage sampling technique employed to choose the respondents from the population of the students using multi-stage sampling technique. Data analysis was done with the use of Statistical Package for Social Sciences (SPSS) version 20. The analysis was done at univariate level using frequency distribution and percentages. Means scores were calculated for each Likert scale questions to make decision since the affected variables are ordinal in nature. The study showed that vast majority of the female student's experienced menstrual pains. The study further revealed that sizable percentage reported irregular cycles. It is also reported that the most commonly known contraceptive methods among the female undergraduate students are oral pills, injection and condom. It is revealed that contraception help female undergraduate students of higher learning to control their menstrual flow, reduce menstrual pain and have regular menstrual cycle. The study highlights the importance of better reproductive health education and services to enhance menstrual health and harmless contraceptive practices among female undergraduate students. These conclusions provide valuable understandings for policymakers and healthcare service providers to improve reproductive health care in tertiary institutions.
... Perceived stress was measured using an 11-item scale, with mean scores ranging from 0 to 4. Stress levels were categorised as not or somewhat stressed (0-0.9), moderately stressed (1-1.9) and very or extremely stressed (2)(3)(4) [34]. The use of contraceptives (combined oral contraceptive pill, progestogen-only contraception, injectable, implants, vaginal ring and intrauterine device) was dichotomised into two categories (used, not used). ...
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Objective To assess the association between menstrual disorders and workforce participation among Australian women. Design Population‐based cohort study. Setting Secondary analysis of eight surveys collected between 2000 and 2021. Population A total of 11 152 Australian women, born between 1973 and 1978. Methods Between 2000 and 2021, self‐reported longitudinal survey data were collected. At each survey, menstrual disorders and workforce participation were measured. Data were analysed using generalised estimating equations for multinomial responses, with stratification by age. Main Outcome Measures Workforce participation. Results Women who often experienced premenstrual tension reported lower odds of working part‐time compared to full‐time work (Adjusted Odds Ratio (AOR) = 0.74; 95% CI: 0.61, 0.90), with this finding strongest among women aged 31 to 40 (AOR = 0.68, 95% CI: 0.59, 0.78). While overall, women who often experienced irregular periods had higher odds of working part‐time compared to full‐time (AOR = 1.32, 95% CI: 1.08, 1.61), women aged 22 to 30 had lower odds of working part‐time (AOR = 0.61, 95% CI: 0.39, 0.97). Women who experienced severe period pain had higher odds of being unemployed compared to working full‐time (AOR = 1.18; 95% CI: 1.01, 1.36), with this association strongest in women aged 41 and older (AOR = 1.19, 95% CI: 1.01, 1.40). Conclusions There is substantial variation in the association between menstrual disorders and workforce participation, and the role of women's ages in these associations. Increased awareness of and further elucidation of these factors may improve women's engagement in the workforce.
... Premenstrual syndrome (PMS) refers to a cluster of physical, behavioural, and emotional symptoms occurring during the luteal phase, typically the week before menstruation [4]. These symptoms, often commencing after the 13th day of the menstrual cycle, can often disrupt women's daily lives [1]. ...
... These hormones will send out signals to her body, and some of them will tell the body to start to prepare for pregnancy every month. The menstrual cycle is the recurrent approximately monthly menstruation and provides hormones, to keep one healthy (Begum, Das, & Sci, 2016). It also prepares the female body for pregnancy each month. ...
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Menstrual cycle and menstruation can be given definitions as both are studied biologically hence the production of many literatures throughout the years. Recently, herbal medications are used as an alternative to oral contraceptive pills (OCPs) to treat women fertility in general and several literatures can be found to prove the effectiveness of herbal medicines on menstruation. The objectives of this paper are to learn if the female pre-university students are aware of their menstrual cycle and to study the effects of herbs on menstrual cycle. This questionnaire study is conducted within a population of 108 female pre-university students by distributing a web-based questionnaire through a shortened link. Cronbach alpha test is done after transferring data in the IBM SPSS Statistics ver.25 to measure the internal consistency of a test or a scale. The result shows that only 7.41% have used herbal treatments. Further studies analysis needs to be done to identify the effectiveness of the herbal treatments used on menstrual cycle.
... PMS can cause days of disruption to a woman's routine life. 3 For the first time, Frank referred to PMS as "Premenstrual Tension" in a clinical setting in 1931. Greene and Dalton coined the term "Premenstrual Syndrome" in 1953 to demonstrate that it manifests in many ways than merely emotional stress. ...
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Many women around the world are suffering from common physical discomfort just before their menstrual cycle. Symptoms may vary women to women which can be mild to severe such that it could affect their regular activities. Based on the diagnostic criteria, 2.5-3% of women of reproductive age have the severe form of PMS, while 40% of these women experience the moderate type. The symptoms seen were fluid retention, pain in pelvic region, mastalgia, psychological changes, behavioural changes, gastrointestinal problems, skin related problems and nervous system affecting problem. The targeting therapies to cure PMS includes allopathic as well as ayurvedic remedies. Allopathic includes mainly targeting brain SSRIs and some pharmacotherapies including administration of NSAIDs, anxiolytic agents, gonadotropin-releasing hormone (GnRH) agonists. etc. and recent studies shows combined oral contraceptives shows good effect to cure PMS prominently. And daily physical exercise can also overcome the PMS related problems wisely.
... A wide range of vaccine related adverse effects were documented in numerous trials that cover minor symptoms like fever, chills, headache, exhaustion, and arm pain to serious side effects like anaphylaxis and thrombosis (2). Other preventive measures include physical or social distancing, quarantining, ventilation of indoor spaces, use of face masks or coverings in public, covering coughs and sneezes, hand washing, and keeping unwashed hands away from the face (3). ...
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Menstrual irregularities are quite common in teenage girls, especially in the early years after menarche, during which periods may be irregular, heavy, or painful. While serious underlying conditions are rare, disruptions in menstruation can significantly impact daily activities and lead to school absences. Although most treatment evidence is derived from adult studies, there are many safe therapeutic options available for adolescents. This article presents a clinical review of current practices, focusing on the management of girls with additional medical conditions and learning disabilities
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Which treatments are used for dysmenorrhea and with what reported outcome? A questionnaire was sent to 2400 students and apprentices, following the "retrospective treatment-outcome" method. The response rate was 22%. Most frequent treatments used are ibuprofene (53%), paracetamol (51%), hormonal contraception (40%), hot-water bottle (or hot pad) (35%), food supplements or medicinal plants (23%). Physicians only discuss a tiny proportion of dysmenorrhea treatment in their consultation, because it is mostly a matter of self-treatment, with the family as the source of information in 80% of the cases. Rather surprising because not mentioned in most official guidelines, hot-water bottle (or hot pad) appears as the treatment followed by the best reported outcome (satisfactory in 92% of users).
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Study Objectives To assess the effectiveness of fennel on primary dysmenorrhea symptoms and menorrheal duration. Design Clinical trial study. Setting Islamic Azad University, Toyserkan. Participants 80 female students were randomly divided in to two groups of intervention (n = 40) and control (n = 40). Interventions The intervention group was given one soft capsule Fennel (30 mg) every 4 hours, 3 days before menstruation till the 5th day and continued for 3 months. The control group received no medication. Main Outcome Measures The severity of samples pain was graded using a visual analogue scale. 5 standard questionnaires include of Visual analog scale pain (VAS), McGill pain questionnaire, the range of stress about dysmenorrheal (VASA), Perceived stress scale, Well being scale were filled out in intervals of before, during and after fennel capsule uptake. Data were analyzed by SPSS 17 software. P < .05 was considered to be statistically significant. Results The mean of nausea intensity and weakness decreased to 1.93, and 2.88 after 3 months, whereas they were 2.37, 6.65 in control group which indicated a significant difference. Reduce the duration of menstrual period, a significant difference was found after two and three months of use. Concern in terms of quality and feelings of well-being after 1 and 3 months, was observed significant difference compared with before using. Conclusion Considering the safety of herbal medicines, this drug can use to relieve dysmenorrheal signs and menstrual duration.
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Objective To study the microscopic evaluation and physicochemical analysis of Origanum majorana Linn leaves.Methods Fresh and dried powdered leaf samples was studies for its morphology, microscopy, organoleptic characters, fluorescence analysis and various other WHO recommended methods for standardisation.ResultsLeaves are simple, petiolated, ovate to oblong-ovate, (0.5-1.5 cm) long, (0.2-0.8 cm) wide, with obtuse apex, entire margin, reticulate veination and symmetrical but tapering base. The microscopy revealed the dorsiventral nature of the leaf. Both the surfaces show presence of numerous covering trichomes, diacytic stomata and thin walled, wavy epidermal cells. The covering trichomes are multicellular, uniseriate, thin walled and pointed. In the midrib region, the epidermis is followed by collenchyma and vascular bundle (xylem and phloem). Whereas; the mesophyll exhibited only palisade cells and spongy parenchyma.Conclusions It can be concluded that the pharmacognostic profile can serve as tool for developing standards for identification, quality and purity of Origanum majorana Linn leaves.
Article
This review examined the currently available evidence supporting the use of acupuncture to treat primary dysmenorrhoea. To determine the efficacy and safety of acupuncture in the treatment of primary dysmenorrhoea when compared with a placebo, no treatment, or conventional medical treatment (for example oral contraceptives and non-steroidal anti-inflammatory medication (NSAIDs)). The following databases were searched (from inception until March 2010): the Cochrane Menstrual Disorders and Subfertillity Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), PubMed, CINAHL, PsycINFO, Chinese Biomedical Literature Database (CBM), Chinese Medical Current Content (CMCC), China National Knowledge Infrastructure (CNKI), VIP database, Dissertation Abstracts International, BIOSIS, AMED (The Allied and Complementary Medicine Database), Acubriefs, and Acubase. Inclusion criteria included all published and unpublished randomised controlled trials comparing acupuncture with placebo control, usual care, and pharmacological treatment. The following modes of treatment were included: acupuncture, electro-acupuncture, and acupressure. Participants were women of reproductive age with primary dysmenorrhoea during the majority of the menstrual cycles or for three consecutive menstrual cycles, and moderate to severe symptoms. Meta-analyses were performed using odds ratios (OR) for dichotomous outcomes and mean differences or standard mean differences (SMD) for continuous outcomes, with 95% confidence intervals (CI). Primary outcomes were pain relief and improved menstrual symptoms, measured by self-rating scales. Other outcomes included use of analgesics, quality of life, and absence from school or work. Ten trials were included in the review with data reporting on 944 participants. Six trials reported on acupuncture (n = 673) and four trials (n = 271) reported on acupressure. There was an improvement in pain relief from acupuncture compared with a placebo control (OR 9.5, 95% CI 21.17 to 51.8), NSAIDs (SMD -0.70, 95% CI -1.08 to -0.32) and Chinese herbs (SMD -1.34, 95% CI -1.74 to -0.95). In two trials acupuncture reduced menstrual symptoms (for example nausea, back pain) compared with medication (OR 3.25, 95% CI 1.53 to 6.86); in one trial acupuncture reduced menstrual symptoms compared with Chinese herbs (OR 7.0, 95% CI 2.22, 22.06); and in one trial acupuncture improved quality of life compared with usual care.There was an improvement in pain relief from acupressure compared with a placebo control (SMD -0.99, 95% CI -1.48 to -0.49), and in one trial acupressure reduced menstrual symptoms compared with a placebo control (SMD -0.58, 95% CI -1.06 to -0.10). The risk of bias was low in 50% of trials. Acupuncture may reduce period pain, however there is a need for further well-designed randomised controlled trials.
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To evaluate the results of uterine artery embolization (UAE) for symptomatic uterine leiomyoma by use of porous gelatin particles (PGP) in comparison with conventional hand-cut gelatin sponge particles. One hundred and fifteen consecutive patients who had undergone UAE were retrospectively assessed. The first 64 patients were treated with hand-cut gelatin sponge and the last 51 with PGP. Extent of infarction, volume reduction of the dominant leiomyoma on magnetic resonance (MR) imaging, and change in symptoms were assessed. UAE was successfully performed for all patients. No major complications were observed. MR images one month after UAE showed that the mean extent of infarction of the dominant leiomyoma was 97 % for patients treated with PGP and 96 % for those treated with hand-cut gelatin sponge. Volume reductions of the dominant leiomyoma after 3, 6, 12, and 24 months were, respectively, 45, 56, 62, and 66 % for use of PGP and 45, 57, 63, and 68 % for use of hand-cut gelatin sponge. Symptoms including heavy menstrual bleeding, heavy menstrual pain, and abdominal heaviness had improved by 95-100 % at 12 months. There was no difference between the two groups. UAE with PGP is safe, and as effective as conventional gelatin sponge particles.
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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.
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Pelvic inflammatory disease (PID) is characterized by infection and inflammation of the upper genital tract in women and can cause significant reproductive health sequelae for women. Although a definitive diagnosis of PID is made by laparoscopic visualization of inflamed, purulent fallopian tubes, PID is generally a clinical diagnosis and thus represents a diagnostic challenge. Therefore, diagnosis and treatment algorithms advise a high index of suspicion for PID in any woman of reproductive age with pelvic or abdominal pain. Antibiotic therapy should be started early, and given for an adequate period of time to reduce the risk of complications. Coverage for anaerobic organisms should be considered in most cases.
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For centuries, and still at present, the social history of premenstrual syndrome (PMS) and phenomena is entangled with the social history of gender relations. At of the turn of the 20th century there have been two main approaches to PMS: a biomedical–hormonal school which emphasizes the reproductive‐related biological aspects of PMS, and several psychosocial schools initially influenced by psychoanalytically‐oriented interpretations of phenomena. During the last several decades several feminist writers incorporated PMS, or more precisely denial of its existence, into their agenda. Currently, a biosocial approach to PMS is being shaped integrating genetic preponderance with dynamically evolving vulnerability, internal and external environments, hormonal triggers, brain–body responses and culturally‐sensitive phenomena. Hopefully exponentially accumulating facts and knowledge will overcome opinions and lead to a balanced approach to PMS and women's reproductive‐related disorders in general.