Abstract
Introduction
Fennel has many medicinal properties and is used in the treatment of dysmenorrhea. Given the widespread use of herbal medicine among women for menstrual problems and considering the fact that there has been no study to date about the effect of fennel on menstrual bleeding and duration of menstrual bleeding through systematic review, the present study was conducted to determine the effect of fennel on the amount (primary outcome) and duration of menstrual bleeding and its side-effects (secondary outcomes).
Materials
All articles, including Persian and English, with no time limit were searched for in the following databases: Medline (through PubMed), Scopus, EMBASE (through Ovid), Cochrane Library, Web of Sciences, Google Scholar, ProQuest, Clininaltrial.gov, SID, Magiran, Irandoc, and Iranmedex, using MeSH terms, including menstrual bleeding, menstruation, severity of bleeding, hypermenorrhea, menorrhagia, fennel, fennelin, Foeniculum vulgare, dysmenorrhea, and painful menstruation, which were searched separately or in combination. Two authors separately reviewed articles to determine the inclusion criteria, and any disagreement was resolved by reaching consensus with a third person.
Results
A total of 7993 articles were identified through searching the databases, of which 7327 were excluded as duplicates and 666 were screened for inclusion. Six hundread and forty six were excluded by title and abstract based on not being relevant to the review and being conducted on animals. Eventually, six articles were included in the study and four articles entered into the meta-analysis. The results from meta-analysis showed that using fennel caused a significant increase in mean menstrual bleeding in the first cycle after treatment in the intervention group compared to the control (Std. mean difference: 0.46; 95 % CI: 0.18–0.73; p = 0.001; I2 = 9 %). However, it had no significant effect on menstrual bleeding in the second cycle after treatment (Mean difference: 1.44; 95 % CI:-5.09 to 7.96; p = 0.67; I2 = 0 %).
Conclusions
The results of meta-analysis of four articles showed that in the first cycle after treatment, use of fennel increased menstrual bleeding in the intervention group compared to the control, but meta-analysis of two articles showed no significant difference between intervention and control groups in the amount of menstrual bleeding in the second cycle after treatment. Given the poor quality of articles, conducting clinical trials to determine the effect of fennel on menstrual bleeding appears necessary.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
[1] Ryan KJ, Berkowitz RS, Barbieri RL, Dunaif A, editors. Kistner’s gynecology and women’s health. 7th ed. New York: Mosby Incorporated; 1999. p. 24.Search in Google Scholar
[2] Bewley S, Cheong Y, Creighton SM, Dobbs S, Gebbie AE, Gupta J, et al. The normal menstrual cycle. In: Monga A, Dobbs SP, editor(s). Gynaecology by ten teachers, 19th ed. London: CRC Press, 2011:50–53.Search in Google Scholar
[3] Hillard PJA. Benign diseases of the female reproductive tract. In: Berek SJ, editor. Berek and Novak’s Gynecology. 15th ed. Philadelphia: Lippincott Williams and Wilkins; 2012. p. 720.Search in Google Scholar
[4] Carol Sakala. Botanical medicines, CAM, and integrative medicine: definitions and use prevalence. In: Romm AJ, editor(s). Botanical medicine for women’s health, 2nd ed. St. Louis: Churchill Livingstone/ Elsevier, 2010:1–32.Search in Google Scholar
[5] World Health Organization. WHO traditional medicine strategy: 2014-2023. Available at: http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/.Pdf. Accessed: 20 Sep 2017.Search in Google Scholar
[6] Fong HH. Integration of herbal medicine into modern medical practices: issues and prospects. Integr Cancer Ther. 2002;1:287–93.10.1177/153473540200100313Search in Google Scholar PubMed
[7] Mirhaidar H, editor. Spice, condiments and aromatic plants. In: Plant sciences [Persian], 7th ed. Tehran: Nashre Farhange Eslami, 2005:292–93.Search in Google Scholar
[8] Kooti W, Moradi M, Akbari SA, Sharafi-Ahvazi N, Asadi-Samani M, Ashtary-Larky D. Therapeutic and pharmacological potential of Foeniculum vulgare Mill: a review. J HerbMed Pharmacol. 2015;4:1–9.Search in Google Scholar
[9] Badgujar SB, Patel VV, Bandivdekar AH. Foeniculum vulgare Mill: a review of its botany, phytochemistry, pharmacology, contemporary application, and toxicology. Biomed Res Int. 2014;2014:1–32.10.1155/2014/842674Search in Google Scholar
[10] Mirabi P, Alamolhoda SH, Esmaeilzadeh S, Mojab F. Effect of medicinal herbs on primary dysmenorrhoea-a systematic review. Iran J Pharm Res. 2014;13:757.Search in Google Scholar
[11] Saei Gharenaz M, Ozgoli G. Effect of medicinal plants in the treatment of primary dysmenorrhea in Iran: a review article. Iran J Obstet Gynecol Infertil. 2015;18:14–31.Search in Google Scholar
[12] Barij Essence Pharmaceutical Company. Products > Human > Medicine. Available at: http://www.barijessence.com/Default.aspx?culture=en-US&Page=products&categoryid=35. Accessed: 13 Sep 2017.Search in Google Scholar
[13] Bokaie M, Enjezab B. The effects of oral fennel extract on the intensity of menstrual bleeding in relieving dysmenorrheal: a randomized clinical trial. Journal of Community Health. 2014;8:55–62.Search in Google Scholar
[14] Akhavan Amjadi M, Zahrani S, Mojab F, Alavi Majd H. Efficacy of Foeniculum vulgare mill extract on menstrual bleeding over the students of shahid beheshti university in Tehran 2005. J Med Plants. 2010;2:117–23.Search in Google Scholar
[15] Shobeiri F, Zeraati F, Araghchian M, Nazari M. The effect of fennelin,vitagnus and mefenamic acid in the treatment of menstrual bleeding. Sci J Hamdan Univ Med Sci. 2014;21:171–76.Search in Google Scholar
[16] Khorshidi N, Ostad S, Mosaddegh M, Soodi M. Clinical effects of fennel essential oil on primary dysmenorrhea. Iranian J Pharm Res. 2003;2:89–93.Search in Google Scholar
[17] Higgins JP, Altman DG. Assessing risk of bias in included studies. In: Higgins JP, John GS, editor(s). Cochrane handbook for systematic reviews of interventions. London: Wiley & Sons, 2011.Search in Google Scholar
[18] IRCT Search: Efficacy of oral fennel drop in treatment of primary dysmenorrhea. Available at: http://en.search.irct.ir/view/6547. Accessed: 9 Nov 2017.Search in Google Scholar
[19] Ghodsi Z, Asltoghiri M. The effect of fennel on pain quality, symptoms, and menstrual duration in primary dysmenorrhea. J Pediatr Adolesc Gynecol. 2014;27:283–86.10.1016/j.jpag.2013.12.003Search in Google Scholar PubMed
[20] Nazarpour S, Azimi H. Comparison of therapeutic effects of Fennelin and Mefenamic Acid on primary dysmenorrhea. J Mazandaran Univ Med Sci. 2007;17:54–61.Search in Google Scholar
[21] Ostad S, Soodi M, Shariffzadeh M, Khorshidi N, Marzban H. The effect of fennel essential oil on uterine contraction as a model for dysmenorrhea, pharmacology and toxicology study. J Ethnopharmacol. 2001;76:299–304.10.1016/S0378-8741(01)00249-5Search in Google Scholar PubMed
[22] Forster H, Niklas H, Lutz S. Antispasmodic effects of some medicinal plants. Planta Med. 1980;40:309–19.10.1055/s-2008-1074977Search in Google Scholar PubMed
[23] Tognolini M, Ballabeni V, Bertoni S, Bruni R, Impicciatore M, Barocelli E. Protective effect of Foeniculum vulgare essential oil and anethole in an experimental model of thrombosis. Pharmacol Res. 2007;56:254–60.10.1016/j.phrs.2007.07.002Search in Google Scholar
[24] Rather MA, Dar BA, Sofi SN, Bhat BA, Qurishi MA. Foeniculum vulgare: a comprehensive review of its traditional use, phytochemistry, pharmacology, and safety. Arabian Journal of Chemistry. 2016;9:S1574–S1583.10.1016/j.arabjc.2012.04.011Search in Google Scholar
[25] Malini T, Vanithakumari G, Devi NMSAK, Fiango V. Effect of Foeniculuai vulgare mill seed extract on the genital organs of male and female rats. Ind J Physiol Pharmac. 1985;29:22–26.Search in Google Scholar
[26] Namavar Jahromi B, Tartifizadeh A, Khabnadideh S. Comparison of fennel and mefenamic acid for the treatment of primary dysmenorrhea. Int J Gynaecol Obstet. 2003;80:153–57.10.1016/S0020-7292(02)00372-7Search in Google Scholar PubMed
© 2018 Walter de Gruyter GmbH, Berlin/Boston
