BioMed Research International / 2018 / Article / Tab 5

Review Article

Herbal Medicine for Oligomenorrhea and Amenorrhea: A Systematic Review of Ancient and Conventional Medicine

Table 5

Studies on medicinal plants used for treatment of oligomenorrhea and amenorrhea.

NumberAuthors/country/year Scientific namePart/compoundDesignParticipantSample sizeIntervention protocol Duration of study Results

Kort and Lobo  
2014 [28]
Cinnamomum verum Supplements (Cinnulin PF; Integrity Nutraceuticals
International, Spring Hill, TN)
Prospective, placebo controlled, double-blinded randomized trialPCOs patients 18–38 years in two groups; treatment
() and placebo ()
451.5 g/d supplements or placebo (4 capsules of 125 mg, TDS)6 monthsSignificant improvement in menstrual cyclicity in cinnamon group compared with baseline and placebo.
Menstrual bleeding was resulted from ovulatory cycle because of luteal phase progesterone levels (>3 ng/ml) in 5 samples in the cinnamon group
No considerable changes in markers of insulin resistance, serum androgen, SHBG levels, weight and ovarian volume in both groups.

Mohebbi-Kian et al.
2014 [29]
Foeniculum vulgare Mill.Essential oil from fennel seeds (containing 71–90 mg anethole)Double-blind double-dummy randomized, placebo-controlled, parallel trial15–45 years married women using DMPA and without menstrual bleeding for 45–140 days prior in three groups; fennel essential oil (FEO, ), LD-COC () and placebo ()78Each pack contained 21 LD-COC pills + 42 placebo capsules, 21 placebo pills + 42 fennel capsules,
21 placebo pills
and 42 placebo capsules
One pill and a capsule BID
21 daysExperience of menstrual bleeding in 73% of women in the FEO and 81% of women in LD-COC groups which markedly higher than the placebo group (19%), but no significant alteration between fennel and LD-COC groups
↑ mean amount of menstrual bleeding in the FEO group (21 cc) compared to the LD-COC (14 cc) and placebo (12 cc) groups
↑ duration of menstrual bleeding/spotting and the number of used sanitary pads in the FEO group (5.2 days, 10.4 pads) compared to the LD-COC (4 days, 7.4 pads) and placebo (4 days, 6.8 pads) groups
↓ mean duration of drug using in fennel group (14 days) compared to LD-COC (21 days) and placebo (20 days) groups ()
↑ injections of DMPA after intervention in fennel (73%) and LD-COC groups (65%) compared to placebo group (31%).

Mokaberinejad et al.
2012 [30]
Mentha longifoliaEthanolic extract of dried plant powder prepared as syrupDouble-blind, randomized, placebo-controlled, multi center study18–35 years women with secondary amenorrhea and oligomenorrhea () in two groups; treatment () and placebo ()12045 ml of plant extract or placebo syrup TDS (in treatment group: 300 mg ethanol extract of plant in 5 ml of syrup)three menstrual cycles68.3% patients in the treatment and 13.6% in the placebo group experienced uterus bleeding during the first cycle (), regular bleeding during three cycles in one third of the patients treated with the herbal syrup (33.3%) compared to placebo (3.3%).
↓ LH in treatment group compared to placebo (), no changes in other hormonal parameters in both groups.

Mokaberinejad et al.
2014 [31]
Mentha longifoliaHerbal tea of dried leavesPilot study, before & afterAmenorrheic 30–40 years old women with POF27A 250 mL cup of herbal tea (250 mL of boiling water over 2 g of the dried leaves) TDS2 weeks ↓ FSH (), occurrence of menstrual bleeding in all patients except four on average 19.2 days after taking the medication ().

Ushiroyama et al.
2001 [32]
Paeonia lactiflora with Cinnamomum cassiaUnkei-toRandomized controlled clinical trialAnovulatory women with high plasma LH levels (PCOs = 38 and non PCOs = 62) in two groups; control () and treatment ()100Not mentioned8 weeks ↓ LH (mean rate = 22.2 ± 35.7% in PCOs and 49.7 ± 15.3% in non- PCOs patients) and ↑ estradiol in unkei-to treatment group
Development of the dominant follicle in patients treated with unkei-to.
Improvement in menstrual cyclicity (50% in PCOs and 60% in the non-PCOs group) in unkei-to treatment group but no significant difference between the two groups.

Yavari et al.
2014 [33]
Sesamum indicum L.PowderPilot study20 to 40 years old women with oligomenorrhea and complaint of more than 2 weeks menstruation retard2160 g powdered with a tea spoon of honey once daily before breakfast7 daysExperience of menstrual bleeding in 85% of the patient after treatment within two weeks
Higher volume of menstrual bleeding in 20% () of the patient after treatment
Drug-free episode of menstruation in 80% of the patient in less than 2 weeks.

Yavari et al.
2016 [34]
Sesamum indicum L.PowderSingle blind randomized controlled clinical trialWomen with oligomenorrhea in two groups; progesterone () and sesame group ()5660 g sesame powdered once daily or Medroxy Progesterone 5 mg tablets BIDA weekOccurrence of menstrual bleeding in 72% of the patient in the sesame group and 93.10% in the progesterone group (significantly higher than the sesame group, )
No marked increasing in volume of blood flow and severity of pain in both groups
↓ duration of drug using for experiencing menstrual bleeding in sesame group compared to progesterone group (10.38 days versus 11.8)
On-time menstruation in drug-free episode in 50% of the patients in sesame group compared to 6% in progesterone group.

Bashtian et al.
2013 [35]
Trigonella foenum-graecumHydroalcoholic extract of seedsProspective randomized, double-blind, placebo-controlled trial20–35 year-old women with PCOs + menstrual disturbances and infertility ± clinical signs of hyperandrogenism chief complaints in two groups; treatment () and placebo ()58500 mg of extract or placebo BID plus metformin TDS8 weeks ↓ significant in polycystic-appearing ovaries in ultrasound scans in extract group after treatment ()
No significant changes in BMI, markers of insulin resistance (HOMA-IR) and insulin sensitivity (QUICKI), testosterone and 17-α OHP levels, F-G score in both groups.
Normalizing menstrual cycle in 12 women with oligo-amenorrhea in extract group.

Swaroop et al.
2015 [36]
Trigonella foenum-graecumA patent-pending water-ethanol extract of seeds Open-label, single arm, non-randomized, clinical studyPremenopausal women (18–45 years) with PCOs502 capsule of 500 mg daily3 months ↑ LH () and ↑ FSH (),
↓ LH/FSH ratio (3.16 to 1.61), but not significant
↓ left & right ovary volume (↓17.82% & 28.25%), ↓ cyst size in 47 subjects, no cyst in 36 subjects,
regular cycles in 71% of subjects,
↑ Hb levels, ↓ ALP, no significant change in WBC, AST, ALT, BUN and creatinine and 12% pregnancy after treatment compared to the baseline.

Najafipour et al.
2014 [37]
Urtica dioicaDried extract of rootRandomized controlled clinical trialHyperandrogenism female in two groups; experimental (extract, ) and control (standard treatment, )40300–600 mg of plant dried extract or cyproterone compound and Spironolactone4 months ↓ total, free testosterone () and DHEA () after treatment in the experimental group
No significant difference between the study parameters (total, free testosterone and DHEAS) in two groups
↑ improvement of acne, greasy skin (), menstrual cycle situation () in the control group compared to the experimental group after the treatment.

Bergmann et al.
2000 [38]
Vitex agnus-castus Homeopathic preparation (Silybum marianum, Vitex agnus-castus, Chelidonium majus)Randomized, placebo-controlled clinical double-blind studyWomen with oligomenorrhea () or amenorrhea () in two groups; treatment and placebo6750 drops of Phyto Hypophyson L or placebo TDS3 months or 3 cyclesOccurrence of menstruation and shortening of the cycle in the treatment group compared to the placebo.
↑ luteal phase progesterone in oligomenorrheal women after treatment relative to placebo.
Improvement of ovulation and 38 pregnancy out of 67 women in the treatment group compared to the placebo.

Shahnazi et al.
2016 [39]
Vitex agnus-castusFruit extractRandomized, triple-blind clinical trial with a placebo controlledWomen 18–45 years old with PCOS and oligomenorrhea or amenorrhea in two equal groups; LD and Vitex agnus-castus groups70Capsule contained LD pill or extract daily3 monthsNormalization the menstrual cycle duration in 68.6% of the LD group members and 60% of the extract participants without considerable difference between the two groups ()
↓ means of the free testosterone, prolactin and DHEAS level in the LD and the extract groups after treatment, but no significant difference between the two groups.

↑: increase, ↓: decrease, PCOs: polycystic ovary syndrome, BMI: body mass index, FSH: follicle-stimulating hormone, LH: luteinizing hormone, DHEAS: dehydroepiandrosterone sulfate, SHBG: sex hormone-binding globulin, HOMA-IR: homeostasis model assessment for insulin resistance, QUICKI: quantitative insulin sensitivity check index, WBC: white blood cells, Hb: hemoglobin, AST: aspartate aminotransferase, ALT: alanine aminotransferase, ALP: alkaline phosphatase, BUN: blood urea nitrogen, F-G: Ferriman–Gallwey score, LD-COC: low dose combined oral contraceptive, and DMPA: depot medroxyprogesterone acetate.

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