Polyherbal Formulation for Primary Dysmenorrhea: A Review

Abstract

Primary dysmenorrhea (PD) is defined as painful menstrual flow in teenagers who have no other gynaecological symptoms. High absenteeism to school and work have been reported in women with primary dysmenorrhea. Non-steroidal anti-inflammatory drugs (NSAIDs) and low dose oral contraceptive pills (OCPs) are the conventional treatment for primary dysmenorrhea. Despite their effectiveness, various side effects hinder the patients away from long time management with conventional treatment. Various polyherbal formulation have been used for centuries in the management of primary dysmenorrhea. However, scientific evidence of its mechanism of action and clinical effectiveness are scarce. A summarised overview of the molecular pathogenesis of the primary dysmenorrhea has been provided to understand the mechanistic pathway involved in primary dysmenorrhea. A total of 8 polyherbal formulations have been included. Pre-clinical and clinical trials of polyherbal formulation commonly used in primary dysmenorrhea have been discussed in this review to provide a picture of the current practice of traditional medicines in the management of primary dysmenorrhea. Most of the preparations demonstrated their actions through regulation of inflammatory markers and hormones in vivo. Inconsistency in sample size, doses of herbal preparation and primary outcomes of clinical trials created controversial findings on the effectiveness of the polyherbal preparation in human.