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Copyright  © 2022 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
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Herbal Products for Gynecological Disorders 

Harshna Vishwakarma*, Sakshi Patel, Sahil Chouksey, Sachin Lodhi, Rituraj Kurmi, Prakhar Nema 

*Adina College of Pharmacy, ADINA Campus Rd, Lahdara, Sagar, MP, 470001 

Article Info: 
_________________________________________
Article History: 

Received 03 March 2022      
Reviewed 21 April 2022 
Accepted 04 May 2022 
Published 15 June 2022 

_________________________________________ 
Cite this article as:  

Vishwakarma H, Patel S, Chouksey S, Lodhi S, 
Kurmi R, Nema P, Herbal Products for 
Gynecological Disorders, Asian Journal of Dental 
and Health Sciences. 2022; 2(2):1-8 

DOI: http://dx.doi.org/10.22270/ajdhs.v2i2.15                                  

_________________________________________
*Address for Correspondence:   
Harshna Vishwakarma, Adina College of 
Pharmacy, ADINA Campus Rd, Lahdara, Sagar, MP, 
470001 

Abstract 
___________________________________________________________________________________________________________________ 

Herbal products are often used as an alternative to pharmacological therapy. Menopausal symptoms 
and gynecological disorders (such as premenstrual syndrome and dysmenorrhea) are the indications 
where pharmacological therapy may have serious adverse events; hence many women prefer to use 
herbal products to help with these symptoms. Here, we reviewed plants and derived products, which 
are commonly used for the abovementioned indications, focusing on clinical data, safely profile and 
whether or not their use is justified. We noted that limited data are available on the use of some plants 
for alleviating the symptoms of menopause and gynecological disorders. While black cohosh 
(Cimicifuga racemose) and red clover (Trifolium pretense) were consistently shown to help reduce 
menopausal symptoms in clinical studies, currently available data do not fully support the use of 
fenugreek (Trigonella foenum-graecum), hops (Humulus lupulus), valerian (Valeriana officinalis), and 
soybean (Glycine max and Glycine soja) for this indication. For premenstrual syndrome and 
premenstrual dysphoric disorder, chaste tree (Vitex agnus-castus) shows effectiveness, but more 
clinical studies are needed to confirm such effect upon the use of evening primrose (Oenothera 
biennis).  

Keywords: Menopause; Dysmenorrhea; Premenstrual syndrome; Gynecological disorders; Herbal 
products; Medicinal plants. 

Email: vishwakarmaneelu679@gmail.com 

Introduction  

Women often seek help for various gynecological disorders. 
Most commonly, these are premenstrual syndrome, 
dysmenorrhea, and menopausal symptoms. Often, they prefer 
alleviation of symptoms with herbal products over 
pharmacological therapy 1. This is especially the case with, e.g., 
hormone replacement therapy in menopause, as this therapy 
bears the possibility for serious adverse events, such as breast 
cancer 2. Premenstrual syndrome is characterized by 
irritability, tension, depressed mood, breast tenderness and 
bloating in the weeks before menstruation 3. These symptoms 
are severe in 5–8% of women. Typical pharmacological 
therapies include analogues of gonadotropin releasing 
hormone, estradiol, contraceptives and serotonin reuptake 
inhibitors. Dysmenorrhea is the occurrence of painful cramps 
of the uterus 4. Here, we will focus on primary dysmenorrhea, 
which is present due to menstruation as opposed to secondary 
dysmenorrhea, which can have different underlying reasons, 
such as endometriosis, pelvic inflammatory disease, ovarian 
cysts, and adenomyosis, to name a few 5. Typical therapies for 
primary dysmenorrhea are contraceptives, progestins and 
non-steroidal anti-inflammatory drugs 4. Menopause occurs 
approximately one year after the last menstruation cycle, 
which stops due to the gradual decrease in ovarian function 6. 
The mean age of women entering menopause is 51 years. The 
transition period, characterized by the cessation of ovarian 
function, is called perimenopause and starts several years 
prior to menopause. Women entering perimenopause and 
menopause experience several symptoms, which are assessed 
by different criteria. Kupperman menopausal index is often 
used to measure the intensity of menopausal symptoms (hot 
flashes, excessive sweating, sleep disturbances, irritability, 

depressive mood, attention deficit disorder, joint and bone 
pain, headache, arrhythmias, paresthesia) assessed on a 1 
through 4 scales 7. Other similar assessments are done with 
the Greene climacteric scale, or the menopause rating scale 8. 
Pharmacological treatments for these symptoms include 
hormone replacement therapy, selective serotonin reuptake 
inhibitors and selective serotonin-norepinephrine reuptake 
inhibitors 6, 9-11.  

Herbal plants for the treatment of 
gynecological disorders  

Fenugreek (Trigonella foenum-graecum L)  

Fenugreek or Trigonella foenum-graecum L. is a member of 
the Fabaceae family. It is grown in the Mediterranean, 
northern Africa and Indian peninsula to be used as a herb, 
spice, or in traditional medicine. Fenugreek is an annual plant, 
which grows up to the height of 60 cm, has trifoliate leaves 
and white to yellow flowers. Fenugreek seeds grow in thin 
pods, which are about 15 cm long, and are a part of plant 
which is commonly used in formulations, such as powder, dry 
extract or soft extract 12, 13. The seeds are golden yellow and 
contain polysaccharides (24–25% galactomannans), 0.016% 
essential oil, 0.6–1.7% saponins (from diosgenin, yamogenin, 
tigogenin, and others), sterols (β-sitosterol), flavonoids 
(orientin, isoorientin, isovitexin) and other secondary 
metabolites (protoalkaloids, trigonelline, choline) 12. A wide 
array of versatile compounds contained in fenugreek seeds is 
the reason that many health effects have been attributed to 
this plant. These include antidiabetic, antihyperlipidemic, 
antiobesity, anticancer, anti-inflammatory, antioxidant, 
antifungal, antibacterial, galactagogue activities, and to help 
with climacteric and period problems 13. In this review, we 

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concentrate on the alleviation of menopausal symptoms and 
dysmenorrhea.  

Diosgenin and yamogenin are steroidal sapogenins, which are 
obtained after the acid hydrolysis of fenugreek seeds. They are 
of interest for the pharmaceutical industry due to the 
possibility to synthesize oral contraceptives and steroid 
hormone drugs from them, and due to their own 
pharmacological activity. Another compound with the activity 
on the endocrine system is the alkaloid trigonelline, which is a 
phytoestrogen, as it activates the estrogen receptor (ER) 13. 
Another set of compounds, which might play a role in 
alleviating menopausal symptoms and are contained in 
fenugreek, are flavonoids. Not only trigonelline, but also 
fenugreek extract showed the ability to bind to ER in a 
competitive ER binding assay and to have agonist activity on 
this receptor in a transactivation gene reporter assay 13, 14. 
Furthermore, fenugreek extracts upregulated the expression 
of the estrogen-responsive gene and induced proliferation of 
estrogen dependent breast cell line MCF-7 14. Another study 
showed the antiproliferative effect of fenugreek extract on 
several breast cancer cell lines, including MCF-7 cells 15. The 
same cell line was used for subcutaneous implantation in 
female mice where diosgenin (which is present in fenugreek 
seed) inhibited tumor growth 13, 16. Extract preparation and 
active compound content may thus be the underlying reason 
for different results in these studies. Fenugreek extract was 
shown to improve sexual function in women in a randomized 
placebo-controlled study, where increased plasma 17β-
estradiol was measured, possibly due to increased aromatase 
conversion of testosterone to 17β-estradiol 13, 17. In a placebo 
controlled study on 101 women, fenugreek extract helped 
with dysmenorrhea symptoms during menstruation 13. 
Duration of pain was decreased and reduction of systemic a 
more than 20% reduction in hot flashes, night sweats, 
insomnia, and more than 30% improvement of depression 18, 

19. Increases in serum 17β-estradiol, free testosterone and 
progesterone were observed, and decreases in follicle-
stimulating hormone and steroid hormone-binding globulin. 
Authors speculated that this indicates the phytoestrogenic 
effect of fenugreek and an establishment of hormonal balance 
in postmenopausal women upon taking fenugreek extracts 19. 
In terms of safety and possible interactions, fenugreek is 
generally safe, but patients taking antidiabetic drugs should 
monitor their blood sugar regularly 13. Fenugreek can cause 
digestive disorders and allergic reactions 12. It should not be 
taken during pregnancy due to uterine stimulatory and 
abortifacient activities. Moreover, non-clinical data suggest 
embryo-lethal effects, testicular toxicity and decreased thyroid 
hormone levels 12 symptoms, such as fatigue, headache and 
nausea, was observed 20. A study from 2006, where 
postmenopausal women were given 6 g of fenugreek seed 
powder for eight weeks revealed improvement of hot flashes 
and night sweats after four weeks 21.  

Hops (Humulus lupulus L)  

There are three main species in the genus Humulus 
(Cannabaceae): Humulus lupulus L., H. scandens (Lourr.) Merr. 
and H. yunnanensis Hu. 22. Humulus lupulus L. is native to 
central Europe; however, today it is naturalized throughout 
the northern temperate regions. It is a perennial and dioecious 
climbing plant with a herbaceous stem which can reach 10 m. 
Male small flowers are organized in clusters. The female 
inflorescences are cones that contain foliaceous bracts and so-
called glandular trichomes in the lupulin glands containing 
essential oil (constituents: β-myrcene, β-caryophyllene, α-
humulene, β-farnesene, α-selinene, β-selinene, humulene 
epoxides, β-bisabolol, 2-methyl-3-buten-2- ol, a.s.o.), 
prenylated acylphloroglucinols (α-acids: humulone = HU, its 
derivatives, and β-acids: lupulones), prenylated flavanones 

(isoxanthohumol = IX, 6-prenylnaringenin = 6PN, 8-
prenylnaringenin = 8PN), chalcones (xanthohumol = XH, 
desmethylxanthohumol), triterpenes, flavonols, and tannins 23. 
XH is the main chalcone in the lupulin glands (0.1–1% of cone 
dry weight) 24. Although IX, 6PN and 8PN are present in 
different varieties of hops 25, some authors theorized these 
derivatives could be partly decomposition products emerging 
during drying and storage 26. Female inflorescence of hop is 
important for the production of beer. Moreover, there is a 
pharmacopoeial drug monograph used for the quality check 
during the production of herbal teas or herbal preparations 
(comminuted or powdered herbal drug; liquid extract (DER 
1:1), extracted with ethanol 45% v/v; liquid extract (DER 
1:10), extracted with sweet wine; tincture (ratio of herbal 
substance to extraction solvent 1:5), extracted with ethanol 
60% v/v; and dry extract (DER 4-5:1), extracted with 
methanol 50% v/v). They are all mentioned in a category of 
traditional herbal medicinal products, used for the relief of 
mild symptoms of mental stress and to aid sleep 27. Increased 
interest in therapeutic use of hops dates back to the end of the 
last century when it was discovered that hops contains 
prenylflavonoids which are thought to be phytoestrogens. 
Milligan and colleagues isolated estrogenic 8PN by bioassay-
guided fractionation of hops extracts 28. It has long been 
traditionally believed that hops has strong estrogenic activity, 
e.g., in women, harvesting hops by hand, who started 
menstruating two days after the hops harvesting began. Koch 
and Heim claimed that the estrogenic activity of hops 
corresponds to the presence of the equivalent of 20–300 g 
17β-estradiol/g 29.  

Red Clover (Trifolium pratense L)  

Red clover or Trifolium pretense L. is a member of the 
Fabaceae family. It is native to Europe, Asia and Africa, and has 
been introduced to every other continent 30. It is grown in 
terrestrial and wetlands, and is used for pasturage, hay and 
silage for the livestock 31. It is a herbaceous, perennial plant, 
which grows up to 80 cm tall. The leaves are trifoliate 
(compounded typically of three leaflets) and alternate. The 
flowers are pink to red or white in color. Red clover at the 
flowering stage contains isoflavones formononetin, biochanin 
A, daidzein and genistein in cumulative concentrations of 5.4–
8.1 mg/g of dry matter, where formononetin and biochanin A 
contribute 51% and 40% of the weight, respectively 32. Leaves 
contribute to 73.9% of the total isoflavone content, while 
stems contribute 17.6% and flowers approximately 9% 32. In 
addition, glycitein and prunetin can also be found in red clover 
in smaller amounts 8. Isoflavones act as phytoestrogens, as 
they activate ERs by binding to two isoforms: to estrogen 
receptor β (ERβ) with higher affinity and to estrogen receptor 
α (ERα) with lower affinity 8. This may, in turn, lead to a 
reduction of gonadotropin-releasing hormone, follicle-
stimulating hormone, and luteinizing hormone levels 33. 
Additionally, isoflavones are thought to have antioxidant 
properties, to inhibit tyrosine kinases, and affect ion transport 
8. Breeding problems of sheep herds in Australia in 1940s, 
which fed on clover, brought attention to possible hormonal 
effects of this plant 34. Many clinical studies were conducted to 
determine whether red clover could be used to help with 
menopausal symptoms due to its putative estrogenic activity. 
A recent (2021) systematic review and meta-analysis by 
Kanadys et al. presented randomized controlled trials on the 
use of red clover extract inmenopause 8. The effectiveness of 
red clover isoflavone extracts on the relief of hot flashes and 
menopausal symptoms in peri- and postmenopausal women 
was assessed. Eight trials out of 107 potentially relevant 
randomized controlled trials passed the quality criteria and 
were included in comparisons. In most of these trials, 40–80 
mg of red clover isoflavone extract was given to participants 
per day. A meta-analysis revealed a reduction in the hot 



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flashes frequency, by 1.73 hot flashes per day. The 
menopausal symptoms were alleviated upon treatment with 
red clover isoflavone extract according to Kupperman 
menopausal index and menopause rating scale, but not 
according to Greene climacteric scale. The red clover 
isoflavone extract was more effective in women experiencing 
more than five hot flashes per day, in doses higher than 80 mg 
of the extract per day, and when the content of biochanin A 
was higher. Red clover is likely safe when used as a 
supplement to relieve menopausal symptoms 33. No significant 
side effects were seen upon a year of use of such supplements. 
However, due to its estrogenic activity, patients on hormone 
replacement therapy or contraceptives, and patients with a 
history of hormone-dependent cancers should pay special 
attention to any adverse events. Due to coumarin in red clover, 
it could have an effect on platelet aggregation; therefore 
special care is needed if used concomitantly with 
anticoagulants 34. Overall, clinical studies support the use of a 
red clover isoflavone extract for women suffering from 
menopausal symptoms. Red clover supplements are 
considered safe for this indication. 

Valerian (Valeriana officinalis L)  

Valeriana genus (Caprifoliaceae) is comprised of 289 species. 
The most important one, Valeriana officinalis L. (valerian), is 
known under at least 22 synonyms. It grows naturally in 
Europe and western Asia, and was introduced to North 
America. It prefers moist locations, but can also be found in 
drier soils. Morphology of valerian is very diverse. In the 
second year of growth, the plant produces a round, furrowed 
and hollow flowering stem, 80–120 cm tall and branched at 
the top. The pale green (upper side) lanceolate feathery leaves 
grow either from one feathered shape or from 9 to 21 finely 
serrated leaflets. Leaves are attached in pairs to either side of 
the stem. The stems terminate in umbels bearing many 
branches and tiny white and pale pink flowers. Valerian has a 
robust rhizome with many secondary roots and stolons. The 
European Pharmacopoeia requires as a pharmaceutical 
material dried, whole or fragmented underground parts of 
valerian (Valeriana officinalis L. s.l.), including rhizome 
surrounded by the roots and stolons (Valerianae radix, 35) or 
dried, cut underground parts of valerian, including rhizome, 
roots and stolons (Valerianae radix minutata,). This use in folk 
medicine has been translated into official therapy, which is 
confirmed by the existence of a European herbal monograph 
36. Here, we can find indications “for the relief of mild nervous 
tension and sleep disorders“ in the well-established use 
category, and “for relief of mild symptoms of mental stress and 
to aid sleep“ in the traditional use category. The use of valerian 
root for nervous disorders during menopause is mentioned 
only by Usmanghani et al. (1997) 37.  

Soybean (Glycine max (L.) Merr and Glycine subsp soja 
(Siebold & Zucc.) H. Ohashi)  

Wild soybean or Glycine soja is an annual or perennial 
climbing herb from the legume family (Fabaceae). It is native 
in eastern Asia, Russian Far East, eastern China, Korean 
peninsula and Japan. Wild soybean is not to be mistaken for 
widely cultivated domesticated soybean or Glycine max. In 
contrast to domesticated soybean, wild soybean has dormant 
seeds. They are about 1.8–2.5 mm wide, 2.5–4.0 mm long, 
ellipsoid shape and black in color. Domestic soybean has less 
genetic diversity and is more susceptible to damage from 
climatic changes, while wild soybean is more resilient due 
to2.8. Soybean (Glycine max (L.) Merr. and Glycine subsp. soja 
(Siebold & Zucc.) H. Ohashi) Wild soybean or Glycine soja is an 
annual or perennial climbing herb from the legume family 
(Fabaceae). It is native in eastern Asia, Russian Far East, 
eastern China, Korean peninsula and Japan. Wild soybean is 
not to be mistaken for widely cultivated domesticated soybean 

or Glycine max. In contrast to domesticated soybean, wild 
soybean has dormant seeds. They are about 1.8–2.5 mm wide, 
2.5–4.0 mm long, ellipsoid shape and black in color 38-41. 
Domestic soybean has less genetic diversity and is more 
susceptible to damage from climatic changes, while wild 
soybean is more resilient due to its widespread presence in 
diverse climates and could consequently be a good resource 
for creating improved genetic variants of domesticated 
soybean 42. Wild soybean beans contain a wide range of 
compounds, among them saponins and isoflavones (e.g., 
daidzein, 6-hydroxy-daidzein, daidzein glycosides, genistein, 
genistein glycosides, glycitein, and glycitein glycosides), 
trypsin inhibitors, and twice the amount of α-linolenic acid in 
triglycerides as domesticated soybean 40. Glycoside forms of 
the three aglycons may be β-glucosides, 6”-O-malonyl-
glucosides and 6”-O-acetyl-glucosides. Isoflavonoid content in 
domesticated soybean per gram soybeans is up to: 516 µg 
daidzin, 1079 µg genistin, 177 µg glycitin, 768 µg 
malonyldaidzin, 158 µg malonylglycitin, 2446 µg 
malonylgenistin, 265 µg genistein. A better absorption was 
shown for aglycone isoflavonoids than the glycoside forms in 
humans. Soy isoflavones are of particular interest in the 
pharmaceutical industry. They mimic estrogen and are thus 
classified as phytoestrogens, and have antioxidant properties 
43-45. The estrogenic properties of some isoflavones are also 
the basis for the hypothesis that soy could act as a hormone 
replacement therapy and thus help alleviate menopausal 
symptoms. The typical isoflavone ingestion through 
supplements intended for the relief of menopausal symptoms 
is 35–150 mg/day. Among soy isoflavones, genistein is the 
most potent with regard to ER binding, followed by daidzein. 
Namely, genistein binds to ERβ with 30 times lower affinity 
than 17β-estradiol, and to ERα with a 10,000 times lower 
affinity. This raises a question of whether soy isoflavones 
could act as selective ER modulators, i.e., exert estrogenic 
effects in some tissues, but none or antiestrogenic effects in 
other tissues 44-48. 

Black Cohosh (Actaea racemosa L/Cimicifuga racemosa (L) 
Nutt)  

Black cohosh or Cimicifuga racemosa syn. Actaea racemosa is 
a perennial and is endemic to the eastern United States and 
Canada. This plant belongs to the family Ranunculaceae. It 
forms up to 2 m of creeping rhizomes. It has elongated fringed 
divided leaves 49. Inflorescences of small, white flowers in the 
form of long clusters appear at the end of branched stems 
from May to August. The rhizome is used as a herbal drug for 
medicinal purposes. Native American tribes living in the area 
of growth of this plant have traditionally used it for centuries 
49, 50. Common names for this herb are black cohosh, macrotys, 
rattle weed and black snake root. In some European countries, 
the herbal preparations of black cohosh rhizome are marketed 
as herbal medicines with proven use to relieve menopausal 
symptoms, e.g., hot flashes. In the United Kingdom, black 
cohosh is a traditional drug for the symptomatic relief of 
rheumatic pain 50, 51. There are three groups of compounds in 
black cohosh that are responsible for its pharmacological 
action: phenolic compounds, including ferulic acid, isoferulic 
acid and caffeic acid derivatives, cycloartane triterpene 
glycosides (actein, 26-deoxyactein) and phenylpropanoids. 
The phytoestrogenic flavonoid formononetin was also found 
in early studies of the constituents of this plant 52, but this was 
confirmed in neither the raw herb nor the standardized 
extracts in later studies 49. Despite numerous research efforts, 
we do not know the exact composition or function of this 
plant. The preparations of black cohosh are standardized to 
the triterpene glycoside content of 26-deoxyactein. Other 
important triterpene glycosides are actein and cimicifugoside 
(aglycone cimegenol) 49. A black cohosh extract contains many 
triterpene glycosides 53, but there is no direct evidence that 



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these are the main active ingredients in relieving menopausal 
symptoms, especially hot flashes 50. The efficacy of black 
cohosh extract in reducing hot flashes may be attributed to the 
binding and modulation of key central nervous system 
receptors for thermoregulation, mood, and sleep (e.g., 
receptors for serotonin, dopamine, γ-aminobutyric acid 
(GABA), µ-opioids). It also affects the improvement of 
metabolism in the brain and its overall activity 54, 55. The 
extract contains active ingredients that act as partial agonists 
of the serotonin receptors (also known as 5-HT or 5-
hydroxytryptamine receptors), which are located in the 
hypothalamus and are associated with thermoregulation. 
From the 75% ethanol extract standardized to 5.6% triterpene 
glycosides, the compound Nωmethyl serotonin was isolated, 
which could be the main active ingredient of the extract. 
Another mode of action of the rhizome extract could be via 
triterpenoids (especially 23-Oacetylshengmanol-3-O-D-
xylopyranoside) through modulation of GABAA receptors. The 
triterpenoid deoxyactein has also been associated with 
beneficial effects in osteoporosis by influencing osteoclast 
growth and differentiation and mineralization 56, 59. 

Chaste Tree (Vitex agnus-castus L)  

Chaste tree or Vitex agnus-castus L. is a deciduous shrub or a 
small tree of the Lamiaceae family, native to areas stretching 
from the Mediterranean to northern India. It grows to a height 
of 6 m. It has pale violet panicular inflorescences that ripen 
into brown fruits with a characteristic, aromatic and peppery 
aroma 60, 61. The fruits have been used traditionally for their 
emmenagogue, lactagogue, vulnerary, carminative, 
antihelmintic and anti-inflammatory properties 62, while in 
terms of rational phytotherapy, they are considered herbal 
substances most frequently used in the treatment of 
premenstrual syndrome 61. V. agnus-castus is also believed to 
have been used by monks as an anaphrodisiac, to diminish 
their sex drive, hence the common names monk’s pepper, 
chaste tree and chasteberry 61. Phytochemical compounds of 
the fruit include volatile compounds (essential oil), flavonoids 
and other phenolic compounds, iridoids, ketosteroids and 
diterpenoids 62, 63. In 2016, an LC/MS method for 
differentiation between the chaste tree and two related 
species popular in Japan, V. rotundifolia and V. trifolia, was 
described, based on the identification of chastol and epichastol 
diterpenoids proposed to be marker compounds in chaste tree 
fruits 64, 65. According to the European Pharmacopeia 66, whole, 
ripe and dried fruits are used as an herbal substance (Agni 
casti fructus). Casticin, also known as vitexicarpin, which is a 
methoxylated flavonol, is defined to a minimum of 0.08% 
content in the dried herbal substance. In addition, the extract 
of chaste trees (Agni casti fructus extractum siccum) is 
prepared from the herbal substance by a suitable procedure 
using ethanol (40–80%, v/v) and must conain a minimum of 
0.1% casticin (dried herbal substance) 66. 

Evening Primrose (Oenothera biennis L)  

Evening primrose or Oenothera biennis L. is a biennial plant 
that grows to between 30 and 150 cm in height. It is native to 
Central America, from where it spread first to North America 
and Europe. It grows today in regions with a moderate climate 
all over the world. The plant was named after the pleasant 
spectacle that unfolds every evening at dusk, when its yellow 
flowers open. However, they only last until the following day. 
Fruits are up to 4 cm long and contain numerous small seeds 
67, 68. The plant’s stem and leaf juices and poultices were used 
by Native Americans dermally to treat skin inflammation, 
bruises and minor wounds, while the leaves were used 
internally for gastrointestinal disorders and sore throats 69. 
Today, the seed oil is well-known, particularly in alternative 
treatments, for use in inflammatory conditions such as atopic 
dermatitis, eczema and rheumatoid arthritis, and women’s 

conditions, which are described in the following sections. The 
seeds of evening primrose contain approx. 20% of oil 
(triglycerides), which is yellow to greenish-yellow when 
unrefined, with a typical odor. Linoleic acid is a highly 
predominant fatty acid (typically ~70%) followed by γ-
linolenic acid (typically ~10%) 67. Both belong to the group of 
polyunsaturated omega-6 fatty acids. The European 
Pharmacopeia specifies limits for individual fatty acids, i.e., 
palmitic (4–10%), stearic (1–4%), oleic (5–12%), linoleic (65–
85%), γ-linolenic (7–14%) and α-linolenic (max 0.5%) acids, 
as well as unsaponifiable matter (max. 2.5% determined on 5 
g of oil) [34]. Due to the high oxidative instability of the oil, it 
is important that manufacturers ensure the peroxide value of 
max. 10.0 (or max. 5.0 if intended for use in parenteral 
preparations 34. Regulatory accepted in the European Union is 
the use of oil obtained from two Oenothera species, O. biennis 
L. and O. lamarckiana L., in the form of a traditional herbal 
medicinal product for the symptomatic relief of itching in 
acute and chronic dry skin conditions, exclusively based upon 
long-standing use 70. The mechanism of action of Oenothera oil 
is attributed to the effects of omega-6 fatty acids on immune 
cells and the synthesis of prostaglandins, cytokines and 
cytokine mediators 69. It is also assumed that low levels of 
prostaglandin E1 in women with premenstrual syndrome lead 
to increased sensitivity to luteal phase prolactin 71. Research 
studies and findings which proposed a possible connection 
between premenstrual syndrome, prolactin levels, 
prostaglandins and γ-linolenic acid, an essential fatty acid 
precursor of prostaglandin E1, originate from the early 1980s 
72, 73, including first clinical studies showing success in the 
treatment with Oenothera oil, for premenstrual syndrome 74 
and mastalgia 75. Data showed that women with premenstrual 
syndrome have the inability to convert linoleic acid to γ-
linolenic acid due to a decreased activity of the delta-6 
desaturase enzyme 76, 82, in addition to hormonal disbalance 71. 
Cerin et al. 71 investigated hormonal status (progesterone, 
estradiol, prolactin, cortisol, aldosterone) and cholesterol, 
triglyceride, lipoprotein, magnesium and calcium levels, and 
glucose tolerance in the follicular and luteal phases of the 
menstrual cycle in women diagnosed with premenstrual 
syndrome vs. symptom-free controls. The parameters were 
found to be similar in both groups, except for aldosterone 
which was lower in the follicular and luteal phases, and 
cholesterol which was higher in the follicular phase in women 
with premenstrual syndrome. In the same study, the effect of 
Oenothera oil was also evaluated in a randomized, double-
blind crossover design, but no effects were found for any of 
the biochemical parameters. 

Commiphora Wightii  

A therapeutic flowering plant known by many common names, 
including Guggulu, Guggul, and Gugal, Commiphora wightii is a 
member of the Burseraceae family.  Although  it  can  also  be 
found  in  Central  Asia,  guggul  is  most  frequently  found  in 
Northern  India.  Guggul extract, also known as Gugulipid, is a 
frequent ingredient in Ayurvedic and herbal remedies. Guggul 
contains a variety of therapeutic essential oils, gum extracts, 
and   resinous   compounds. The   study   demonstrated   that 
Guggul   reduces   the   DHEA-induced   PCOS   in   the   ovarian 
follicles, which is a key factor in minimizing morphological 
abnormalities. As a result, the hormonal fluctuations return to 
normal.  The  study  also  shown  that  the  DHEA-induced  
PCOS profile,  which  includes  the  hormones FSH,  LH,  
progesterone, estrogen   andtestosterone,   experienced   a   
sharp   rise   in hormone  levels.  Elevated  glucose  levels  were  
also  observed28.For  the  purpose  of  raising  awareness,  
promoting  the  use  of guggul  as  a  nutritional/dietary  
supplement,  and  determining the  safety  of  usein  humans,  
the  National  Institute  of  Health Environmental Sciences 
nominated the Gum Guggul to extract for    examination    of    



Vishwakarma et al                                                                                                                          Asian Journal of Dental and Health Sciences. 2022; 2(2):1-8 

[5]                                                                                                                                                                                                                                                 AJDHS.COM 

the    Toxicological    parameters    and characterization.   Gum   
Guggul   has   been   shown   to   provide advantages   for   

female   reproductiveorgans   andhormonal balance 81. 

 

Table 1: Commonly used plants in relieving menopausal symptoms 

Plant Species, Drug 
Part  

Active Compounds Biological Activities/Supposed Mechanism of 
Action 

Black cohosh 
(Cimicifuga racemosa) 
rhizome 

Phenolic compounds (ferulic acid, isoferulic acid and 
caffeic acid derivatives, cycloartane triterpene 
glycosides (actein, 26-deoxyactein, cimicifugoside)) 
and phenylpropanoids, possibly phytoestrogenic 
flavonoid formononetin, Nω-methylserotonin, 23-O-
acetylshengmanol-3-O-Dxylopyranoside [52,56,27] 

• Modulation of key central nervous system 
receptors for thermoregulation, mood, and 
sleep (e.g., receptors for serotonin, dopamine, γ-
aminobutyric acid (GABA), µ-opioids) [54, 55]  

• Improvement of metabolism in the brain and 
its overall activity [54,55]  

• Modulating osteoclast growth and 
differentiation and mineralization [58, 59] 

Chaste tree (Vitex 
agnus-castus) fruit 
Volatile compounds 
(essential oil),  

flavonoids and other phenolic compounds, iridoids, 
ketosteroids, chastol and epichastol diterpenoids [62–
65] Methoxylated flavonol casticin, (also known as 
vitexicarpin) [66] 

• Binding to dopamine receptors followed by a 
decreased release of prolactin [77,78]  

• Involvement of serotoninergic system has 
been proposed [79]  

• Decreased serum prolactin levels [80] 

Evening primrose 
(Oenothera biennis) 
seed  

20% of oil (triglycerides) containing linoleic acid, γ-
linolenic acid, palmitic acid, stearic acid, oleic acid, α-
linolenic acid, unsaponifiable matter [66,67] 

• Modulation of the immune response and the 
synthesis of prostaglandins, cytokines and 
cytokine mediators [69] 

Fenugreek (Trigonella 
foenum-graecum) seed  

Polysaccharides (24–25% galactomannans), 0.016% 
essential oil, secondary metabolites (protoalkaloids, 
trigonelline, choline), 0.6–1.7% saponins (from 
diosgenin, yamogenin, tigogenin, and others), sterols 
(β-sitosterol), and flavonoids (orientin, isoorientin, 
isovitexin) [12] 

• Activation of the estrogen receptor (ER) [13]  

• Upregulation of the expression of estrogen 
responsive genes [14]  

• Proliferation of estrogen-dependent breast 
cells as well as antiproliferative effect on several 
cell lines [13-16]  

• Increased plasma 17β-estradiol [13,17,19]  

• Increased free testosterone and progesterone 
[19]  

• Decreased in follicle stimulating hormone and 
steroid hormone binding globulin [19] 

Hops (Humulus 
lupulus) inflorescence  

Essential oil (constituents: β-myrcene, β-
caryophyllene, α-humulene, β-farnesene, α-selinene, 
β-selinene, humulene epoxides, β-bisabolol, 2-methyl-
3-buten-2-ol, a.s.o.), prenylated acylphloroglucinols 
(α-acids: humulone, its derivatives, and β-acids: 
lupulones), prenylated flavanones (isoxanthohumol, 
6-prenylnaringenin, 8-prenylnaringenin), chalcones 
(xanthohumol, desmethylxanthohumol), triterpenes, 
flavonols, and tannins [23] 

• Estrogenic effect [28,29] 

Red clover (Trifolium 
pratense) stem, leaf, 
flower  

Isoflavones formononetin, biochanin A, daidzein and 
genistein, glycitein and prunetin [8,32] 

 

• Activation of the ERs by binding to two 
isoforms: to estrogen receptor β (ERβ) with 
higher affinity and to estrogen receptor α (ERα) 
with lower affinity [8] 

 • Reduction of gonadotropin releasing 
hormone, follicle stimulating hormone, and 
luteinizing hormone levels [32] 

 • Antioxidant activity, inhibition of tyrosine 
kinases and modulation of ion transport [8] 

Soybean (Glycine max 
and Glycine soja) seed  

Saponins and isoflavones (e.g., daidzein, 6-hydroxy-
daidzein, daidzein glycosides, genistein, genistein 
glycosides, glycitein, and glycitein glycosides), trypsin 
inhibitors, and twice the amount of α-linolenic acid as 
domesticated soybean [40] Glycoside forms of the 
three aglycons may be β-glucosides, 6 00-O-malonyl-
glucosides and 6 00-O-acetyl-glucosides [43] 

• Estrogenic effect–genistein binds to ERβ with 
30 times lower affinity than 17β-estradiol, and 
to ERα with a 10,000 times lower affinity 
[44,45]  

• Antioxidant activity [45] 



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Conclusions  

Based on this review, we noted limited data are available on 
the use of some plants for alleviating the symptoms of 
menopause and gynecological disorders. While black cohosh 
and red clover were consistently shown to help reduce 
menopausal symptoms in clinical studies, currently available 
data do not fully support the use of fenugreek, hops, valerian, 
and soybean for this indication. For premenstrual syndrome 
and premenstrual dysphoric disorder, chaste tree shows 
effectiveness, but more clinical studies are needed to confirm 
such effect upon the use of evening primrose. 

References  

1. Nedrow A, Miller J, Walker M, Nygren P, Huffman LH, Nelson HD. 
Complementary and alternative therapies for the management of 
menopause-related symptoms: a systematic evidence review. 
Archives of internal medicine. 2006; 166(14):1453-65. 
https://doi.org/10.1001/archinte.166.14.1453 

2. Marjoribanks J, Farquhar C, Roberts H, Lethaby A. Long term 
hormone therapy for perimenopausal and postmenopausal 
women. Cochrane database of systematic reviews. 2012(7). 
https://doi.org/10.1002/14651858.CD004143.pub4 

3. Yonkers KA, O'Brien PS, Eriksson E. Premenstrual syndrome. The 
Lancet. 2008; 371(9619):1200-10. 
https://doi.org/10.1016/S0140-6736(08)60527-9 

4. Bernardi M, Lazzeri L, Perelli F, Reis FM, Petraglia F. Dysmenorrhea 
and related disorders. F1000Research. 2017; 6. 
https://doi.org/10.12688/f1000research.11682.1 

5. Dawood MY. Dysmenorrhea. Clinical Obstetrics and Gynecology. 
1990; 33(1):168-78. https://doi.org/10.1097/00003081-
199003000-00023 

6. Greendale GA, Lee NP, Arriola ER. The menopause. The Lancet. 
1999; 353(9152):571-80. https://doi.org/10.1016/S0140-
6736(98)05352-5 

7. Kupperman HS, Blatt MH, Wiesbader H, Filler W. Comparative 
clinical evaluation of estrogenic preparations by the menopausal 
and amenorrheal indices. The Journal of Clinical Endocrinology & 
Metabolism. 1953; 13(6):688-703. https://doi.org/10.1210/jcem-
13-6-688 

8. Kanadys W, Barańska A, Błaszczuk A, Polz-Dacewicz M, Drop B, 
Kanecki K, Malm M. Evaluation of clinical meaningfulness of red 
clover (Trifolium pratense L.) extract to relieve hot flushes and 
menopausal symptoms in peri-and post-menopausal women: A 
systematic review and meta-analysis of randomized controlled 
trials. Nutrients. 2021; 13(4):1258. 
https://doi.org/10.3390/nu13041258 

9. Orleans RJ, Li L, Kim MJ, Guo J, Sobhan M, Soule L, Joffe HV. FDA 
approval of paroxetine for menopausal hot flushes. New England 
Journal of Medicine. 2014; 370(19):1777-9. 
https://doi.org/10.1056/NEJMp1402080 

10. Cheema D, Coomarasamy A, El-Toukhy T. Non-hormonal therapy 
of post-menopausal vasomotor symptoms: a structured evidence-
based review. Archives of gynecology and obstetrics. 2007; 
276(5):463-9. https://doi.org/10.1007/s00404-007-0390-9 

11. Handley AP, Williams M. The efficacy and tolerability of 
SSRI/SNRIs in the treatment of vasomotor symptoms in 
menopausal women: a systematic review. Journal of the American 
Association of Nurse Practitioners. 2015; 27(1):54-61. 
https://doi.org/10.1002/2327-6924.12137 

12. Westferry C, Wharf C. Committe on Herbal medicinal Products 
(HMPC). European Medicines Agency Science Medicines Health. 
2010. 

13. Nagulapalli Venkata KC, Swaroop A, Bagchi D, Bishayee A. A small 
plant with big benefits: Fenugreek (Trigonella foenum‐graecum 
Linn.) for disease prevention and health promotion. Molecular 
nutrition & food research. 2017; 61(6):1600950. 
https://doi.org/10.1002/mnfr.201600950 

14. Sreeja S, Anju VS, Sreeja S. In vitro estrogenic activities of 
fenugreek Trigonella foenum graecum seeds. Indian Journal of 
Medical Research. 2010; 131(6):814. 

15. Shabbeer S, Sobolewski M, Anchoori RK, Kachhap S, Hidalgo M, 
Jimeno A, Davidson NE, Carducci M, Khan SR. Fenugreek: a 
naturally occurring edible spice as an anticancer agent. Cancer 
biology & therapy. 2009; 8(3):272-8. 
https://doi.org/10.4161/cbt.8.3.7443 

16. Srinivasan S, Koduru S, Kumar R, Venguswamy G, Kyprianou N, 
Damodaran C. Diosgenin targets Akt‐mediated prosurvival 
signaling in human breast cancer cells. International Journal of 
Cancer. 2009; 125(4):961-7. https://doi.org/10.1002/ijc.24419 

17. Rao A, Steels E, Beccaria G, Inder WJ, Vitetta L. Influence of a 
specialized Trigonella foenum‐graecum seed extract (libifem), on 
testosterone, estradiol and sexual function in healthy 
menstruating women, a randomised placebo controlled study. 
Phytotherapy Research. 2015; 29(8):1123-30. 
https://doi.org/10.1002/ptr.5355 

18. Purohit A, Jain S, Nema P, Jain DK, Vishwakarma H, Jain PK, A 
Comprehensive Review on Tailoring an Herbal Approach for 
Treatment of Poly Cystic Ovarian Syndrome, Asian Journal of 
Dental and Health Sciences. 2022; 2(1):27-32. 
https://doi.org/10.22270/ajdhs.v2i1.13  

19. Hakimi S, Mohammad Alizadeh S, Delazar A, Abbasalizadeh F, 
Bamdad Mogaddam R, Siiahi MR, Mostafa Garabagi P. Probable 
effects of fenugreek seed on hot flash in menopausal women. 
Journal of Medicinal Plants. 2006; 5(19):9-14. 

20. Khanna A, John F, Das S, Thomas J, Rao J, Maliakel B, Im K. Efficacy 
of a novel extract of fenugreek seeds in alleviating vasomotor 
symptoms and depression in perimenopausal women: A 
randomized, double‐blinded, placebo‐controlled study. Journal of 
Food Biochemistry. 2020; 44(12):e13507. 
https://doi.org/10.1111/jfbc.13507 

21. Thomas JV, Rao J, John F, Begum S, Maliakel B, Krishnakumar IM, 
Khanna A. Phytoestrogenic effect of fenugreek seed extract helps 
in ameliorating the leg pain and vasomotor symptoms in 
postmenopausal women: A randomized, double-blinded, placebo-
controlled study. PharmaNutrition. 2020; 14:100209. 
https://doi.org/10.1016/j.phanu.2020.100209 

22. The Plant List: Search Results for Humulus. Available online: 
http://www.theplantlist.org/tpl1.1/search?q=Humulus. 

23. Bocquet L, Sahpaz S, Hilbert JL, Rambaud C, Rivière C. Humulus 
lupulus L., a very popular beer ingredient and medicinal plant: 
Overview of its phytochemistry, its bioactivity, and its 
biotechnology. Phytochemistry reviews. 2018; 17(5):1047-90. 
https://doi.org/10.1007/s11101-018-9584-y 

24. Stevens JF, Taylor AW, Deinzer ML. Quantitative analysis of 
xanthohumol and related prenylflavonoids in hops and beer by 
liquid chromatography-tandem mass spectrometry. Journal of 
Chromatography A. 1999; 832(1-2):97-107. 
https://doi.org/10.1016/S0021-9673(98)01001-2 

25. Stevens JF, Ivancic M, Hsu VL, Deinzer ML. Prenylflavonoids from 
Humulus lupulus. Phytochemistry. 1997; 44(8):1575-85. 
https://doi.org/10.1016/S0031-9422(96)00744-3 

26. Chadwick LR, Nikolic D, Burdette JE, Overk CR, Bolton JL, van 
Breemen RB, Fröhlich R, Fong HH, Farnsworth NR, Pauli GF. 
Estrogens and Congeners from Spent Hops (Humulus l upulus). 
Journal of natural products. 2004; 67(12):2024-32. 
https://doi.org/10.1021/np049783i 

27. Werner RD, Merz AD. Committee on Herbal Medicinal Products 
(HMPC). 

28. Milligan SR, Kalita JC, Heyerick A, Rong H, De Cooman L, De 
Keukeleire D. Identification of a potent phytoestrogen in hops 
(Humulus lupulus L.) and beer. The Journal of Clinical 
Endocrinology & Metabolism. 1999; 84(6):2249-. 
https://doi.org/10.1210/jcem.84.6.5887 

29. Koch W, Heim G. Östrogene Hormone in Hopfen und Bier. Med. 
Wchnschr. 1953; 95:845. 

https://doi.org/10.1001/archinte.166.14.1453
https://doi.org/10.1002/14651858.CD004143.pub4
https://doi.org/10.1016/S0140-6736(08)60527-9
https://doi.org/10.12688/f1000research.11682.1
https://doi.org/10.1097/00003081-199003000-00023
https://doi.org/10.1097/00003081-199003000-00023
https://doi.org/10.1016/S0140-6736(98)05352-5
https://doi.org/10.1016/S0140-6736(98)05352-5
https://doi.org/10.1210/jcem-13-6-688
https://doi.org/10.1210/jcem-13-6-688
https://doi.org/10.3390/nu13041258
https://doi.org/10.1056/NEJMp1402080
https://doi.org/10.1007/s00404-007-0390-9
https://doi.org/10.1002/2327-6924.12137
https://doi.org/10.1002/mnfr.201600950
https://doi.org/10.4161/cbt.8.3.7443
https://doi.org/10.1002/ijc.24419
https://doi.org/10.1002/ptr.5355
https://doi.org/10.22270/ajdhs.v2i1.13
https://doi.org/10.1111/jfbc.13507
https://doi.org/10.1016/j.phanu.2020.100209
https://doi.org/10.1007/s11101-018-9584-y
https://doi.org/10.1016/S0021-9673(98)01001-2
https://doi.org/10.1016/S0031-9422(96)00744-3
https://doi.org/10.1021/np049783i
https://doi.org/10.1210/jcem.84.6.5887


Vishwakarma et al                                                                                                                          Asian Journal of Dental and Health Sciences. 2022; 2(2):1-8 

[7]                                                                                                                                                                                                                                                 AJDHS.COM 

30. Trifolium pratense L. Plants of the World Online, Kew Science. 
Available online: http://www.plantsoftheworldonline.org/taxon/ 
urn:lsid:ipni.org:names:523575-1. 

31. Trifolium Pratense (Red Clover): Go Botany. Available online: 
https://gobotany.nativeplanttrust.org/species/trifolium/ 
pratense. 

32. Lemežienė N, Padarauskas A, Butkutė B, Cesevičienė J, Taujenis L, 
Norkevičienė E, Mikaliūnienė J. The concentration of isolavones in 
red clover (Trifolium pratense L.) at lowering stage. Zemdirbyste-
Agriculture. 2015; 102(4). https://doi.org/10.13080/z-
a.2015.102.057 

33. Nelsen J, Ulbricht C, Barrette EP, Mac DS, Tsouronis C, Rogers A, 
Basch S, Hashmi S, Bent S, Basch E. Red clover (Trifolium 
pratense) monograph: a clinical decision support tool. Journal of 
Herbal Pharmacotherapy. 2002; 2(3):49-72. 
https://doi.org/10.1080/J157v02n03_06 

34. Messina M, Mejia SB, Cassidy A, Duncan A, Kurzer M, Nagato C, 
Ronis M, Rowland I, Sievenpiper J, Barnes S. Neither soyfoods nor 
isoflavones warrant classification as endocrine disruptors: a 
technical review of the observational and clinical data. Critical 
Reviews in Food Science and Nutrition. 2022; 62(21):5824-85. 
https://doi.org/10.1080/10408398.2021.1895054 

35. European Medicines Agency (EMA); Committee on Herbal 
Medicinal Products (HMPC). EMA/HMPC/150848/2015, Corr. 
European Union Herbal Monograph on Valeriana officinalis L., 
Flos; EMA: Amsterdam, The Netherlands; HMPC: London, UK, 
2016; 31:1-9. 

36. Hoberg E, Orjala J, Meier B, Sticher O. Diterpenoids from the fruits 
of Vitex agnus-castus. Phytochemistry. 1999; 52(8):1555-8. 
https://doi.org/10.1016/S0031-9422(99)00181-8 

37. Usmanghani K, Saeed A, Alam MT. Indusyunic Medicine: 
Traditional Medicine of Herbal Animal and Mineral Origin in 
Pakistan. Department of Pharmacognosy, Faculty of Pharmacy, 
University of Karachi; 1997. 

38. Glycine max subsp. soja (Siebold & Zucc.) H.Ohashi. Plants of the 
World Online, Kew Science. Available online: http: 
//www.plantsoftheworldonline.org/taxon/urn:lsid:ipni.org:name
s:920989-1. 

39. Wang KJ, Li XH, Zhang JJ, Chen H, Zhang ZL, Yu GD. Natural 
introgression from cultivated soybean (Glycine max) into wild 
soybean (Glycine soja) with the implications for origin of 
populations of semi-wild type and for biosafety of wild species in 
China. Genetic Resources and Crop Evolution. 2010; 57(5):747-61. 
https://doi.org/10.1007/s10722-009-9513-4 

40. Kuroda Y, Kaga A, Tomooka N, Yano H, Takada Y, Kato S, Vaughan 
D. QTL affecting fitness of hybrids between wild and cultivated 
soybeans in experimental fields. Ecology and Evolution. 2013; 
3(7):2150-68. https://doi.org/10.1002/ece3.606 

41. Xu Z, Ren T, Marowa P, You X, Lu X, Li Y, Zhang C. Establishment of 
a Cultivation Mode of Glycine soja, the Bridge of Phytoremediation 
and Industrial Utilization. Agronomy. 2020; 10(4):595. 
https://doi.org/10.3390/agronomy10040595 

42. Nawaz MA, Lin X, Chan TF, Ham J, Shin TS, Ercisli S, Golokhvast KS, 
Lam HM, Chung G. Korean wild soybeans (Glycine soja Sieb & 
Zucc.): Geographic distribution and germplasm conservation. 
Agronomy. 2020; 10(2):214. 
https://doi.org/10.3390/agronomy10020214 

43. Murphy PA, Barua K, Hauck CC. Solvent extraction selection in the 
determination of isoflavones in soy foods. Journal of 
Chromatography B. 2002; 777(1-2):129-38. 
https://doi.org/10.1016/S1570-0232(02)00342-2 

44. European Medicines Agency (EMA); Committee on Herbal 
Medicinal Products (HMPC). EMA/HMPC/220598/2016. 
Assessment Report on Glycine max (L.) Merr., Lecithinum; EMA: 
Amsterdam, The Netherlands; HMPC: London, UK, 2017; 31: 2-27. 

45. Izumi T, Piskula MK, Osawa S, Obata A, Tobe K, Saito M, Kataoka S, 
Kubota Y, Kikuchi M. Soy isoflavone aglycones are absorbed faster 
and in higher amounts than their glucosides in humans. The 

Journal of nutrition. 2000; 130(7):1695-9. 
https://doi.org/10.1093/jn/130.7.1695 

46. Khare B, Jain D, Jain M, Jain D, Khangar PK, Jain DK. An Overview of 
Lassa fever, an Rising Old World Haemorrhagic Viral Disease, 
Asian Journal of Dental and Health Sciences. 2022; 2(1):20-26. 
https://doi.org/10.22270/ajdhs.v2i1.12  

47. Skledar DG, Tvrdý V, Kenda M, Zega A, Pour M, Horký P, Mladěnka 
P, Dolenc MS, Mašič LP. Applicability of the OECD 455 in-vitro 
assay for determination of hERa agonistic activity of isoflavonoids. 
Toxicology and Applied Pharmacology. 2020; 386:114831. 
https://doi.org/10.1016/j.taap.2019.114831 

48. Messina M. Soy and health update: evaluation of the clinical and 
epidemiologic literature. Nutrients. 2016; 8(12):754. 
https://doi.org/10.3390/nu8120754 

49. Pizzorno E, Murray MT. A textbook of Natural Medicine,(4thedn). 
Churchill livingstone, an imprint of Elservier inc. 2013; 355. 

50. European Medicines Agency (EMA); Committee on Herbal 
Medicinal Products (HMPC). EMA/HMPC/48744/2017 
Assessment report on Cimicifuga racemosa (L.) Nutt., Rhizome; 
EMA: Amsterdam, The Netherlands; HMPC: London, UK, 2017; 44: 
1-64. 

51. European Medicines Agency (EMA); Committee on Herbal 
Medicinal Products (HMPC). EMA/HMPC/48745/2017 European 
Union Herbal Monograph on Cimicifuga racemosa (L.) Nutt., 
Rhizoma; EMA: Amsterdam, The Netherlands; HMPC: London, UK, 
2017; 44: 1-8. 

52. Kennelly EJ, Baggett S, Nuntanakorn P, Ososki AL, Mori SA, Duke J, 
Coleton M, Kronenberg F. Analysis of thirteen populations of black 
cohosh for formononetin. Phytomedicine. 2002; 9(5):461-7. 
https://doi.org/10.1078/09447110260571733 

53. He K, Zheng B, Kim CH, Rogers L, Zheng Q. Direct analysis and 
identification of triterpene glycosides by LC/MS in black cohosh, 
Cimicifuga racemosa, and in several commercially available black 
cohosh products. Planta medica. 2000; 66(07):635-40. 
https://doi.org/10.1055/s-2000-8619 

54. Reame NE, Lukacs JL, Padmanabhan V, Eyvazzadeh AD, Smith YR, 
Zubieta JK. Black cohosh has central opioid activity in 
postmenopausal women: Evidence from naloxone blockade and 
PET neuroimaging studies. Menopause (New York, NY). 2008; 
15(5):832. https://doi.org/10.1097/gme.0b013e318169332a 

55. Rhyu MR, Lu J, Webster DE, Fabricant DS, Farnsworth NR, Wang ZJ. 
Black cohosh (Actaea racemosa, Cimicifuga racemosa) behaves as 
a mixed competitive ligand and partial agonist at the human μ 
opiate receptor. Journal of agricultural and food chemistry. 2006; 
54(26):9852-7. 

https://doi.org/10.1021/jf062808u 

56. Powell SL, Go decke T, Nikolic D, Chen SN, Ahn S, Dietz B, 
Farnsworth NR, Van Breemen RB, Lankin DC, Pauli GF, Bolton JL. 
In vitro serotonergic activity of black cohosh and identification of 
N ω-methylserotonin as a potential active constituent. Journal of 
agricultural and food chemistry. 2008; 56(24):11718-26. 
https://doi.org/10.1021/jf803298z 

57. Cicek SS, Khom S, Taferner B, Hering S, Stuppner H. Bioactivity-
guided isolation of GABAA receptor modulating constituents from 
the rhizomes of Actaea racemosa. Journal of natural products. 
2010; 73(12):2024-8. https://doi.org/10.1021/np100479w 

58. Cui G, Leng H, Wang K, Wang J, Zhu S, Jia J, Chen X, Zhang W, Qin L, 
Bai W. Effects of remifemin treatment on bone integrity and 
remodeling in rats with ovariectomy-induced osteoporosis. PloS 
one. 2013; 8(12):e82815. 
https://doi.org/10.1371/journal.pone.0082815 

59. Choi EM. Deoxyactein stimulates osteoblast function and inhibits 
bone‐resorbing mediators in MC3T3‐E1 cells. Journal of Applied 
Toxicology. 2013; 33(3):190-5. https://doi.org/10.1002/jat.1733 

60. Nema P, Jain S, Vishwakarma H, Purohit A, Jain PK. A complete 
review on aromatherapy: a complementary alternative 
medication therapy with recent trend. International Journal of 
Medical Sciences and Pharma Research, 2021; 7(4): 1-7. 

https://doi.org/10.13080/z-a.2015.102.057
https://doi.org/10.13080/z-a.2015.102.057
https://doi.org/10.1080/J157v02n03_06
https://doi.org/10.1080/10408398.2021.1895054
https://doi.org/10.1016/S0031-9422(99)00181-8
https://doi.org/10.1007/s10722-009-9513-4
https://doi.org/10.1002/ece3.606
https://doi.org/10.3390/agronomy10040595
https://doi.org/10.3390/agronomy10020214
https://doi.org/10.1016/S1570-0232(02)00342-2
https://doi.org/10.1093/jn/130.7.1695
https://doi.org/10.22270/ajdhs.v2i1.12
https://doi.org/10.1016/j.taap.2019.114831
https://doi.org/10.3390/nu8120754
https://doi.org/10.1078/09447110260571733
https://doi.org/10.1055/s-2000-8619
https://doi.org/10.1097/gme.0b013e318169332a
https://doi.org/10.1021/jf062808u
https://doi.org/10.1021/jf803298z
https://doi.org/10.1021/np100479w
https://doi.org/10.1371/journal.pone.0082815
https://doi.org/10.1002/jat.1733


Vishwakarma et al                                                                                                                          Asian Journal of Dental and Health Sciences. 2022; 2(2):1-8 

[8]                                                                                                                                                                                                                                                 AJDHS.COM 

61. Schulz V, Hänsel R, Blumenthal M, Tyler VE. Rational 
phytotherapy: A reference guide for physicians and pharmacists. 
Springer Science & Business Media; 2004; 15. 
https://doi.org/10.1007/978-3-662-09666-6 

62. Certo G, Costa R, D'Angelo V, Russo M, Albergamo A, Dugo G, 
Germanò MP. Anti-angiogenic activity and phytochemical 
screening of fruit fractions from Vitex agnus castus. Natural 
product research. 2017; 31(24):2850-6. 
https://doi.org/10.1080/14786419.2017.1303696 

63. Chen SN, Friesen JB, Webster D, Nikolic D, van Breemen RB, Wang 
ZJ, Fong HH, Farnsworth NR, Pauli GF. Phytoconstituents from 
Vitex agnus-castus fruits. Fitoterapia. 2011; 82(4):528-33. 
https://doi.org/10.1016/j.fitote.2010.12.003 

64. Masada S. Authentication of the botanical origin of Western herbal 
products using Cimicifuga and Vitex products as examples. Journal 
of natural medicines. 2016; 70(3):361-75. 
https://doi.org/10.1007/s11418-016-1006-0 

65. Oshima N, Masada S, Suzuki R, Yagi K, Matsufuji H, Suenaga E, 
Takahashi Y, Yahagi T, Watanabe M, Yahara S, Iida O. Identification 
of new diterpenes as putative marker compounds distinguishing 
agnus castus fruit (chaste tree) from shrub chaste tree fruit 
(Viticis fructus). Planta Medica. 2016; 82(01/02):147-53. 
https://doi.org/10.1055/s-0035-1558089 

66. European Directorate for the Quality of Medicines (EDQM). 
European Pharmacopoeia (Ph. Eur.), 10th ed.; Council of Europe: 
Strasbourg, France, 2019. 

67. Vishwakarma H, Thakur K, Purohit A, Jain S, Nema P, Jain PK. A 
herbal approach for the treatment of kidney stone. International 
Journal of Medical Sciences and Pharma Research, 2022; 8(1): 1-9. 

68. Oenothera biennis L. Plants of the World Online, Kew Science. 
Available online: http://www.plantsoftheworldonline.org/taxon/ 
urn: lsid: ipni.org: names: 172755-2. 

69. Qureshi A, Jain PK, Shrivastava A, Jain S, Nema P, Jain H. Evaluation 
of antidepressant activity of aqueous and ethanolic extracts of 
glycyrrhiza glabra. Asian Journal of Pharmaceutical Education and 
Research, 2022; 11(2): 84-92. 

70. European Medicines Agency (EMA); Committee on Herbal 
Medicinal Products (HMPC). EMA/HMPC/753041/2017 European 
Union Herbal Monograph on Oenothera biennis L. or Oenothera 
lamarckiana L., Oleum; EMA: Amsterdam, The Netherlands; 
HMPC: London, UK, 2018; 44:1-6. 

71. Cerin A, Collins A, And BM, Eneroth P. Hormonal and biochemical 
profiles of premenstrual syndrome: treatment with essential fatty 

acids. Acta obstetricia et gynecologica Scandinavica. 1993; 
72(5):337-43. https://doi.org/10.3109/00016349309021108 

72. Horrobin DF. The role of essential fatty acids and prostaglandins in 
the premenstrual syndrome. The Journal of reproductive 
medicine. 1983; 28(7):465-8. 

73. Brush MG, Watson SJ, Horrobin DF, Manku MS. Abnormal essential 
fatty acid levels in plasma of women with premenstrual 
syndrome. American Journal of Obstetrics and Gynecology. 1984; 
150(4):363-6. https://doi.org/10.1016/S0002-9378(84)80139-8 

74. Puolakka J, Mäkäräinen L, Viinikka L, Ylikorkala O. Biochemical 
and clinical effects of treating the premenstrual syndrome with 
prostaglandin synthesis precursors. The Journal of reproductive 
medicine. 1985; 30(3):149-53. 

75. Pye JK, Mansel RE, Hughes LE. Clinical experience of drug 
treatments for mastalgia. The Lancet. 1985; 326(8451):373-7. 
https://doi.org/10.1016/S0140-6736(85)92506-1 

76. Massil HY, O'Brien PS. Approach to the management of 
premenstrual syndrome. Clinical obstetrics and gynecology. 1987; 
30(2):443-52. https://doi.org/10.1097/00003081-198706000-
00024 

77. Hoberg E, Orjala J, Meier B, Sticher O. Diterpenoids from the fruits 
of Vitex agnus-castus. Phytochemistry. 1999; 52(8):1555-8. 
https://doi.org/10.1016/S0031-9422(99)00181-8 

78. Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlova-Wuttke D. 
Chaste tree (Vitex agnus-castus)-pharmacology and clinical 
indications. Phytomedicine. 2003; 10(4):348-57. 
https://doi.org/10.1078/094471103322004866 

79. Marjoribanks J, Brown J, O'Brien PM, Wyatt K. Selective serotonin 
reuptake inhibitors for premenstrual syndrome. Cochrane 
Database of Systematic Reviews. 2013(6). 
https://doi.org/10.1002/14651858.CD001396.pub3 

80. Kilicdag EB, Tarim E, Bagis T, Erkanli S, Aslan E, Ozsahin K, Kuscu 
E. Fructus agni casti and bromocriptine for treatment of 
hyperprolactinemia and mastalgia. International Journal of 
Gynecology & Obstetrics. 2004; 85(3):292-3. 
https://doi.org/10.1016/j.ijgo.2004.01.001 

81. Purohit A, Jain S, Nema P, Jain DK, Vishwakarma H, Jain PK. A 
comprehensive review on tailoring an herbal approach for 
treatment of poly cystic ovarian syndrome. Asian Journal of Dental 
and Health Sciences, 2022; 2(1): 27-32. 

82. Jain S, Purohit A, Nema P, Vishwakarma H, Jain PK. A brief review 
on nutraceuticals and its application. Asian Journal of Dental and 
Health Sciences, 2022; 2(1): 7-13. 

 

 

https://doi.org/10.1007/978-3-662-09666-6
https://doi.org/10.1080/14786419.2017.1303696
https://doi.org/10.1016/j.fitote.2010.12.003
https://doi.org/10.1007/s11418-016-1006-0
https://doi.org/10.1055/s-0035-1558089
https://doi.org/10.3109/00016349309021108
https://doi.org/10.1016/S0002-9378(84)80139-8
https://doi.org/10.1016/S0140-6736(85)92506-1
https://doi.org/10.1097/00003081-198706000-00024
https://doi.org/10.1097/00003081-198706000-00024
https://doi.org/10.1016/S0031-9422(99)00181-8
https://doi.org/10.1078/094471103322004866
https://doi.org/10.1002/14651858.CD001396.pub3
https://doi.org/10.1016/j.ijgo.2004.01.001

