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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.
Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome is defined as endocrinologic diseases among reproductive-age women caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries associated with a high risk for metabolic disorder(1) as resulting of enlarged ovaries(2), leading to hormone imbalance(excessive androgen and anti-müllerian hormone (AMH) )(1)(3)(4)(5), induced Hirsutism(6)(7), reproductive disorder(10(12)), risks of type 2 diabetes(9)(10)(11), metabolic syndrome(10)(12) and early cardiovasular disease(8)(13), acne(10)(14), endometrial cance(18)(19),weight gain and obesity(15)(16)(17). The syndrome effects over 5% of women population or 1 in 20 women.
Unfortunately, according to studies, women with PCOs after the reproductive age, are associated to continuously increase risk of type II diabetes, with no increasing altered glucose tolerance(20), CVD and hypertension(21).
The prevention and management In Herbal Medicine
Polycystic ovary syndrome (PCOS) is unpreventable in Western medicine. Early diagnosis and treatment may reduce risk of its complications, including infertility, metabolic syndrome, obesity, diabetes, cardiovascular diseases, stroke, etc.
Reduce fat intake less than 30% of total calories with a low proportion of saturated fat and high in fiber from predominantly low-glycaemic-index-carbohydrate foods for patients with PCOs(827a). Calorie intake should be distributed between several meals per day with restricted intake of snacks and drinks(828).
The Fertility Herb: Black cohosh
Black cohosh is a glabrous herbaceous perennial plant, producing large, compound leaves from an underground rhizome and belongs to the family Ranunculaceae used in traditional medicine in treating symptoms of all kinds of gynaecological problems(905), including symptoms of premenstrual tension(907) and menopause(906)
Phytoestrogen found it balck cohosh showed to occupy the estrogen receptor sites in women body(908), through it antiestrogenic and extrogenic effects(909), to induce hormone balancing may result in improving the chance of ovulation and fertility(910)(911).
Black cohosh processes anti inflammatory(913)(914) and anti oxidant(914) effect through enhancing immune system fighting against microbial(915)(916) invasion and irregular cell growth(917)(918) and other inflammatory diseases(913). According to School of Medicine, Wuhan University black cohosh may be beneficiary for patient with patients with coronary heart disease, atherosclerosis, pulmonary heart disease and thrombosis throught its anti inflammatory effects(912).
3. Metabolic Syndrome
In rat model study, black cohosh and its triterpene-saponins showed to reduce high load with fat tissue in the PFD and in the knee joints, body weight, serum leptin and cholesterol and glucose levels caused by metabolic syndrome, according to University Medical Center Göttingen(919). The consumption of black cohost also effectively decreases enhanced pituitary LH secretion, attenuates body weight gain, plasma lipids and intra-abdominal fat (IAF) accumulation, lowers FPI and has no effects on uterine mass(920).
Use conjunction with clomiphene citrate, black cohosh induced endometrial thickness, serum progesterone and clinical pregnancy rate and cycle outcomes in some infertile couples(921). According to Assiut University, in the differentiation of relatively low pregnancy rates in CC induction cycles of clomiphene citrate in infertile couple, follicular-phase supplements imicifuga racemosa or ethinyl oestradiol needed significantly fewer days for adequate follicular maturation, had a thicker endometrium and higher oestradiol concentration at the time of human chorionic gonadotrophin injection with better outcome of pregnancy rate(922)(923).
5. Condense Tannins
It also contains condense tannin, a type of proanthocyanidin which has been used as nutritional and therapeutic supplements in Europe in promoting the function of flavonoids as an antioxdant(924)(925) to improve Immunity(926)(927) against auto immune response induced infertility(962)(933) and microbial invasion(928)(929), but also maintain DNA integrity about irregular cell growth(930)(931).
6. Nervous Symptoms
Back cohost is said to contain chemical agent to bind the activities to serotonin receptors(939) in decreasing the risk of depression(936), anxiety(934), sleep problem(935) and emotional and physical stress(937)induced risk of infertility(938).
1. Common side effects include
In high doses of black cohosh may cause abdominal pain, diarrhea, dizziness, headaches, joint pains, nausea, slow heart rate, tremors, visual dimness, vomiting, and weight gain, according to
2. Liver damage
Over dose of back cohosh may cause liver damage(940).
3. Digestive system
Over dose may cause occasional gastrointestinal discomfort, such as diarrhea; nausea and vomiting. sweating; constipation(942).
(1) Adiposity and metabolic dysfunction in polycystic ovary syndrome by Sam S.(PubMed)
(2) A "kiss" before conception: triggering ovulation with kisspeptin-54 may improve IVF by Young SL.(PubMed)
(3.) Androgen hyperfunction and excessive heterosexual hair growth in women, with special attention to the polycystic ovarian syndrome by Lunde O1.(PubMed)
(4) Expression of anti-Müllerian hormone in letrozole rat model of polycystic ovary syndrome by Du DF1, Li XL, Fang F, Du MR.(PubMed)
(5) [Serum levels of anti-muller hormone in women with polycystic ovary syndrome and healthy women of reproductive age].[Article in Bulgarian] by Parahuleva N, Pehlivanov B, Orbecova M, Deneva T, Uchikova E.(PubMed)
(6) [Current opinions on the etiology and pathophysiology of hirsutism].[Article in Polish] by Krysiak R1, Kedzia A, Okopień B.(PubMed)
(7) The clinical evaluation of hirsutism by Somani N1, Harrison S, Bergfeld WF.(PubMed)
(8) Polycystic ovary syndrome and insulin: our understanding in the past, present and future by Mayer SB1, Evans WS, Nestler JE.(PubMed)
(9) Association of mean platelet volume with androgens and insulin resistance in nonobese patients with polycystic ovary syndrome by Dogan BA1, Arduc A2, Tuna MM1, Karakılıc E1, Dagdelen I1, Tutuncu Y1, Berker D1, Guler S1.(PubMed)
(10) Approach to the patient: contraception in women with polycystic ovary syndrome by Yildiz BO1.(PubMed)
(11) Polycystic ovarian syndrome (PCOS): a significant contributor to the overall burden of type 2 diabetes in women by Talbott EO1, Zborowski JV, Rager JR, Kip KE, Xu X, Orchard TJ.(PubMed)
(12) Prevalence of vitamin D deficiency in Slovak women with polycystic ovary syndrome and its relation to metabolic and reproductive abnormalities by Figurová J1, Dravecká I, Javorský M, Petríková J, Lazúrová I.(PubMed)
(13) Role of Insulin Sensitizers on Cardiovascular Risk Factors in Polycystic Ovarian Syndrome: A Meta-Analysis by Thethi TK1, Katalenich B2, Nagireddy P3, Chabbra P4, Kuhadiya N5, Fonseca V1.(PubMed)
(14) Acne in hirsute women by Lumezi BG1, Pupovci HL1, Berisha VL1, Goçi AU2, Gerqari A3.(PubMed)
(15) Obesity and polycystic ovary syndrome by Naderpoor N1, Shorakae S, Joham A, Boyle J, De Courten B, Teede HJ.(PubMed)
(16) Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan by Teede H1, Deeks A, Moran L.(PubMed)
(17) Metabolic Evidence of Diminished Lipid Oxidation in Women With Polycystic Ovary Syndrome. by Whigham LD1, Butz DE2, Dashti H3, Tonelli M3, Johnson LK1, Cook ME2, Porter WP4, Eghbalnia HR5, Markley JL6, Lindheim SR7, Schoeller DA8, Abbott DH9, Assadi-Porter FM10.(PubMed)
(18) Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis by Barry JA1, Azizia MM1, Hardiman PJ2.(PubMed)
(19) Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study by Gottschau M1, Kjaer SK2, Jensen A1, Munk C1, Mellemkjaer L3.(PubMed)
(20) Polycystic ovary syndrome: metabolic consequences and long-term management by Carmina E1.(PubMed)
(21) Arterial stiffness is increased in asymptomatic nondiabetic postmenopausal women with a polycystic ovary syndrome phenotype by Armeni E1, Stamatelopoulos K, Rizos D, Georgiopoulos G, Kazani M, Kazani A, Kolyviras A, Stellos K, Panoulis K, Alexandrou A, Creatsa M, Papamichael C, Lambrinoudaki I.(PubMed)
(827a) Diet and nutrition in polycystic ovary syndrome (PCOS): pointers for nutritional management by Farshchi H, Rane A, Love A, Kennedy RL(PubMed)
(828) The optimal diet for women with polycystic ovary syndrome? by Marsh K, Brand-Miller J.(PubMed)
(913) Aqueous extracts of Cimicifuga racemosa and phenolcarboxylic constituents inhibit production of proinflammatory cytokines in LPS-stimulated human whole blood by Schmid D1, Woehs F, Svoboda M, Thalhammer T, Chiba P, Moeslinger T.(PubMed)
(914) Inhibition of inducible nitric oxide synthesis by Cimicifuga racemosa (Actaea racemosa, black cohosh) extracts in LPS-stimulated RAW 264.7 macrophages by Schmid D1, Gruber M, Woehs F, Prinz S, Etzlstorfer B, Prucker C, Fuzzati N, Kopp B, Moeslinger T.(PubMed)
(915) Triterpenoid glycoside from Cimicifuga racemosa by Lai GF1, Wang YF, Fan LM, Cao JX, Luo SD.(PubMed)
(916) Extracts of Canadian first nations medicinal plants, used as natural products, inhibit neisseria gonorrhoeae isolates with different antibiotic resistance profiles by Cybulska P1, Thakur SD, Foster BC, Scott IM, Leduc RI, Arnason JT, Dillon JA.(PubMed)
(917) Black cohosh (Cimicifuga racemosa [L.] Nutt.): safety and efficacy for cancer patients by Walji R1, Boon H, Guns E, Oneschuk D, Younus J.(PubMed)
(918) Black cohosh, hot flushes, and breast cancer by Merchant S1, Stebbing J2.(PubMed)
(919) Cimicifuga racemosa and its triterpene-saponins prevent the Metabolic Syndrome and deterioration of cartilage in the knee joint of ovariectomized rats by similar mechanisms by Seidlova-Wuttke D1, Eder N, Stahnke V, Kammann M, Stecher G, Haunschild J, Wessels JT, Wuttke W.(PubMed)
(920) Effects of black cohosh extract on body weight gain, intra-abdominal fat accumulation, plasma lipids and glucose tolerance in ovariectomized Sprague-Dawley rats by Rachoń D1, Vortherms T, Seidlová-Wuttke D, Wuttke W.(PubMed)
(921) Adding phytoestrogens to clomiphene induction in unexplained infertility patients--a randomized trial by Shahin AY1, Ismail AM, Zahran KM, Makhlouf AM.(PubMed)
(922) Supplementation of clomiphene citrate cycles with Cimicifuga racemosa or ethinyl oestradiol--a randomized trial by Shahin AY1, Ismail AM, Shaaban OM.(PubMed)
(923) Adding the phytoestrogen Cimicifugae Racemosae to clomiphene induction cycles with timed intercourse in polycystic ovary syndrome improves cycle outcomes and pregnancy rates - a randomized trial by Shahin AY1, Mohammed SA.(PubMed)
(924) Influence of grape seed proanthocyanidin extract in broiler chickens: effect on chicken coccidiosis and antioxidant status by Wang ML1, Suo X, Gu JH, Zhang WW, Fang Q, Wang X.(PubMed)
(925) The fruit extract of Berberis crataegina DC: exerts potent antioxidant activity and protects DNA integrity by Charehsaz M1, Sipahi H2, Celep E3, Üstündağ A4, Cemiloğlu Ülker Ö5, Duydu Y6, Aydın A7, Yesilada E8.(PubMed)
(926) Grape consumption supports immunity in animals and humans by Percival SS1.(PubMed)
(927) Effect of proanthocyanidin-rich extract from Pinus radiata bark on immune response of specific-pathogen-free White Leghorn chickens by Park IJ1, Cha SY, Kang M, So YS, Go HG, Mun SP, Ryu KS, Jang HK.(PubMed)
(928) Synergistic effect of proanthocyanidin on the bactericidal action of the photolysis of H2O2 ,by Ikai H1, Nakamura K, Kanno T, Shirato M, Meirelles L, Sasaki K, Niwano Y.(PubMed)
(929) Proanthocyanidin-rich extracts from cranberry fruit (Vaccinium macrocarpon Ait.) selectively inhibit the growth of human pathogenic fungi Candida spp. and Cryptococcus neoformans by Patel KD1, Scarano FJ, Kondo M, Hurta RA, Neto CC.(PubMed)
(930) Oligomeric proanthocyanidin complexes (OPC) exert anti-proliferative and pro-apoptotic effects on prostate cancer cells by Neuwirt H1, Arias MC, Puhr M, Hobisch A, Culig Z.(PubMed)
(931) The cytotoxic effects of a novel IH636 grape seed proanthocyanidin extract on cultured human cancer cells by Ye X1, Krohn RL, Liu W, Joshi SS, Kuszynski CA, McGinn TR, Bagchi M, Preuss HG, Stohs SJ, Bagchi D.(PubMed)
(932) Antisperm immunity and infertility by Lu JC1, Huang YF, Lu NQ.(PubMed)
(933) Immune infertility: towards a better understanding of sperm (auto)-immunity. The value of proteomic analysis by Bohring C1, Krause W.(PubMed)
(934) Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (black cohosh) in women with anxiety disorder due to menopause by Amsterdam JD1, Yao Y, Mao JJ, Soeller I, Rockwell K, Shults J.(PubMed)
(935) Black cohosh (Cimicifuga racemosa) in tamoxifen-treated breast cancer patients with climacteric complaints - a prospective observational study by Rostock M1, Fischer J, Mumm A, Stammwitz U, Saller R, Bartsch HH.(PubMed)
(936) Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized trial by Oktem M1, Eroglu D, Karahan HB, Taskintuna N, Kuscu E, Zeyneloglu HB.(PubMed)
(937) Black Cohosh and Chasteberry: Herbs Valued by Women for Centuries B Y J OSEPH L. M AYO , MD, FACOG
(938) Is infertility really associated with higher levels of mental distress in the female population? Results from the North-Trøndelag Health Study and the Medical Birth Registry of Norway by Biringer E1, Howard LM, Kessler U, Stewart R, Mykletun A.(PubMed)
(939) Metabolism of Nω -methylserotonin, a serotonergic constituent of black cohosh (Cimicifuga racemosa, L. (Nutt.)), by human liver microsomes by Nikolić D1, Li J, van Breemen RB.(PubMed)
(940) Mechanism of hepatotoxicity due to black cohosh (Cimicifuga racemosa): histological, immunohistochemical and electron microscopy analysis of two liver biopsies with clinical correlation by Enbom ET1, Le MD2, Oesterich L3, Rutgers J4, French SW2.(PubMed)
(941)University of Maryland Medical Center((PubMed)
(942) [Efficacy and safety of Black cohosh (Actaea/Cimicifuga racemosa) in the treatment of vasomotor symptoms--review of clinical trials].[Article in Polish] by Kanadys WM1, Leszczyńska-Gorzelak B, Oleszczuk J.(PubMed)
(943) Black cohosh: an alternative therapy for menopause? by Mahady GB1, Fabricant D, Chadwick LR, Dietz B.(PubMed)