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Efficacy of Habbul aas (fruits of Myrtus communis) in menorrhagia: a single blinded randomized standard control study

  • Rayeesa Banu R. Umarami , Mariyam Roqaiya EMAIL logo and Mohd Aqil Quadri
Published/Copyright: August 27, 2020
Journal of Complementary and Integrative Medicine
From the journal Journal of Complementary and Integrative Medicine Volume 18 Issue 1

Abstract

Objectives

Menorrhagia can be defined as heavy uterine bleeding which comes at regular intervals or uterine bleeding extending more than seven days during menses which has become a considerable problem for females, causing discomfort, anxiety, and poor quality of life. In this study we aimed to compare the effect of Myrtus communis fruits with tranexamic acid in the treatment of menorrhagia.

Methods

In this prospective patient blinded standard controlled study, 40 patients of menorrhagia were randomly assigned to receive either test drug (powdered M. communis fruits) or active control drug (tranexamic acid) for first five days of menstrual cycle consecutively for two cycles. The primary outcome measure was reduction in heavy flow during menses determined by pictorial blood loss assessment chart (PBAC), while improvements in quality of life (QOL) by using short form-36 questionnaire and increase in hemoglobin percentage were kept as secondary outcome measures.

Results

Both the groups were similar at baseline. Test and control drugs significantly reduced the PBAC score during treatment cycles with p-value <0.001 and these changes were not significantly different between the groups. During second treatment cycle significant difference was found in PBAC score (p = 0.024) between the groups. After treatment significant improvement in hemoglobin percentage was noted and marked improvement in overall quality of life was observed in both the groups.

Conclusion

These data suggest that M. communis fruits can be an effective alternate in reducing heavy menstrual bleeding. There is need to confirm these results by designing a trial on large number of patients.

Trial Registration No

CTRI/2017/09/009937.

Keywords: herbal medicine; menorrhagia; quality of life; tranexamic acid
Corresponding author: Mariyam Roqaiya, Assistant Professor, Dept. of Niswan wa Qabala, Luqman Unani Medical College Hospital and Research Centre, Naubag, Vijayapur, Karnataka, India, Mobile: +91 9632560839, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Ethical approval: The present study was a research involving the human subjects and was conducted as per the tenets of declaration of Helsinki and also followed the guidelines. Further the study was approved by the institutional ethics committee of Luqman Unani Medical College Vijayapur with the Ref. No.BJP/LUMC/PG/IEC/2015-16/01/IQAN/02.r.

References

1. Gottapu, K, Golagabathula, S. A study of demographic profile and evaluation of menorrhagia. Indian J Appl Res 2014; 4: 430–3. https://doi.org/10.15373/2249555x/jan2014/131.Search in Google Scholar

2. Kılıc, SC, Sarper, N, Zengin, E, Gelen, SA. Screening bleeding disorders in adolescents and young women with menorrhagia. Turk J Hematol 2013; 30: 168–76. https://doi.org/10.4274/tjh.2011.0048.Search in Google Scholar PubMed PubMed Central

3. Prashanthi, GC, Popuri, PK, Valluri, P. Efficacy of Tranexamic acid in the Management of Menorrhagia. Acta Biomed Sci 2016; 3: 115–9.Search in Google Scholar

4. Reid, PC, Mukri, F. Trends in number of hysterectomies performed in England for menorrhagia: examination of health episode statistics. BMJ 2005; 330: 938–9. https://doi.org/10.1136/bmj.38376.505382.ae.Search in Google Scholar

5. Karaman, K, Ceylan, N, Karaman, E, Akbayram, S, Akbayram, HT, Kaba, S, et al. Evaluation of the hemostatic disorders in adolescent girls with menorrhagia. Indian J Hematol Blood Transfus 2016; 32: 356–61. https://doi.org/10.1007/s12288-015-0583-5.Search in Google Scholar PubMed PubMed Central

6. Ghazizadeh, S, Bakhtiari, F, Rahmanpour, H, Tanha, FD, Ramezanzadeh, F. A randomized clinical trial to comparelevonorgestrel-releasing intrauterinesystem (Mirena) versus trans-cervical endometrial resection for treatment of menorrhagia. Int J Women’s Health 2011; 3: 207–11. https://doi.org/10.2147/ijwh.s20999.Search in Google Scholar

7. Hangarga, US, Rita, D, Edula, RR. To study the role of tranexamic acid in the management of menorrhagia. Int J Reprod Contracept Obstet Gynecol. 2016; 5: 3712–6. https://doi.org/10.18203/2320-1770.ijrcog20163833.Search in Google Scholar

8. Qaraaty, M, Kamali, SH, Dabaghian, FH, Zafarghandi, N, Mokaberinejad, R, Mobli, M, et al. Effect of myrtle fruit syrup on abnormal uterine bleeding: a randomized double-blind, placebo-controlled pilot study. DARU 2014; 22: 1–7. https://doi.org/10.1186/2008-2231-22-45.Search in Google Scholar PubMed PubMed Central

9. Ghani, N R. Khazainul advia. New Delhi: Idarae Kitabul Shifa; YNM; 2011:171–2 pp.Search in Google Scholar

10. Hakim, MA. Bustanul mufredat. New Delhi: Idara Kitabus Shifa; 2002:251–2 pp.Search in Google Scholar

11. Kabeeruddin, M. Maghzinul mufradat. New Delhi: Ejaz publishing House; YNM; 2000:47–8 pp.Search in Google Scholar

12. Ogur, R. Studies with Myrtus communis L. anticancer properties. J Intercult Ethnopharmacol 2014; 3: 135–7. https://doi.org/10.5455/jice.20140803044831.Search in Google Scholar PubMed PubMed Central

13. Prajapati, ND, Purohit, SS, Sharma, AK, Kumar, T. A handbook of medicinal plants. Jodhpur, India: Agrobias;2013:357.Search in Google Scholar

14. Masoud, M, Kopaei, MR, Miraj, S. A comparison of the efficacy of metronidazole vaginal gel and Myrtus (Myrtus communis) extract combination and metronidazole vaginal gel alone in the treatment of recurrent bacterial vaginosis. Avicenna J Phytomed 2016:1–8. https://doi.org/10.7860/jcdr/2016/17211.7392.Search in Google Scholar

15. Walle, M, Walle, B, Zerihun, L, Makonnen, E. Sedative-hypnotic like effect of the essential oil from the leaves of Myrtus communis on mice. Am J Biomed Life Sci 2014; 2: 70–7. https://doi.org/10.11648/j.ajbls.20140204.12.Search in Google Scholar

16. Nejad, BS, Nejad, ME, Naanaie, SY, Zarrin, M. Antifungal efficacy of Myrtus communis Linn. Jentashapir J Health Res 2014; 5: 1–3. https://doi.org/10.17795/jjhr-21879.Search in Google Scholar

17. Memarzadeh, H, Eftekhar, T, Tansaz, M, Dabaghian, FH, Kamalinejad, M, Foroughifar, T, et al. Evaluation of efficacy of Punica granatum L. (Persian gulnar) on uterine leiomyoma related menorrhagia: a pilot study. Int J Biosci 2015; 9: 18–25. https://doi.org/10.12692/ijb/6.9.18-25.Search in Google Scholar

18. Jahan, D, Begum, W, Roqaiya, M, Hussaini, YK. Anti-haemorrhagic activity of polyherbal formulation in menorrhagia: a randomized controlled trial. Altern Integr Med 2016;5. https://doi.org/10.4172/2327-5162.1000219.Search in Google Scholar

19. Hurskainen, R, Aalto, AM, Teperi, J, Grenman, S, Kivela, A, Kujansuu, E, et al. Psychosocial and other characteristics of women complaining of menorrhagia, with and without actual increased menstrual blood loss. Br J Obstet Gynaecol 2001; 108: 281–5. https://doi.org/10.1111/j.1471-0528.2001.00040.x.Search in Google Scholar PubMed

20. Leminen, H, Hurskainen, R. Tranexamic acid for the treatment of heavy menstrual bleeding: efficacy and safety. Int J Women's Health 2012; 4: 413–21. https://doi.org/10.2147/ijwh.s13840.Search in Google Scholar

21. Abbasi, M. A comparative study on the concept of convulsion in traditional Iranian medicine and classic medicine. APJ 2015; 5: 53.Search in Google Scholar

22. Malik, S, Day, K, Perrault, I, Jones, DSC, Smith, SK. Reduced levels of VEGF-A and MMP-2 and MMP-9 activity and increased TNF-a in menstrual endometrium and effluent in women with menorrhagia. Human Reproduction 2006; 21: 2158–66. https://doi.org/10.1093/humrep/del089.Search in Google Scholar PubMed

23. Ghnaya, AB, Chograni, H, Messoud, C, Boussaid, M. Comparative chemical composition and antibacterial activities of Myrtus communis L. essential oils isolated from Tunisian and Algerian population. J Plant Pathol Microb 2013;4. https://doi.org/10.4172/2157-7471.1000186.Search in Google Scholar

24. Chatterjee, A, Pakrashi, SC. The treatise on Indian medicinal plants. New Delhi: National Institute of Science Communication and Information Resources, CSIR; 2010:12–3. Vol IV.Search in Google Scholar

25. Sumbul, S, Ahmad, MA, Asif, M, Akhta, M. Myrtus communis Linn. a review. Indian J Nat Prod Resour 2011; 2: 395–402.Search in Google Scholar

26. Memarzadeh, H, Eftekhar, T, Tansaz, M, Dabaghian, FH, Kamalinejad, M, Foroughifar, T, et al. Evaluation of efficacy of Punica granatum L. (Persian gulnar) on uterine leiomyoma related menorrhagia: a pilot study. Int J Biosci 2015; 9: 18–25. https://doi.org/10.12692/ijb/6.9.18-25.Search in Google Scholar

27. Rossi, A, Paola, RD, Mazzon, E, Genovese, T, Caminiti, R, Bramanti, P, et al. Myrtucommulone from Myrtus communis exhibits potent anti-inflammatory effectiveness in vivo. J Pharmacol Exp Therapeut 2009; 329: 76–86. https://doi.org/10.1124/jpet.108.143214.Search in Google Scholar PubMed

28. Hosseinzadeh, H, Khoshdel, M, Ghorbani, M. Antinociceptive, anti-inflammatory effects and acute toxicity of aqueous and ethanolic extracts of Myrtus communis L. aerial parts in mice. J Acupunct Meridian Stud 2011; 4: 242–7. https://doi.org/10.1016/j.jams.2011.09.015.Search in Google Scholar PubMed

29. Masoudi, M, Miraj, S, Kopaei, MR. Comparison of the effects of Myrtus Communis L, berberis vulgaris and metronidazole vaginal gel alone for the treatment of bacterial vaginosis. J Clin Diagn Res 2016; 10: 4–7. https://doi.org/10.7860/jcdr/2016/17211.7392.Search in Google Scholar

30. Gokyildiz, S, Aslan, E, Beji, NK, Mecdi, M. The effects of menorrhagia on women’s quality of life: a case-control study. ISRN Obstet Gynecol 2013;2013, 918179:1–7 https://doi.org/10.1155/2013/918179.Search in Google Scholar

31. Prasad, DB, Jagannath, P, Bora, BMK. Evaluation of menorrhagia in adolescent girls: a clinical study. Sch J App Med Sci 2016; 4: 2307–11. https://doi.org/10.21276/sjams.2016.4.6.91.Search in Google Scholar

32. Lukes, AS, Baker, J, Eder, S, Adomako, TL. Daily menstrual blood loss and quality of life in women with heavy menstrual bleeding. Women's Health 2012; 8: 503–11. https://doi.org/10.2217/whe.12.36.Search in Google Scholar

33. Weisberg, E, McGeehan, K, Fraser, I S. Effect of perceptions of menstrual blood loss and menstrual pain on women’s quality of life. Eur J Contracept Reprod Health Care 2016; 21: 431–5. https://doi.org/10.1080/13625187.2016.1225034.Search in Google Scholar

34. Deliwala, KJ, Shah, HH, Shah, BS, Goswami, HM, ShahPK, Patil, S. Evaluation of menstrual problems among urban females of Ahmedabad. J Clin Res Lett 2013; 4: 49–53.Search in Google Scholar

35. Hurskainen, R, Teperi, J, Rissanen, P, Aalto, AM, Grenman, S, Kivela, A, et al. Quality of life and cost-effectiveness of levonorgestrel-releasing intrauterine system versus hysterectomy for treatment of menorrhagia: a randomized trial. Lancet 2001; 357: 273–7. https://doi.org/10.1016/S0140-6736(00)03615-1.Search in Google Scholar

36. Gupta, J, Kai, J, Middleton, L, Pattison, H, Gray, R, and Daniels, J. Levonorgestrel intrauterine system versus medical therapy for menorrhagia. N Engl J Med. 2013; 368: 128–37. https://doi.org/10.1056/nejmoa1204724.Search in Google Scholar

37. Anastasakis, E, Kingman, CE, Lee, CA, Economides, DL, Kadir, RA. Menstrual problems in university students: an electronic mail survey. In Vivo 2008; 22: 617–20.Search in Google Scholar

38. Bruinvels, G, Burden, R, Brown, N, Richards, T, Pedlar, C. The prevalence and impact of heavy menstrual bleeding (menorrhagia) in eliteand non-elite athletes. PLOS One 2016; 11: e0149881. https://doi.org/10.1371/journal.pone.0149881.Search in Google Scholar PubMed PubMed Central

39. Abbot, JA, Garry, R. A surgical management of menorrhagia. Hum Reprod Update. 2002; 8: 68–78. https://doi.org/10.1093/humupd/8.1.68.Search in Google Scholar PubMed

40. Harve, LJ, Armah, CN, Dainty, JR, Foxall, RJ, Lewis, DJ, Langford, NJ, et al. Impact of menstrual blood loss and diet on iron deficiency among women in the UK. Br J Nutr 2005; 94: 557–64. https://doi.org/10.1079/bjn20051493.Search in Google Scholar PubMed

41. Djukic, SM, Lekovic, D, Jovic, N, Varjacic, M. Unnecessary hysterectomy due to menorrhagia and disorders of hemostasis: an example of overuse and excessive demand for medical services. Front Pharmacol 7:507. https://doi.org/10.3389/fphar.2016.00507.Search in Google Scholar

42. Ibrahim, R, Khan, A, Raza, S, Kafeel, M, Dabas, R, Haynes, E, et al. Triad of iron deficiency anemia, severe thrombocytopenia and menorrhagia—a case report and literature review. Clin Med Insights Case Rep 2012; 5: 23–7. https://doi.org/10.4137/ccrep.s9329.Search in Google Scholar

43. Forret, ABL, Harvey, PJ, Thier, SML. Menorrhagia: a synopsis of management focusing on herbal and nutritional supplements, and chiropractic. J Can Chiropr Assoc 2007; 51: 235–46.Search in Google Scholar

44. Harlow, SD, Campbell, OMR. Epidemiology of menstrual disorders in developing countries: a systematic review. BJOG Int J Obstet Gynaecol 2004; 111: 6–16. https://doi.org/10.1111/j.1471-0528.2004.00012.x.Search in Google Scholar

45. Baron, YM. Menorrhagia: risk factors, diagnosis and treatment. Academic Department of Obstetrics and Gynaecology University of Malta Medical School; July 2015. Available from https://www.researchgate.net/publication/286931389_Menorrhagia_Risk_Factors_Diagnosis_and_Treatment.Search in Google Scholar

46. Lee, JY, Hahn, PM, Dijk, JPV, Reld, RL. Treatment of menorrhagia with tranexamic acid. J Soc Obstet Gynaecol Can 2000; 22: 794–8. https://doi.org/10.1016/s0849-5831(16)31019-9.Search in Google Scholar

47. Panahi, Y, Nayeeni, SMM, Sahebkar, A, Fanaie, SA, Rahimnia, A, Beiraghdar, F. Myrtus communis essential oil for the treatment of hemorrhoids: a randomized double-blind double-dummy parallel-group comparative study. Turk J Pharm Sci 2014; 11: 1–8.Search in Google Scholar

Received: 2019-02-15
Accepted: 2020-02-16
Published Online: 2020-08-27

© 2020 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. Endocannabinoids release after Osteopathic Manipulative Treatment. A brief review
  4. A pervasive scientific overview on mangiferin in the prevention and treatment of various diseases with preclinical and clinical updates
  5. Clinical trials of homeopathy in urological disorders: a systematic review
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  8. Cytoprotective and antisecretory properties of methanolic extract of Distemonanthus benthamianus (Caesalpiniaceae) stem bark on acute gastric ulcer in rats
  9. Screening chemical inhibitors for alpha-amylase from leaves extracts of Murraya koenigii (Linn.) and Aegle marmelos L.
  10. Ayurvedic formulations containing benzoic and ascorbic acids as additives: benzene formation during storage and impact of additives on quality parameters
  11. High cholesterol diet promotes dysfunction of arginase and cholinergic enzymatic system in rats: ameliorative role of caffeic and chlorogenic acids
  12. Cytokine and inflammatory mediators are associated with cytotoxic, anti-inflammatory and apoptotic activity of honeybee venom
  13. Anti-anaemic effect of ethanol leaf extract of Cnidosculus aconitifolius on cyclophosphomide-induced anaemia in rats
  14. Alterations in histological, biochemical and hematological parameters in Plasmodium berghei NK-65 infected balb/c mice treated with Bridelia ferruginea stem bark extract
  15. Structural characterization, antioxidant, and antibiofilm activities of Coffea canephora green seeds
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  17. Safety, efficacy and tolerability of a combination micronutrient and polyherbal preparation (GoutFighterTM) for gout: a single-arm open-label pilot study
  18. Efficacy of Habbul aas (fruits of Myrtus communis) in menorrhagia: a single blinded randomized standard control study
  19. Ginger (Zingiber officinale) and turmeric (Curcuma longa L.) supplementation effects on quality of life, body composition, bone mineral density and osteoporosis related biomarkers and micro-RNAs in women with postmenopausal osteoporosis: a study protocol for a randomized controlled clinical trial
  20. Lithotriptic effect of Safūf Hajar-al Yahūd in patients of Hasat-ul Kilya (Nephrolithiasis) – an open prospective clinical validation trial
  21. Efficacy of Qurs-e-Gulnar in Ziabetus (type 2 Diabetes Mellitus): a single blind randomized controlled trial
  22. Immediate effect of Kapalbhathi pranayama on short term heart rate variability (HRV) in healthy volunteers
  23. Designing and validation of a yoga-based module for obesity with metabolic comorbidities
  24. A mixed-method randomized feasibility trial evaluating progressive muscle relaxation or autogenic training on depressive symptoms and quality of life in people living with human immunodeficiency virus (HIV) who have depressive symptoms
  25. Analysis of the bio-psychological characteristics of Sasang typology in Korean preschool children using the ponderal index and the temperament and character inventory
  26. Complementary and alternative medicine is positively associated with religiousness/spirituality
  27. Comparison the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue in hemodialysis patients: a randomized clinical trial
  28. Improvement in resilience and stress-related blood markers following ten months yoga practice in Antarctica
  29. Neutral douche: a hydrotherapeutic tool to manage pain and systemic symptoms in primary dysmenorrhea - a randomised controlled study
  30. Short Communication
  31. The effects of omega-3 on the sleep quality of patients with uremic pruritus undergoing hemodialysis: a randomized crossover study
  32. Case Reports
  33. Āyuṛveda management of keratosis pilaris – a case report
  34. Improvement in impaired ocular accommodation by parietal acupoint therapy to relieve neck stiffness: a case report
https://doi.org/10.1515/jcim-2018-0235
Keywords for this article
herbal medicine; menorrhagia; quality of life; tranexamic acid

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. Endocannabinoids release after Osteopathic Manipulative Treatment. A brief review
  4. A pervasive scientific overview on mangiferin in the prevention and treatment of various diseases with preclinical and clinical updates
  5. Clinical trials of homeopathy in urological disorders: a systematic review
  6. Strategies in traditional Persian medicine to maintain a healthy life in the elderly
  7. Research articles Basic
  8. Cytoprotective and antisecretory properties of methanolic extract of Distemonanthus benthamianus (Caesalpiniaceae) stem bark on acute gastric ulcer in rats
  9. Screening chemical inhibitors for alpha-amylase from leaves extracts of Murraya koenigii (Linn.) and Aegle marmelos L.
  10. Ayurvedic formulations containing benzoic and ascorbic acids as additives: benzene formation during storage and impact of additives on quality parameters
  11. High cholesterol diet promotes dysfunction of arginase and cholinergic enzymatic system in rats: ameliorative role of caffeic and chlorogenic acids
  12. Cytokine and inflammatory mediators are associated with cytotoxic, anti-inflammatory and apoptotic activity of honeybee venom
  13. Anti-anaemic effect of ethanol leaf extract of Cnidosculus aconitifolius on cyclophosphomide-induced anaemia in rats
  14. Alterations in histological, biochemical and hematological parameters in Plasmodium berghei NK-65 infected balb/c mice treated with Bridelia ferruginea stem bark extract
  15. Structural characterization, antioxidant, and antibiofilm activities of Coffea canephora green seeds
  16. Research articles Clinical
  17. Safety, efficacy and tolerability of a combination micronutrient and polyherbal preparation (GoutFighterTM) for gout: a single-arm open-label pilot study
  18. Efficacy of Habbul aas (fruits of Myrtus communis) in menorrhagia: a single blinded randomized standard control study
  19. Ginger (Zingiber officinale) and turmeric (Curcuma longa L.) supplementation effects on quality of life, body composition, bone mineral density and osteoporosis related biomarkers and micro-RNAs in women with postmenopausal osteoporosis: a study protocol for a randomized controlled clinical trial
  20. Lithotriptic effect of Safūf Hajar-al Yahūd in patients of Hasat-ul Kilya (Nephrolithiasis) – an open prospective clinical validation trial
  21. Efficacy of Qurs-e-Gulnar in Ziabetus (type 2 Diabetes Mellitus): a single blind randomized controlled trial
  22. Immediate effect of Kapalbhathi pranayama on short term heart rate variability (HRV) in healthy volunteers
  23. Designing and validation of a yoga-based module for obesity with metabolic comorbidities
  24. A mixed-method randomized feasibility trial evaluating progressive muscle relaxation or autogenic training on depressive symptoms and quality of life in people living with human immunodeficiency virus (HIV) who have depressive symptoms
  25. Analysis of the bio-psychological characteristics of Sasang typology in Korean preschool children using the ponderal index and the temperament and character inventory
  26. Complementary and alternative medicine is positively associated with religiousness/spirituality
  27. Comparison the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue in hemodialysis patients: a randomized clinical trial
  28. Improvement in resilience and stress-related blood markers following ten months yoga practice in Antarctica
  29. Neutral douche: a hydrotherapeutic tool to manage pain and systemic symptoms in primary dysmenorrhea - a randomised controlled study
  30. Short Communication
  31. The effects of omega-3 on the sleep quality of patients with uremic pruritus undergoing hemodialysis: a randomized crossover study
  32. Case Reports
  33. Āyuṛveda management of keratosis pilaris – a case report
  34. Improvement in impaired ocular accommodation by parietal acupoint therapy to relieve neck stiffness: a case report
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