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The Pharma Innovation Journal 2023; 12(4): 931-939
ISSN (E): 2277-7695
ISSN (P): 2349-8242
NAAS Rating: 5.23
TPI 2023; 12(4): 931-939
© 2023 TPI
www.thepharmajournal.com
Received: 01-01-2023
Accepted: 04-02-2023
Deeptimayee Mahapatra
Ph.D. Scholar, Department of
Food Science and Nutrition,
College of Community Science,
Assam Agriculture University,
Assam, India
Jwngsar Baro
Ph.D. Scholar, Department of
Food Science and Nutrition,
College of Community Science,
Assam Agriculture University,
Assam, India
Mamoni Das
Professor, Department of Food
Science and Nutrition, College of
Community Science, Assam
Agriculture University, Assam,
India
Corresponding Author:
Deeptimayee Mahapatra
Ph.D. Scholar, Department of
Food Science and Nutrition,
College of Community Science,
Assam Agriculture University,
Assam, India
Advantages of seed cycling diet in menstrual
dysfunctions: A review based explanation
Deeptimayee Mahapatra, Jwngsar Baro and Mamoni Das
Abstract
The seed cycling/seed rotation diet is a new trend that claims to be effective for female menstrual
dysfunctions such as irregular menstruation, menstrual cramps, infertility, menopausal symptoms (hot
flashes, fatigue, etc.), and PCOS. The higher prevalence of hormonal imbalance in women is a
contributing factor to all of these menstrual dysfunctions. The major hormones that control menstruation
in females include progesterone, estrogen, luteinizing hormone (LH), and follicular stimulating hormone
(FSH), and a simple imbalance in their concentration is the root cause of a variety of menstrual problems.
The practice of eating specific seeds during the two main phases of the menstrual cycle (follicular and
luteal) to promote a healthy balance of estrogen and progesterone levels in women is known as the seed
rotation diet. During the follicular stage consumption of pumpkin seed and flax seed is advised and in the
luteal stage consumption of sunflower seed and sesame seed is advised in this diet. Recent studies have
shown that pumpkin seeds are rich in phytoestrogen which is a polyphenol compound that exerts a
mammalian estrogenic-like effect in body. Similarly, flax seed in the first phase helps to bind the excess
estrogen produced to maintain the hormonal homeostasis. Sesame seeds, which are high in zinc and
lignans, are thought to help with progesterone balance during the luteal phase, while sunflower seeds,
which are high in vitamin E and selenium aids in, increasing progesterone production and liver
detoxification of excess estrogen. However, despite plenty of anecdotal accounts of its usefulness,
scientific evidence to back its claims is still weak or lacking.
Keywords: Menstrual dysfunctions, seed cycling diet, hormonal imbalance
Introduction
Menstrual dysfunctions are a group of acute difficulties that women suffer around the world
during their reproductive years and for a few years beyond menopause, and they have a
significant impact on women's daily lives. Premenstrual syndrome (PMS), dysmenorrhea,
amenorrhea, hypomenorrhea, menorrhagia, polymenorrhea, and oligomenorrhea are examples
of prevalent menstrual dysfunctions [1] (Table. 1). Menstrual disorders are among the most
common gynecological symptoms, particularly among adolescents, with PCOS and infertility
being the most pressing issues nowadays. During the menstrual cycle, body undergoes many
physiological and hormonal changes. The process begins with the brain triggering certain
hormones to stimulate egg growth followed by the traveling of a mature egg from the ovary to
the uterus through the fallopian tube and finally disposal through the vagina with blood in
absence of fertilization. As a result, a simple disruption in the hormonal management of the
menstrual cycle might result in a variety of menstruation issues. Treatment for these conditions
varies depending on the origin, nature, and stage of life (before pregnancy, and old age).
Anovulatory menstrual dysfunctions (missing periods, irregularities, and infrequent periods)
are commonly treated with oral contraceptives, cyclic progestin, and non-medical treatments
(nutritional therapy, dietary changes, and workouts, for example) [2, 3]. Treatments such as
hormone-releasing intrauterine devices, hormone-containing drugs, and non-steroidal
pharmaceuticals, among others, are currently in use for ovulatory menstrual dysfunctions
(heavy or extended menstrual bleeding) with specific limits and sideeffects [4, 5, 6, 7].
Seed cycling/seed rotation is a developing diet trend that has been claimed to improve
hormonal balance, fertility, and menstrual health dysfunctions in women of reproductive age
and those approaching menopause. It mostly entails the ingestion of seeds such as flax,
pumpkin, sesame, and sunflower seeds at various points throughout the month to regulate
hormones that regulate female menstruation health (Fig. 1.). Pumpkin, seed, and flaxseed are
recommended to be ingested during the follicular period since they can aid in increasing
estrogen levels while preventing excess estrogen production.
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Pumpkin seed contains phytoestrogens that mimic estrogenic
activities [8], whereas flax seeds the second major seed
prescribed in the diet contain lignans which bind to excess
estrogen and maintain the hormonal balance. During the
second phase of the menstrual cycle / the luteal phase, sesame
seeds and sunflower seeds are believed to boost progesterone
production in this diet. Sesame seeds are also rich sources of
zinc which bestows similar effects to progesterone production
and also contain lignans that help to block excess estrogen
while progesterone rises. Sunflower seeds are a rich source of
two vital micronutrients such are vitamin E and selenium.
Vitamin E can elevate progesterone production, while
selenium helps in the detoxification of excess estrogen from
the liver. However, sesame seeds are beneficial for
postmenopausal women by improving blood lipids,
antioxidants, and sex hormones (Fig. 1).
Even though this diet has gained popularity, scientific
research on its effectiveness is limited. As a result, this article
attempts to incorporate scientific studies that have
demonstrated the therapeutic effects of these seeds on female
menstruation health, as well as to explore the mode of action
of these seeds in various menstrual dysfunctions.
Methodology:
A detailed literature search for this review article was
conducted in two phages in electronic databases like Google
scholar, Pubmed, Mendeley library, and Medline for the
collection of research papers. The first phage literature search
was conducted with the objective to find out the prevalence of
menstrual problems in women of different ages. The
keywords or combination of words like "prevalence of
menstrual dysfunction" OR “prevalence of menstrual
problems” were used and adapted for each database search.
Each study included in this phage was selected based on the
year of publication (2010-2022) and the number of menstrual
problems reported (>3 types). Advanced search criteria like
‘words present in title only’, and ‘English language only’
were applied while searching publications on the cited
databases.
The second phage search was undertaken with the objective to
justify the effect of the seed cycling diet on menstrual health
through scientific studies signifying the effect of individual
components of this diet. The following keywords or
combination of words were used and adapted for each
database for the second phage search: (“flax seed and
menstrual health”) AND (“sunflower seed and menstrual
health”) AND (“pumpkin seed and menstrual health”) AND
(“sesame seed and menstrual health”) AND (“phytoestrogen
and menstrual health”) AND (“lignan and menstrual health”)
AND (“vitamins and menstrual health”) AND (“minerals and
menstrual health”). No time frame was specified for the
literature search in this phase. Advanced search criteria like
‘words present anywhere in the article’, and ‘English
language only’ were applied while searching publications on
the cited databases.
For both phages thesis, dissertations, and unpublished studies
were excluded from this review article. All the included
studies were selected by screening the titles first, followed by
abstract analysis. Selected studies were downloaded in a full-
text article form and critically screened according to the
inclusion and exclusion criteria of both phages.
Discussion
Menstrual dysfunctions and their prevalence:
Menstruation can be characterized as the periodic shedding of
endometrial tissue along with some amount of blood through
the vagina in absence of any pregnancy. The first
menstruation of a female (menarche) is considered as an
important developmental milestone of puberty and an
indicator of maturity in females [9]. From the third year after
menarche, clinical evidence suggests that the time between
menstrual cycles is generally 21-34 days, and a flow lasting
from 3 to 7 days with 35 ml (range 5-80 ml) of mean
menstrual blood loss [10]. Variability in this menstruation trend
will lead to menstrual dysfunctions (Table. 1.) [11, 12, 13].
However, the most discussed cause of this variability in
menstrual trends is hormonal imbalance.
Table 1: Characteristics of common menstrual dysfunctions:
Sl. No
Menstrual Dysfunctions
Characteristics
1.
Dysmenorrhea
Mild to severe pain before or at onset of menstrual flow.
2.
Amenorrhea
No menstruation for ≥3 months
3.
Hypomenorrhea
Scanty blood flow/ shorter duration (<2 days)/ both
4.
Menorrhagia/Hypermenorrhea
Bleeding for >8 days/ >4 fully soaked pads per day
5.
Irregularity
Menstrual cycle <22 days / >35 days
6.
Premenstrual syndrome
Mood swings, headache, bloating, stress, anxiety, and backache
7.
Metrorrhagia
Inter-menstrual bleeding
8.
Menometrorrhagia
Prolonged and excessive bleeding, irregularity and frequent menstruations
9.
Polymenorrhea
Menstrual cycle <21 days
10.
Oligomenorrhea
Menstrual cycle ≥35 days,
11.
Mastalgia
Tenderness / soreness of breast just before or during menstruation
From the table, we can conclude that the most prevalent
menstrual problem recorded with the highest percentages are
dysmenorrhea (range: 15-96%), followed by PMS (33-96%),
irregularity of period (10-62%), oligo-menorrhea (6-22%),
menorrhagia (1-37%), and polymenorrhea (2-21%).
Menstrual dysfunctions and hormonal imbalance
A female experiences an average of 450 menses throughout
her life which makes it a topic very engrossing for researchers
and clinicians. Moreover, a complete knowledge of the
interplay of hormones in the physiology of menstruation is
very essential for perceiving menstrual dysfunctions more
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precisely and concluding a treatment for the same. The very
first menstruation (menarche) starts when the gonadotrophin-
releasing hormone (GnRH) starts secreting from the
hypothalamus in a pulsatile and periodic manner towards the
age of menarche. GnRH then stimulates the anterior pituitary
to release FSH and LH which acts on ovaries. Ovaries under
the influence of FSH release estrogen from their granulose
cells and a little amount of progesterone from theca cells
under LH influence. This stage is named the proliferative
stage or the follicular stage that lasts from the 1st to14th day
of a menstrual cycle. During this stage estrogen levels
increase to promote follicular growth (from primordial to
graafian follicle), endometrial growths, and to facilitate the
establishment of sperm channels [14]. Towards the end of this
stage, the excess estrogen gives negative feedback to the
hypothalamus to reduce the production of FSH as the graafian
follicle needs to be ruptured for ovulation to happen. This
period is just before ovulation when FSH is reducing in
concentration as LH is increasing is denoted as LH surge. The
second phase or the luteal phase lasts from day 14th-day 28th.
It is characterized by the increased production of progesterone
and slowly reduced estrogen levels. At beginning of the
second phase, the egg from the mature follicle is released and
the corpus luteum is created under the effect of progesterone
and LH surge. Again towards the end of the luteal stage,
excess progesterone gives negative feedback to the anterior
pituitary to decrease the production of FSH and LH. During
this decline of hormones corpus luteum works as a secretory
vessel of progesterone and estrogen to maintain the levels.
Progesterone secreted from the corpus luteum towards the end
of the phase slows down the endometrial proliferation,
decreases lining thickness creates more complex glands, etc.
and estrogen on the other hand secreted at a comparatively
lower concentration (only from the corpus luteum) aids in
endometrial proliferation. At around the 28th day and just
before that the corpus luteum starts to degenerate in absence
of implantation of a fertilized ovum. Therefore the estrogen
and progesterone levels decrease rapidly causing the uterine
endometrial wall to shed which is called menses and it lasts
grossly from 0-5th day of the next menstrual cycle (Fig. 1) [15,
16, 17, 18].
Studies have suggested that mild elevation of female
androgens (hyperandrogenism) is the most common
endocrinopathy in women which affects about 10-20% of
them19. It is the causative factor for disruptive gonadal
functions and menstrual irregularities. Moreover, it has a
direct link to the degree of menstrual irregularities in women
because of its direct correlation with testosterone levels and
the length of the follicular phase, and its indirect correlation
with the length of the luteal phase20. Therefore imbalance of
the essential gonadal hormones is crucial among the few
factors for the menstrual changes and dysfunctions recorded
across age, ethnicity, and body weights [21, 22].
Pumpkin seed and its role in menstrual dysfunctions
The oil of pumpkin seeds has proved to contain a high
percentage of phytoestrogens, minerals (Zn, Mg, Cu, Mn, Fe,
P) and sterols (secoisolariciresinol, lariciresinol) [23, 24].
Phytoestrogens as the name suggest mimic the function of
estrogen due to their ability to bind with the estrogen
receptors8. These are polyphenols present in plant extracts
and are present in pumpkin seeds at a concentration of 265
mg/100g of seeds [25]. Rodent model studies have proven the
estrogenic activities of pumpkin seeds such as regulating lipid
metabolism, bone remodeling, and mammary gland and
uterus epithelial cell development [26, 27, 28]. Due to these
effects, phytoestrogens and phytoestrogen-containing diet are
suggested to be useful for the prevention and treatment of
vasomotor menopausal symptoms especially hot splashes and
night sweats. Unfortunately, demonstrable evidence for such
effects is weak at present, with most clinical trials showing no
or minimal results which require more scientific in-depth
studies [29, 30, 31, 32].
Moreover, the zinc in pumpkin seeds supports progesterone
production towards the progesterone rise in the second phase
of the menstrual cycle. The mineral zinc promotes the
formation of the corpus luteum, which is responsible for
producing progesterone and stimulates the uterus to thicken in
preparation for potential implantation [33]. Zinc has been
proven associated with progesterone levels in the body by few
researchers. The study by Kechrid et al., in 2006 suggested
that zinc supplementation can improve the progesterone level
significantly in the non-pregnant mice group [34]. A similar
type of result was also reported by Nishi, in 1996 where
hypogonadism led by Zn deficient diet was recorded [35]. Om
and Chung (1996) showed that zinc deficiency led to
inhibition in LH and estrogen levels [36]. Nonetheless, a
remarkable finding supporting the relation between zinc and
estrogen was that zinc was a significant stimulator in estradiol
synthesis [37]. Another theory that strongly supports the
relationship between estrogen and zinc is the oxidants and
luteal formation and progesterone theory. An increased
intracellular oxidant level impairs luteal formation and also
progesterone production which can be reduced by
antioxidants like Zn/Cu-superoxide dismutase. These Zn-
superoxide dismutases require Zn to function [38].
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Table 2: Selected Studies citing prevalence of menstrual dysfunctions among women:
Study ID
Country,
region
Study Design
Age
group
Sample
Size
Menstrual Problems
Dysmenorrhea
Irregular
cycle
PMS
Menorrhagia
Polymenorrhea
Oligomenorrhea
Bahrami et al.,
2022 [83]
Iran (Mashhad
and Sabzevar)
Descriptive
survey
10-19 yr
897
68.80%
18.70%
47.60%
2.10%
3.10%
15.60%
Kanmani et al.,
2016 [84]
India (Tamil
Nadu)
Descriptive
survey
12-18 yr
166
28.30%
36.70%
-
-
8.40%
4.80%
Shiferaw et al.,
2014 [85]
Ethiopia
Cross-sectional
17-24 yr
470
85.10%
46.20%
72.80%
4.30%
3.80%
14.90%
Antherjanam et
al., 2016 [86]
India (Kerala)
Cross-sectional
13-18 yr
1722
71.50%
-
-
-
22.30%
18.10%
Omidvar et al.,
2011 [87]
India (Mysore)
Cross-sectional
18-27 yr
194
78.20%
11.90%
-
4.10%
2.20%
6.00%
Dambhare et al.,
2012 [88]
India
(Maharashtra)
Cross-sectional
10-19 yr
1100
56.15%
57.90%
56.16%
1.25%
8.38%
22.10%
Karout N., 2015
[89]
Saudi Arabia
(Al Khobar)
Cross-sectional
18-20 yr
342
96.30%
36.40%
95.60%
9.10%
21.30%
21.60%
Karki et al., 2017
[90]
Nepal
(Kathmandu)
Cross-sectional
18-23 yr
171
53.80%
35.70%
67.30%
2.90%
4.10%
9.90%
Ali et al., 2020 [91]
Saudi Arabia
(Al Neelain)
Cross-sectional
18-24 yr
149
94.00%
55.00%
-
2.63%
-
-
Tabassum et al.,
2020 [92]
Pakistan
(Balochistan)
Cross-sectional
>18y r
100
15.00%
62.00%
>50%
13.00%
-
-
Gaddala et al.,
2021 [93]
India
(Telengana,
Karimnagar)
Cross-sectional
19-25 yr
100
86.00%
25.00%
83.00%
12.00%
6.00%
19.00%
Varghese et al.,
2019 [94]
India (kerala,
Thiruvanantha
puram)
Descriptive
survey
13-18 yr
350
79.00%
24.00%
84.00%
4.00%
12.60%
-
Yaliwal et al.,
2020 [95]
India
(Karnataka)
Cross-sectional
10-19 yr
1016
62.00%
33.36%
-
12.20%
11.60%
21.80%
Samreen et al.,
2016 [96]
India
(Kashmir)
Cross-sectional
15-45 yr
810
51.00%
10.00%
48.00%
24.00%
1.85%
8.88%
Ekpenyong et al.,
2011 [1]
Nigeria (Uyo)
Cross-sectional
16-23 yr
393
-
-
33.10%
37.50%
-
19.90%
Nwankwo et ak.,
2010 [97]
Nigeria
(Enugu)
Cross-sectional
10-19 yr
495
25.00%
31.10%
-
4.60%
19.20%
12.10%
Fig 1: Role of Seed cycling diet in menstrual health
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Flaxseed and its role in menstrual dysfunctions
Literature suggests that flaxseed helps in lengthening the
luteal phase, improving ovulation, and reducing common
PMS symptoms such as mastalgia (cyclic breast pain) and
cramping. Several human trials have proved that flax seed
consumption can cure menstrual irregularity due to the
presence of a specific compound named lignin [39, 40, 41].
Lignans are a group of phytochemicals that have been shown
to possess weak estrogenic and antiestrogenic properties
depending upon duration, dose, and stage of development [42,
43, 44, 45, 46, 47, 48, 49]. A balanced randomized cross-over design
study recorded an increased luteal phase length and higher
progesterone to estrogen ratio in the flax seed ingested group
than in control [50]. Again Vaziri et al., in 2014 suggested that
flaxseed was effective in reducing mastalgia which was later
substantiated by the results of the study conducted by
Jaafarnejad, et al., in 2017 [51, 52]. Mastalgia condition
generally started in the later luteal phage and before
menstruation started due to the increased estrogen, decreased
progesterone, and elevated prolactin concentrations [53]. This
may explain the recommendation of flax seed from the 1st to
14th day of a menstrual cycle under the seed cycling diet.
Again few research articles witnessed improved menstrual
cycles/regularity and increased progesterone secretion due to
the supplementation of omega-3, [54] which could be another
reason for flax seed recommendation in this diet.
Similarly, negative effects or antiestrogenic effects of flax
seed lignans were reported by several studies [55, 56, 57, 58, 59].
According to in-vitro and in-vivo studies, flax seed/ lignan
(especially enterolactone) ingestion is associated with
increased synthesis of sex hormone-binding globulin or sex
steroid-binding globulin (SHBG) protein concentration [60, 61]
which can be a possible explanation for the antiestrogenic
effect of lignan on menstrual cycle [62].
Sunflower seed and its role in menstrual dysfunctions
Sunflower seeds are a rich source of vitamin E and minerals
like calcium, iron, magnesium, phosphorus, potassium,
sodium, zinc, copper, manganese, and selenium [63]. Out of
these important constituents, the principal nutrients that are
believed to be crucial for menstrual health in the seed cycling
diet are Vitamin-E and selenium. The trace mineral selenium
supports estrogen detoxification in the liver [64, 65] which helps
bind excess estrogen during the luteal phase when estrogen
declines and progesterone rises [66, 67].
Vitamin E the second focal nutrient of sunflower seeds
proved to improve PMS in some human studies. Dadkhah et
al., in 2016 conducted a randomized double-blind, controlled
trial with 86 women facing PMS. 100 mg vitamin E
supplementations were provided to the women for 2 months.
After the study, the mean score of the syndrome significantly
decreased in the experimental group as compared to the
placebo [68]. Another study conducted by Mandana et al., in
2013 to compare the effect of vitamin E, vitamin B6, calcium,
and omega-3 on the treatment of premenstrual syndrome
showed statistically significant differences regarding the
physical symptoms, and mental symptoms of the vitamin E
group. This double-blind clinical randomized trial study was
carried out on two hundred girls with moderate and severe
forms of premenstrual syndrome divided into 4 groups. The
vitamin-E supplementation group received 100 mg of Vit-E
daily for three consecutive cycles [69]. Similar results were
recorded in a single double-blind trial that evaluated the
effects of vitamin E supplementation in PMS. In that trial, 41
women with PMS received 400 IU/day of vitamin E for three
cycles. The results showed a significant improvement in some
affective and physical symptoms in the vitamin E group [70].
Sesame seed and its role in menstrual dysfunctions
Sesame seed is a good source of omega-3, omega-6, and
vitamin E which is self-explanatory for its recommendation in
the seed cycling diet. Due to the presence of these nutrients
sesame seed is also believed to improve hormone production
and follicle function as sunflower seed and flax seed. Again
as pumpkin seed, the higher concentration of Zn in it is
predicted to improve the formation of the corpus luteum in the
uterus, which is responsible for producing progesterone and
stimulates the uterus to thicken in preparation for potential
implantation [71, 72]. Sesame also contains lignans which help
to block excess estrogen during the luteal phase as flax seeds
and pumpkin seeds. In a randomized, placebo-controlled,
crossover study supplementation of sesame seeds showed
decreased serum dehydroepiandrosterone sulfate (helps in
estrogen production), and increased serum sex hormone-
binding globulin (binds excess sex hormones) and urinary 2-
hydroxy estrone (estrogen metabolites) in postmenopausal
women [73]. This study supported the lignan theory of sesame
seeds.
PCOS and Seed cycling diet
Polycystic ovary syndrome is a complicated disease
characterized by interconnected genetic, endocrine,
environmental, and behavioral variables that result in different
reproductive, metabolic, and psychological characteristics [74].
Irregularity and longer menstruation cycles are believed to be
the hallmark of this syndrome. Studies revealed that PCOS is
reported in 85-90% of women suffering from oligomenorrhea
whereas 30-40% in women struggling with amenorrhea [75, 76].
Similarly, hyperandrogenism accounts for the presence of
PCOS in grossly 80% of women [77]. Although the
etiopathogenesis of PCOS is poorly understood yet, genetic
factors, endocrine factors, and environmental factors are some
of the broad areas that include all the identified causes for the
onset of this syndrome [78, 79]. Other than genetic factors the
other two factors are modifiable for which these are always
been topics of interest for researchers. Endocrine factors for
PCOS include FSH deficiency, hypersecretion of LH, and
hyperandrogenemia. Shreds of evidence suggested that
hyperandrogenemia condition arouse due to the
overproduction of androgens from ovaries or reduced
production of sex hormone-binding protein from hepatocytes
in PCOS patients. In-vitro studies have suggested that high
levels of androgen suppressed oocyte maturation rate and also
contributed to the inhibition of its meiotic maturation
resulting in faulty folliculogenesis [80, 81, 82]. Though a direct
effect of seed cycling diet in improving PCOS is not yet
scientifically explored, as discussed in this paper the
individual seeds have proven their efficacies in correcting
hormonal imbalances (hyperandrogenism, LH: FSH ratio) and
improving menstrual problems which can be served as a base
for anticipating a positive effect of seed cycling diet on PCOS
management and prevention. Hence extensive clinical studies
are needed for this diet and its therapeutic benefits.
Conclusion
According to the literature cited in this paper it can be
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concluded that menstrual dysfunctions and menstrual
morbidities are prevalent in younger women than older which
are affecting their physical as well as psychological well-
beings resulting in disrupting their productivity. Though the
existing treatments available are efficient to manage these
dysfunctions, but they come with their repercussions. Hence
seed cycling diet, as a diet based therapy can be studied
further to establish its evidence based dose dependent
effectiveness on female menstrual health.
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