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

Role of Inflammation, Oxidative Stress, and Mitochondrial Changes in Premenstrual Psychosomatic Behavioral Symptoms with Anti-Inflammatory, Antioxidant Herbs, and Nutritional Supplements

Premenstrual syndrome (PMS) significantly lowers the quality of life and impairs personal and social relationships in reproductive-age women. Some recommendations are that inappropriate oxidative stress and inflammatory response are involved in PMS. Various nutritional supplements and herbs showed neuro-psycho-pharmacological activity with antioxidant and anti-inflammatory properties. This study aims to determine the systematic review of randomized controlled trials (RCTs) of herbal medicine and nutritional supplements in PMS. We also comprehensively highlighted the role of oxidative stress, inflammation, and mitochondrial changes on PMS with the application of computational intelligence. We used PRISMA and research question-based techniques to collect the data for evaluation of our study on different databases such as Scopus, PubMed, and PROSPERO from 1990 to 2022. The methodological quality of the published study was assessed by the modified Jadad scale. In addition, we used network visualization and word cloud techniques to find the closest terms of the study based on previous publications. While we also used computational intelligence techniques to give the idea for the classification of experimental data from PMS. We found 25 randomized controlled studies with 1949 participants (mean ± SD: 77.96 ± 22.753) using the PRISMA technique, and all were high-quality studies. We also extracted the closest terms related to our study using network visualization techniques. This work has revealed the future direction and research gap on the role of oxidative stress and inflammation in PMS. In vitro and in vivo studies showed that bioactive molecules such as curcumin, allicin, anethole, thymoquinone, cyanidin 3-glucoside, gamma-linoleic acid, and various molecules not only have antioxidant and anti-inflammatory properties but also other various activities such as GABA-A receptor agonist, serotonergic, antidepressant, sedative, and analgesic. Traditional Unani Herbal medicine and nutritional supplements can effectively relieve PMS symptoms as they possess many bioactive molecules that are pharmacologically proven for the aforementioned properties. Hence, these biomolecules might influence a complex physical and psychological disease process like PMS. However, more rigorous research studies are recommended for in-depth knowledge of the efficacy of bioactive molecules on premenstrual syndrome in clinical trials.

Influence of Lavandula angustifolia, Melissa officinalis and Vitex angus-castus on the organism of rats fed with excessive fat-containing diet

Plant food additives are becoming more and more popular and broadly applied products, though the information on risks they poses to the organism is limited and contradictive. Obesity and overeating are some of the commonest health issues around the world, and people are increasingly consuming workability-enhancing preparations as a simple and fast method of weight control. The plant-based preparations are considered less harmful than the synthetic chemical ones. Lavandula angustifolia Mill., Melissa officinalis L. and Vitex angus-castus L. are broadly used as food additives and medicinal plants, despite the fact that their complex physiological assessment on model animals in the conditions of obesity has not yet been performed. We carried out a 30-day experiment on white male rats. All the animals were given high-fat diet, and the experimental animals, in addition to this diet, received 5% crumbled dry herbs of L. angustifolia, M. officinalis or V. angus-castus. Taking into account the overall amount of consumed food, the mean daily gain in body weight; at the end of the experiment, we determined the index of the weight of the internal organs, biochemical and morphological blood parameters. At the beginning and the end of the experiment, the rats were examined for motor and orienting activities, and emotional status. Rats on high-fat diet gained up to 112% body weight by the end of the experiment, while rats that had received V. angus-castus gained up to 119%, M. officinalis – 135%, L. angustifolia – 139%, compared with the initial body weight. Addition of medicinal plants to the diet led to increase in average daily weight increment, significantly and reliably after consuming lavender and lemon balm, less significantly and unreliably after eating Vitex. L. angustifolia and M. officinalis reduced the relative brain weight, and ingestion of L. angustifolia and M. officinalis caused notable decrease in the relative mass of the thymus (down to 58% and 47% of the relative weight of thymus in animals of the control group respectively). Also, these plants decreased the motor and orienting activities of the rats by the end of the experiment. As for the biochemical parameters of blood, the activity of alkaline phosphatase significantly increased to 406% following consumption of Melissa, to 350% after consuming lavender, and to 406% after Vitex, compared to the control group. Furthermore, all the groups were observed to have increased AST and ALT activities. Intake of lavender led to increases in cholesterol (to 125%) and LDL cholesterol (to 228%), whereas the groups that consumed lemon balm were observed to have decreases in urea nitrogen (to 79%), totalbilirubin (to 63%) and triglycerides (to 63%). Addition of Vitex led to increase in the index of aterogenecity against the background of notable fall in HDL cholesterol (to 52% of the control group). The medicinal plants also contributed to the normalization of the glucose level. Morphological analysis of blood revealed no significant changes, except heightened content of monocytes in blood, which is characteristic of all groups, including the control. Effects of L. angustifolia, M. officinalis and V. angus-castus on the organism of rats on excessive-fat diet require additional histological, histochemical and immunological surveys.

Effectiveness of Echium amoenum on premenstrual syndrome: a randomized, double-blind, controlled trial

Background

The present study aimed to evaluate the effect of Echium amoenum (EA) on the severity of premenstrual syndrome (PMS) in comparison with placebo.

Methods

The present study was a randomized double-blind controlled clinical trial. A checklist questionnaire was completed by 120, 18 to 35-year-old, college students. And then, 84 eligible women (20 to 35 years old) were enrolled in the trial; they were randomly assigned to two groups of intervention (EA) and control (placebo), with 42 participants in each group. Participants in the intervention group received 450 mg capsules of EA per day (three times a day) from the 21st day of their menstrual cycle until the 3rd day of their next cycle for two consecutive cycles. The severity of PMS was measured and ranked using the premenstrual symptoms screening tool (PSST). The generalized estimating equation was used to compare the total score of the severity of PMS between the two groups.

Results

Sixty-nine women with regular menstrual cycles suffering from PMS completed the study. The mean scores of the symptoms in the EA group were 35.3 and 16.1 (P ≤ 0.001) at baseline and after 2 months, respectively, while the mean scores of the symptoms in the placebo group were 31.0 and 28.3 (P = 0.09) at baseline and after 2 months, respectively. The evaluation of the first and the second follow-ups in the intervention group showed that, after being adjusted for age and body mass index (P ≤ 0.001), the mean scores of the premenstrual syndrome, using GEE analysis, have decreased to 6.2 and 11.6, respectively.

Conclusion

Based on the results, in comparison with the placebo group, EA was found to be more effective in improving the symptoms of PMS, and is highly recommended for treatment of this syndrome.

Trial registration

IRCT2015110822779N3; Registration date: 2015–11–27.

Using Medicinal Plants in Valmalenco (Italian Alps): From Tradition to Scientific Approaches

This ethnobotanical survey was carried out in Caspoggio (Valmalenco, SO, Italy) with the purpose of investigating the traditional uses of medicinal plants. Moreover, a bibliographic research meant to validate or refute the uses, focusing on the potentially responsible compounds, was performed. Fifty-nine species, attributable to 30 families (Asteraceae, Pinaceae, Malvaceae, and Lamiaceae the most cited), were mentioned. Arnica montana, anti-inflammatory for traumas and musculoskeletal pains; Pinus mugo, expectorant; Malva sylvestris, anti-inflammatory and soothing; Achillea moschata, digestive. The compounds, responsible for the therapeutic activities, are often polyphenols and terpenoids: helenanin in A. montana, α-pinene, δ-3-carene, and limonene in P. mugo, gossypin and malvin in M. sylvestris, luteolin and apigenin in A. moschata. Scientific evidence for at least one of the traditional activities described was found for 50 species but only in 26 out of 196 works consulted, it is possible to make a comparison between investigated extracts and traditional preparations. This study is thus a stimulus to new phytochemical investigations, mimicking as much as possible the traditional preparations. This work is part of the European Interreg Italy-Switzerland B-ICE project, aimed at creating a management model for the ongoing climate change and searching for new sources of territory valorization as attractions for tourists.

The effect of Salvia officinalis extract on symptoms of flushing, night sweat, sleep disorders, and score of forgetfulness in postmenopausal women

Background:

Complications of hormone therapy (as replacement) during menopause prompted us to research on alternative therapies including herbal therapy in this regard.

Objectives:

The effect of Salvia officinalis extract on symptoms of flushing, night sweat, sleep disorders, and score of forgetfulness in postmenopausal women on Namazi Hospital Bone Density Center in Shiraz 2015.

Methods:

In a double-blind randomized controlled clinical trial, 66 postmenopausal women complaining of menopausal symptoms were divided into two groups of intervention and control, respectively. The intervention group received S. officinalis tablets (containing 100 mg S. officinalis extract), with a dose of three tablets a day for 3 months, while the control group received placebo tablets with the same prescription order. MRS (Menopause Rating Scale) and PSQI (Pittsburgh Sleep Quality Index) questionnaires were completed at the beginning and end of the study. The checklists of hot flushing and night sweating were completed a week before the intervention and at weeks 2, 4, 6, 8, 10, 12 during the intervention. Finally, the data were analyzed through SPSS₁₈ software, using paired t-test, ANOVA. A significant level of 5% was considered.

Results:

According to the paired t-test, the mean score of flushing, palpitation, sleeping disorders, muscle and joint aches, depression, nervousness, anxiety, and sexual desire and satisfaction significantly decreased by 1.6, 0.4, 1.6, 2.1, 1.4, 1.2, 1.6, and 0.8 units, respectively, in the intervention group compared to the control group (P < 0.001). Therefore, the mean score of PSQI significantly decreased by 3.8 units in the intervention group after the intervention (9.4 ± 3.7 vs 5.6 ± 1.9 (P < 0.05).

Conclusions:

Salvia extract improved menopausal symptoms such as flushing, night sweat, heart palpitations, muscle and joint pain, depression, anxiety, sleep disorders, and sexual desire.

The impact of education on attachment skills in the promotion of happiness among women with unplanned pregnancy

BACKGROUND

Happiness is among the factors that promote mental health in mothers with unplanned pregnancy. The present study aimed to determine the impact of attachment skills training on happiness among women with unplanned pregnancy.

MATERIALS AND METHODS

This clinical trial was conducted on 84 women with unplanned pregnancy referred to three prenatal clinics in Shiraz in 2018. The participants were randomly divided into an intervention group and a control group using permutation block. At first, the participants were requested to sign written informed consent form, demographic information form, and mental health questionnaire. Then, they were asked to complete Oxford Happiness Questionnaire and Cranley's Maternal-Fetal Attachment Scale. The intervention group received attachment training through six 90-min sessions, while the control group underwent the hospital's routine care. The two groups were required to fill out the study questionnaires once more after 4 weeks after the intervention. After all, the data were analyzed using Chi-square test, Fisher's exact test, independent t-test, and ANOVA.

RESULTS

There was a significant difference between the two groups' pretest and posttest mean scores of happiness (P = 0.0001). The results showed that in the experimental group, pretraining and posttraining period mean scores were 89.64 (7.2) and 93.13 (6.09), respectively; while in the control group, pretraining and posttraining period mean scores were, respectively, 91.69 (9.96) and 91 (8.82). The difference between the two groups was statistically significant. No significant relationship was observed between happiness and the couples' occupations, number of pregnancies, and number of miscarriages in the two groups (P > 0.05).

CONCLUSION

The mean score of happiness increased after the training, being significantly different from that in the control group. Therefore, happiness is a changeable feature that can be promoted among pregnant women via interventional methods.

The effect of aromatherapy on mental, physical symptoms, and social functions of females with premenstrual syndrome: A randomized clinical trial

Objective:

This study was designed to compare the effect of aromatherapy with Rosa Damascena and Citrus Aurantium blossom on psychological and physical symptoms and social functions of females with premenstrual syndrome.

Materials and Methods:

This double-blind clinical trial was conducted on 95 students. They were randomly divided into three aromatherapy groups (aromatherapy with 4% concentration of Rosa Damascena and 0.5% concentration of Citrus Aurantium blossom essential oil) and aromatherapy with sweet almond oil (as control group). Premenstrual Symptoms Screening Tool questionnaire (PSST) was completed before and during the first and second month of the intervention. Data were analyzed by SPSS software version 22.

Results:

After intervention, the scores of mental symptoms decreased in all three groups and this decrease was significant in both Citrus Aurantium (P = 0.004) and Rosa Damascena groups (P = 0.007). The score of physical symptoms was decreased in all three groups but it was significant only in the Rosa Demecensa group (P = 0.042). The reduction of effect of symptoms on social function was observed in two intervention groups which were significant only in Rosa Damascena group (P < 0.001).

Conclusion:

Essential oils of Rosa Damascena and Citrus Aurantium were both effective in improving the symptoms of premenstrual syndrome but the effect of Rosa Damascena, with regard to improvement of symptoms of premenstrual syndrome was more than that of Citrus Aurantium in all psychological, physical, and social aspects.

Evaluation of aromatherapy with essential oils of Rosa damascena for the management of premenstrual syndrome

OBJECTIVE

To investigate the efficacy of aromatherapy with essential oils of Rosa damascena for the management of premenstrual syndrome (PMS).

METHODS

The present triple-blind randomized clinical trial was conducted between March 5, 2016, and February 20, 2017, among female students attending Shiraz University of Medical Sciences, Shiraz, Iran, who experienced PMS, had a menstrual cycle of 24-35 days, were not using vitamin supplements or hormonal drugs, and did not have any underlying diseases. Block randomization was used to assign participants to an intervention group receiving aromatherapy with R. damascena at a 4% concentration or a control group who received aromatherapy with 100% sweet almond oil. Aromatherapy was performed for 5 minutes, twice daily, for a total of 5 days during the luteal phase. The premenstrual symptoms screening tool questionnaire was completed at baseline and after 1 and 2 months of treatment. Per-protocol analyses were performed with patients and investigators masked to group assignments.

RESULTS

There were 66 participants enrolled and 64 completed the study (33 in the intervention group and 31 in the control group). At 2 months, aromatherapy with R. damascena was associated with improved psychological (P<0.001), physical (P<0.001), social (P=0.002), and total (P<0.001) PMS symptoms compared with baseline. By contrast, no improvements were recorded in the control group.

CONCLUSION

Aromatherapy with R. damascena improved multiple symptoms of PMS.

IRANIAN REGISTRY OF CLINICAL TRIALS

IRCT2016031113940N3.

The Effects of Lemon balm on Menstrual Bleeding and the Systemic Manifestation of Dysmenorrhea

We conducted a double-blind randomized placebo controlled trial to evaluate the impact of Lemon balm (Melissa officinalis L.) on the bleeding and systemic manifestations of menstruation. A total of 90 students were randomly assigned to treatment or placebo group. Bleeding and systemic manifestations were evaluated with a menstrual pictogram and multidimensional verbal scale before and during 2 consecutive menstrual cycles, respectively. Statistical tests indicated that in both groups, the severity of the systemic symptoms associated with dysmenorrhea significantly decreased (P = 0.001). Among the systemic symptoms, the mean severity of fatigue, the lethargy, and nervous changes in the two groups decreased after the treatment, which was statistically significant. There was no significant difference between the two groups regarding fatigue in the three cycles, but there was a significant difference between the two groups regarding lethargy in the first cycle (P = 0.05) and the second cycle (P = 0.001) after the treatment. The present study demonstrated that Melissa officinalis decreases the severity of the systemic signs associated with menstruation. It showed that the herb does not increase the severity of bleeding and the duration of menstruation. However, it reduces the mean total score of the severity of all the systemic symptoms associated with dysmenorrhea.

The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review

OBJECTIVE

Premenstrual syndrome (PMS) is one of the most common problems among women of reproductive age. The popularity of complementary/alternative therapies has grown in recent years, and these treatments have been more commonly used by women (48.9%) than men (37.8%). The aim of this systematic review was to assess effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome.

METHODS

PubMed, Scopus, Cochrane, and Google Scholar were searched along with SID, Magiran and Irandoc up to Dec 2017.Inclusion criteria consist of Iranian, published, randomized controlled trials (RCTs) using Iranian herbal medicine for treatment of reproductive age women with PMS. Eventually Eighteen RCTs met the inclusion criteria.

RESULTS

Overall, studies have shown that Vitex agnuscastus, Hypericum perforatum,Matricaria chamomilla, saffron, Curcumin, Melissa officinalis, Zataria multiflora,Wheat Germ Extract, Echinophora platyloba, Foeniculum vulgare, Valerian root extract,Citrus sinensis, Zingiber officinale and Flax seed might alleviate symptoms of PMS.

CONCLUSION

This research demonstrated efficacy and safety of Iranian herbal medicines in alleviating PMS. Therefore, herbal medicine can be regarded as an alternative treatment for women suffering from PMS.

The effect of tablet containing Boswellia serrata and Melisa officinalis extract on older adults' memory: A randomized controlled trial

BACKGROUND

Memory deficits and age-related memory loss are currently two significant concerns in older adults. In Iranian herbal medicine, there are some prescriptions for memory improvement.

OBJECTIVE

This study was designed to investigate the effect of tablet containing Boswellia serrata (BS) extract and Mellisa officinalis (MO) extract on memory of the older adults.

METHOD

This is a randomized, parallel, double-blind, placebo-controlled clinical trial that performed among 70 older adults who referred to healthcare centers of Kashan University of Medical Sciences, Iran. Subjects were randomly assigned to receive either tablets (n = 35) or placebo (n = 35) for a month (n = 30). Data were collected using a demographic questionnaire and the Wechsler Memory Scale-Revised (WMS-R). Data were analyzed using Chi-square, independent-samples t-tests, paired t-test, repeated measure ANOVA, and ANCOVA using SPSS v13.

RESULT

Participants' baseline characteristics were similar in the two groups. The study was completed by 53 participants. However, as the analysis was based on an intention-to treat approach, all 70 older adults were included in the final analysis. Comparison of the two groups with showed that the total scores of the WMS-R and the subscales, including auditory immediate, immediate memory, visual immediate and working memory, were increased after consumption of the containing BS and MO tablets (p < 0.0001).

CONCLUSION

The BS and MO tablet in older adults can be beneficial on improvement of memory. This is still necessary to investigate effects and durability of the tablets on older adults with memory impairments in future studies.

Premenstrual Syndrome Is Associated With a Higher Frequency of Female Sexual Difficulty and Sexual Distress

Few prospective studies have evaluated the impact of premenstrual symptoms (PMS) on female sexual function and sexuality-related distress. The purpose of the present study was therefore to find out risk factors of PMS for  female sexual function and sexuality-related personal distress. This prospective cohort study was conducted at the Süleymaniye Women and Children's Health Training and Research Hospital in Istanbul, Turkey, between February 2014 and March 2016. The study group consisted of women admitted to the general gynecology outpatient clinic aged 18 to 40 years who met the inclusion criteria. The American College of Obstetricians and Gynecologists criteria were used for the initial diagnosis of PMS and the participants were allocated to PMS(+) and PMS(-) groups (healthy subjects). All participants completed the Beck Depression Inventory to exclude those at risk for depression. The patients with an initial diagnosis of PMS then completed the PMS Daily Record of Severity of Problems form prospectively for two consecutive menstrual cycles to confirm PMS diagnosis. Lastly, both sexual function and sexual distress of eligible PMS(+) (n = 143) and PMS(-) (n = 143) participants were assessed with both the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). According to the FSFI cutoff value, 77.6% of patients in the PMS(+) group and 27.3% of patients in the PMS(-) group had sexual concerns (p < 0.05). The sexuality-related personal distress rate was 51.7% in the PMS(+) group and 24.5% in the PMS(-) group (p < 0.05). Overall, 51.7% of the PMS(+) and 24.5% of the PMS(-) group were recognized as having sexual difficulties based on the presence of sexual distress and the low FSFI scores (p < 0.05). We concluded that women with PMS are likely to have sexual difficulties and a higher level of sexual distress, emphasizing the importance of the sexual aspects of PMS in clinical practice.

The Effect of Melissa Officinalis Extract on the Severity of Primary Dysmenorrha

Primary dysmenorrhea refers to painful cramps during menstruation with no organic reason. With respect to its high incidence and adverse outcomes in quality of life and some evidences regarding the sedative and antispasmodic effects of Melissa officinailson smooth muscles as an herb, this double-blind clinical trial was conducted to determine the effects of its capsules on severity of dysmenorrhea in the students of Islamic Azad University of Zanjan in 2014. 110 students were matched in terms of dysmenorrhea severity and experience; age; menarche; body mass index (BMI); occupation as well as educational level of parents; and duration, interval as well as amount of bleeding. Then, they were randomly divided into 2 herb (55 subjects) and placebo (55 subjects) groups. The former was given capsules 330 mg of the herb 3 times a day over 3 days at the onset of hemorrhage while the latter was given placebo in similar capsules containing corn starch with the same protocol. Pain severity was evaluated with a visual analogue scale (0 to 10 cm). Different statistical tests were used for data analysis with SPSS package. No significant difference was found between the means of pain severity in the groups before the intervention. However, the severity was reduced in both groups after the intervention (P<0.001) but the amount of it was more in Melissa group with a significant difference (P<0.05). With respect to the findings, it seems that M. officinalismay decrease dysmenorrhea, which may be related to antispasmodic effects of this herb.