Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 131
  • Home
  • Print this page
  • Email this page


 
   Table of Contents      
ORIGINAL ARTICLE
Year : 2014  |  Volume : 19  |  Issue : 6  |  Page : 581-584

Comparative evaluation of the efficacy of herbal drugs (fennelin and vitagnus) and mefenamic acid in the treatment of primary dysmenorrhea


1 Department of Pharmacology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
2 Department of Midwifery, Research Center for Child and Maternity Care, Hamadan University of Medical Sciences, Hamadan, Iran
3 Department of Medical Entomology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4 Department of Research and Development, The Head of Clinical Research Center of Barij Essence, Tehran, Iran

Date of Submission13-Oct-2013
Date of Acceptance16-Apr-2014
Date of Web Publication25-Oct-2017

Correspondence Address:
Associate Prof. Fatemeh Shobeiri
Research Center for Child and Maternity Care, Hamadan University of Medical Sciences, Hamadan
Iran
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions
  Abstract 

Background: Different therapeutic methods have been applied for the treatment of dysmenorrhea and the method with the lesser side effects is preferred. The aim of this study was to compare the effects of herbal products (fennelin and vitagnus) and mefenamic acid in the treatment of primary dysmenorrhea.
Materials and Methods: This ouble-blind clinical trial was carried out in 105 students with mild and moderate dysmenorrhea. The students were randomly divided into four groups which received the extracts of fennelin and vitagnus, mefenamic acid, and placebo, respectively. Severity of pain was detected by the Visual Analog Scale (VAS) during one cycle before and two cycles after the intervention. Data were analyzed by SPSS version 16 and (P < 0.05 was considered significant.
Results: Demographic characteristics of the students were similar in the four groups. There was no significant difference in the mean of severity of dysmenorrhea during one cycle before the intervention between the four groups, but the difference was significant during two cycles after the intervention. Fennelin had similar effects as vitagnus on dysmenorrhea. Mefenamic acid had less effect than both the drugs (P <0.05).
Conclusion: Fennelin and vitagnus had higher effect than mefenamic acid. Use of these products is suggested for dysmenorrhea.

Keywords: Dysmenorrhea, fennelin, Iran, vitagnus


How to cite this article:
Zeraati F, Shobeiri F, Nazari M, Araghchian M, Bekhradi R. Comparative evaluation of the efficacy of herbal drugs (fennelin and vitagnus) and mefenamic acid in the treatment of primary dysmenorrhea. Iranian J Nursing Midwifery Res 2014;19:581-4

How to cite this URL:
Zeraati F, Shobeiri F, Nazari M, Araghchian M, Bekhradi R. Comparative evaluation of the efficacy of herbal drugs (fennelin and vitagnus) and mefenamic acid in the treatment of primary dysmenorrhea. Iranian J Nursing Midwifery Res [serial online] 2014 [cited 2022 Dec 4];19:581-4. Available from: https://www.ijnmrjournal.net/text.asp?2014/19/6/581/146224


  Introduction Top


Dysmenorrhea occurs in around 50%of women with regular menstruation. [1],[2] This induces disability in more than 10% of women in their daily activities. [3] Prevalence of dysmenorrhea in adolescents is over 85% [4] but the prevalence rates have been reported to be as high as 90% in women aged 1845 years [5] The prevalence of dysmenorrhea worldwide is similar to that in the US, with the rates ranging from 15.8 to 89.5% and with higher prevalence rates reported in adolescent populations. [6],[7],[8],[9],[10],[11]

Nonsteroidal anti-inflammatory drugs (NSAIDs) form the basis of treatment and contraceptive pills are also used in treatment. [12] About 10% of patients do not respond to these treatments.

NSAIDs inhibit prostaglandin synthesis, and so, they are important in the treatment of this disease. The effectiveness of these agents has been consistently confirmed, with response rates exceeding 75% in most studies. [13]

Since the effective chemical drugs for primary dysmenorrhea, such as mefenamic acid, acetaminophen, ibuprofen, etc., have side effects including dizziness, nausea, diarrhea, digestive disorders, tc., replacing these drugs with herbal ones which have less side effects can be effective. In this case, many researches have been done. According to these studies, those plants with few side effects are easily accepted among people. Two herbal drops known as vitagnus and fennelin are available in the market. Fennelin contains Foeniculum vulgare extract. The effects of this plant extract on pain, inflammation, and dysmenorrhea were studied by different researchers. [14],[15],[16],[17] Vitagnus contains Vitex agnus extract and there are different studies about its effects on premenstrual syndrome (PMS). [18],[19],[20] There is no comparative study about these drugs. Therefore, we decided to compare the effects of these herbal drugs on primary dysmenorrhea.


  Materials And Methods Top


This study was a clinical trial carried out on female students of Hamadan Medical School, with primary dysmenorrhea assayed by (Visual Analog Scale (VAS) method. The exclusion criteria were: (1) presence of any systemic disease such as liver, kidney, thyroid, orcoagulation disease; (2) hypersensitivity to drug; (3) use of analgesic drugs during the study; and (4) use of oral contraceptive pills (OCP) or intrauterine device (IUD).

Drugs

One hundred and five study participants were divided into four groups. Group 1 received fennelin, 30 drops every 4 h, 1 day before the start of the cycle until the third day; Group 2 received vitagnus, 40 drops once a day in the morning, 1 day before the start of the cycle until the third day; Group 3 received mefenamic acid capsules 250 mg every 4 h, 1 day before the start of the cycle until the third day; and Group 4 received placebo, 30 drops every 4 h, 1 day before the start of the cycle until the third day. Pain was measured and compared by means of VAS.

Each group was assayed for three cycles, one without any drugs and then two cycles with them.

Statistical analysis

Statistical analysis was carried out using SPSS version 16. Analysis of variance (ANOVA) was used to compare pain between different groups.


  Results Top


A total of 105 female students aged 18-25 years who complained of primary dysmenorrhea were contacted. Demographic characteristics of research groups are presented in [Table 1]. As specified in the table, the subjects of the study groups were similar in age, number of days of menstruation, age at first menstruation, and dysmenorrhea interval, and the differences were not statistically significant. But the age at menarche was significantly different (P < 0.05).

Family history of dysmenorrhea, drug use during menstruation, history of exercise, and disruption in the daily chores were not significantly different.

In this study, pain intensity was evaluated within a cycle (zero cycle) before treatment with oral drops, mefenamic acid, and placebo drops, and the mean pain intensity of the four groups was not significantly different at the end of the cycle; but after the intervention (drugs), this difference was significant (P < 0.05) at the end of the first and second cycles [Table 2].


  Discussion Top


Dysmenorrhea and PMS are the common problems occurring in women during childbearing age. Many studies have been conducted on finding the best treatment for these conditions. Most researches have proved the positive effects of different drugs. Administration of NSAIDs is the most commonly used treatment for dysmenorrhea. NSAIDs decrease the menstrual pain by decreasing intrauterine pressure and lowering prostaglandin F2 (PGF2)-alpha levels in menstrual fluid. [21],[22],[23] Khodakrami et al. examined the effect of combination of three Iranian herbal drugs in the treatment of primary dysmenorrhea. The effects of saffron, celery seed, and anise (SCA) extract were compared with those of mefenamic acid and placebo. The authors showed that both SCA and mefenamic acid have adequate analgesic effects on dysmenorrhea. The SCA was found to be more effective than mefenamic acid for severe pain relief in dysmenorrhea. [24]

Nazarpoor et al. conducted a comparative study between fennelin and mefenamic acid in primary dysmenorrhea. Fennelin showed an effectsimilar to that of mefenamic acid. [18] In other studies, similar effects of vitagnus and fennelin were reported primary dysmenorrhea. [25],[26]

In this study, the pain intensity before treatment with herbal oral drops and mefenamic acid capsules and placebo drops in one cycle (zero cycle) was studied. Average pain intensity in the three groups was not significantly different at the end of the zero cycle; but at the end of the first and second cycles of the intervention (drugs), this difference was significant. The study results showed that both drugs were able to reduce pain during treatment. The effects of the two herbal drugs were the same but higher than that of mefenamic acid. The average pain intensity in both herbal drug groups was reduced not only at the end of the first prescription medication but also at the end of the second month after treatment.

In another study, Shahhosaini et al. studied the effect of vitagnus on dysmenorrhea and found that the maximumeffect was induced at the end of the third cycle. [27] No side effects of the herb were reported in this study.


  Conclusion Top


Treatment with herbal drops vitagnus, fennelin, and mefenamic acid capsule could reduce dysmenorrheal pain, and the effects of vitagnus and fennelin were higher than that of mefenamic acid. Thus, these herbal medicines are safe and effective for use in dysmenorrhea.


  Acknowledgments Top


The authors would like to thank Barij Essence Pharmaceutical Company for the preparation of fennelin and placebo drops in this study. This work was financially supported and ethically approved by the Vice-Chancellor for Research, Hamadan University of Medical Sciences, Hamadan, Iran.

 
  References Top

1.
Ryan KJ, Berkowitz RL, Barbieri RL, Donaif A. Kistner' In Gynecology and Women' Health 1999. Translated by In: Ghazijahani B, Ghotbi R, editors. 7 th ed. Tehran: Golban Publication; 2005. p. 189.  Back to cited text no. 1
    
2.
Sadatian SA. Fundamental Affectations of Gynecology CMMD. In: Sadatian SA, editor, 3 rd ed. Tehran: Nore Danesh Publication; 2004. p. 33-5.  Back to cited text no. 2
    
3.
Lindh I, Ellstrom AA, Milsom I. The effect of combined oral contraceptives and age on dysmenorrhoea: An epidemiological study. Hum Reprod 2012;27:676-82.  Back to cited text no. 3
    
4.
Banikarim C, Chacho MR, Kelder SH. Prevalence and Impact of Dysmenorrhea on Hispanic Female Adolescents. Arch Pediatr Adolesc Med 2000;154:1226-9.  Back to cited text no. 4
    
5.
Jamieson DJ, Steege JF. The prevalence of dysmenorrhea, dyspareunia, pelvic pain and irritable bowel syndrome in primary care practices. Obstet Gynecol 1996;87:55-8.  Back to cited text no. 5
    
6.
Sharma P, Malhotra C, Taneja DK, Saha R. Problems related to menstruation amongst adolescent girls. Indian J Pediatr 2008;75:125-9.  Back to cited text no. 6
    
7.
Lee LK, Chen PC, Lee KK, Kaur J. Menstruation among adolescent girls in Malaysia: A cross-sectional school survey. Singapore Med J 2006;47:869-74.  Back to cited text no. 7
    
8.
El-Gilany AH, Badawi K, El-Fedawy S. Epidemiology of dysmenorrhoea among adolescent students in Mansoura, Egypt. East Mediterr Health J 2005;11:155-63.  Back to cited text no. 8
    
9.
Osuga Y, Hayashi K, Kobayashi Y, Toyokawa S, Momoeda M, Koga K, et al. Dysmenorrhea in Japanese women. Int J Gynaecol Obstet 2005;88:82-3.  Back to cited text no. 9
    
10.
Cakir M, Mungan I, Karakas T, Girisken I, Okten A. Menstrual pattern and common menstrual disorders among university students in Turkey. Pediatr Int 2007;49:938-42.  Back to cited text no. 10
    
11.
Burnett MA, Antao V, Black A, Feldman K, Grenville A, Lea R, et al. Prevalence of primary dysmenorrhea in Canada. J Obstet Gynaecol Can 2005;27:765-70.  Back to cited text no. 11
    
12.
Dawood MY. Primary Dysmenorrhea Advances in Pathogenesis and management. Obstet Gynecol 2006;108:824-34.  Back to cited text no. 12
    
13.
Coco AS. Primary dysmenorthea. Am Fam Physician 1999;6:486-96.  Back to cited text no. 13
    
14.
Savino F, Cresi F, Castagno E, Silvestro L, Oggero R. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Phytother Res 2005;19:335-40.  Back to cited text no. 14
    
15.
Namavar Jahromi B, Tartifizadeh A, Khabnadideh S. Comparison of fennel and mefenamic acid for the treatment of primary dysmenorrhea. Int J Gynaecol Obstet 2003;80:153-7.  Back to cited text no. 15
    
16.
Choi EM, Hwang JK. Antiinflammatory, analgesic and antioxidant activities of the fruit of Foeniculum vulgare. Fitoterapia 2004;75:557-65.  Back to cited text no. 16
    
17.
Modaress Nejad V, Asadipour M. Comparison of the effectiveness of fennel and mefenamic acid on pain intensity in dysmenorrhoea. East Mediterr Health J 2006;12:423-7.  Back to cited text no. 17
    
18.
Döll M. The premenstrual syndrome: Effectiveness of Vitex agnus castus. Med Monatsschr Pharm 2009;32:186-91.  Back to cited text no. 18
    
19.
Ma L, Lin S, Chen R, Wang X. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Gynecol Endocrinol 2010;26:612-6.  Back to cited text no. 19
    
20.
Ma L, Lin S, Chen R, Zhang Y, Chen F, Wang X. Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Aust N Z J Obstet Gynaecol 2010;50:189-93.  Back to cited text no. 20
    
21.
Milsom I, Andersch B, Sundell G. The effect of flurbiprofen and naproxen sodium on intra-uterine pressure and menstrual pain in patients with primary dysmenorrhea. Acta Obstet Gynecol Scand 1988;67:711-6.  Back to cited text no. 21
    
22.
Chan WY, Fuchs F, Powell AM. Effects of naproxen sodium on menstrual prostaglandins and primary dysmenorrhea. Obstet Gynecol 1983;61:285-91.  Back to cited text no. 22
    
23.
Dawood MY, Khan-Dawood FS. Clinical efficacy and differential inhibition of menstrual fluid prostaglandin F2alpha in a randomized, double-blind, crossover treatment with placebo, acetaminophen, and ibuprofen in primary dysmenorrhea. Am J Obstet Gynecol 2007;196:31-5.  Back to cited text no. 23
    
24.
Khodakrami N, Moatar F, Ghahiri A, Shahdan S. The Effect of an Iranian Herbal Drug on PrimaryDysmenorrhea: A Clinical Controlled Trial. J Midwifery Womens Health 2009;54:401-4.  Back to cited text no. 24
    
25.
NazarPoor S, Azimi H. Comparison of fennel and mefenamic acid for the treatment of primary dysmenorrheal. J Mazand Univ Med Sci 2006;17:54-61.  Back to cited text no. 25
    
26.
Modares Nejad V, Motamedi B, Asadi Pour M. Comparison between the Pain-Relief Effect of Fennelin and Mefenamic Acid on Primary Dysmenorrhea. J Rafsanjan Univ Med Sci 2006;5:1-6.  Back to cited text no. 26
    
27.
Shah Hosseini Z, Amin GH, Salehi Sormaghi MH, Danesh MM, Abedian K. Double blind study of anti-primary dysmenorrhea effects of Vitagnus. J Mazendaran Univ Med Sci 2005;15:15-21.  Back to cited text no. 27
    



 
 
    Tables

  [Table 1], [Table 2]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Introduction
Materials And Me...
Results
Discussion
Conclusion
Acknowledgments
References
Article Tables

 Article Access Statistics
    Viewed1177    
    Printed28    
    Emailed0    
    PDF Downloaded58    
    Comments [Add]    

Recommend this journal