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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 Herbal Treatment for Polycystic Ovarian Syndrome (PCOs)
Epidemically, increased incidence and prevalence of overweight and obesity over 3 decades in the develop world now has spread to South East Asian population, due to over 20 years of economic prosperity causes of lifestyle changes in populations with very different initial habits. Suggestions of reduced fat intake less than 30% of total calories with a low proportion of saturated fat with high in fiber from predominantly low-glycaemic-index-carbohydrate foods is recommended. Calorie intake should be distributed between several meals per day with restricted intake of snacks and drinks(827a)(828).
1. Turmeric
Turmeric is a perennial plant in the genus Curcuma, belonging to the family Zingiberaceae, native to tropical South Asia. The herb has been used in traditional medicine as anti-oxidant, hypoglycemic, colorant, antiseptic, wound healing agent, and to treat flatulence, bloating, and appetite loss, ulcers, eczema, inflammations, etc.
Berberine (BBR), a major chemical constituents found abundantly in turmeric and plants exerted its effect in improving some of the metabolic(829) and hormonal derangements in a group of treated Chinese women with PCOS(829).
2. Korean red ginseng
Ginseng Asia is also known as Panax ginseng. Since it has been grown in the cold places in the Asian, Asian ginseng is considered as yang promoting, according to traditional Chinese medicine.
Korean red ginseng extract (KRGE) in the experiment in PCOs induced rodent, improved PCO-related ovarian dysfunction(830). In rat model, induced by injection of estradiol valerate (EV), the extract also regulated sympathetic nerve activity by significantly lower expression of NGF protein (involved in the growth of peripheral nerve cells) and NGF mRNA(the form of RNA that carries information from DNA) involved in the abnormal process caused by steroid-induced PCO(830). Also, in the experiment of Ginseng total saponins (GTS) involved polycystic ovaries induced by a single intramuscular injection of 4 mg estradiol valerate (EV) in rats, GTS decreased the expression of NGF in ovary tissue(831).
3. Aloe vera
Aloe Vera is species of succulent plant in the genus Aloe, belonging to the Family Xanthorrhoeaceae, native to Sudan. It has become very popular for commercial cultivation due to its health benefits. Aloe vera has been used in herbal medicine in treating many kinds of disease, including wound(842), burn healing(835)(836), minor skin infections(837), sebaceous cysts(838), diabetes(839)(840)(843), and elevated of cholesterol(841), etc. It is also one of many popular herb studied in scientific ways with some conflicted results.
Aloe vera gel (AVG) exhibited significant reduction in plasma triglyceride and LDL cholesterol levels, with an increase in HDL cholesterol(843) and reversion of abnormal estrous cyclicity, glucose intolerance, and lipid metabolizing enzyme activities, to normal in PCOS induced in Charles Foster female rats(833). On Letrozole induced polycystic ovarian, Aloe vera gel formulation exerted a protective effect against the PCOS phenotype by restoring the ovarian steroid status, and altering key production of steroids activity(834).
4. Salvia miltiorrhiza (Dan Shen)
Dan Shen is also known as Red Sage Root. The bitter and slightly cold herb has been used in TCM as antithrombotic, antihypertonic (lowering blood pressure), antimicrobial, antipyretic, anti-inflammatory, sedative agent and to treat dysmenorrhea, amenorrhea, palpable tumors, angina,restlessness, insomnia, irritability, etc., by enhancing the functions of heart and liver(848).
Cryptotanshinone, isolated from Salvia miltiorrhiza, in the experiment involved prenatally androgenized (PNA) rats as a model of polycystic ovary syndrome, improved estrous cycles, reduced 17-hydroxyprogesterone, androstenedione, testosterone, glucose, insulin levels, and lowered AUC-Glu(Measurements were made of the area under the curve of glucose by intravenous glucose tolerance test) and HOMA-IR( a method used to quantify insulin resistance and beta-cell function)(832).
5. Chamomile
Chamomile is also known as camomile, common name of many species daisy-like plants in the family Asteraceae, used in traditional medicine as antispasmodic(844) and anti-inflammatory(845) constituents and for treatments of diarrhea(844), menstrual cramps(844) and sleep disorders(847), reduce cramping and spastic pain in the bowels(844), relieve excessive gas and bloating in the intestine(844), etc.
Intraperitoneal injections of Chamomile alcoholic-extract for ten days in the testing on the biochemical and clinical parameters in a rat model of PCOS not only induced recovery from a PCO induced state in rats(846), but also increased dominant follicles and better endometrial tissue arrangements(846)(849).
6. Spearmint tea
Spearmint tea is a species of Mint belonging to the Lamiaceae, native to Europe and southwest Asia. The herb has been used in folk medicine for treatment of pain reliever(850), loss of appetite(851), common cold(851), bronchitis(851), sinusitis(851), fever(851), nausea(851), vomiting and indigestion(851), etc.
Spearmint tea inhibited the production of the levels or activity of androgen hormones in the human body may be considered as a natural agent for PCOs.(852). In Hirsutism polycystic ovarian syndrome (PCOS), drinking spearmint tea twice a day for a 1 month period, showed the significantly reduce total testosterone levels, due to the inhibition of androgen properties(853). In other study of polycystic ovary syndrome and idiopathic hirsutism, steep Spearmint tea for 5 days twice a day in the follicular phase of their menstrual cycles significant decreased in free testosterone and increased in luteinizing hormone, follicle-stimulating hormone and estradiol(854).
8. Licorice
Gan Cao is also known as Licorice root. The sweet and neutral herb has been used in TCM as anti allergy(856), anti inflammation(855), anti ulcer(857), anti convulsion(858) agent and to treat stomach weakness, tired and lack of strength, cough with abundance of phlegm, stomach and solar plexus pain, and improve cardiac function(855), etc., as it tonifies the Spleen, benefits the Qi, moistens the Lungs, calms cough, deaf or acute pain, by enhancing all 12 channels(859).
In treatment of PCOs(862), combination of licorice and 100 mg spironolactone showed the activation of the renin-aldosterone system in lowering blood pressure and water (fluid) balance(860). reducing the prevalence of side effects related to the diuretic activity of spironolactone(860). In model rats experiment, Ganshao Paste (CGP), showed the decrease of serum levels of LH, T, and FSH and increase of serum estradiol (E2), and progesterone (P)(861)(865).
9. HemoHIM
HemoHIM is a herbal formula containing three edible herbs, Angelica Radix, Cnidium Rhizoma and Paeonia Radix approved by Korean FDA as health functional supplement assisting functions of the immune system(863)(864). In adult PCOs cycling rats induced EV injection and administered orally (100 mg/kg of body weight/day) for 35 consecutive days, the formula lowered the high numbers of antral follicles and increased the number of corpora lutea(864), normalized ovarian morphology and the expression of nerve growth factor (NGF) in PCOs(864).
Ovarian Cysts And PCOS Elimination
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References
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(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)
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(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)
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(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)
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(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)
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(834) Effect of Aloe barbadensis Mill. formulation on Letrozole induced polycystic ovarian syndrome rat model by Maharjan R, Nagar PS, Nampoothiri L.(PubMed)
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(842) Topical Aloe Vera (Aloe barbadensis Miller) Extract Does Not Accelerate the Oral Wound Healing in Rats by Coelho FH1, Salvadori G, Rados PV, Magnusson A, Danilevicz CK, Meurer L, Martins MD.(PubMed)
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(845) Chamomile: an anti-inflammatory agent inhibits inducible nitric oxide synthase expression by blocking RelA/p65 activity by Bhaskaran N1, Shukla S, Srivastava JK, Gupta S.(PubMed)
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(848) Dan shen(Complementary and Alternative Healing University)
(849)Effects of chamomile extract on biochemical and clinical parameters in a rat model of polycystic ovary syndrome by Farideh ZZ, Bagher M, Ashraf A, Akram A, Kazem M.(PubMed)
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(859) Gan Cao(Complementary and Alternative Healing University)
(860) Treatment of polycystic ovary syndrome with spironolactone plus licorice by Armanini D, Castello R, Scaroni C, Bonanni G, Faccini G, Pellati D, Bertoldo A, Fiore C, Moghetti P(PubMed)
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(862) Phytoestrogens and the metabolic syndrome by Jungbauer A1, Medjakovic S.(PubMed)
(863) Immunomodulatory and Antidiabetic Effects of a New Herbal Preparation (HemoHIM) on Streptozotocin-Induced Diabetic Mice by Kim JJ1, Choi J1, Lee MK2, Kang KY3, Paik MJ3, Jo SK4, Jung U4, Park HR4, Yee ST5.(PubMed)
(864) Preventative effect of an herbal preparation (HemoHIM) on development of airway inflammation in mice via modulation of Th1/2 cells differentiation by Kim JJ1, Cho HW, Park HR, Jung U, Jo SK, Yee ST.(PubMed)
(865) [Effects of compound ganshao paste on the levels of sex hormones and hepatic transaminases in polycystic ovarian syndrome rat model].[Article in Chinese] by Wang YH, Wang HL, Zhang YL.(PubMed)
(864) HemoHIM improves ovarian morphology and decreases expression of nerve growth factor in rats with steroid-induced polycystic ovaries by Kim SH, Lee HJ, Kim JS, Moon C, Kim JC, Bae CS, Park HR, Jung U, Jo SK.(PubMed)
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