year 24, Issue 94 (7-2025)
J. Med. Plants 2025, 24(94): 59-69 |
Back to browse issues page
Ethics code: IR.JUMS.REC.1395.169
Clinical trials code: IRCT2016062121653N7
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rasekh jahromi A, Bakhshi Khaniki G, Nasr T, Shahi Sadrabadi F, Nasri S. The effect of herbal combination therapy compared to pharmaceutical treatment on hormonal changes, ovarian cysts, hirsutism, and hair loss in patients with PCOS. J. Med. Plants 2025; 24 (94) :59-69
URL: http://jmp.ir/article-1-3812-en.html
URL: http://jmp.ir/article-1-3812-en.html
Athar Rasekh jahromi1 
, Gholamreza Bakhshi Khaniki2 , Tahereh Nasr2 , Fatemeh Shahi Sadrabadi2 , Sima Nasri *3
, Gholamreza Bakhshi Khaniki2 , Tahereh Nasr2 , Fatemeh Shahi Sadrabadi2 , Sima Nasri *3
1- Obstetrician and Gynecologist, Women's Health and Diseases Research Center of Jahrom University of Medical Sciences, Jahrom, Iran
2- Department of Biology, Payame Noor University, Tehran, Iran
3- Department of Biology, Payame Noor University, Tehran, Iran ,s_nasri2000@yahoo.com
2- Department of Biology, Payame Noor University, Tehran, Iran
3- Department of Biology, Payame Noor University, Tehran, Iran ,
Abstract: (136 Views)
Background: Polycystic ovary syndrome (PCOS) is the most common cause of anovulation and one of the main causes of infertility. Management varies with emphasis on the role of herbal medicines in the treatment of polycystic ovary syndrome (PCOS) compared to medical therapy. Objective: The aim of this study is to compare the herbal regimen Vitex agnus-castus var. + Foeniculum vulgare Mill. +Portula caoleracea L) with a medical regimen (spironolactone + cyproterone acetate with ethinyl estradiol) in polycystic ovarian syndrome patients. Method: The clinical trial, which compared two groups of women with polycystic ovary syndrome (PCOS), included 64 participants aged 18 to 42 years, all referred to a gynecological clinic. In a clinical study, the division of patients into case and control groups using random assignment so that both groups are as similar as possible. The control group receives a medical regimen that is compared to the herbal regimen of the case group. Results: The study did not show any statistically significant difference in Follicle-Stimulating Hormone (FSH), Thyroid-Stimulating Hormone (TSH), or Dehydroepiandrosterone Sulfate (DHEA-S) levels between the control and case groups after the intervention (P > 0.05)." the LH level has declined significantly after the intervention in the case group" is a common finding in this research (P = 0.001). The severity or existence of hirsutism (excessive hair growth in androgen-dependent areas of the female body) did not vary significantly between the two groups being compared (P> 0.05). The case group showed a significant reduction in the rate of hair loss (P = 0.001).Ovarian ultrasound Showed Formation of dominant follicles in case and control groups. Conclusion: The Herbal regimen was as effective as the phamacological regimen. Vitex agnus-castus and Fennel, known for their phytoestrogenic properties, induce negative feedback of luteinizing hormone with long-term use, leading to decrease in testosterone production. The synergistic effect of Vitax agnus-castus, Fennel and Purslane combination reduce testosterone levels and accelerates the treatment of PCOS.
Keywords: PCOS, Hirsutism, Vitex agnus-castus, Foeniculum vulgare, Portula caoleracea, Pharmacological regimen
Type of Study: Research |
Subject:
Pharmacognosy & Pharmaceutics
Received: 2024/12/31 | Accepted: 2025/06/10 | Published: 2025/07/1
Received: 2024/12/31 | Accepted: 2025/06/10 | Published: 2025/07/1
References
1. Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F and Kumar M. Polycystic ovary syndrome:etiology, current management, and future therapeutics. J. Clin. Med. 2023; 12(4): 1454. [DOI:10.3390/jcm12041454]
2. Rao P and Bhide P. Controversies in the diagnosis of polycystic ovary syndrome. Ther. Adv. Reprod Health. 2020. [DOI:10.1177/2633494120913032]
3. Kopera D, Wehr E and Obermayer-Pietsch B. Endocrinology of hirsutism. Int. J. Trichol. 2010; 2(1): 30-35. [DOI:10.4103/0974-7753.66910]
4. Malik S, Saeed S, Saleem A, Imran Khan M, Khan A, Furqan Akhtar M. Alternative treatment of polycystic ovary syndrome: pre-clinical and clinical basis for using plant-based drugs. Front Endocrinol. 2024; 14: 1294406. [DOI:10.3389/fendo.2023.1294406]
5. Zhang J, Saeed A, Hussain M, Siddique R, Xu H, Rashid Bazmi R, Hussain L and Lv G. Aqueous ethanolic extract of Inonotus obliquus ameliorates polycystic ovarian syndrome by modulating oxidative stress and downregulating TNF-α and Interleukin-6. J. Food Biochem. 2024; 2024(1): 1003797. [DOI:10.1155/2024/1003797]
6. Hohl A, Ronsoni MF and de Oliveira M. Hirsutism: diagnosis and treatment. Arq Bras Endocrinol. Metabol. 2014; 58(2): 97-107. [DOI:10.1590/0004-2730000002923]
7. Armata I and Prakash A. An update on the assessment and management of hirsutism. Obstet Gynaecol & Reprod. Med. 2024; 34(4): 81-87. [DOI:10.1016/j.ogrm.2024.01.001]
8. Cheraghi Niroumand M, Heydarpour F and Farzaei MH. Pharmacological and therapeutic effects of Vitex agnus castus L.: A review. Phcog. Rev. 2018; 12(23): 103-114. [DOI:10.4103/phrev.phrev_22_17]
9. Hӧller M, Steindl H, Abramov-Sommariva D, Kleemann J, Loleit A, Abels C and Stute P. Use of Vitex agnus-castus in patients with menstrual cycle disorders:a single-center retrospective longitudinal cohort study. Arch. Gynecol. Obstet. 2024; 309(5): 2089-2098. [DOI:10.1007/s00404-023-07363-4]
10. PartoviGolshan R, Moradi M, Rakhshandeh H, Ghavami V and Moshirian Farahi SM. Comparison of the effects of Vitagnus, soy, and Vitagnus-soy capsules on premenstrual syndrome in university students: arandomized clinical trial. IJCBNM.. 2025; 13(1): 2-15.
11. Kamal N, Asni N.S.M, Rozlan I.N.A, Mohd Azmi M.A, Mazlan N.W, Mediani A, Baharum S.N, Latip J, Assaw S and Edrada-Ebel Ru Angelie. Traditional medicinal uses, phytochemistry, biological properties and health applications of Vitex sp. Plants (Basel). 2022; 11(15): 1944. [DOI:10.3390/plants11151944]
12. Ogbonna CE, Kavaz D, Adekunle YA and Olawade DB. Phytochemical assessment, elemental composition and biological kinetics of Foeniculum vulgare Mill. Stalks. Pharmacol. Res-Mod Chin Med. 2024; 11: 100453. [DOI:10.1016/j.prmcm.2024.100453]
13. Iranshahy M, Javadi B, Iranshahi M, Jahanbakhsh SP, Mahyari S, Vahdati Hassani F and Karimi GR. A review of traditional uses, phytochemistry and pharmacology of Portulaca oleracea L. J. Ethnopharmacol. 2017; 9(205): 158-172. [DOI:10.1016/j.jep.2017.05.004]
14. Baradaran Rahimi V, Ajam F, Rakhshandeh H and Askari VR. A Pharmacological review on Portulaca oleracea L.: focusing on anti-Inflammatory, anti- oxidant, immuno-modulatory and antitumoractivities. J. Pharmacopuncture. 2019; 22(1): 7-15. [DOI:10.3831/KPI.2019.22.001]
15. Rathnayake D and Sinclair R. Innovative use of spironolactone as an antiandrogen in the treatment of female pattern hair loss. Dermatol. Clin. 2010; 28(3): 611-8. [DOI:10.1016/j.det.2010.03.011]
16. Ruan X, Kubba A, Aguilar A and Mueck AO. Use of cyproterone acetate/ethinylestradiol in polycystic ovary syndrome: rationale and practical aspects. Eur. J. Contracept. Reprod. Health Care. 2017; 22(3): 183-190. [DOI:10.1080/13625187.2017.1317735]
17. Berek JS. Berek, Berek & Novak's Gynecology. 16th ed., Philadeiphia: LWW; 2019.
18. Lumezi BG, Berisha VL, Latifi Pupovci H, Goci A and Hajrushi A.B. Grading of hirsutism based on the ferryman-Gallwey scoring system in kosvar women. Postepy Dermatol Alergol. 2018; 35(6): 631-635. [DOI:10.5114/ada.2018.77615]
19. Hacivelioglu S, Gungor A.N.C, Gencer M, Uysal A, Hizli D, Koc E and Cosar E. Acne severity and the global acne grading system in polycystic ovary syndrome. Int. J. Gynaecol Obstet. 2013; 123(1): 33-6. [DOI:10.1016/j.ijgo.2013.05.005]
20. Dhurat R and Saraogi P. Hair evaluation methods: merits and demerits. Int. J. Trichol. 2009; 1(2): 108-119. [DOI:10.4103/0974-7753.58553]
21. Agrawal N.K. Management of hirsutism. Indian J. Endocrinol Metab. 2013; 17(Suppl. 1): S77-S82. [DOI:10.4103/2230-8210.119511]
22. Behboudi-Gandevani S, Abtahi H, Saadat N, Tohidi M and Ramezani Tehrani F. Effect of phlebotomy versus oral contraceptives containing cyproterone acetate on the clinical and biochemical parameters in women with polycystic ovary syndrome: A randomized controlled trial. J. Ovarian Res. 2019; 12: 78. [DOI:10.1186/s13048-019-0554-9]
23. Akha O, Rabiei K, Kashi Z, Bahar A, Zaeif-Khorasani E, Kosaryan M, Saeedi M, Ebrahimzadeh MA and Emadian O. The effect of fennel (Foeniculum vulgare) gel 3% in decreasing hair thickness in idiopathic mild to moderate hirsutism, A randomized placebo controlled clinical trial. Caspian. J. Intern. Med. 2014; 5(1): 26-29.
24. Ghavi F, Taghizadeh M, Taebi M and Abdolahian S. Effect of Foeniculum vulgare essence on symptoms of polycyctic ovarian syndrome (PCOS): A randomized double-blind , placebo-controlled trial. J. Herb. Med. 2019; 17-18. 100277. [DOI:10.1016/j.hermed.2019.100277]
25. Khazaei F, Naseri L, Akbaribazm M and Khazaei M. Foeniculum vulgare extract enhances estrogen levels, total antioxidant capacity, and protect ovarian histology in rats exposed to Bisphenol A. Endocrinol. Res. Pract. 2023; 27(4): 227-232. [DOI:10.5152/erp.2023.23269]
26. Nelson K, Tlyles J, Saitta A, Addie-Noye E, Tyler P and Quave CL. Anti acne activity of Italian medicinal plants used for skin infection. Front Pharmacol. 2016; 7: 425: [DOI:10.3389/fphar.2016.00425]
27. Nasri H, Bahmani M, Shahinfard N, Moradi Nafchi A, Saberianpour SH and Rafieian Kopaei M. Medicinal plants for the treatment of acne vulgaris: A review of recent evidences. Jundishapur J. Microbiol. 2015; 8(11): e25580. [DOI:10.5812/jjm.25580]
28. Hamza A, Widadm A and Alfaris M. Effect of Vitex agnus-castus plant extract on polycystic ovary syndrome complications in experimental rat model. Asian Pac. J. Reprod. 2019; 8(2): 63-69. [DOI:10.4103/2305-0500.254647]
29. Fezollahi Z, Mohseni Kouchesfehani H, Jalali H, Eslimi-Esfahani D and Sheikh Hosseini A. Effects of Vitex agnus-castus ethanolic extract on hypothalamic Kiss-1 gene expression in a rat model of polycystic ovary syndrome. Avicenna J. Phytomed. 2021; 11(3): 292-301.
30. Ghodsi Z and Asltoghiri M. The effect of fennel on pain quality, symptoms and menstrual duration in primary dysmenorrhea. J. Pediatr Adolesc. 2014; 27(5): 283-286. [DOI:10.1016/j.jpag.2013.12.003]
31. Armanini D, Andrisani A, Bordin L and Sabbadin C. Spironolactone in the treatment of polycystic ovary syndrome. Expert Opin. Pharmacother. 2016; 17(13): 1713-1715. [DOI:10.1080/14656566.2016.1215430]
32. Fernández-Poyatos MDP, Lorent-Martinez EJ and Ruiz-Medina A. Phytochemical composition and antioxidant activity of Potulaca oleracea: influence of the steaming cooking process. Foods 2021; 10(1): 94. [DOI:10.3390/foods10010094]
33. Barakat H, Alkabeer IA, Aljutaily T, Almujaydil M, Algheshairy RM, Alhomaid RM, Almutairi AS and Mohamed A. Phenolics and volatile compounds of fennel (Foeniculum vulgare) seeds and their sprouts prevent oxidative DNA damage and ameliorates CCl4-induced hepatotoxicity and oxidative stress in rats. Antioxidants (Basel). 2022; 11(12): 2318. [DOI:10.3390/antiox11122318]
34. Kavaz A, Işik M, Dikici E and Yüksel M. Anticholinergic, antioxidant and antibacterial properties of Vitex agnus-castus L. seed extract: Assessment of its phenolic content by LC/MS/MS. Chem. Biodivers. 2022; 19(10): e202200143. [DOI:10.1002/cbdv.202200143]
35. Bhattacharya K, Dey R, Sen D, Paul N, Basak AK, Purkait MP Shukla N, Chaudhuri GR, Bhattacharya A, Maiti R, Adhikary K, Chatterjee P, Karak P and Kumar Syamal A. Polycyctic ovary syndrome and its management: in view of oxidative stress. Biomol. Concepts. 2024: 15(1). [DOI:10.1515/bmc-2022-0038]
36. Alizadeh F, Ramezni M and Piravar Z. Effects of Stachys sylvatica hydroalcoholic extract on the ovary and hypophysisgonadal axis in a rat with polycystic ovary syndrome. Middle East Fertil. Soc. J. 2020; 25(4): 2-7. [DOI:10.1186/s43043-020-0015-9]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
