Remediable Medicinal Plants used for Dysmenorrhea treatment- A short review

A.K. Meena¹*, Anshul Sinha¹, H.C. Mehta¹, M. D. Gupta¹, M. M. Rao² and M. M. Padhi³

¹National Research Institute for Ayurveda -Siddha Human Resource Development, Gwalior-474009

²Ayurveda Central Research Institute, New Delhi

³Central Council for Research in Ayurvedic Sciences, New Delhi-110058, (India)

ABSTRACT:

The medical term for menstrual cramps is dysmenorrhea. Menstrual cramps are pains that begin in the lower abdomen and pelvis, i.e. below the waistline. The cramps can be a quite painful or simply a dull ache. They can be periodic or continual. More than 10000 plant species are used as traditional medicines in the treatment of dysmenorrhea. Since the ancient times, plants have been exemplary sources of medicine. Ayurveda and other Indian medicinal system literature mention the use of plants in various human ailments. India has about 45000 plant species and among them several thousand are claimed to possess medicinal properties. Researchers conducted in the last few decades on the plants mentioned in ancient literature or used traditionally for dysmenorrhea. This review reveals that plants and their extracts used as dysmenorrhea remedy.

KEYWORDS: Dysmenorrhea, Medicinal plants, Menstruation, Active constituents.

INTRODUCTION:

Dysmenorrhea is painful menstrual cramps. The pain from menstrual cramps can range from mild to severe and can involve the lower belly, back, or thighs. Women may also have headaches, nausea, dizziness or fainting, or diarrhea or constipation with cramps. There are two types of dysmenorrhea primary and secondary. Primary dysmenorrhea is thought to be caused by excessive levels of prostaglandins, hormones that make uterus contract during menstruation and childbirth. Its pain probably results from contractions of uterus that occur when the blood supply to its lining (endometrium) is reduced. Secondary dysmenorrhea is menstrual pain that is generally related to some kind of gynecologic disorder, such as endometriosis, adenomyosis, uterine fibroids and infection. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and last longer than common menstrual cramps. Most of these disorders can be easily treated with medications or surgery. Due to secondary dysmenorrhea often start sooner in the menstrual cycle than those of primary dysmenorrhea and usually last longer. Secondary dysmenorrhea is more likely to affect women during adulthood ^[1-3].

Remediable Medicinal Plants for Dysmenorrhea:

Some medicinal plants are listed below which are effective for treatment of dysmenorrhea with minimal or without side effects.

Trichilia emetica Vahl.

Trichilia emetica fruits are diuretic and also used against poisoning, hepatitis, ulcer, dysmenorrhoea, asthma, cirrhosis and internal worms ^[4]. The plant is used as purgative, antiepileptic, antipyretic, general tonic and for bronchial inflammation ^[5]. Trichilia emetica plant contains fats, resin, tannin, polyphenolic and bitter principle related to calicedrin,^[5] limonoids ^[6-7]. Trichilia emetica possess many biological activities like antifungal, bactericidal and antiviral, antimalarial, insect antifeedant and growth regulation properties ^[8-9] and antischistosomiasis activities ^[10]. The limonoids are powerful inhibitors of leukotriene biosynthesis of human leucocytes ^[11].

Acorus calamus Linn. :

Acorus calamus Linn is commonly known as sweet flag is an aromatic medicinal plant belonging to the Araceae family, it is wild or cultivated throughout Himalayas at an altitude ascending up to 6000 ft ^[12]. Rhizome, roots and leaves contain volatile oil, where asarone and ß‐asarone are the important constituents, Presence of small quantities of palmitic, heptylic and butyric. Main chemical constituents and components are asarone, alpha pinene, beta asarone, calamenol, calamene, calamenone, eugenol, methyl eugenol, calamone, azulene, sugars, glucosides and flavones. Roots contain tricyclic sesquitepene‐ Callaminon, aclamendiol and isocalamendiol ^[13]. The rhizomes of Acorus calamus contain aromatic oil and are considered to possess anti‐spasmodic, carminative and anthelmintic, aromatic, expectorant, nauseant, nervine, sedative, stimulant properties and also used for the treatment of epilepsy, mental ailments, chronic diarrhea, dysentery, dysmenorrhea bronchial catarrh, intermittent fevers and glandular and abdominal tumors. Acorus calamus is also employed for kidney and liver troubles, rheumatism, sinusitis, and eczema ^[14].

Cannabis indica:

Cannabis indica extracts may represent an efficacious and safe alternative for treatment of a wide range of conditions in women including dysmenorrhea, dysuria, hyperemesis gravidarum, and menopausal symptoms ^[15]. Cannabis indica have great value and it has been found useful in uterine sub involution, chronic inflammation, irritation, metrorrhagia and nervous spasmodic. Cannabis indica used in symptomatic treatment of convulsive disorders, migraine, insomnia and dysmenorrhea ^[16].

Cannabis sativa:

Cannabis sativa leaves are bitter, astringent, tonic, aphrodisiac, alterative, intoxicating, stomachic, analgesic and abortifacient. They are used in convulsions, otalgia, abdominal disorders, malaria, dysentery, diarrhea, skin diseases, hysteria, insomnia, gonorrhea, colic, tetanus and hydrophobia. Its excessive use causes dyspepsia, cough, impotence, melancholy, dropsy, restlessness and insanity. The bark is tonic and useful in inflammations, hemorrhoids and hydrocele. The inflorescence of female plant is intoxicating, stomachic, soporific, abortifacient and useful in convulsions. Seeds are carminative, astringent, aphrodisiac, antiemetic and anti- inflammatory. The resin is smoked to allay hiccough and bronchitis. It is useful in insomnia, sick headaches, neuralgia, rnigrain, mania, whooping cough, asthma, dysuria and in relieving pain in dysmenorrhoea and menorrhagia.

Main chemical constituents are Spiro compounds, viz., cannabispiran, dehydrocannabi-spiran, and beta- cannabispiranol, dehydrostilbenes-3-[2-(3-hydroxy-4-methoxyphenyl) ethyll-5-methoxyphenol and canniprene, acylated 0-glucoside of apigenol, 0-glycosides of vitexin, isovitexin, orientin , α-bergamotene, β -caryophyllene, α-humulene, γ-elemene, α -gurjunene, β - isabolene, β- caryophyllene-epoxide and α-bisabolol, cannabinoids, tetrahydro-cannabinol, cannabinol, α -pinene, myrcene, limonene, terpinolene, friedelin epifridelinol, β -sitosterol, carvone, dihydrocarvone , vitexin, isovitexin, orientin, acyl derivative of apigenol, N-acetyl-glucosamine, N-acetylgalactosamine, 22- 0-glucopyranosylvitexin ^[17].

Papaver somniferum Linn.

Papaver somniferum have anticonvulsant, analgesic, ^[18-20] antitissuve, cardiovascular, synergistic, antinociceptive ^[21], anorectic, locomotor, hypotensive, sedative, antispasmodic ^[22], hydrolytic ^[23], antitumour ^[24], hypoglycaemic, carcinogenesis protective ^[25] and antidiarrhoeal activities. It beneficial in migraine, malaria, dysmenorrhea, cystitis, menorrhagia and other painful conditions ^[26-28]. Papaver somniferum contains about 25 alkaloids among which morphine (10-16%) is the most important base. The other alkaloids isolated are codeine, narcotine, thebaine, noscapine, narceine, papaverine etc ^[29]. Fixed oil of Papaver somniferum contains esters of linoleic, palmitic, oleic acids ^[30].

Leucas cephalotes Spreng:

The leaves and flowers of Leucas cephalotes are acrid, thermogenic, carminative, digestive, anthelmintic, anti-inflammatory, emmenagogue, sudorific, antipyretic, expectorant, antibacterial and depurative. They are useful in colic, dyspepsia, verminosis, arthralgia, chronic skin eruptions, psoriasis, cough and catarrh in children, amenorrhoea, dysmenorrhoea, intermittent fevers and ulcers ^[28]. The whole plant is laxative, diaphoretic, and useful in bronchitis, jaundice, inflammations, asthma, dyspepsia, paralysis and leukemia ^[31-33]. Plant is cardiac depressant, hypotensive ^[34], antiseptic ^[35], insectisidal ^[12], antiscabies ^[36] and anticoagulant ^[37]_.

Nineteen compounds were isolated by chromatographic separation of 1-butanolsoluble fraction of the MeOH extract of Leucas cephalotes ^[38]. The structures of known compounds were identified as oleanolic acid, 7-oxysitisterol ^[39-40], 7-oxostigmasterol ^[41], 7 alpha-hydroxy-sitosterol ^[39], 7 alpha-hydroxystigmasterol ^[38], stigmasterol ^[42], 5-hydroxy-7,4,1-dimeathoxy-flavone ^[43], gonzalitosin ^[44], tricin ^[45] and apigenin 7-0-β-D-(6-O-p-coumaroyl) glucopyranoside ^[46-47].

Juniperus communis Linn.

Fruits of Juniperus communis are carminative, stimulant, styptic, stimulant, emmenagogue, digestive, diuretic, disinfectant, antiseptic and are useful in chronic bright's disease, dropsy, asthma, cough, respiratory affections, migraine, rheumatic and painful swellings, nephrotic dropsy of children, cattarah, gonorrhoea, pulmonary blennorhoea, arthritis, amenorrhea, diabetes, infantile tuberculosis, bladder affections, chronic pyelonephritis, dysmenorrhea, piles and abdominal disorders. The bark is applied in skin infections. The plant is used as appetizer, carminative, anthelmintic, alexipharmic, laxative, useful in diarrhea, abdominal pains, strangury diseases of the spleen and abdomen, ascites, tumours, piles, bronchitis, indigestion, constipation and vaginal discharges ^[32].

The fruit of Juniperus communis Linn. contains the main constituents viz. mono-terpenoids, -pinene, myrcene, sabinene, camphene, camphor, cineole, p-cymene ^[48], cadinenes, bornyl acetate^[49], limonene, -pinene, - terpinene, terpinen-4-ol, -phellandrene; diterpenoids: caryophyllene, sandaracopinaric acid, isocupressic acid, isopimaric acid, imbricatolic acid, 16-epoxy-12- hydroxy-8(17),13(16),14-labdatrien-19-oic acid ^[50], flavonoids luteolin-7-O-D-glucoside,kaempferol-3-O-D-glucoside, quercitrin, apigenin, luteolin, robustaflavone, apodocar-pusflavone, hinokiflavone ^[51], catechins: (+)- afzelechin, (-)-epiafzelechin, (+)-catechin, (-)-epicatechin, (+)-gallocatechin, (-)-epigallocatechin ^[52]. The leaf contains essential oils: -pinene (17%), sabinene (12%), terpinen-4-ol (7.7%), phellandrene (7.3%), widdrene (6.4%), terpinene (5.9%), - terpinene (4.3%), -terpinene (3.8%) ^[53], limonene (4.2%), terpinen-4-ol (2.7%), myrcene (2.6%), -pinene (2.0%) ^[54] and also contains biflavonoids: cupressuflavone, amentoflavone, hinokiflavone, isocryptomerin, sciadopitysin^[55-56].

Piper cubeba Linn.

The fruits of Piper cubeba are acrid, bitter, thermogenic, aromatic, stimulant, carminative, diuretic, expectorant ^[7], analgesic, dentifrice, antiinflammatory, anthelmintic, deobstruant, vulnerary, appetising, digestive, stomachic, cardiotonic, rejuvenating, emmenagogue, sedative and antiseptic. It is useful in body ache, odontalgia, cephalalgia, halitosis, inflammation, helminthiasis, worm’s infestation, wounds and ulcers, catarrh, anorexia, dyspepsia, flatulence, haemorrhoids, cardiac debility, cough, asthma, bronchitis and various respiratory disorders, amenorrhoea and dysmenorrhea, ^[28]. Fruits contain an essential oil beneficial as a local remedy in the form of lozengel of relief throat troubles when taken internally. It exerts a positive antiseptic effect on urine hence used in genitourinary diseases ^{[17, 26, 57]}. Phytochemical screening of Piper cubeba extracts has detected alkaloids/amides, lignans, neolignans and terpenes, including aschantin, dihydrocubebin, piperine alkaloid, piperol A, B and C, piperol A-triacetate, the terpenes α-copaene, ρ-cymene, germacrene D and limonene(among others), sesamin and (+)-Zeylinol ^[58]. In a more recent review, Usia et al. reported sixteen known compounds (α-asarone, (-)-clusin, (-)-dihydroclusin, ethoxyclusin, (-)-cubebin, (-)-cubebinin, (-)-cubebininolide, (-)-dihydrocubebin, α-methylcubebin, (-)-hinokinin, magnosalin, medioresinol, 2,4,5-trimetoxiphenylacetone, 1-(2,4,5-trimetoxyphenyl)-1,2-propanedione, (-)-thujaplicatin trimethyl ether, (-)-yatein), two new lignans ((8R,8’R)-4-hydroxycubebinone and (8R, 8’R,9’S)-5-methoxyclusin) and two new sesquiterpenes (5α,8α-2-oxo-1(10),3,7(11)-guaiatrien-12,8-olide and (1α,2β,5α,8α,10α)-1,10-epoxy-2-hydroxy-3,7(11)-guaiadien-12,8-olide ^[59].

Bambusa arundinacea (Retz.) Willd.

Leaves of Bambusa arundinacea are antileprotic, anthelmintic, astringent, emmengogue, beneficial in dysmenorrhoea and haemoptysis ^[60]. The stem and leaves are useful in diseases of blood and inflammatory conditions. Seeds are acrid, laxative and beneficial in strangury and urinary discharges. The juice of the flowers is used as a drop in the earache and deafness. The plant extract is used as a remedy in snake and scropion bite ^[28]. The buds are tonic, its paste is restorative, cooling and stomachic. Leaf, root, shoot and seed of Bambusa arundinacea possess Anti-inflammatory, Antiulcer, Anti-diabetic, Anti-oxidant ^[61]. Main chemical constituents of Bambusa arundinacea are silica 90%, silacum, potash, lime, aluminia, cholin, betain, hydrate of silicic acid, nuclease, urease, proteolytic enzyme, cyanogentic glucoside and an alkaloid. Shoot has active constituents are diferuloyl arabinoxylanhexasaccharide, diferuloyl oligosaccharide, (5, 5’-di--(diferul-9, 9’-dioyl)-[α-Larabinofuranosyl-(1-3) -O-β-D-xylopyranosyl-9 (1-4) –D-xylopyranose] (taxiphyllin). Seed contain arginine, cysteine, histidine, isoleucine, leucine, lysine, methionine, phenylamine, threonine, valine, tyrosine, niacin, riboflavin, thiamine. Leaves mainly contain Protein, gluteline, contains lysine, methionine, betain, cholin, proteolytic enzyme, nuclease, urease ^[60].

Capparis spinosa Linn.

Fresh fruits of Capparis spinosa used in sciatica and dropsy. Dry powdered fruit combined with honey is used in colds, rheumatism, gout, sciatica and backache. In decoction it is said efficient against gastric pain. Applied on the all body this decoction is said to be good in epilepsy. Seeds used for treatment of feminine sterility and dysmenorrhea. Crushed seeds used in ulcers, scrofula and ganglions ^[61]. Flower buds are refreshing, stimulant and slightly diuretic. The herb has a hepatoprotective effect it reduced significantly serum transaminases. It has an antitumor activity against human leukemia in vitro. It has an immunosuppressive effect. Chemical constituents of Capparis spinosa is Alkaloids ranges 0.91% in the root bark, 0.86% in the seeds, 0.02% in the leaves and 0.04% in the fruits. Stachydrine was isolated and identified in the plant. Quercetin-3-rutinoside, quercetin-7-glucorhamnoside, kaempferol-3-rutinoside, kaempferol-3-rhamnorutinoside and rutin (2.1%). Glucocapparin volatile oil; sterols and saponins ^[62]. Capparis spinosa fruit and roots contain spermidine alkaloids ^[63] similar to isocodonocarpine ^[64]. Mainly three alkaloids such as capparispine, capparispine 26-O0-β-D-glucoside and cadabicine 26-O-β-D-glucoside hydrochloride were isolated.

Solanum nigrum Linn.

The plant has been extensively used in traditional medicine in India and other parts of world to cure liver disorders, chronic skin ailments (psoriasis and ringworm), inflammatory conditions, painful periods, fevers, diarrhea, eye diseases, hydrophobia etc ^[32]. Leaf, root and stalk used for dysmenorrhea in females ^[62]. The fruit of Solanum nigrum showed antiulcer, antioxidant and antitumor, inflammation, tuberculosis, diuretics activities ^[65-68], plant is also used in the Oriental systems of medicine for various purposes – as an antitumorigenic, antioxidant, anti-inflammatory ^[69]. The Active chemical constituents of Solanum nigrum are glycoalkaloids (solanine, solamargine, solanigrine and solasodine), steroidal glycosides (β-solamargine, solasonine and α, β- solansodamine), steroidal saponins (diosgenin), steroidal genin (gitogenin), tannin and polyphenolic compounds. Mature fruits are low in alkaloid (solanine) content ^[70].

Some other important medicinal herbs used in the treatment of Dysmenorrhea:

Roots of Angelica sinensis, leaves and stem of Turnera difusa, root of Chamalerium luteum, leaves of Petroselinum crispum, Mentha piperita, Trifolium pretense, leaves of Ruta graveolens, Urtica urens Linn., Agave americana Linn., Artemisia absinthium Linn., Matricaria chamomilla Linn. Berberis vulgaris Linn., Chenopodium ambrosioides Linn., Salvia officinalis Linn. ^[17,71-74].

ACKNOWLEDGEMENT:

The authors are very grateful to Director General CCRAS, New Delhi for providing facilities and encouragement for carrying out this review work.

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Received on 08.10.2012

Modified on 20.10.2012

Accepted on 31.10.2012

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Research J. Science and Tech. 4(5): September –October, 2012: 229-234