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DARU Journal of Pharmaceutical Sciences

, Volume 27, Issue 2, pp 863–877 | Cite as

A comprehensive review of clinical studies with herbal medicine on polycystic ovary syndrome (PCOS)

  • Arezoo Moini Jazani
  • Hamidreza Nasimi Doost Azgomi
  • Alireza Nasimi Doost Azgomi
  • Ramin Nasimi Doost AzgomiEmail author
Review article

Abstract

Background

Polycystic ovary syndrome (PCOS) is a frequent medical condition characterized by both metabolic and reproductive disorders. Different pharmaceutical treatments have been proposed for PCOS. However, side effects of long-term treatments and their probable low efficacy have made complementary and alternative treatments a valuable option. Recent reports have indicated the increased use of complementary treatments. Herbal medicine, as part of complementary medicine, was find introduced in traditional Persian and Chinese medicine. Medicinal herbs have used for a long time in the treatment of gynecological and infertility problems of PCOS patients. In this study, we aimed to review herbal medicines used for PCOS worldwide.

Methods

PubMed, Embase, Cochrane, and Scopus databases were searched for clinical trials and Randomized Controlled Trials based on related keywords. Data were collected from 1990 to 2019.

Results

According to a multitude of studies, a wide spectrum of herbs can be used to improve various aspects of PCOS. Herbs such as Cinnamomum verum, Trigonella foenum-graecum L., and Vitex agnus-castus can impact on menstrual and ovulatory dysfunctions, obesity, insulin resistance, lipid-metabolism dysfunction, and androgen excess-related conditions.

Conclusion

Some plants as natural remedies may have beneficial effects on improving different aspects of PCOS; but further studies are needed to investigate their mechanisms and safety.

Keywords

Polycystic ovary syndrome PCOS Herbal medicine Complementary medicine 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest or financial relationships.

References

  1. 1.
    Eshre TR, Asrm-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25.Google Scholar
  2. 2.
    Ozcan Dag Z, Alpua M, Isik Y, Buturak SV, Tulmac OB, Turkel Y. The evaluation of temperament and quality of life in patients with polycystic ovary syndrome. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2017;33(3):250–3.Google Scholar
  3. 3.
    Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016;31(12):2841–55.PubMedGoogle Scholar
  4. 4.
    Celik O, Acbay O. Effects of metformin plus rosuvastatin on hyperandrogenism in polycystic ovary syndrome patients with hyperlipidemia and impaired glucose tolerance. J Endocrinol Investig. 2012;35(10):905–10.Google Scholar
  5. 5.
    Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet. 2007;370(9588):685–97.PubMedGoogle Scholar
  6. 6.
    Helvaci N, Yildiz BO. Oral contraceptives in polycystic ovary syndrome. Minerva Endocrinol. 2014;39(3):175–87.PubMedGoogle Scholar
  7. 7.
    Seaman HE, de Vries CS, Farmer RD. Venous thromboembolism associated with cyproterone acetate in combination with ethinyloestradiol (Dianette): observational studies using the UK general practice research database. Pharmacoepidemiol Drug Saf. 2004;13(7):427–36.PubMedGoogle Scholar
  8. 8.
    Messinis IE. Ovulation induction: a mini review. Hum Reprod. 2005;20(10):2688–97.PubMedGoogle Scholar
  9. 9.
    Tannus S, Burke YZ, Kol S. Treatment strategies for the infertile polycystic ovary syndrome patient. Womens Health (Lond). 2015;11(6):901–12.Google Scholar
  10. 10.
    Vrbikova J, Cibula D. Combined oral contraceptives in the treatment of polycystic ovary syndrome. Hum Reprod Update. 2005;11(3):277–91.PubMedGoogle Scholar
  11. 11.
    Franik S, Kremer JA, Nelen WL, Farquhar C. Aromatase inhibitors for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2014;2:CD010287.Google Scholar
  12. 12.
    Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN, et al. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update. 2016;22(6):687–708.PubMedGoogle Scholar
  13. 13.
    Abu HH. Twenty years of ovulation induction with metformin for PCOS; what is the best available evidence? Reprod BioMed Online. 2016;32(1):44–53.Google Scholar
  14. 14.
    Lunny CA, Fraser SN. The use of complementary and alternative medicines among a sample of Canadian menopausal-aged women. J Midwifery Womens Health. 2010;55(4):335–43.PubMedGoogle Scholar
  15. 15.
    Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children; United States. Natl Health Stat Report. 2007.Google Scholar
  16. 16.
    Bishop JL, Northstone K, Green J, Thompson EA. The use of complementary and alternative medicine in pregnancy: data from the Avon longitudinal study of parents and children (ALSPAC). Complement Ther Med. 2011;19(6):303–10.PubMedGoogle Scholar
  17. 17.
    Birdee GS, Kemper KJ, Rothman R, Gardiner P. Use of complementary and alternative medicine during pregnancy and the postpartum period: an analysis of the National Health Interview Survey. J Womens Health (Larchmt) (2002). 2014;23(10):824–9.Google Scholar
  18. 18.
    Hosseinkhani A, Asadi N, Pasalar M, Zarshenas MM. Traditional Persian medicine and management of metabolic dysfunction in polycystic ovary syndrome. J Tradit Complement Med. 2017.Google Scholar
  19. 19.
    Ong M, Peng J, Jin X, Qu X. Chinese herbal medicine for the optimal management of polycystic ovary syndrome. Am J Chin Med. 2017;45(03):405–22.PubMedGoogle Scholar
  20. 20.
    Mokaberinejad R, Zafarghandi N, Bioos S, Dabaghian FH, Naseri M, Kamalinejad M, et al. Mentha longifolia syrup in secondary amenorrhea: a double-blind, placebo-controlled, randomized trials. Daru. 2012;20(1):97.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Moini Jazani A, Hamdi K, Tansaz M, Nazemiyeh H, Sadeghi Bazargani H, Fazljou SMB, et al. Herbal medicine for Oligomenorrhea and amenorrhea: a systematic review of ancient and conventional medicine. Biomed Res Int. 2018;2018.Google Scholar
  22. 22.
    Mohammad MB, Seghinsara AM. Polycystic ovary syndrome (PCOS), diagnostic criteria, and AMH. Asian Pac J Cancer Prev: APJCP. 2017;18(1):17.Google Scholar
  23. 23.
    Lujan ME, Chizen DR, Pierson RA. Diagnostic criteria for polycystic ovary syndrome: pitfalls and controversies. J Obstet Gynaecol Can. 2008;30(8):671–9.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Wood JR, Dumesic DA, Abbott DH, Strauss JF III. Molecular abnormalities in oocytes from women with polycystic ovary syndrome revealed by microarray analysis. J Clin Endocrinol Metab. 2006;92(2):705–13.PubMedGoogle Scholar
  25. 25.
    Borzoei A, Rafraf M, Niromanesh S, Farzadi L, Narimani F, Doostan F. Effects of cinnamon supplementation on antioxidant status and serum lipids in women with polycystic ovary syndrome. J Tradit Complement Med. 2018;8(1):128–33.PubMedGoogle Scholar
  26. 26.
    Forouhari S, Heidari Z, Tavana Z, Salehi M, Sayadi M. The effect of soya on some hormone levels in women with polycystic ovary syndrome (balance diet): a cross over randomized clinical trial. Bull Env Pharmacol Life Sci. 2013;3(1):246–50.Google Scholar
  27. 27.
    Arentz S, Smith CA, Abbott J, Fahey P, Cheema BS, Bensoussan A. Combined lifestyle and herbal medicine in overweight women with polycystic ovary syndrome (PCOS): a randomized controlled trial. Phytother Res. 2017;31(9):1330–40.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Tehrani HG, Allahdadian M, Zarre F, Ranjbar H, Allahdadian F. Effect of green tea on metabolic and hormonal aspect of polycystic ovarian syndrome in overweight and obese women suffering from polycystic ovarian syndrome: a clinical trial. J Educ Health Promot. 2017;6.Google Scholar
  29. 29.
    Swaroop A, Jaipuriar AS, Gupta SK, Bagchi M, Kumar P, Preuss HG, et al. Efficacy of a novel fenugreek seed extract (Trigonella foenum-graecum, FurocystTM) in polycystic ovary syndrome (PCOS). Int J Med Sci. 2015;12(10):825–31.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Shayan A, Masoumi SZ, Shobeiri F, Tohidi S, Khalili A. Comparing the effects of agnugol and metformin on oligomenorrhea in patients with polycystic ovary syndrome: a randomized clinical trial. J Clin Diagn Res: JCDR. 2016;10(12):QC13–6.PubMedGoogle Scholar
  31. 31.
    Hajimonfarednejad M, Nimrouzi M, Heydari M, Zarshenas MM, Raee MJ, Jahromi BN. Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: a randomized double-blind placebo controlled clinical trial. Phytother Res. 2018;32(2):276–83.PubMedGoogle Scholar
  32. 32.
    Grant P. Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Phytother Res: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 2010;24(2):186–8.Google Scholar
  33. 33.
    Shahnazi M, Khalili AF, Hamdi K, Ghahremaninasab P. The effects of combined low-dose oral contraceptives and Vitex agnus on the improvement of clinical and paraclinical parameters of polycystic ovarian syndrome: A triple-blind, randomized, controlled clinical trial. Iran Red Crescent Med J. 2016;18(12).Google Scholar
  34. 34.
    Chen J-T, Tominaga K, Sato Y, Anzai H, Matsuoka R. Maitake mushroom (Grifola frondosa) extract induces ovulation in patients with polycystic ovary syndrome: a possible monotherapy and a combination therapy after failure with first-line clomiphene citrate. J Altern Complement Med. 2010;16(12):1295–9.PubMedGoogle Scholar
  35. 35.
    Kuek S, Wang W, Gui S. Efficacy of Chinese patent medicine Tian Gui Capsule in patients with polycystic ovary syndrome: a randomized controlled trial. Zhong xi yi jie he xue bao= J Chin Integr Med. 2011;9(9):965–72.Google Scholar
  36. 36.
    Shahin AY, Mohammed SA. Adding the phytoestrogen Cimicifugae Racemosae to clomiphene induction cycles with timed intercourse in polycystic ovary syndrome improves cycle outcomes and pregnancy rates–a randomized trial. Gynecol Endocrinol. 2014;30(7):505–10.PubMedGoogle Scholar
  37. 37.
    Chan CC, Koo MW, Ng EH, Tang O-S, Yeung WS, Ho P-C. Effects of Chinese green tea on weight, and hormonal and biochemical profiles in obese patients with polycystic ovary syndrome—a randomized placebo-controlled trial. J Soc Gynecol Investig. 2006;13(1):63–8.PubMedGoogle Scholar
  38. 38.
    Ebrahimi-Mamaghani M, Saghafi-Asl M, Pirouzpanah S, Asghari-Jafarabadi M. Effects of raw red onion consumption on metabolic features in overweight or obese women with polycystic ovary syndrome: a randomized controlled clinical trial. J Obstet Gynaecol Res. 2014;40(4):1067–76.PubMedGoogle Scholar
  39. 39.
    Wu XK, Wang YY, Liu JP, Liang RN, Xue HY, Ma HX, Shao XG, Ng EH, Hou LH, Tian F, Xie YM. Randomized controlled trial of letrozole, berberine, or a combination for infertility in the polycystic ovary syndrome. Fertil Steril. 2016;106(3):757–65.PubMedGoogle Scholar
  40. 40.
    Ushiroyama T, Ikeda A, Sakai M, Hosotani T, Suzuki Y, Tsubokura S, et al. Effects of unkei-to, an herbal medicine, on endocrine function and ovulation in women with high basal levels of luteinizing hormone secretion. J Reprod Med. 2001;46(5):451–6.PubMedGoogle Scholar
  41. 41.
    Bashtian MH, Emami SA, Mousavifar N, Esmaily HA, Mahmoudi M, Poor AHM. Evaluation of fenugreek (Trigonella foenum-graceum L.), effects seeds extract on insulin resistance in women with polycystic ovarian syndrome. Iran J Pharm Res: IJPR. 2013;12(2):475.Google Scholar
  42. 42.
    Kumarapeli M, Karunagoda K, Perera PK. A randomized clinical trial to evaluate the efficacy of Satapushpashatavari powered drug with Satapushpa-shatavari grita for the management of polycystic ovary syndrome (PCOS). IJPSR. 2018;9(6):2494–9.Google Scholar
  43. 43.
    Jamilian M, Asemi Z. The effects of soy isoflavones on metabolic status of patients with polycystic ovary syndrome. J Clin Endocrinol Metab. 2016;101(9):3386–94.PubMedGoogle Scholar
  44. 44.
    Kort DH, Lobo RA. Preliminary evidence that cinnamon improves menstrual cyclicity in women with polycystic ovary syndrome: a randomized controlled trial. Am J Obstet Gynecol. 2014;211(5):487. e1–6.Google Scholar
  45. 45.
    Wang JG, Anderson RA, Graham GM III, Chu MC, Sauer MV, Guarnaccia MM, et al. The effect of cinnamon extract on insulin resistance parameters in polycystic ovary syndrome: a pilot study. Fertil Steril. 2007;88(1):240–3.PubMedGoogle Scholar
  46. 46.
    Kamel HH. Role of phyto-oestrogens in ovulation induction in women with polycystic ovarian syndrome. Eur J Obstet Gynecol Reprod Biol. 2013;168(1):60–3.PubMedGoogle Scholar
  47. 47.
    Lai L, Flower A, Prescott P, Wing T, Moore M, Lewith G. Standardised versus individualised multiherb Chinese herbal medicine for oligomenorrhoea and amenorrhoea in polycystic ovary syndrome: a randomised feasibility and pilot study in the UK. BMJ Open. 2017;7(2):e011709.PubMedPubMedCentralGoogle Scholar
  48. 48.
    Kalgaonkar S, Almario R, Gurusinghe D, Garamendi E, Buchan W, Kim K, et al. Differential effects of walnuts vs almonds on improving metabolic and endocrine parameters in PCOS. Eur J Clin Nutr. 2011;65(3):386–93.PubMedGoogle Scholar
  49. 49.
    Wiweko B, Susanto CA. The effect of metformin and cinnamon on serum anti-mullerian hormone in women having PCOS: a double-blind, randomized, controlled trial. J Hum Reprod Sci. 2017;10(1):31–6.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Mombaini E, Jafarirad S, Husain D, Haghighizadeh MH, Padfar P. The impact of green tea supplementation on anthropometric indices and inflammatory cytokines in women with polycystic ovary syndrome. Phytother Res. 2017;31(5):747–54.PubMedGoogle Scholar
  51. 51.
    Khani B, Mehrabian F, Khalesi E, Eshraghi A. Effect of soy phytoestrogen on metabolic and hormonal disturbance of women with polycystic ovary syndrome. Journal Res Med Sci: the official journal of Isfahan University of Medical Sciences. 2011;16(3):297–302.Google Scholar
  52. 52.
    Farzana F, Sulaiman A, Ruckmani A, Vijayalakshmi K, Karunya Lakshmi G, Shri RS. Effects of flax seeds supplementation in polycystic ovarian syndrome. J Res Med Sci. 2015;31(1):113–9.Google Scholar
  53. 53.
    An Y, Sun Z, Zhang Y, Liu B, Guan Y, Lu M. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol. 2014;80(3):425–31.Google Scholar
  54. 54.
    Jalilian N, Modarresi M, Rezaie M, Ghaderi L, Bozorgmanesh M. Phytotherapeutic management of polycystic ovary syndrome: role of aerial parts of wood betony (Stachys lavandulifolia). Phytother Res. 2013;27(11):1708–13.PubMedGoogle Scholar
  55. 55.
    Mirmasoumi G, Fazilati M, Foroozanfard F, Vahedpoor Z, Mahmoodi S, Taghizadeh M, et al. The effects of flaxseed oil omega-3 fatty acids supplementation on metabolic status of patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Exp Clin Endocrinol Diabetes. 2018;126(04):222–8.PubMedGoogle Scholar
  56. 56.
    Haj-Husein I, Tukan S, Alkazaleh F. The effect of marjoram (O riganum majorana) tea on the hormonal profile of women with polycystic ovary syndrome: a randomised controlled pilot study. J Hum Nutr Diet. 2016;29(1):105–11.PubMedGoogle Scholar
  57. 57.
    Liang Y, Tian Q, Mu Y, Du H. Effects of Cangfu Congxian decoction on oxidative stress in polycystic ovary syndrome patients. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi= Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016;36(6):685–9.PubMedGoogle Scholar
  58. 58.
    Liu Y, Mao L-H. Effect of danzhi xiaoyao pill on ovulation induction of polycystic ovarian syndrome patients of pathogenic fire derived from stagnation of gan-qi. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi= Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013;33(9):1191–5.PubMedGoogle Scholar
  59. 59.
    Naeimi SA, Tansaz M, Sohrabvand F, Hajimehdipoor H, Nabimeybodi R, Saber S, et al. Assessing the effect of processed nigella sativa on oligomenorrhea and amenorrhea in patients with polycystic ovarian syndrome: a pilot study. Int J Pharm Sci Res. 2018;9(11):4716–22.Google Scholar
  60. 60.
    Borzoei A, Rafraf M, Asghari-Jafarabadi M. Cinnamon improves metabolic factors without detectable effects on adiponectin in women with polycystic ovary syndrome. Asia Pac J Clin Nutr. 2018;27(3):556–63.PubMedGoogle Scholar
  61. 61.
    Esmaeilinezhad Z, Babajafari S, Sohrabi Z, Eskandari M-H, Amooee S, Barati-Boldaji R. Effect of synbiotic pomegranate juice on glycemic, sex hormone profile and anthropometric indices in PCOS: a randomized, triple blind, controlled trial. Nutr Metab Cardiovasc Dis. 2019;29(2):201–8.PubMedGoogle Scholar
  62. 62.
    Moini Jazani A. Celery plus Anise versus metformin for the treatment of oligomenorrhea in the polycystic ovary syndrome: a triple-blind randomized clinical trial: Tabriz University of Medical Sciences, School of Traditional Medicine; 2018.Google Scholar
  63. 63.
    Heidary M, Yazdanpanahi Z, Dabbaghmanesh MH, Parsanezhad ME, Emamghoreishi M, Akbarzadeh M. Effect of chamomile capsule on lipid-and hormonal-related parameters among women of reproductive age with polycystic ovary syndrome. J Res Med Sci. 2018;23.Google Scholar
  64. 64.
    Armanini D, Castello R, Scaroni C, Bonanni G, Faccini G, Pellati D, et al. Treatment of polycystic ovary syndrome with spironolactone plus licorice. Eur J Obstet Gynecol Reprod Biol. 2007;131(1):61–7.PubMedGoogle Scholar
  65. 65.
    Mokaberinejad R, Rampisheh Z, Aliasl J, Akhtari E. The comparison of fennel infusion plus dry cupping versus metformin in management of oligomenorrhoea in patients with polycystic ovary syndrome: a randomised clinical trial. J Obstet Gynaecol. 2019:1–7.Google Scholar
  66. 66.
    Ding C-F, Wang C-Y, Yang X, Zheng R-H, Yan Z-Z, Chen W-Q. Effect of modified cangfu daotan decoction in improving endometrial receptivity in infertility patients with polycystic ovarian syndrome. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongguo Zhong Xi Yi Jie He Za Zhi. 2014;34(11):1297–301.PubMedGoogle Scholar
  67. 67.
    Roemheld-Hamm B. Chasteberry. Am Fam Physician. 2005;72(5):821–4.PubMedGoogle Scholar
  68. 68.
    Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlova-Wuttke D. Chaste tree (Vitex agnus-castus)–pharmacology and clinical indications. Phytomedicine. 2003;10(4):348–57.PubMedGoogle Scholar
  69. 69.
    Webster D, Lu J, Chen S-N, Farnsworth N, Wang ZJ. Activation of the μ-opiate receptor by Vitex agnus-castus methanol extracts: implication for its use in PMS. JJ Ethnopharmacol. 2006;106(2):216–21.Google Scholar
  70. 70.
    Ahangarpour A, Najimi SA, Farbood Y. Effects of Vitex agnus-castus fruit on sex hormones and antioxidant indices in a D-galactose-induced aging female mouse model. J Chin Med Assoc. 2016;79(11):589–96.PubMedGoogle Scholar
  71. 71.
    Sigal RJ, Kenny GP, Boulé NG, Wells GA, Prud'homme D, Fortier M, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007;147(6):357–69.PubMedGoogle Scholar
  72. 72.
    Heibashy M, Mazen G, Shahin M. Metabolic changes and hormonal disturbances in polycystic ovarian syndrome rats and the amelioration effects of metformin and/or cinnamon extraction. J Am Sci. 2013;9(12):54–p62.Google Scholar
  73. 73.
    Khodaeifar F, Fazljou SMB, Khaki A, Torbati M, Madarek EOS, Khaki AA, et al. Investigating the role of Hydroalcoholic extract of Apium graveolens and cinnamon zeylanicum on metabolically change and ovarian oxidative injury in a rat model of polycystic ovary syndrome. Int J Womens Health Reprod Sci. 2019;7:92–8.Google Scholar
  74. 74.
    Ulbricht C, Basch E, Burke D, Cheung L, Ernst E, Giese N, et al. Fenugreek (Trigonella foenum-graecum L. Leguminosae): an evidence-based systematic review by the natural standard research collaboration. J Herb Pharmacother. 2008;7(3–4):143–77.Google Scholar
  75. 75.
    Geil P, Shane-McWhorter L. Dietary supplements in the management of diabetes: potential risks and benefits. J Am Diet Assoc. 2008;108(4):S59–65.PubMedGoogle Scholar
  76. 76.
    Kandasamy S, Inmozhi Sivagamasundari R, Bupathy A, Sethupathy S. The plasma nitric oxide and homocysteine levels and their association with insulin resistance in south Indian women with polycystic ovary syndrome. Int J Res Med Sci. 2016;4(11):4829.Google Scholar
  77. 77.
    Kafali H, Iriadam M, Ozardalı I, Demir N. Letrozole-induced polycystic ovaries in the rat: a new model for cystic ovarian disease. Arch Med Res. 2004;35(2):103–8.PubMedGoogle Scholar
  78. 78.
    Tamanini C, Basini G, Grasselli F, Tirelli M. Nitric oxide and the ovary. J Anim Sci. 2003;81(14_suppl_2):E1–7.Google Scholar
  79. 79.
    Modaresi M, Mahdian B, Jalalizand A, editors. The effect of hydro-alcoholic extract of fenugreek seeds on female reproductive hormones in mice. International Conference on Applied Life Sciences; 2012: IntechOpen.Google Scholar
  80. 80.
    Seidlová-Wuttke D, Hesse O, Jarry H, Christoffel V, Spengler B, Becker T, et al. Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta. Eur J Endocrinol. 2003;149(4):351–62.PubMedGoogle Scholar
  81. 81.
    Bhathena SJ, Velasquez MT. Beneficial role of dietary phytoestrogens in obesity and diabetes. Am J Clin Nutr. 2002;76(6):1191–201.PubMedGoogle Scholar
  82. 82.
    Qin Y, Shu F, Zeng Y, Meng X, Wang B, Diao L, et al. Daidzein supplementation decreases serum triglyceride and uric acid concentrations in hypercholesterolemic adults with the effect on triglycerides being greater in those with the GA compared with the GG genotype of ESR-β Rsa I. J Nutr. 2013;144(1):49–54.PubMedGoogle Scholar
  83. 83.
    Nynca A, Sadowska A, Orlowska K, Jablonska M, Ciereszko RE. The effects of phytoestrogen genistein on steroidogenesis and estrogen receptor expression in porcine granulosa cells of large follicles. Folia Biol (Krakow). 2015;63(2):119–28.Google Scholar
  84. 84.
    Whitehead SA, Rice S. Endocrine-disrupting chemicals as modulators of sex steroid synthesis. Best Pract Res Clin Endocrinol Metab. 2006;20(1):45–61.PubMedGoogle Scholar
  85. 85.
    Lacey M, Bohday J, Fonseka SM, Ullah AI, Whitehead SA. Dose–response effects of phytoestrogens on the activity and expression of 3β-hydroxysteroid dehydrogenase and aromatase in human granulosa-luteal cells. J Steroid Biochem Mol Biol. 2005;96(3–4):279–86.PubMedGoogle Scholar
  86. 86.
    Low Y-L, Dunning AM, Dowsett M, Folkerd E, Doody D, Taylor J, et al. Phytoestrogen exposure is associated with circulating sex hormone levels in postmenopausal women and interact with ESR1 and NR1I2 gene variants. Cancer Epidemiol Biomark Prev. 2007;16(5):1009–16.Google Scholar
  87. 87.
    Törmälä R, Appt S, Clarkson TB, Mueck A, Seeger H, Mikkola T, et al. Impact of soy supplementation on sex steroids and vascular inflammation markers in postmenopausal women using tibolone: role of equol production capability. Climacteric. 2008;11(5):409–15.PubMedGoogle Scholar
  88. 88.
    Tatsch E, Bochi GV, da Silva PR, Kober H, Agertt VA, de Campos MMA, et al. A simple and inexpensive automated technique for measurement of serum nitrite/nitrate. Clin Biochem. 2011;44(4):348–50.PubMedGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, School of MedicineArdabil University of Medical SciencesArdabilIran
  2. 2.Pharmaceutical Sciences Research CenterArdabil University of Medical SciencesArdabilIran
  3. 3.Students Research Committee, School of MedicineArdabil University of Medical SciencesArdabilIran

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