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Lepidium Meyeni and Pfaffia Paniculata May Improve QoL in Postmenopausal Women

April 2019
Journal of Gynecology and Womens Health 14(5)

DOI:10.19080/JGWH.2019.14.555896

Authors:

General characteristics of the study groups at the beginning of the study.

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Mean±SD of hot flashes number per day in both groups during the study.

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Mean±SD of hot flashes severity score per day in both groups during the study.

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Mean±SD of Kuppermann Index (KI) value in both groups during the study.

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Mean±SD of KI value in the supplement group at baseline and after 3 months.

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Research Article

Volume 14 Issue 5 - April 2019

DOI: 10.19080/JGWH.2019.14.555896

J Gynecol Women’s Health

J Gynecol Women’s Health 14(5): JGWH.MS.ID.555896 (2019) 001

Journal of

Gynecology and Women’s Health

ISSN 2474-7602

Introduction

Menopause is a biological event associated with a cessation

of women reproductive ability as a consequence of the

exhaustion of the ovarian reserve. Age at menopause in the

world ranges between 40-58, with an average of 51 years [1].

It also involves menopause-related complaints and disorders.

Hormone changes observed in this period may cause a variety

of symptoms: irregular menstrual cycle, vasomotor and psycho-

emotional disorders, urogenital dysfunctions, cardiovascular

diseases, lipid disorders, osteoporosis, type 2 diabetes mellitus,

and mental disorders. Approximately 70% of midlife western

       



and, in certain cases, even up to 30 years [2]. Following recent

medical advances and the consequent increase in life expectancy,

the number of menopausal women is on a rapid rise in western

countries, thus postmenopausal years constitute about one-third

        

either alone or in combination with progestogens, is often

recommended for the management of menopausal symptoms

[3]. However, many women prefer complementary or alternative

remedies such as herbal preparations or nutraceuticals, which

are often perceived as natural and therefore free of adverse





spread in several South American countries. For centuries, Maca

has been used successfully by native people of Peru for hormonal

imbalances, menstrual irregularities and infertility [4]. Some

reports suggest that Maca can be helpful in reducing discomfort



    

         

common root in South America, especially in Brazil, popularly

known as Brazilian ginseng, with reported estrogen-like effects

           

supplement might improve the quality of life of postmenopausal

women.

Material and Methods

         





           

other alternative treatment and no psychiatric treatment by the

        

informed about the possibility of taking part in the study, and after

an informed consent, they were randomly assigned to receive the

    



was used for randomization. Placebo and supplement tablets had

a similar appearance. All 60 participants included in the study

were instructed to record in a diary the number and the severity

  

calculated as the mean of the last 7 days before treatment and

before each monthly control. Reductions from the baseline in the



          







          

         

         

the woman had to stop her activity.

      

      

questionnaire that measures the physical and psychological



Improve QoL in Postmenopausal Women

Basile F*, Rizzo L, Graffeo G and R. D’Anna

Department of Human Pathology and Development, University of Messina, Messina, Italy

Submission: April 01, 2019; Published: April 10, 2019

*Corresponding author: Francesca Basile, Department of Human Pathology and Development, University of Messina, Italy

Keywords: 

Abbreviatations: 

How to cite this article: Basile F, Rizzo L, Graeo G, DAnna R. Lepidium Meyeni and Pfaa Paniculata May Improve QoL in Postmenopausal Women.

J Gynecol Women’s Health. 2019: 14(5): 555896. DOI: 10.19080/JGWH.2019.14.555896

002

Journal of Gynecology and Women’s Health

      

       

sweats, insomnia, nervousness, melancholia, dizness, fatigue,

arthritic pain, headache, palpitations and formication. Each





   

   

       

no menopausal symptoms, 17-25 points-mild symptoms, 26-30

points-moderate symptoms, and more than 30 points-severe

   

in frequency and severity of menopausal symptoms in the group

treated with this new supplement. Written informed consent

was obtained from all participants; the protocol and other

materials were in accord with the Helsinki Declaration of 1975

and approved by institutional review boards.

Statistical Analyses

       

         

          

the differences between the independent groups. A two-way

analysis of variance with repeated measures followed by a post

hoc multiple-comparison procedure was performed to verify

        

between different treatment groups and within groups over time.



P<0.05, and data were analyzed with SPSS software, version 17.0



Result

Table 1: General characteristics of the study groups at the beginning

of the study.

Supplement n. 30 Placebo n. 30 P

 52.1±5.5 52.7±5.8 ns

226.8±4.9 26.5±4.7 ns



 34±25 33±26 ns

ns = not signicant

Among postmenopausal women referred to our Menopause

Center, sixty women were recruited who met the inclusion

        

study, failing the appointment at the end of the study, probably

thinking that the supplement didn’t work; one dropped out in the

supplement group for not well precised side effects of the drug.

General characteristics of postmenopausal women enrolled are

     



    

    

difference was shown at baseline between groups. Instead, in

   

either between groups after 3 months, either in the treated

group comparing the values at the beginning and at the end

     



      

was highlighted either between groups after 3 months, either in

the treated group comparing the values at the beginning and at

    

      

         

difference was highlighted only for nervousness, melancholia

   



Table 2: Mean±SD of hot ashes number per day in both groups

during the study.

Supplement n. 29 Placebo n. 27 P

 8.1±5,8 8.9±5,6 ns

3th 5.8±5.6 8.7±4.6 < 0.01

P< 0.01 ns

ns = not signicant

Table 3: Mean±SD of hot ashes severity score per day in both groups

during the study.

Supplement n. 29 Placebo n. 27 P

 2.6±0.4 2.4±0,6 ns

3th 1.8±0.7 2.2±0.6 0.04

P< 0.01 ns

ns = not signicant

Table 4: Mean±SD of Kuppermann Index (KI) value in both groups

during the study.

Supplement n. 29 Placebo n. 27 P

 32.9±7.2 34.8±7.2 ns

th 16.6±4.2 32.6±7.5 0.01

P0.01 ns

ns = not signicant

Table 5: Mean±SD of KI value in the supplement group at baseline and after 3 months.

Symptomps Baseline N. 30 3° Month N.29 P

 10.3±2.0 6.3±2.05 < 0.01

 4.3±1.6 2.8±1.5 0.03

Insomnia 2.1±2.6 1.3±1.9 ns

 4.1±1.8 1.3±1.5 < 0.01

Melancholia 1.0±1.1 0.2±0.4 0.04

Dizzness 1.0±1.1 1.1±1.1 ns

003

Journal of Gynecology and Women’s Health

How to cite this article: Basile F, Rizzo L, Graeo G, DAnna R. Lepidium Meyeni and Pfaa Paniculata May Improve QoL in Postmenopausal Women.

J Gynecol Women’s Health. 2019: 14(5): 555896. DOI: 10.19080/JGWH.2019.14.555896

Fatigue 1.9±1.1 1.0±1.1 0.06

Arthritic pain 2.6±0.4 2.0±1.1 ns

Headache 0.7±0.8 0.3±0.4 ns

Palpitation 1.2±1.1 0.2±0.4 < 0.01

Formication 1.1±1.2 0.7±0.9 ns

Discussion

        



         

women treated with this supplement changed from the area

          

        

         

         

nervousness and melancholia, which suggests some effects

on mood. Furthermore, experimental studies showed that

Maca may improve memory impairment [7]. A border line

       

study, in which 2 fractions of polysaccarhide extracted from

    

on the fatigue related parameters [8]. A systematic review that

         

symptoms in healthy perimenopausal, early postmenopausal,

       

favorable effects of Maca on menopausal symptoms using the

   

methodological quality. However, it’s probably that such effects

may depend on plant sterols, which act as chemical trigger to

produce higher level of hormones appropriate to the age and

gender [4]. Furthermore, Gonzales et al. [9] reported that the

glucosinolates of maca could function as antioxidants and free

radical scavengers, improving fertility and sexual function in

rats.

Safety has not yet been proven, although Maca has been

reported to have low toxicity in both in vivo and in vitro studies

    

        

because its main components are stigmasterol, sitosterol,

       



saponins are considered the main active components of the root

and they have several biological properties [5]. Experimental

  

    

       



new supplement has been used for the treatment of menopausal

        

  

   

Phytosterols contained in both substances of the supplement



and for a longer time of treatment are needed to ascertain the



References

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Association of Age at Menopause With Incident Heart Failure: A Pro-

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3. -



4. 





5.     

   



6.    

clinical evaluation of estrogenic preparations by the menopausal and



7.         

        

improvement of mythocondrial activity and upregulation of autopha-

gy-related proteins in middle-aged mouse cortex. Evid Based Comple-

ment Alternat Med 2016: 4394261.

8. 



Biol Macromol 95: 1305-1311.

9. 

        

Endocrinol 3: 5.

10.          

    



How to cite this article: Basile F, Rizzo L, Graeo G, DAnna R. Lepidium Meyeni and Pfaa Paniculata May Improve QoL in Postmenopausal Women.

J Gynecol Women’s Health. 2019: 14(5): 555896. DOI: 10.19080/JGWH.2019.14.555896

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Preservation of Cognitive Function by Lepidium meyenii (Maca) Is Associated with Improvement of Mitochondrial Activity and Upregulation of Autophagy-Related Proteins in Middle-Aged Mouse Cortex

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Aug 2016
EVID-BASED COMPL ALT

Maca has been used as a foodstuff and a traditional medicine in the Andean region for over 2,000 years. Recently the neuroprotective effects of maca also arouse interest of researchers. Decrease in mitochondrial function and decline in autophagy signaling may participate in the process of age-related cognitive decline. This study aimed to investigate if maca could improve cognitive function of middle-aged mice and if this effect was associated with improvement of mitochondrial activity and modulation of autophagy signaling in mouse cortex. Fourteen-month-old male ICR mice received maca powder administered by gavage for five weeks. Maca improved cognitive function, motor coordination, and endurance capacity in middle-aged mice, accompanied by increased mitochondrial respiratory function and upregulation of autophagy-related proteins in cortex. Our findings suggest that maca is a newly defined nutritional plant which can improve mitochondrial function and upregulate autophagy-related proteins and may be an effective functional food for slowing down age-related cognitive decline.

Association of Age at Menopause With Incident Heart Failure: A Prospective Cohort Study and Meta‐Analysis

Article

Full-text available

Aug 2016

Background Early age (<45 years) at menopause has been postulated to be associated with increased cardiovascular disease risk; however, evidence of its relation with heart failure (HF) incidence is limited. We examined whether age at menopause is associated inversely with HF incidence in the Atherosclerosis Risk In Communities (ARIC) study and summarized all existing data in a meta‐analysis. Methods and Results In ARIC, data were obtained from 5629 postmenopausal women (mean age 56 years, 26% with bilateral oophorectomy) without HF. During a median follow‐up of 21.4 years, 965 incident HF events occurred. In a Cox regression model adjusted for reproductive health and HF risk factors, the hazard ratios for incident HF across categories of age at menopause (<45, 45–49, 50–54, and ≥55 years) were 1.32, 1.17, 1.00 (referent), and 1.12, respectively. Compared with women with later onset of menopause (aged ≥45 years), those with early menopause had elevated HF risk (hazard ratio 1.20, 95% CI 1.01–1.43). For the meta‐analysis, we searched Medline and Embase for articles published through December 2015 that prospectively evaluated age at menopause and HF risk. Summarized estimates from the 3 included studies (3568 events) showed higher HF risk among women with early menopause compared with those with later menopause (hazard ratio 1.33, 95% CI 1.15–1.53). Conclusions These results provided evidence that early age at menopause is associated with a modestly greater risk of HF. Identification of women with early menopause offers a window of opportunity to implement interventions that will improve overall cardiovascular health during the postmenopausal years.

Risk Factors for Extended Duration and Timing of Peak Severity of Hot Flashes

Article

Full-text available

May 2016
PLOS ONE

Objective: To identify risk factors associated with the duration of hot flashes and the time of peak hot flash severity in mid-life women. Methods: A cohort of 647 women reporting hot flashes were followed for 1-7 years, with survey data and hormone measurements. Survival analysis determined the association of risk factors with the duration of hot flashes. Linear regression determined the association of risk factors with the time of peak severity. Final models were determined through stepwise model selection. Results: Average hot flash duration was 2.5 years (range: 1-33), with peak severity on average at 2.96 years (range: 1-20). Duration of hot flashes was associated with race, education, menopause status, smoking history, BMI, alcohol consumption, leisure activity levels, and levels of estradiol and progesterone. In the final model, only race, alcohol consumption, leisure activity, and menopause were retained. White women had significantly shorter hot flash durations than non-white women. Women consuming at least 12 alcoholic drinks in the previous year had a significantly shorter duration of hot flashes with a smaller effect of hot flash duration on increasing in time to peak severity compared to those who consumed less than 12 alcoholic drinks in that year. Higher serum progesterone levels were associated with later peak severity if the duration of the hot flashes was less than 2 years and an earlier peak severity otherwise. Conclusions: These results suggest that some behaviors (such as moderate alcohol consumption) are associated with shorter durations of hot flashes, and that progesterone was associated with the dynamics of hot flash severity.

Red Maca (Lepidium meyenii) reduced prostate size in rats

Article

Full-text available

Feb 2005
REPROD BIOL ENDOCRIN

Epidemiological studies have found that consumption of cruciferous vegetables is associated with a reduced risk of prostate cancer. This effect seems to be due to aromatic glucosinolate content. Glucosinolates are known for have both antiproliferative and proapoptotic actions. Maca is a cruciferous cultivated in the highlands of Peru. The absolute content of glucosinolates in Maca hypocotyls is relatively higher than that reported in other cruciferous crops. Therefore, Maca may have proapoptotic and anti-proliferative effects in the prostate. Male rats treated with or without aqueous extracts of three ecotypes of Maca (Yellow, Black and Red) were analyzed to determine the effect on ventral prostate weight, epithelial height and duct luminal area. Effects on serum testosterone (T) and estradiol (E2) levels were also assessed. Besides, the effect of Red Maca on prostate was analyzed in rats treated with testosterone enanthate (TE). Red Maca but neither Yellow nor Black Maca reduced significantly ventral prostate size in rats. Serum T or E2 levels were not affected by any of the ecotypes of Maca assessed. Red Maca also prevented the prostate weight increase induced by TE treatment. Red Maca administered for 42 days reduced ventral prostatic epithelial height. TE increased ventral prostatic epithelial height and duct luminal area. These increases by TE were reduced after treatment with Red Maca for 42 days. Histology pictures in rats treated with Red Maca plus TE were similar to controls. Phytochemical screening showed that aqueous extract of Red Maca has alkaloids, steroids, tannins, saponins, and cardiotonic glycosides. The IR spectra of the three ecotypes of Maca in 3800-650 cm (-1) region had 7 peaks representing 7 functional chemical groups. Highest peak values were observed for Red Maca, intermediate values for Yellow Maca and low values for Black Maca. These functional groups correspond among others to benzyl glucosinolate. Red Maca, a cruciferous plant from the highland of Peru, reduced ventral prostate size in normal and TE treated rats.

Pfaffia paniculata-Induced Changes in Plasma Estradiol17β, Progesterone and Testosterone Levels in Mice

Article

Full-text available

May 2003

The present study undertook chemical analysis of components of Pfaffia paniculata roots. In addition, an animal experiment was conducted in which mice had ad libitum access to water enriched with powdered P. paniculata root for 30 days. Changes in plasma concentrations of estradiol-17beta and progesterone in female mice and of testosterone in male mice were ascertained. The results revealed that P. paniculata roots contain two types of phytosteroids, beta-sitosterol and stigmasterol, in addition to other compounds such as pfaffic acid, allantoin, saponins, beta-sitosteryl-beta-D-glucoside, and stigmasteryl-beta-D-glucoside. Regarding changes in plasma concentrations of hormones, levels of the sex hormones estradiol-17beta, progesterone and testosterone were clearly higher for mice that drank P. paniculata root-enriched water than for mice that drank plain water. Powdered P. paniculata root is easily dissolved in feed or water, and as no adverse reactions were seen in mice within 30 days of oral intake, consumption of P. paniculata for long periods of time appears safe.

Anti-fatigue activity of polysaccharide fractions from Lepidium meyenii Walp. (maca)

Article

Nov 2016

The two fractions of polysaccharide MPS-1 and MPS-2 were extracted from Lepidium meyenii Walp. (maca) by water, and purified using a DEAE-52 and a Sephadex G-100 column. The molecular weight (MW) of MPS-1 was 7.6 kDa, and the MW of MPS-2 was 6.7 kDa. The MPS-1 was composed of xylose, arabinose, galactose and glucose, with the mole ratio 1:1.7:3.3:30.5; the MPS-2 was composed of arabinose, galactose and glucose, with the mole ratio 1:1.3:36.8. The IR spectrum implied that only α-pyranose existed in MPS-1, and both α-pyranose and β-pyranose existed in MPS-2. The anti-fatigue activities of MPS-1 and MPS-2 were measured by the forced swimming test, along with the determination of blood lactate (BLA), urea nitrogen (BUN), lactic dehydrogenase (LDH) activity and liver glycogen (LG). The results indicated that both MPS-1 and MPS-2 presented dose-dependently positive effects on the fatigue related parameters. Additionally, MPS-2 has a better anti-fatigue effect than MPS-1.

Menopausal hormone therapy and menopausal symptoms

Article

Apr 2014

A majority of women will experience bothersome symptoms related to declining and/or fluctuating levels of estrogen during their menopausal transition. Vasomotor symptoms, vaginal dryness, poor sleep, and depressed mood have all been found to worsen during the menopausal transition. While vasomotor symptoms gradually improve after menopause, the time course can be many years. Vaginal dryness does not improve without treatment, while the long-term course of sleep and mood deterioration is not clearly defined at this time. A small minority of women have vasomotor symptoms that persist throughout the remainder of their lives. These common menopausal symptoms all improve with estrogen treatment. Over the last 10 years, we have witnessed a dramatic reduction in enthusiasm for menopausal hormone therapy, despite its high efficacy relative to other treatments. We have also seen the emergence of sound, evidence-based clinical trials of non-hormonal alternatives that can control the common menopausal symptoms. Understanding the natural history of menopausal symptoms, and the risks and benefits of both hormonal and non-hormonal alternatives, helps the clinician individualize management plans to improve quality of life.

Maca (Lepidium meyenii) for treatment of menopausal symptoms: A systematic review

Article

Aug 2011

Maca (Lepidium meyenii), an Andean plant of the brassica (mustard) family has been used for centuries in the Andes as an adaptogenic plant to manage anemia, infertility and female hormone balance. The aim of this review was to assess the evidence for and against the effectiveness of the maca plant as a treatment for menopausal symptoms. We searched 17 databases from their inception up to June 2011 and included all randomized clinical trials (RCTs) that compared any type of maca-based intervention to a placebo for the treatment of menopausal symptoms. All studies were assessed for methodological quality using the Cochrane 'risk of bias' assessment tool. Four RCTs met all inclusion criteria. These RCTs tested the effects of maca on menopausal symptoms in healthy perimenopausal, early postmenopausal, and late postmenopausal women. Using the Kupperman Menopausal Index and the Greene Climacteric Score, all RCTs demonstrated favorable effects of maca. There have been very few rigorous trials of maca for menopausal symptoms. The results of our systematic review provide limited evidence for the effectiveness of maca as a treatment for menopausal symptoms. However, the total number of trials, the total sample size, and the average methodological quality of the primary studies, were too limited to draw firm conclusions. Furthermore, the safety has not been proved yet. Therefore, the efficacy and safety should be tested in larger studies.

Comparative clinical evaluation of estrogenic preparations By the menopausal and amenorrheal indices

Article

Jul 1953

ESTROGENS for clinical use are usually standardized either by animal assay or by unit weight of crystalline material. Although such methods yield some information as to the expected comparative efficacy of these preparations in man they are inadequate for exact dosage relationships in clinical medicine. Hence, it is desirable that the relative activity of estrogens be based upon human ‘assay’ rather than biologic or chemical standardization procedures. The investigation of the clinical efficacy of different hormonal preparations, however, presents many difficulties and must, of necessity, entail large series of subjects to offset the inroads of biologic variation. Unfortunately, in the clinical evaluation of the effectiveness of steroid estrogens or their stilbene confreres, greater variability of response and less predictability of results occur than in animal assay procedures. In the latter assay methods one can adhere to a rigid selection of an adequate number of properly standardized subjects. The hormonal deficiency state produced in the laboratory animal according to the appropriate assay technique also provides an adequate base level from which one can establish the degree of response of the animal to the administered endocrine preparation. Such hypoglandular states cannot be induced at will clinically, and only patients exhibiting endocrine insufficiencies can be employed in the human evaluation of the different estrogenic hormones.

Toxicological aspects of south American herbs: Uncaria tomentose (Cat’s Claw) and Lepidium meyenii (Maca). A Critical Synopsis

Article

Feb 2005
Toxicol Rev

Recent exceptional growth in human exposure to natural products known to originate from traditional medicine has lead to a resurgence of scientific interest in their biological effects. As a strategy for improvement of the assessment of their pharmacological and toxicological profile, scientific evidence-based approaches are being employed to appropriately evaluate composition, quality, potential medicinal activity and safety of these natural products. Using this approach, we comprehensively reviewed existing scientific evidence for known composition, medicinal uses (past and present), and documented biological effects with emphasis on clinical pharmacology and toxicology of two commonly used medicinal plants from South America with substantial human exposure from historical and current global use: Uncaria tomentosa (common name: cat’s claw, and Spanish: uña de gato), and Lepidium meyenii (common name: maca). Despite the geographic sourcing from remote regions of the tropical Amazon and high altitude Andean mountains, cat’s claw and maca are widely available commercially in industrialised countries. Analytical characterisations of their active constituents have identified a variety of classes of compounds of toxicological, pharmacological and even nutritional interest including oxindole and indole alkaloids, flavonoids, glucosinolates, sterols, polyunsaturated fatty acids, carbolines and other compounds. The oxindole alkaloids from the root bark of cat’s claw are thought to invoke its most widely sought-after medicinal effects as a herbal remedy against inflammation. We find the scientific evidence supporting this claim is not conclusive and although there exists a base of information addressing this medicinal use, it is limited in scope with some evidence accumulated from in vitro studies towards understanding possible mechanisms of action by specific oxindole alkaloids through inhibition of nuclear factor (NF)-κB activation. Although controlled clinical studies have demonstrated reduction in pain associated with cat’s claw intake in patients with various chronic inflammatory disorders, there is insufficient clinical data overall to draw a firm conclusion for its anti-inflammatory effects. An important observation was that experimental results were often dependent upon the nature of the preparation used. It appears that the presence of unknown substances has an important role in the overall effects of cat’s claw extracts is an important factor for consideration. The available animal toxicological studies did not indicate severe toxicity from oral intake of cat’s claw preparations but rather were suggestive of a low potential for acute and subacute oral toxicity, and a lack of evidence to demonstrate genotoxic potential and mutagenic activity. Maca is a clear example of a herb with substantial medicinal use in traditional herbal medicine by indigenous cultures in South America since the first recorded knowledge of it in the seventeenth century. The hypocotyls of maca are the edible part of the plant used for nutritional and proposed fertility-enhancing properties. Maca has been described to possess many other medicinal properties in traditional herbal medicine but only a few of them have been well studied scientifically. Published clinical studies of maca seem to be related to its property as a nutrient, for male fertility and for energy. There are inadequate data regarding the precise mechanism of action of maca. Some studies suggest that secondary metabolites found in maca extracts are important constituents responsible for its physiological effects. Maca has been reported in the scientific literature to have a low degree of acute oral toxicity in animals and low cellular toxicity in vitro. An important finding unveiled by this review is the importance of standardisation in quality and additional basic and clinical research to scientifically validate and understand composition, biological activity, safety and risk. Development of a comprehensive pharmacological and toxicological profile through critical evaluation of existing and future experimental data, especially carefully conducted clinical studies would facilitate the scientific evidence-based approach to understanding potential biological effects of these major traditionally based herbals in current global use.