Abstract
Background and aims: Fennel is often advocated for primary dysmenorrhea. Whether this herb has a real effect on pain relief is still a matter of debate in medicine. Therefore, this study was conducted to evaluate the effect of fennel on primary dysmenorrhea. Methods: This systematic review was conducted on clinical trials (non-randomized, randomized, historical study with concurrent control) published in PubMed (MEDLINE), Web of Science, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), ProQuest, and Persian databases (Magiran, IranMedex, SID, Irandoc) regarding the effect of fennel on pain intensity in primary dysmenorrhea from 1990 to 2019. Nine studies met all inclusion criteria. Any clinical trials on young women with primary dysmenorrhea were included in the study. Studies that used fennel plus other products investigated fennel effect on premenstrual syndrome (PMS) and bleeding; studies without a control group and nonclinical trials were excluded. In all studies, participants were young female university or high school students. All of them had moderate to severe primary dysmenorrhea. Results: In all of the studies except for one, fennel had been more effective than placebo in pain relief (P<0.01). Non-steroidal drugs had the same result as fennel for pain relief. However, in one study, the difference between non-steroidal anti-inflammatory drugs (NSAIDs) and fennel in pain relief was observed. Only one study reported increasing vaginal bleeding after fennel consumption in some cases. Conclusion: Collectively, these studies favored fennel over NSAID, other herbal drugs, and placebo. But more investigation is needed to draw a firm conclusion.
Highlights
Primary dysmenorrhea is one of the most important public health problems among young females worldwide, which interfere with their social responsibility and quality of life
Ischemia and pain were induced by increasing vasopressin, and uterine contraction was induced by PG E2 and F2Α
The inclusion criteria were as follows: Any clinical trials on young women with primary dysmenorrhea were included in this study
Summary
Primary dysmenorrhea is one of the most important public health problems among young females worldwide, which interfere with their social responsibility and quality of life. Foeniculum vulgare (Fennel) is used as foodstuff and an herbal drug in traditional medicine It is an anti-inflammatory and anti-spasmodic substance.[2] In a study, Ostad et al reported a decrease in the frequency and intensity of uterine contraction in rats after using fennel.[3] The standard treatment to relieve pain is medical therapy by oral contraceptive or non-steroidal anti-inflammatory drugs (NSAIDs) such as mefenamic acid or ibuprofen.[4,5] The treatment with NSAIDS still has 20% to 25% failure rates.[1] due to the side effects of medical treatment, many women are currently seeking conservative treatment. Fennel is known as an anti-inflammatory and estrogenic substance It has demonstrated beneficial effects in the treatment of primary dysmenorrhea.[6] The authors’ search showed that there are several clinical trials that compare different types of fennel with other herbs, NSAIDs, and placebo for pain relief in young women. Registration: PROSPERO - 42015023725 Keywords: Foeniculum, Herbal medicine, Traditional treatment, Dysmenorrhea
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