Understanding premenstrual syndrome from a Chinese medicine perspective

Profiling GABA(A) Receptor Subunit Expression in the Hippocampus of PMDD Rat Models Based on TCM Theories

γ-Aminobutyric acid type A receptors (GABAARs) play an important role in cognitive and emotional regulation and are related to the hippocampus. However, little is known regarding patterns of hippocampal GABAAR subunit expression in rat models of premenstrual dysphoric disorder (PMDD). This study investigated the above changes by establishing two PMDD rat models based on Traditional Chinese Medicine (TCM) theories, namely, PMDD liver-qi invasion syndrome (PMDD-LIS) and PMDD liver-qi depression syndrome (PMDD-LDS). Behavioral tests were used to detect depression and irritability emotion. Western blot analysis was used to investigate protein levels of GABAAR α1, α2, α4, α5, β2, β3, and δ subunits, whereas ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) analysis was performed to determine gamma-aminobutyric acid (GABA) and glutamate (Glu) levels in the hippocampus across each group. Concurrently, behavioral data indicated that the PMDD-LDS and PMDD-LIS rat models had been successfully established. GABAAR α2, α5, β2, and δ subunit was significantly upregulated, whereas α4 was significantly downregulated (P < 0.05) in PMDD-LDS rat models relative to controls. On the other hand, GABAAR α1, α2, and β3 were significantly downregulated while α4 and β2 were significantly upregulated in PMDD-LIS rat models relative to the control group (P < 0.05). Moreover, GABA levels significantly decreased, while Glu and the ratio of glutamate to GABA increased in PMDD-LIS rat models (P < 0.05). Conversely, GABA and Glu levels significantly decreased, whereas the ratio of glutamate to GABA increased in PMDD-LIS rat models (P < 0.05). Conclusively, our results revealed differential expression of GABAAR α1, α2, α4, α5, β2, β3, and δ subunits between PMDD-LIS and PMDD-LDS rat models, suggesting that they may be biomarkers in the pathogenesis of PMDD.

Comparison of Herbal Medicines Used for Women's Menstruation Diseases in Different Areas of the World

Aims: This review aims to compare the use of herbal medicine used to treat women's menstruation and the prevalence of menstrual diseases in different regions, which reveal the use of herbal medicine globally and provide scientific guidance for improving women's health. Materials and Methods: The information available on herbal medicines for women between the years 2000 and 2021 was systematically collected via the library and electronic search systems such as Google Scholar, PubMed, ScienceDirect, and Web of Science as well as secondary resources including books and conference proceedings. Results: Totally, 571 ethnic medicines commonly used for women's menstruation health in Asia, Europe, Oceania, Africa, and America were accounted. Zingiber officinale Roscoe (Ginger), Ruta graveolens L. (Common rue), Angelica sinensis (Oliv.) Diels (Angelica sinensis), Foeniculum vulgare Mill (Fennel), Catharanthus roseus (L.) G. Don (Catharanthus roseus) and other medicines which have obvious advantages and long-term usage are utilized in the treatment of menstrual diseases. Family Asteraceae, Lamiaceae, Apiaceae, Fabaceae, and Zingiberaceae are the most common medicinal plant families used for such treatments. In many instances, the application of fresh parts of plants was observed because of the healers' belief regarding the higher efficiency of the medicine made from fresh plants. Edible plants are used in a wide range of countries. Conclusion: Women's menstruation health is directly related to their health condition. Traditional medicines of most ethnic groups have contributed to women's health care and treatment of gynecological diseases. Practitioners in this field have gained elaborate experience in treatments and medication, and assembled a large number of effective drugs and prescriptions. These experiences have also been inherited and developed by modern clinical application and scientific research. However, the basic research on these drugs is not sufficient, the knowledge of drug use has not been fully popularized, the advantages of drugs have not been fully utilized, and the guiding potential to modern drug research continues to be insufficient. As such, it is necessary to further promote and make a significant contribution to women's health.

Transcutaneous electrical acupoint stimulation (TEAS) relieved cancer-related fatigue in non-small cell lung cancer (NSCLC) patients after chemotherapy

BACKGROUND

To explore the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) approach on cancer-related fatigue (CRF) in non-small cell lung cancer (NSCLC) chemotherapy patients.

METHODS

A total of 162 participants who treated with gemcitabine combined with platinum-based drugs (GP chemotherapy) were randomly assigned to three groups: Control (Group A, n=56), Sham TEAS (Group B, n=49), and TEAS (Group C, n=57). The following acupoints were used in this study: Qihai (CV6), Keshu (UB17), and Zusanli (ST36). The Revised Piper Fatigue Scale (RPFS) were used to measure CRF on the day before chemotherapy (P1), days 8 (P2) and 28 (P3) separately. The Differences among three groups were analyzed.

RESULTS

At the 28th day, the outcomes of the fatigue scores for Group C, Group B and Group A were 2.06±0.90, 2.80±1.34, 3.00±1.29 respectively. There were significantly different among three groups (F=9.784, P<0.01). At the 28th day, the outcomes of the affective fatigue (F=8.161, P<0.01), sensory fatigue (F=3.06, P=0.05) and cognitive fatigue (F=8.06, P<0.01) for Group C, Group B and Group A were significantly different among three groups.

CONCLUSIONS

Chemotherapy may increase the fatigue from P1 to P2 and P3 in NSCLC patients. And TEAS could help to relived CRF, especially at P3.

Effect of Melissa officinalis Capsule on the Intensity of Premenstrual Syndrome Symptoms in High School Girl Students

BACKGROUND

Several studies are conducted on Premenstrual Syndrome (PMS). However, a few herbal surveys exist on the treatment of PMS in Iran. Due to the sedative effects of Melissa officinalis (M. officinalis), this question comes to mind that "can it be used in the treatment of PMS symptoms?"

OBJECTIVES

The current study aimed to assess the effect of M. officinalis capsule on the intensity of PMS in high-school girls.

MATERIALS AND METHODS

A double-blind randomized, placebo-controlled trial was performed on 100 high school girls from 2013 to 2014. The intervention group (n = 50) received 1200 mg of M. officinalis essence daily from the first to the last day of their menstrual cycle for three consecutive cycles. The second group (n = 50) received the placebo. The premenstrual symptoms screening tool was used to assess the intensity of PMS symptoms in the two groups before and one, two, and three months after the intervention. The data were analyzed using paired t-test and repeated measures analysis of variance.

RESULTS

The results of repeated measures test revealed a significant reduction (P < 0.001) in PMS symptoms. Overall, the mean score of PMS intensity in the intervention group was 42.56 + 15.73 before the intervention and changed to 32.72 ± 13.24, 30.02 ± 12.08, and 13.90 ± 10.22 at the three consecutive months after the intervention, respectively (P = 0.001).

CONCLUSIONS

M. officinalis capsules were effective in reduction of the PMS symptoms. Yet, application of this medication requires further investigations.

Effects of Elsholtzia splendens and Cirsium japonicum on premenstrual syndrome

Premenstrual syndrome is a common chronic disorder in most women of reproductive age. The main symptoms are depression, anxiety, tension, feeling out of control, and mastalgia. In premenstrual syndrome, the effects of aromatic edible Elsholtzia splendens and Cirsium japonicum were investigated for over 3 months in 30 women participants in their twenties. In the Elsholtzia splendens capsule treated group, scores of depression and anxiety were significantly lower than those in the Cirsium japonicum capsule treated group. Moreover, instability of the premenstrual assessment form was significantly decreased in the Elsholtzia splendens capsule treated group. Our results suggest that Elsholtzia splendens could be an effective plant material in relieving symptoms of premenstrual syndrome.

Women's health: selected topics

Complementary and alternative medicine (CAM) therapies have become increasingly popular for the treatment of a variety of conditions. The World Health Organization has recognized the value of traditional healing techniques, which are classified as CAM, for 30 years. In the United States nearly 50% of women use CAM for common medical conditions, significantly more than men. This pattern is frequently seen in the treatment of women's health conditions such as infertility, premenstrual syndrome, and menopause. This article provides an integrative approach for conditions commonly encountered in the primary care setting among women, discusses alternative therapies used to treat these health conditions, and provides an evidence-based summary of recommendations based on a review of the literature.

A culturally sensitive study of premenstrual and menstrual symptoms among Chinese women

This is a two-part study of perimenstrual symptomatology in Chinese women. We developed and validated the Chinese Questionnaire of Perimenstrual Symptoms (CQ-PERI-MS), which was adapted from the Moos Menstrual Distress Questionnaire, and used this instrument to assess the prevalence and nature of perimenstrual symptoms among Chinese women in Hong Kong. The initial CQ-PERI-MS was first administered to a sample of 538 menstruating Chinese women in Hong Kong together with measures of anxiety, depression and neuroticism. Psychometric analyses rendered a 32-item CQ-PERI-MS which demonstrated good reliability, convergent and discriminant validity, and factorial validity. Four factors were yielded, namely, Dysphoria, Somatic distress, Cognitive problems and Arousal. The CQ-PERI-MS was then administered to a separate sample of 339 menstruating Chinese women in Hong Kong for further examination of validity as well as pattern of perimenstrual symptoms. It was found that perimenstrual symptoms were common, with 18.6% and 34.2% of the participants reporting 10 or more premenstrual and menstrual symptoms, respectively. Both premenstrual and menstrual distress were characterised by a combination of emotional and somatic symptoms. Contrary to previous preconceptions, perimenstrual symptoms are commonly experienced by Chinese women, with both overlapping and distinct features when compared with patterns in the West.

A controlled trial of Chinese herbal medicine for premenstrual syndrome

Premenstrual syndrome (PMS) is a common disorder troubling many women during their reproductive years. The Chinese have been using herbal medicines to treat menstrual cycle related symptoms for centuries. The present study examined the effectiveness of Chinese herbal medicine for the treatment of PMS among Australian women within the theoretical framework of traditional Chinese medicine (TCM). Sixty-one women were assigned randomly into two groups within different TCM patterns. Herbal medicine and placebo were provided sequentially for a period of three months. There were significant differences (p < 0.01) in scores after three months of treatment between Chinese herbal medicine and placebo in premenstrual physical and psychological symptoms, depression, anxiety and anger favoring herbal medicine, but with no difference in perceived stress (p > 0.05). There were highly significant reductions (p < 0.001) between baseline and the end of the third herbal treatment month in all assessments in both groups except that a significant result (p < 0.05) was recorded on perceived stress only in the herbs-first group. No adverse effects were reported by any participant. The results support the hypothesis that the symptoms occurrence and severity of PMS can be effectively reduced by the use of Chinese herbal medicine.

Isolating with physical restraint low status female monkeys during luteal phase might make an appropriate premenstrual depression syndrome model

BACKGROUND

Rhesus monkeys (Macaca mulatta) have a close phylogenetic relationship to humans, and have a similar 28-day menstrual cycle with similar hormonal fluctuations. In this study, we attempt to establish the premenstrual depression syndrome of rhesus monkey (M. mulatta) models by isolation with physical restraint of low social status young female monkeys during their luteal phase.

METHODS

Low social status young female rhesus monkeys (M. mulatta) were isolated with physical restraint during their luteal phase by using a specifically designed isolating-cage. During the entire menses cycle, serum levels of 5-hydroxytrypamine, noradrenalin and adrenalin were detected by capillary zone electrophoresis, and the changes in the serum levels of progesterone, estradiol and prolactin were investigated by radioimmunoassay. At the same time, the pharmaceutical interference effect of Jingqianshu granule, a traditional Chinese medicine specifically used to cure premenstrual depression patients, was tested using this premenstrual depression syndrome monkey model.

RESULTS

After being immured in two consecutive menstrual cycles, monkeys presented depressive symptoms during the premenstrual phase of three consecutive menstrual cycles. The serum contents of the three kinds of monoamine neurotransmitters in depressive monkeys were significantly higher than the normal ones. The serum levels of progesterone and prolactin increased obviously, and a marked change in the pattern of progesterone secretion could be observed. Moreover, the premenstrual depressive symptoms of model group monkeys could not only be cured by Jingqianshu granule, but the higher serum levels of prolactin and monoamine neurotransmitters in these monkeys could be reduced by this herbal medicine. These data were well in line with clinical observations of women with premenstrual depression syndrome.

CONCLUSION

Our results in this study for the first time indicate that isolation with physical restraint of low status young female monkeys during their luteal phase makes an appropriate premenstrual depression syndrome model. This model might potentially facilitate studies on the etiology of premenstrual depression syndrome and the development of better methods for the therapy of this disease.