ArticlePDF Available

Advantages of seed cycling diet in menstrual dysfunctions: A review based explanation

Authors:

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.
~ 931 ~
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.
~ 932 ~
The Pharma Innovation Journal https://www.thepharmajournal.com
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
~ 933 ~
The Pharma Innovation Journal https://www.thepharmajournal.com
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].
~ 934 ~
The Pharma Innovation Journal https://www.thepharmajournal.com
Table 2: Selected Studies citing prevalence of menstrual dysfunctions among women:
Study ID
Study Design
Age
group
Sample
Size
Menstrual Problems
Dysmenorrhea
Irregular
cycle
PMS
Menorrhagia
Polymenorrhea
Oligomenorrhea
Bahrami et al.,
2022 [83]
Descriptive
survey
10-19 yr
897
68.80%
18.70%
47.60%
2.10%
3.10%
15.60%
Kanmani et al.,
2016 [84]
Descriptive
survey
12-18 yr
166
28.30%
36.70%
-
-
8.40%
4.80%
Shiferaw et al.,
2014 [85]
Cross-sectional
17-24 yr
470
85.10%
46.20%
72.80%
4.30%
3.80%
14.90%
Antherjanam et
al., 2016 [86]
Cross-sectional
13-18 yr
1722
71.50%
-
-
-
22.30%
18.10%
Omidvar et al.,
2011 [87]
Cross-sectional
18-27 yr
194
78.20%
11.90%
-
4.10%
2.20%
6.00%
Dambhare et al.,
2012 [88]
Cross-sectional
10-19 yr
1100
56.15%
57.90%
56.16%
1.25%
8.38%
22.10%
Karout N., 2015
[89]
Saudi Arabia
Cross-sectional
18-20 yr
342
96.30%
36.40%
95.60%
9.10%
21.30%
21.60%
Karki et al., 2017
[90]
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
Cross-sectional
18-24 yr
149
94.00%
55.00%
-
2.63%
-
-
Tabassum et al.,
2020 [92]
Cross-sectional
>18y r
100
15.00%
62.00%
>50%
13.00%
-
-
Gaddala et al.,
2021 [93]
Cross-sectional
19-25 yr
100
86.00%
25.00%
83.00%
12.00%
6.00%
19.00%
Varghese et al.,
2019 [94]
Descriptive
survey
13-18 yr
350
79.00%
24.00%
84.00%
4.00%
12.60%
-
Yaliwal et al.,
2020 [95]
Cross-sectional
10-19 yr
1016
62.00%
33.36%
-
12.20%
11.60%
21.80%
Samreen et al.,
2016 [96]
Cross-sectional
15-45 yr
810
51.00%
10.00%
48.00%
24.00%
1.85%
8.88%
Ekpenyong et al.,
2011 [1]
Cross-sectional
16-23 yr
393
-
-
33.10%
37.50%
-
19.90%
Nwankwo et ak.,
2010 [97]
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
~ 935 ~
The Pharma Innovation Journal https://www.thepharmajournal.com
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
~ 936 ~
The Pharma Innovation Journal https://www.thepharmajournal.com
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.
References
1. Ekpenyong CE, Davis KJ, Akpan UP, Daniel NE.
Academic stress and menstrual disorders among female
undergraduates in Uyo, South Eastern Nigeria-the need
for health education. Nigerian journal of physiological
science: Official publication of the Physiological Society
of Nigeria. 2011;26(2):193-198.
2. ACOG Committee on Practice BulletinsGynecology,
American College of Obstetricians and Gynecologists.
Practice bulletin no. 136: Management of abnormal
uterine bleeding associated with ovulatory dysfunction.
Obstetrics and Gynecology, 2013;122(1):176-
185. PMID: 23787936.
3. Practice Committee of the American Society for
Reproductive Medicine. Current evaluation of
amenorrhea. Fertility and Sterility. 2008;90:S219-S225.
4. Lethaby A, Irvine G, Cameron I. Cyclical progestogens
for heavy menstrual bleeding. Cochrane Database of
Systematic Reviews. 1998;4:CD001016.
5. Lethaby A, Shepperd S, Cooke I, Farquhar C.
Endometrial resection and ablation versus hysterectomy
for heavy menstrual bleeding. Cochrane Database of
Systematic Reviews. 1992;2:CD000329.
6. Lethaby AE, Cooke I, Rees M. Progesterone/progestogen
releasing intrauterine systems versus either placebo or
any other medication for heavy menstrual
bleeding. Cochrane Database of Systematic
Reviews. 2005;4:CD002126.
7. Apgar BS, Kaufman AH, George-Nwogu U, Kittendorf
A. Treatment of menorrhagia. American Family
Physician. 2007;75(12):1813-1819.
8. Lestari Beni, Meiyanto Edy. A Review: The Emerging
Nutraceutical Potential of Pumpkin Seeds. Indonesian
Journal of Cancer Chemoprevention. 2018;9(2):92.
10.14499/indonesianjcanchemoprev9iss2pp92-101.
9. Amaza DS, Sambo N, Zirahei JV, Dalori MB, Japhet H,
Toyin H. Menstrual pattern among female medical
students in university of Maiduguri, Nigeria. BJMMR.
2012;2(3)327-37.
10. Rigon F, De Sanctis V, Bernasconi S, Bianchin L, Bona
G, Bozzola M, et al. Menstrual pattern and menstrual
disorders among adolescents: an update of the Italian
data. Ital J Pediatr. 2012;14:38. Doi: 10.1186/1824-7288-
38-38. PMID: 22892329; PMCID: PMC3462713.
11. Karki G. Menstrual Pattern and Disorders Among Female
Studens of Kathmandu Medical Colle. International
Journal of Public Health. 2017;6(12):222-231.
12. Kulshrestha S, Durrani AM, Author C. Prevalence of
Menstrual Disorders and Their Association with Physical
Activity in Adolescent Girls of Aligarh City.
International Journal of Health Sciences & Research
(Www.Ijhsr.Org). 2019;9(8):384.
13. Bahrami A, Ariakia F, Ferns GA, Ghayour-Mobarhan M.
The Prevalence of Menstrual Problems amongst
Adolescent Girls in Northeastern Iran. Journal of
Advances in Medical and Biomedical Research.
2022;30(138):61-68.
https://doi.org/10.30699/jambs.30.e55702
14. Herbison AE. A simple model of estrous cycle negative
and positive feedback regulation of GnRH
secretion. Front Neuroendocrinol. 2020;57:100837.
15. Harlow SD. Menstrual Cycle Changes as Women
Approach the Final Menses: What Matters? Obstet
Gynecol Clin North Am. 2018;45(4):599-611.
16. Gibson DA, Simitsidellis I, Collins F, Saunders PTK,
Endometrial Intracrinology: Oestrogens, Androgens and
Endometrial Disorders. Int J Mol Sci. 2018, 19(10).
17. Pan B, Li J. The art of oocyte meiotic arrest
regulation. Reprod Biol Endocrinol. 2019;17(1):8.
18. Carlson LJ, Shaw ND. Development of Ovulatory
Menstrual Cycles in Adolescent Girls. J Pediatr Adolesc
Gynecol. 2019;32(3):249-253.
19. Redmond GP. Androgens in women’s health. Int J Fertil
Womens Med. 1998;43(2):91-97.
20. Smith KD, Rodriguez-Rigau LJ, Tcholakian RK,
Steinberger E. The relation between plasma testosterone
levels and the lengths of phases of the menstrual cycle.
Fertil Steril. 1979;32(4):403-407.
21. Santoro N, Lasley B, McConnell D, Allsworth J,
Crawford S, Gold EB, et al., Body size and ethnicity are
associated with menstrual cycle alterations in women in
the early menopausal transition: The Study of Women’s
Health across the Nation (SWAN) Daily Hormone Study.
J Clin Endocrinol Metab. 2004;89(6):2622-2631.
22. Santoro N, Crawford SL, Lasley WL, Luborsky JL,
Matthews KA, McConnell D, et al. Factors related to
declining luteal function in women during the
menopausal transition. J Clin Endocrinol Metab.
2008;93(5):1711-1721.
23. Seymen M, Uslu N, Türkmen Ö, Al Juhaimi F, Özcan M.
Chemical Compositions and Mineral Contents of Some
Hull-Less Pumpkin Seed and Oils. Journal of the
American Oil Chemists' Society. 2016;93(8):1095-1099.
24. Datta S, Sinha B, Bhattacharjee S, Seal T. Nutritional
composition, mineral content, antioxidant activity and
quantitative estimation of water soluble vitamins and
phenolics by RP-HPLC in some lesser used wild edible
plants. Heliyon. 2019;5(3):e01431.
25. Phillips KM, Ruggio DM, Ashraf-Khorassani M.
Phytosterol Composition of Nuts and Seeds Commonly
Consumed in The United States. J. Agric. Food Chem.
2005;53(24):9436-9445.
26. Jones PJH, Raeini-Sarjaz M, Ntanios FY, Vanstone CA,
Feng JY, et al. Modulation of Plasma Lipid Levels and
Cholesterol Kinetics by Phytosterol versus Phytostanol
Esters. J Lipid Res. 2000;41(5):697-705.
27. Gossell-Williams M, Lyttle K, Clarke T, Gardner M,
Simon O. Supplementation with Pumpkin Seed Oil
Improves Plasma Lipid Profile and Cardiovascular
Outcomes of Female Nonovariectomized and
Ovariectomized Sprague Dawley Rats. Phytother. Res.
2008;22(7):873-877.
28. Zeb A, Ahmad S. Changes in Acyl-glycerols
Composition, Quality Characteristics and In vivo Effects
of Dietary Pumpkin Seed Oil upon Thermal Oxidation.
Front. Chem. 2017;5:55.
~ 937 ~
The Pharma Innovation Journal https://www.thepharmajournal.com
Doi: 10.3389/fchem.2017.00055.
29. Kurzer MS. Phytoestrogen supplement use by women. J.
Nutr. 2003;133(6):1983S-1986S.
30. Kurzer MS. Soy consumption for reduction of
menopausal symptoms. Inflammopharmacology.
2008;16:227-229.
31. Jacobs A, Wegewitz U, Sommerfeld C, Grossklaus R,
Lampen A. Efficacy of isoflavones in relieving
vasomotor menopausal symptoms-a systematic review.
Mol. Nutr. Food Res. 2009;53(9):1084-1097.
32. Shen W, Stearns V. Treatment strategies for hot flushes.
Expert. Opin. Pharmacother. 2009;10(7):1133-1144.
33. Sunar F, Baltaci AK, Ergene N, Mogulkoc R. Zinc
deficiency and supplementation in ovariectomized rats:
Their effect on serum estrogen and progesterone levels
and their relation to calcium and phosphorus. Pakistan
Journal of Pharmaceutical Sciences. 2009;22(2):150-154.
34. Kechrid Z, Amamra S, Bouzerna N. The effect of zinc
deficiency on zinc status, carbohydrate metabolism and
progesterone level in pregnant rats. Turkish Journal of
Medical Sciences. 2006;36(6):337-342.
35. Nishi Y. Zinc and growth. J. Am. Coll. Nutr.
1996;15(4):340-344.
36. Om AS, Chung KW. Dietary zinc deficiency alters 5
alpha-reduction and aromatization of testosterone and
androgen and estrogen receptors in rat liver. J Nutr.
1996;126(4):842-848.
37. Humeny A, Bokenkamp D, Thole H. The HDQVH-motif
in domain E of the estradiol receptor alpha is responsible
for zinc-binding and zinc-induced hormone release. Mol.
Cell Endocrinol. 1999;153:71-78.
38. Noda Y, Ota K, Shirasawa T, Shimizu T. Copper/Zinc
superoxide dismutase insufficiency impairs progesterone
secretion and fertility in female mice. Biology of
Reproduction. 2012;86(1):1-8.
https://doi.org/10.1095/biolreprod.111.092999
39. Oner G, Muderris I. Efficacy of omega-3 in the treatment
of polycystic ovary syndrome. J Obstet Gynaecol.
2013;33(3):289-291.
40. Khani B, Mardanian F, Fesharaki SJ. Omega-3
supplementation effects on polycystic ovary syndrome
symptoms and metabolic syndrome. J Res Med Sci.
2017;22(1):644.
41. Haidari F, Banaei-Jahromi N, Zakerkish M, Ahmadi K.
The effects of flaxseed supplementation on metabolic
status in women with polycystic ovary syndrome: A
randomized open-labeled controlled clinical trial.
Nutrition Journal. 2020;19(1):1-11.
https://doi.org/10.1186/s12937-020-0524-5
42. Tham DM, Gardner CD, Haskell WL. Potential health
benefits of dietary phytoestrogens: a review of the
clinical, epidemiological, and mechanistic evidence.
Journal of Clinical Endocrinology and Metabolism.
1998;83(7):2223-2235.
43. Tou JCL, Chen J, Thompson LU. Flaxseed and its lignan
precursor, secoisolariciresinol diglycoside, affect
pregnancy outcome and reproductive development in
rats. Journal of Nutrition. 1998;128(11):1861-1868.
44. Tou JCL, Thompson LU. Exposure to flaxseed or its
lignin component during different developmental stages
influences rat mammary gland structures. Carcinogenesis.
1999;20(9):1831-1835.
45. Tou JCL, Chen J, Thompson LU. Dose, timing, and
duration of flaxseed exposure affect reproductive indices
and sex hormone levels in rats. Journal of Toxicology
and Environmental Health, Part A. 1999;56(8):555-570.
46. Ward WE, Jiang FO, Thompson LU. Exposure to
flaxseed or purified lignan during lactation influences rat
mammary gland structures. Nutrition and Cancer.
2000;37(2):69-74.
47. Ward WE, Chen J, Thompson LU. Exposure to flaxseed
or its purified lignan during suckling only or
continuously does not alter reproductive indices in male
and female offspring. Journal of Toxicology and
Environmental Health, Part A. 2001a;64(7):567-577.
48. Ward WE, Yuan YV, Cheung AM, Thompson LU.
Exposure to purified lignan from flaxseed (Linum
usitatissimum) alters bone development in female rats.
British Journal of Nutrition. 2001b;86:499-505.
49. Ward WE, Yuan YV, Cheung AM, Thompson LU.
Exposure to flaxseed and its purified lignan reduces bone
strength in young but not older male rats. Journal of
Toxicology and Environmental Health. 2001c;63(1):53-
65.
50. Phipps WR, Martini MC, Lampe JW, Slavin JL, Kurzer
MS. Effect of flax seed ingestion on the menstrual cycle.
The Journal of Clinical Endocrinology & Metabolism.
1993;77(5):1215-1219. Doi:10.1210/jcem.77.5.8077314
51. Vaziri F, Zamani Lari M, Samsami Dehaghani A, Salehi
M, Sadeghpour H, Akbarzadeh M, et al., Comparing the
effects of dietary flaxseed and omega-3 Fatty acids
supplement on cyclical mastalgia in Iranian women: A
randomized clinical trial. Int J Family Med.
2014;17(4):532.
52. Jaafarnejad F, Adibmoghaddam E, Emami SA, Saki A.
Compare the effect of flaxseed, evening primrose oil and
Vitamin E on duration of periodic breast pain. J Edu
Health Promot. 2017;6:85.
53. Kataria K, Dhar A, Srivastava A, Kumar S, Goyal A. A
systematic review of current understanding and
management of mastalgia. Indian J Surg. 2014;76:217-
22.
54. Nadjarzadeh A, Dehghani-Firouzabadi R, Daneshbodi H,
Lotfi MH, Vaziri N, Mozaffari-Khosravi H. Effect of
Omega-3 supplementation on Visfatin, Adiponectin, and
anthropometric indices in women with polycystic ovarian
syndrome. J Reprod Infertil. 2015;16:212-220.
55. Thompson LU, Seidl MM, Rickard SE, Orcheson LJ,
Fong H. Antitumorigenic effect of a mammalian lignan
precursor from flaxseed. Nutr Cancer. 1996;26:159-65.
doi:10.1080/01635589609514472
56. Thompson LU, Rickard SE, Orcheson LJ, Seidl MM.
Flaxseed and its lignan and oil components reduce
mammary tumor growth at a late stage of carcinogenesis.
Carcinogenesis. 1996;17:1373-1376.
doi:10.1093/carcin/17.6.1373
57. Thompson LU, Boucher BA, Liu Z, Cotterchio M,
Kreiger N. Phytoestrogen content of foods consumed in
Canada, including isoflavones, lignans and coumestan.
Nutr Cancer. 2006;54(2):184-201.
doi:10.1207/s15327914nc5402_5
58. Adolphe JL, Whiting SJ, Juurlink BHJ, Thorpe LU,
Alcorn J. Health effects with consumption of the flax
lignan secoisolariciresinol diglucoside. Br J Nutr.
2010;103(7):929-938. Doi:10.1017/S0007114509992753
59. McCann SE, Edge SB, Hicks DG, Thompson LU,
~ 938 ~
The Pharma Innovation Journal https://www.thepharmajournal.com
Morrison CD, Fetterly G, et al. A pilot study comparing
the effect of flaxseed, aromatase inhibitor, and the
combination on breast tumor biomarkers. Nutr Cancer.
2014;66(4):566-575.
Doi:10.1080/01635581.2014.894097
60. Adlercreutz H, Hockerstedt K, Bannwart C, et al., Effect
of dietary components, including lignans and
phytoestrogens, on enterohepatic circulation and liver
metabolism of estrogens and on sex hormone binding
globulin (SHBG). J Steroid Biochem. 1987;27(4-6):1135-
1144.
61. Adlercreutz H, Mousavi Y, Hiickerstedt K. Diet and
breast cancer. Acta Oncol. 1992;31(2):175-181.
62. Andrea M, Hutchins Margaret C, Martini B, Amy Olson,
William Thomas, Joanne Slavin L. Flaxseed
Consumption Influences Endogenous Hormone
Concentrations in Postmenopausal Women. Nutrition and
Cancer. 2001;39(1):58-65.
DOI: 10.1207/S15327914nc391_8
63. Nandha R, Singh H, Garg K, Rani S. Therapeutic
Potential of Sunflower Seeds: an Overview. International
Journal of Research and Development in Pharmacy &
Life Sciences. 2014;3(3):967-972.
64. Hodges RE, Minich DM. Modulation of Metabolic
Detoxification Pathways Using Foods and Food-Derived
Components: A Scientific Review with Clinical
Application. Journal of Nutrition and Metabolism; c2015.
https://doi.org/10.1155/2015/760689
65. Guan YS, He Q. Plants Consumption and Liver Health.
Evidence-Based Complementary and Alternative
Medicine; c2015. https://doi.org/10.1155/2015/824185
66. Lee SO, Nadiminty N, Wu XX, Lou W, Dong Y, Ip C, et
al. Selenium disrupts estrogen signaling by altering
estrogen receptor expression and ligand binding in human
breast cancer cells. Cancer Res. 2005;65(8):3487-92.
Doi: 10.1158/0008-5472.CAN-04-3267.
PMID: 15833885.
67. Shah YM, Al-Dhaheri M, Dong Y, Ip C, Jones FE,
Rowan BG. Selenium disrupts estrogen receptor (alpha)
signaling and potentiates tamoxifen antagonism in
endometrial cancer cells and tamoxifen-resistant breast
cancer cells. Mol Cancer Ther. 2005;4(8):1239-1249.
Doi: 10.1158/1535-7163.MCT-05-0046.
PMID: 16093440.
68. Dadkhah H, Ebrahimi E, Fathizadeh N. Evaluating the
effects of Vitamin D and Vitamin E supplement on
premenstrual syndrome: A randomized, double-blind,
controlled trial. Iranian Journal of Nursing and
Midwifery Research. 2016;21(2):159-164.
https://doi.org/10.4103/1735-9066.178237
69. Mandana Z. Evaluation the Effects of VitB6 on the
Treatment of Premenstrual Syndrome: A Clinical
Randomized Trial. Advances in Research.
2014;2(11):590-595.
https://doi.org/10.9734/ijpss/2014/10181
70. London RS, Murphy L, Kitlowski KE, Reynolds MA.
Efficacy of alpha-tocopherol in the treatment of the
premenstrual syndrome. J Reprod Med. 1987;32(6):400-
404.
71. Habib FK, Maddy SQ, Stitch SR. Zinc induced changes
in the progesterone binding properties of the human
endometrium. Acta Endocrinol (Copenh). 1980;94(1):99-
106. Doi: 10.1530/acta.0.0940099. PMID: 7386123.
72. Tian X, Diaz FJ. Zinc depletion causes multiple defects
in ovarian function during the periovulatory period in
mice. Endocrinology. 2012;153(2):873-886.
Doi: 10.1210/en.2011-1599.
73. Wu WH, Kang YP, Wang NH, Jou HJ, Wang TA.
Sesame ingestion affects sex hormones, antioxidant
status, and blood lipids in postmenopausal women. J
Nutr. 2006;136(5):1270-1275.
Doi: 10.1093/jn/136.5.1270. PMID: 16614415.
74. Louwers YV, Laven JSE, Characteristics of polycystic
ovary syndrome throughout life. Therapeutic Advances in
Reproductive Health, 2020, 14.
https://doi.org/10.1177/2633494120911038
75. Sirmans SM, Pate KA. Epidemiology, diagnosis, and
management of polycystic ovary syndrome. Clinical
Epidemiology. 2013;6(1):1-13.
https://doi.org/10.2147/clep.s37559
76. Harris H, Titus L, Cramer D, Terry K. Long and irregular
menstrual cycles, polycystic ovary syndrome, and
ovarian cancer risk in a population-based case-control
study. International Journal of Cancer. 2016;140(2):285-
291.
77. Azziz R, Sanchez L, Knochenhauer ES, et al. Androgen
excess in women: experience with over 1000 consecutive
patients. J Clin Endocrinol Metab. 2004;89(2):453-462.
78. Qiao J, Feng HL. Extra-and intra-ovarian factors in
polycystic ovary syndrome: Impact on oocyte maturation
and embryo developmental competence. Human
Reproduction Update. 2011;17(1):17-33.
https://doi.org/10.1093/humupd/dmq032
79. De Leo V, Musacchio MC, Cappelli V, Massaro MG,
Morgante G, Petraglia F. Genetic, hormonal and
metabolic aspects of PCOS: An update. Reproductive
Biology and Endocrinology. 2016;14(1):1-17.
https://doi.org/10.1186/s12958-016-0173-x
80. Laufer N, DeCherney AH, Haseltine FP, Behrman HR.
Steroid secretion by the human egg-corona-cumulus
complex in culture. J Clin Endocrinol Metab.
1984;58(6):1153-1157.
81. Tesarik J, Mendoza C. Nongenomic effects of 17 beta-
estradiol on maturing human oocytes: relationship to
oocyte developmental potential. J Clin Endocrinol Metab.
1995;80(4):1438-1443.
82. Dumesic DA, Padmanabhan V, Abbott DH. Polycystic
ovary syndrome and oocyte developmental competence.
Obst Gyn Surv. 2007;63(1):39-48.
83. Bahrami A, Ariakia F, Ferns GA, Ghayour-Mobarhan M.
The Prevalence of Menstrual Problems amongst
Adolescent Girls in Northeastern Iran. Journal of
Advances in Medical and Biomedical Research.
2022;30(138):61-68.
https://doi.org/10.30699/jambs.30.e55702
84. Kanmani K, Ravisankar AK. Prevalence of Menstrual
problems and Treatment-seeking behavior: A study
among visually challenged women. International Journal
of Scientific and Research Publications. 2014;6(1):621.
www.ijsrp.org
85. Shiferaw Teshom M, Wubshet M, Tegabu D. Menstrual
problems and associated factors among students of Bahir
Dar University, Amhara National Regional State,
Ethiopia: A cross-sectional survey. The Pan African
Medical Journal. 2014;17:246.
https://doi.org/10.11604/pamj.2014.17.246.2230
~ 939 ~
The Pharma Innovation Journal https://www.thepharmajournal.com
86. Antherjanam SD, Karunakaran U, Jayasree AK, Antony
R, Anitha SS, Harsha CH. Prevalence and pattern of
menstrual disorders among school going adolescents in
northern district of Kerala. Public Health Rev Int J Public
Health Res. 2016;3(3):109-118.
87. Omidvar S, Begum K. Menstrual pattern among
unmarried women from south India. Journal of Natural
Science, Biology and Medicine. 2011;2(2):174-179.
https://doi.org/10.4103/0976-9668.92329
88. Dambhare DG, Wagh SV, Dudhe JY. Age at menarche
and menstrual cycle pattern among school adolescent
girls in Central India. Global Journal of Health Science.
2012;4(1):105-111.
https://doi.org/10.5539/gjhs.v4n1p105
89. Karout N. Prevalence and pattern of menstrual problems
and relationship with some factors among Saudi nursing
students. Journal of Nursing Education and Practice.
2015;5(12):1-8. https://doi.org/10.5430/jnep.v5n12p1
90. Karki G. Menstrual Pattern and Disorders Among Female
Studens of Kathmandu Medical Colle. International
Journal of Public Health. 2017;6(12):222-231.
91. Ali A, Khalafala H, Fadlalmola H. Menstrual Disorders
Among Nursing Students at Al Neelain University,
Khartoum State. Sudan Journal of Medical Sciences.
2020;15(2):199-214.
https://doi.org/10.18502/sjms.v15i2.7067
92. Tabassum Khan N. Prevalence of Menstrual Distress
among Young Undergraduate Females in Quetta
Balochistan. Epidemiology International Journal.
2020;4(1). https://doi.org/10.23880/eij-16000136
93. Gaddala A, Gurnule S, Matli P, Rajamouli J, Gurnule S.
A cross sectional study to assess the prevalence of
menstrual abnormalities in medical students of
Karimnagar. Ejmcm. 2021;07(11):6959-6965.
94. Varghese L, Prakash PJ, Viswanath L. A study to identify
the menstrual problems and related practices among
adolescent girls in selected higher secondary school in
thiruvananthapuram, Kerala, India. Journal of SAFOG.
2019;11(1):13-16. https://doi.org/10.5005/jp-journals-
10006-1642
95. Yaliwal RG, Biradar AM, Kori SS, Mudanur SR, Pujeri
SU, Shannawaz M. Menstrual Morbidities, Menstrual
Hygiene, Cultural Practices during Menstruation, and
WASH Practices at Schools in Adolescent Girls of North
Karnataka, India: A Cross-Sectional Prospective Study.
Obstetrics and Gynecology International; c2020.
https://doi.org/10.1155/2020/6238193
96. Samreen DS, Hassan DM, Khatana DG, Ashraf DA.
Prevalence of Various Menstrual Disorders Among
Females of Reproductive Age-Group of Kashmir: A
Cross-Sectional Study. International Journal of Advanced
Research. 2016;4(8):348-354.
https://doi.org/10.21474/ijar01/1223
97. Nwankwo TO, Aniebue UU, Aniebue PN. Menstrual
Disorders in Adolescent School Girls in Enugu, Nigeria.
Journal of Pediatric and Adolescent Gynecology.
2010;23(6):358-363.
https://doi.org/10.1016/j.jpag.2010.04.001
98. Patisaul HB, Jefferson W. The pros and cons of
phytoestrogens. Frontiers in Neuroendocrinology.
2010;31(4):400-419.
https://doi.org/10.1016/j.yfrne.2010.03.003
... Various review papers have explored the role of different seeds -such as flaxseeds, sesame seeds, pumpkin seeds, and sunflower seeds -individually in improving hormonal disturbances and insulin resistance in patients with PCOS 20,21 . Currently, there is limited literature on the use of complete seed cycling as a treatment modality of PCOS, even though it also is an androgen-related disorder. ...
... Several studies have highlighted the positive impact of seed cycling on improving FSH levels 20,21,25 . In the present study, serum prolactin levels also showed significant improvement in the intervention group. ...
Research
Full-text available
Background: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder of reproductive age group in women and is characterized by obesity, hyper-insulinemia, hyperandrogenism and insulin resistance. Seed cycling has emerged as a potential treatment modality for managing PCOS symptoms. Methods: A total of 290 women diagnosed with PCOS, aged 18-40, and were enrolled in this study after meeting specific eligibility criteria. Participants were randomly divided into two groups: a control group (n=145) and an intervention group (n=145). The control group received a portion-controlled diet along with a daily dose of Metformin 500 mg for 12 weeks. The intervention group followed the same diet but incorporated seed cycling into their regimen. Assessments, including anthropometric measurements, biochemical analyses, hormonal evaluations, and nutritional assessments, were conducted at baseline and after the 12-week treatment period. The Mann-Whitney U test was used to compare outcomes between the two groups before and after treatment, with significance determined at p<0.05. Results: The majority of participants were aged 26-30 years (46.90%), with 60% being non-vegetarian. Among them, 36% were employed, and 14% engaged in physical activity. The intervention group demonstrated significant improvements in anthropometric, biochemical, and hormonal parameters compared to the control group. Notably, there was a decrease in mean energy consumption, carbohydrate intake, and fat intake in the intervention group, while mean protein intake remained unchanged between the groups after 12 weeks. These improvements were statistically significant (p<0.05). Conclusion: The study concluded that women with PCOS showed substantial improvements in anthropometric, biochemical, and hormonal profiles following seed cycling therapy combined with dietary modifications. This suggests that seed cycling, along with a portion-controlled diet, can be an effective strategy for managing PCOS symptoms.
Article
Full-text available
Menstrual related issues poses substantial health implications in young women who faces problems such as misses their school, not be able to participate in activities, struggle to carry out their usual daily activities, feel uncomfortable around people etc. In addition symptoms like cramps, tiredness, back pain, swollen abdomen, and tender breasts were reported in women suffering from menstrual distress leading to damaging effects on their psychological and reproductive health. Therefore the aim of this study was to determine the prevalence of menstrual issues among young females and also to identify those factors that contributes in causing such a distress. Our obtained results suggested high prevalence of menstrual distress as 47% of undergraduate females were suffering from menstruation distress of different kinds due to high stress, poor health etc.
Article
Full-text available
Background. Issues of menstrual morbidities, menstrual hygiene, and cultural practices are rarely discussed by adolescents. The burden of menstruation and cultural practices which the adolescent girls have to face has been less quantified. This study aims to assess the issues related to menstruation in school girls. Method. A cross-sectional prospective study was conducted on 1016 school-going adolescent girls in January 2020. A questionnaire in English and in Kannada was distributed to girls of class 8–12 of ages between 10 and 19 years. Results. 70.5% of the girls attained menarche by 12 to 14.9 years, 37.2% of the girls had their periods every 28–34 days, and 12.2% of the girls said they have heavy periods. 61.95% of the girls had dysmenorrheal, and 9.7% of the girls said that they required medications for the pain. 70.7% of the girls were using commercial sanitary napkins, 12.7% were using cloth, and 15.3% were using both. 55.5% of the girls who were using cloth as an absorbent were not drying the cloth in sunlight. 57.1% of the girls were washing their genitals more than 2 times a day. 93.8% were having bath during menses and 87.2% were using soap along with water. 37.7% of the girls disposed their pads by burning them, 50.8% of then disposed them in the dust bin, and 4.9% of them buried them. 8.6% of the girls said that they remained completely absent from school during periods. 17.85% said that they remained absent for a day. 53.4% of the respondents said that they have difficulty in concentrating at school. 76.1% said that they had adequate water and sanitation facilities at school. 22.3% said that there was adequate facility to change their pads at school. 73.2% said that they could get a spare pad at school. 43.3% of the girls said they avoided cultural functions during their periods, and 38.5% said that they avoided religious ceremonies and practices during their periods. 8.7% of the girls were made to sit outside the house during their periods. The girls from rural areas had poorer hygienic habits, in comparison to the urban girls. Cultural restrictions such as sitting outside the house during menstruation and restricting play were more in the rural girls than the urban girls. Conclusion. Menstrual morbidities, menstrual hygiene management, and cultural beliefs all play a role in school absenteeism in adolescent girls. Improvement of facilities at school and conducting awareness programs can help adolescent girls to attend schools. 1. Background Menstrual hygiene is a subject which is as old as humanity but has gained recent importance due to the readiness of the society to accept its challenges. Attaining menarche is a celebrated event across cultures. The physiological and psychological changes that the girl endures are also associated with the stress of menstrual hygiene management. Menstrual hygiene management (MHM) at school is very important as well. The WHO (World Health Organization) and UNICEF (United Nations International Children’s Emergency Fund) advice WASH facilities at school, i.e. water, sanitation, and hygiene [1]. In India, the Swachh Bharat: Swachh Vidyalaya campaign has been launched in every school to provide WASH facilities, which includes soap and water for sanitation and private space for changing and disposal of menstrual absorbents. MHM has been made an integral part of the Swachh Bharath guidelines. Efforts are being made to provide low-cost sanitary napkin vending machines and incinerators to dispose MHM products at schools [2]. However, the extent to which all these guidelines percolate down to the ground level has yet to be seen. Inadequate facilities at the school may, in turn, result in school absenteeism and diminished school performance. Various absorbents have been used during the menstruation. The reusable absorbents are made up of cloth. They need to be washed and dried in sunlight prior to the next use. The nonreusable sanitary pads are made up of cellulose and plastic. They are user friendly. However, they are expensive and they are nonbiodegradable. Bamboo fiber pad, banana fiber pad, and water hyacinth pad are the biodegradable ecofriendly sanitary napkins. They are not readily available. Reusable and nonreusable tampons are also available. Menstrual cups are also used. These have to be inserted in the vagina. Hence, they are not suitable for all adolescents. Nonreusable pads have to be disposed in the dustbins. However cultural beliefs and lack of disposal facility have made certain communities burry or burn the pads [3]. Reusable cloths are to be washed with soap and dried in the sunlight to prevent growth of bacteria. Due to cultural beliefs, the cloths are not properly washed with soap, and many a time, they are kept to dry away from the sunlight and away from the sight of other family members. Such unhygienic practices lead to vaginitis, pelvic infections, and urinary tract infections [4, 5]. Minor ailments during the menstrual period are common. Abdominal pain, lack of concentration, and breast pricking are common complaints [6]. These symptoms may require help from the teachers at school. Approachability and sensitivity of the teacher are also very important for the girls. Menstruation is still considered as a taboo across various cultures, and young girls of some communities feel that that menstruation is a curse or burden [7]. Women in their menstrual period are considered as filthy, shameful, or impure. Many communities restrict menstruating women from various activities such as cooking, touching food, being with family members, attending religious ceremonies, and bathing [8]. Menstruation is a physiological process, and such taboos and myths should be allayed. The present study aims to study the sociodemographic characteristics of adolescent girls, details regarding the menstrual cycle, menstrual hygiene practices, MHM at schools, and cultural beliefs followed during menstruation. To the best of our knowledge, this is the first time a study on MHM is being conducted in Vijayapura, North Karnataka, India. All girls from class 8 to 12 who had attained menarche were included in the study. Adolescents are defined as girls from age 10–19 years of age. Girls who were of ages below 10 and above 19 were excluded from the study. 2. Materials and Methods The cross-sectional prospective study was conducted in January 2020. The study was conducted in 10 schools which included girls from class 8 to class 12 in the district of Vijayapura, Karnataka. Vijayapura is situated in North Karnataka which is considered as less developed as in comparison to its southern counterpart. The students attending the schools were of low- and middle-income groups. Girls attending the schools were from the Vijayapura city and the surrounding villages. Ethical clearance was given by the institutional ethical clearance committee, BLDE (deemed to be university), Vijayapura. Consent from the head of each school was taken before conducting the study. A consent form was given to each student who was involved in the study and was asked to get it signed from their parent. A questionnaire covering the demographic characteristics of the participants, characteristics of the menstrual cycle and menstruation in the participants, menstrual morbidities experienced by the participants, menstrual hygiene practices among the participants, difficulties faced at schools by the participants during menstruation, and cultural beliefs practiced by the participants was prepared in English. As a majority of the schools had Kannada as the medium of instruction, the English questionnaire was translated into Kannada. Kannada is the largest spoken language of the region, and it is also the official language of Karnataka State. The Kannada and English questionnaires were distributed to the girls who were from schools where the medium of instruction was Kannada or English, respectively. The questionnaire was explained to the girls, and, then, they were asked to fill it. Difficulties faced by the girls in filling the forms were addressed to by the research team. The forms were collected by the team of doctors who were conducting the study. The time duration taken to complete the forms was about 45–60 minutes. After filling of the questionnaire, a lecture on MHM was delivered to the girls. The lecture covered basic physiology of reproduction, menstrual hygiene management, contraception, and nutrition. 2.1. Statistical Analysis All characteristics were summarized descriptively. For continuous variables, the summary statistics of mean ± standard deviation (SD) were used. For categorical data, the number and percentage were used in the data summaries and diagrammatic presentation. The Chi-square (χ²) test was used for the association between two categorical variables. If the value was <0.05, then the results were considered to be statistically significant; otherwise, it was considered as not statistically significant. Data were analyzed using SPSS software v.23.0 and Microsoft office 2010. 3. Results 3.1. Sociodemographic Characteristics of the Participants In total, there were 1305 girls, of which 1051 had matured. The questionnaire was given to the girls who had matured. A total of 1016 girls were included in the study, and 35 were excluded due to inappropriate filling of the form (Figure 1). A majority of the girls (60.2%) were from the urban area. Most of the girls (56.7%) attained menarche between 12 and 14 years of age. Most of the girls were from families of poor socioeconomic backgrounds with the parents having a poor educational status. Just under half (44.3%) of the fathers of the girls had primary education or were lesser educated. Similarly, 49.7% of the mothers had primary education or were lesser educated. Most of the fathers of the girls were farmers (29.7%) or laborers (21.1%). A majority of the mothers were housewives (69.7%).
Article
Full-text available
Background: Menstrual disorders can severely affect the daily life of young females, particularly the student population, which generates a massive tension that extends to families, but they seldom affect the quality and standard of life. Objectives: The aim of this study was to determine the morbidity nature of menstrual disorders among nursing students and their effect on students’ life activities. Methods: This study was a descriptive cross-sectional institutional-based study conducted at the Al Neelain University, Faculty of Nursing. Of the 200 students recruited, 149 completed the questionnaire with the responding rate of (74.5%). Data were collected using a self-administered structured questionnaire. Results: Of the 149 participants, most were young and in the age range of 18–24 years with a mean age of 21 years. Most students (74%) started their menarche at a normal age range of 12–15 years. A relatively high dysmenorrhea (94.0 %) was observed among the participants. More than half of the respondents (55.0%) had irregular menstruation. Conclusion: The authors concluded that the prevalence and morbidity of dysmenorrhea and menstrual irregularity were high but broadly comparable to those observed in similar developing countries. Therefore, national health policies need to consider the health and educational impact of menstrual disorders on nursing students and develop the plan through a change in students’ lifestyle; moreover, school authorities and teachers need to be aware of the problems to provide psychological and academic support.
Article
Full-text available
Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. It is a complex disease in which genetic, endocrine, environmental, and behavioral factors are intertwined, giving rise to a heterogeneous phenotype with reproductive, metabolic, and psychological characteristics. Polycystic ovary syndrome affects women’s health and their quality of life across the life course. During different life stages, the polycystic ovary syndrome phenotype can change, which requires a personalized diagnostic approach and treatment. Polycystic ovary syndrome is a major cause of anovulatory infertility; this disorder is also associated with hirsutism and acne. Diagnosing polycystic ovary syndrome during adolescence is challenging because the polycystic ovary syndrome criteria include normal physiological events that occur during puberty. With increasing age, the syndrome evolves from a reproductive disease to a more metabolic disorder. Along with metabolic disturbances, including insulin resistance and abnormalities of energy expenditure, polycystic ovary syndrome is recognized as a major risk factor for the development of type 2 diabetes and cardiovascular disease in later life. Moreover, there is evidence for familial clustering of endocrine and metabolic features of polycystic ovary syndrome. Environmental factors such as diet and obesity appear to contribute to the phenotype. Treatment should be tailored to the specific concerns and needs of the individual patient and involves restoring fertility, treatment of the metabolic complaints, treatment of androgen excess, and providing endometrial protection. The complexity of the disorder, and the impact on quality of life, requires a timely diagnosis, screening for complications, and management strategies for the long-term health issues associated with polycystic ovary syndrome. The syndrome remains underdiagnosed, and women experience significant delays to diagnosis.
Article
Full-text available
Background: Adolescents face a range of health challenges, numerous information and guidance regarding adolescent health remaining ignored due to constraints at different levels of health system.One of the main problems among adolescent girls are irregular menstruation, excessive bleeding and dysmenorrhoea. Menstrual irregularities during adolescent period have association with reproductive morbidities in adulthood. Targeting this age group with awareness and early correction of matters and misconceptions related to adolescent sexual reproductive health issues would enable us to yield a healthy society and empowered youth. Objective:To study the prevalence and pattern of menstrual disorders and its associated factors among IX to XII class adolescent girls in Kannur district. Methods:Cross-sectional study among school going adolescent Girls from class IX to XII in Kannur District Results:Among the 1722 study participants, 48.8% had menstrual disorders, in which dysmenorrhoea is the most common menstrual disorder reported 71.5%. The risk factors like rural residence, lower socio-economic status, mixed diet, non-consumption of egg, not physically active both during routine life and also during menstruation, increased BMI showed a significant association with menstrual disorder among the study participants. Conclusion:Use of services by adolescents is limited may be due to lack of adequate privacy and confidentiality and judgemental attitudes of service providers, who often lack counselling skills. Therefore, effective services like assurance of confidentiality, psychological support, counselling is necessary.
Article
Full-text available
Background: Polycystic Ovary Syndrome (PCOS) is known as the most common endocrine disorder of women in reproductive ages. With the increasing prevalence of PCOS in different countries, the use of herbal medicine as an alternative treatment is growing in these patients. This study aimed to evaluate the effects of flaxseed powder supplementation on metabolic biomarkers of patients with PCOS. Methods: This randomized open-labeled controlled clinical trial was conducted on 41 patients with PCOS. The participants were randomized to take either flaxseed powder (30 g/day) plus lifestyle modification or only lifestyle modification for 12 weeks. Anthropometric and biochemical evaluations were performed for all patients at the beginning and end of the study. Results: The flaxseed group showed a significant reduction in body weight, insulin concentration, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Triglycerides (TG), high-sensitivity C-Reactive Protein (hs-CRP), and leptin and an increase in Quantitative Insulin-Sensitivity Check Index (QUICKI), High Density Lipoprotein (HDL), and adiponectin compared to the baseline (p < 0.05). Flaxseed supplementation also led to a significant reduction in insulin concentration, HOMA-IR, TG, hs-CRP, Interleukin 6 (IL- 6), and leptin and an increase in QUICKI, HDL, and adiponectin compared to the control group (p < 0.05). No significant changes were observed in other parameters. Conclusions: Flaxseed supplementation plus lifestyle modification was more effective compared to lifestyle modification alone in biochemical and anthropometric variables in patients with PCOS. Trial registration: The trial protocol was approved by the Ethics Board at Ahvaz Jundishapur University of Medical Sciences and was registered at Iranian Registry of Clinical Trials (code: IRCT20120704010181N11).
Article
Full-text available
Background: Menarche and menstruation are important aspects of female life. Even though the menstruation is a normal physiological process, adolescent girls have difficulty to handle menstruation. The main objective of this study was to identify the menstrual problems and related practices among adolescent girls. Methodology: A descriptive survey approach was adopted for the study. The sample consisted of 350 adolescent girls selected by proportionate stratified random sampling from the 9th, 10th, 11th and 12th standards of Government Girls Higher Secondary School, Thiruvananthapuram. A semi-structured questionnaire was used to collect data regarding background information, menstrual characteristics, menstrual problems, and related practices. Biophysical measures such as weight, height, and body mass index (BMI) were taken along with the data. Results: Most of the adolescent girls had irregular menstruation (24%), 12.6% had polymenorrhea, 6.3% had scanty menstruation and only 4% adolescent girls had menorrhagia. The majority (79%) were experiencing dysmenorrhea during menstruation. The menstrual symptoms experienced were abdominal pain (74%), backache (42.9%) and fainting (8.9%). Conclusion: Menstrual problems form an important domain of adolescent health and because of these problems are unreported, it is necessary that adequate attention and care is provided. The consequences of the neglect of menstrual problems result in impaired reproductive and sexual health in older women.
Article
Full-text available
The present study aimed to investigate the nutritional properties and antioxidant activities of six underutilized wild edible plants viz. Ipomoea aquatica, Achyranthes aspera, Aasystasia ganjetica, Enhydra fluctuans, Oldenlandia corymbosa and Amaranthus viridis that are commonly consumed as food in the India The antioxidant properties of the plants were evaluated by using 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging activity, ABTS radical scavenging ability, reducing power capacity, metal chelating activity, lipid peroxidation assay, estimation of total phenolic content and flavonoids content in different solvent extraction system like benzene, chloroform, methanol and 70% aqueous (aq.) ethanol. The quantitation of phenolic acids and flavonoids and water soluble vitamins in these plants were carried out by HPLC using Acclaim C 18 column (5 μm particle size, 250 × 4.6 mm), Dionex Ultimate 3000 liquid chromatograph and detection was carried out in photo diode array (PDA) detector. The results of investigation showed that these plants are rich sources of protein, carbohydrate minerals and vitamins, especially the B group of vitamins that can contribute immensely to nutrition, food security, and health and therapeutic benefits. The different levels of antioxidant activities were found in the solvent systems used. The HPLC analysis also showed the presence of phenolic acids and flavonoids in various amounts in these plants which could be utilized as natural antioxidant. Keywords: Nutrition, Food science, Natural product chemistry
Article
The gonadal steroids estradiol and progesterone exert critical suppressive and stimulatory actions upon the brain to control gonadotropin-releasing hormone (GnRH) release that drives the estrous/menstrual cycle. A simple model for understanding these interactions is proposed in which the activity of the “GnRH pulse generator” is restrained by post-ovulation progesterone secretion to bring about the estrus/luteal phase slowing of pulsatile gonadotropin release, while the activity of the “GnRH surge generator” is primed by the rising follicular phase levels of estradiol to generate the pre-ovulatory surge. The physiological fluctuations in estradiol levels across the cycle are considered to clamp the GnRH pulse generator output at a constant level. Independent pulse and surge generator circuitries regulate the excitability of different compartments of the GnRH neuron. As such, GnRH secretion through the cycle is determined simply by the summed influence of the estradiol-clamped, progesterone-regulated pulse and estradiol-regulated surge generators on the GnRH neuron.