Herbal and Complementary Medicines Used for Women’s Health

Chapter

Abstract

Recent data suggest that the global herbal medicines market continues to increase, with estimates of annual sales as high as $160 B USD. In the United States alone, almost 30 % of U.S. adults use herbal medicines, and of the $11.5 billion spent annually on dietary supplements in the U.S., over half a billion dollars are spent on herbal products. Women continue to be the primary users of herbal supplements, and the use of these products to treat or prevent a wide array of ailments including the menopause, common cold, depression, and other non-life threatening medical conditions is on the rise. In terms of herbal medicines used by women, black cohosh, cranberry, dang gui, green tea, and ginseng are the most common worldwide. While the clinical data for efficacy are often equivocal for most herbal products with the exception of St. John’s wort, there are contraindications, drug interactions and some serious adverse events associated with the use of these products. Where no clinical efficacy has been proven but serious adverse events have been reported, the safety risk in negative (no benefit and potential safety risk), and thus such products should not be recommended.

Keywords

Herbal Medicine Dietary Supplement Panax Ginseng Menopausal Symptom Herbal Supplement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Anon (2000) Green tea. Altern Med Rev 5(4):372–375Google Scholar
  2. Anon (2009) USP revises admission criteria and safety classification for dietary supplements. http://www.usp.org/USPNF/notices/USPRevisedAdmissionCriteria.html. Posted: 10 Apr 2009
  3. Anon (2013) The guardian Nigeria, Herbal medicine market hits $160 billion globally. Guardian MobileGoogle Scholar
  4. Aston JL, Lodolce AE, Shapiro NL (2006) Interaction between warfarin and cranberry juice. Pharmacotherapy 26(9):1314–1319PubMedCrossRefGoogle Scholar
  5. ATGA (2006) Australian Therapeutic Goods Administration Statement. New labeling and consumer information for medicines containing black cohosh (Cimicifuga racemosa). http://www.tga.gov.au/cm/0705blkcohosh.htm. Accessed 10 Aug 2006
  6. Awang D (2003) What’s in the name of Panax are those other “Ginsengs”? HerbalGram 57:35–40Google Scholar
  7. Beer AM, Osmers R, Schnitker J et al (2013) Efficacy of black cohosh (Cimicifuga racemosa) medicines for treatment of menopausal symptoms – comments on major statements of the Cochrane Collaboration report 2012 “black cohosh (Cimicifuga spp.) for menopausal symptoms (review)”. Gynecol Endocrinol 29(12):1022–1025PubMedCrossRefGoogle Scholar
  8. Brown MD (1999) Green tea (Camellia sinensis) extract and its possible role in the prevention of cancer. Altern Med Rev 4(5):360–370PubMedGoogle Scholar
  9. Council of Responsible Nutrition (CRN) (2013) Consumer survey on dietary supplements. CRN.orgGoogle Scholar
  10. Daniels S (2013) CRN survey: 85 % of US adults confident in the safety, quality and effectiveness of dietary supplements. Nutraingredients (Nutraingredients-use.com), 23 Sept 2013Google Scholar
  11. European Medicines Agency (EMEA) (2009) Draft assessment report on Cimicifuga racemosa (L.) Nutt., rhizome. Doc. Ref.: EMEA/HMPC/3968/2008. http://www.ema.europa.eu/pdfs/human/hmpc/cimicifugae_rhizoma/396808en.pdf. September 2009
  12. Forgo I, Kayasseh L, Staub JJ (1981) Effect of a standardized ginseng extract on general well-being, reaction capacity, pulmonary function and gonadal hormones. Med Welt 19:751–756Google Scholar
  13. Fu YF, Xia YK, Shi YP (1998) Treatment of 34 cases of infertility due to tubal occlusion with compound ganggui injection by irrigation. Jiangsu Zhongyi 9:15–16Google Scholar
  14. Gao YM, Zhang HK, Duan ZX (1988) Treatment of 112 cases of dysmenorrhea with Danggui jingyou pill. Lanzhou Daxue Xuebao 1:36–38Google Scholar
  15. Gardiner P, Graham R, Legedza AT et al (2007) Factors associated with herbal therapy use by adults in the United States. Altern Ther Health Med 13(2):22–29PubMedGoogle Scholar
  16. Goodin MG, Bray BJ, Rosengreen RJ (2006) Sex- and strain dependent effects of epigallocatechin gallate (EGCG) and epicatechin gallate (ECG) in the mouse. Food Chem Toxicol 44:1496–1504PubMedCrossRefGoogle Scholar
  17. Grant P (2004) Warfarin and cranberry juice: an interaction? J Heart Valve Dis 13(1):25–26PubMedGoogle Scholar
  18. Griffiths AP, Beddall A, Pegler S (2008) Fatal haemopericardium and gastrointestinal haemorrhage due to possible interaction of cranberry juice with warfarin. J R Soc Promot Health 128(6):324–326PubMedCrossRefGoogle Scholar
  19. Guzman G, Kallwitz ER, Wojewoda C et al (2009) Liver injury with features mimicking autoimmune hepatitis following the use of black cohosh. Case Report Med 2009:918156Google Scholar
  20. Haber SL, Cauthon KA, Raney EC (2012) Cranberry and warfarin interaction: a case report and review of the literature. Consult Pharm 27(1):58–65PubMedCrossRefGoogle Scholar
  21. Haines CJ, Lam PM, Chung TK et al (2008) A randomized, double-blind, placebo-controlled study of the effect of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) on menopausal symptoms in Hong Kong Chinese women. Climacteric 11(3):244–251PubMedCrossRefGoogle Scholar
  22. Hamann GL, Campbell JD, George CM (2011) Warfarin-cranberry juice interaction. Ann Pharmacother 45(3):e17PubMedCrossRefGoogle Scholar
  23. Heitmann K, Nordeng H, Holst L (2013) Pregnancy outcome after use of cranberry in pregnancy–the Norwegian Mother and Child Cohort Study. BMC Complement Altern Med 13:345PubMedCentralPubMedCrossRefGoogle Scholar
  24. Herbal Medicinal Products Committee (HMPC) (2007) Assessment of case reports connected to herbal medicinal products containing Cimicifuga racemosa rhizome (black cohosh, root). http://www.emea.europa.eu/pdfs/human/hmpc/26925806en.pdf. Accessed March 2014
  25. Hirata JD, Swiersz LM, Zell B et al (1997) Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertil Steril 68:981–986PubMedCrossRefGoogle Scholar
  26. Hu SY (1976) The genus Panax (ginseng) in Chinese medicine. Econ Bot 30:11–28CrossRefGoogle Scholar
  27. Huang Y, Nikolic D, Pendland S et al (2009) Effects of cranberry extracts and ursolic acid derivatives on P-fimbriated Escherichia coli, COX-2 activity, pro-inflammatory cytokine release and the NF-kappa-beta transcriptional response in vitro. Pharm Biol 47(1):18–25PubMedCentralPubMedCrossRefGoogle Scholar
  28. Isele H (2004) Fatal bleeding under warfarin plus cranberry juice. Is it due to salicylic acid? MMW Fortschr Med 146(11):13PubMedGoogle Scholar
  29. Jepson RG, Craig JC (2008) Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 1, CD001321PubMedGoogle Scholar
  30. Jepson RG, Williams G, Craig JC (2012) Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 10, CD001321PubMedGoogle Scholar
  31. Jepson R, Craig J, Williams G (2013) Cranberry products and prevention of urinary tract infections. JAMA 310(13):1395–1396PubMedCrossRefGoogle Scholar
  32. Jimenez-Saenz M, Martinez-Sanchez C (2007) Green tea extracts and acute liver failure: the need for caution in their use and diagnostic assessment. Liver Transpl 13:1067PubMedCrossRefGoogle Scholar
  33. Jordan SA, Cunningham DG, Marles RJ (2010) Assessment of herbal medicinal products: challenges, and opportunities to increase the knowledge base for safety assessment. Toxicol Appl Pharmacol 243(2):198–216PubMedCrossRefGoogle Scholar
  34. Kim HG, Cho JH, Yoo SR et al (2013) Antifatigue effects of Panax ginseng C.A. Meyer: a randomised, double-blind, placebo-controlled trial. PLoS One 8(4):e61271PubMedCentralPubMedCrossRefGoogle Scholar
  35. Kim Sooi L, Lean Keng S (2013) Herbal medicines: Malaysian women’s knowledge and practice. Evid Based Complement Alternat Med 2013:438139PubMedCentralPubMedCrossRefGoogle Scholar
  36. Leach MJ, Moore V (2012) Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev 9, CD007244PubMedGoogle Scholar
  37. Lee SK, Cho HK, Cho SH et al (2001) Occupational asthma and rhinitis caused by multiple herbal agents in a pharmacist. Ann Allergy Asthma Immunol 86(4):469–474PubMedCrossRefGoogle Scholar
  38. Lim TY, Considine A, Quaglia A et al (2013) Subacute liver failure secondary to black cohosh leading to liver transplantation. BMJ Case Rep, bcr2012009325Google Scholar
  39. Locklear TD, Perez A, Caceres A, Mahady GB (2013) Women’s health in Central America: the complexity of issues and the need to focus on indigenous healthcare. Curr Women’s Health Rev 9:1573–1584Google Scholar
  40. Low Dog T (2005) Menopause: a review of botanical dietary supplements. Am J Med 118(Suppl 12B):98–108PubMedCrossRefGoogle Scholar
  41. Low Dog T (2009) The use of botanicals during pregnancy and lactation. Altern Ther Health Med 15(1):54–58PubMedGoogle Scholar
  42. Lynch M, Blumenthal M (2013) Herbal supplement sales increase 5.5 % in 2012; herbal supplement sales rise for 9th consecutive year; turmeric sales jump 40 % in natural channels. HerbalGram 99:60–65Google Scholar
  43. Mahady GB, Fong HHS, Farnsworth NR (2001a) Cranberry. In: Botanical dietary supplements: quality, safety and efficacy. Swets Publishing, LisseGoogle Scholar
  44. Mahady GB, Fong HHS, Farnsworth NR (2001b) Ginseng. Botanical dietary supplements: quality, safety and efficacy. Swets & Zeitlinger, LisseGoogle Scholar
  45. Mahady GB, Parrot J, Lee C et al (2003) Botanical dietary supplement use in peri- and postmenopausal women. Menopause 10(1):65–72PubMedGoogle Scholar
  46. Mahady GB, Doyle BJ, Locklear TD et al (2006) Black cohosh (Actaea racemosa) for the mitigation of menopausal symptoms: recent developments in clinical safety and efficacy. Womens Health 2(5):773–784Google Scholar
  47. Mahady GB, Low Dog T, Barrett ML et al (2008) United States Pharmacopeia review of the black cohosh case reports of hepatotoxicity. Menopause 15:628–638PubMedCrossRefGoogle Scholar
  48. Mahady G, Low Dog T, Sarma DN, Giancaspro GI et al (2009) Suspected black cohosh hepatotoxicity – causality assessment versus safety signal. Maturitas 64:139–140PubMedCrossRefGoogle Scholar
  49. Mahady GB, Low Dog T, Sarma ND et al (2012) Response to Teschke et al. Pharmacoepidemiol Drug Saf 21(3):339–340PubMedCrossRefGoogle Scholar
  50. Mazzanti G, Menniti-Ippolito F, Moro PA et al (2009) Hepatotoxicity from green tea: a review of the literature and two unpublished cases. Eur J Clin Pharmacol 65(4):331–341PubMedCrossRefGoogle Scholar
  51. Mei QB, Tao JY, Cui B (1991) Advances in the pharmacological studies of radix Angelica sinensis (Oliv.) Diels (Chinese dang gui). Chin Med J 104(9):776–781PubMedGoogle Scholar
  52. Mercado-Feliciano M, Cora MC, Witt KL et al (2012) An ethanolic extract of black cohosh causes hematological changes but not estrogenic effects in female rodents. Toxicol Appl Pharmacol 263(2):138–147PubMedCentralPubMedCrossRefGoogle Scholar
  53. MHRA (2006) MHRA action on safety concerns over black cohosh and liver injury. http://www.mhra.gov.uk/NewsCentre/Pressreleases/CON2024116?ssSourceNodeId=663. Accessed June 2014
  54. Naranjo CA, Busto U, Sellers EM et al (1981) A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 30:239–245PubMedCrossRefGoogle Scholar
  55. National Institutes of Health (2007) The use of complementary and alternative medicine in the United States. National Center for Complementary and Alternative MedicineGoogle Scholar
  56. Natural Health Products Directorate (NHPD) (2007) Black cohosh. http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/pdf/prodnatur/mono_cohosh-grappes_e.pdf. Accessed March 2014
  57. Niklasson A, Andrén L (2006) Interaction between warfarin and cranberry juice. Lakartidningen 103(11):853–854PubMedGoogle Scholar
  58. Pan JC, Tsai YT, Lai JN et al (2014) The traditional Chinese medicine prescription pattern of patients with primary dysmenorrhea in Taiwan: a large-scale cross sectional survey. J Ethnopharmacol S0378–8741(14):00011-17Google Scholar
  59. Pierard S, Coche JC, Lanthier P et al (2009) Severe hepatitis associated with the use of black cohosh: a report of two cases and an advice for caution. Eur J Gastroenterol Hepatol 21:941–945PubMedCrossRefGoogle Scholar
  60. Rahman AB, Ahmad Z, Naing L et al (2007) The use of herbal medicines during pregnancy and perinatal mortality in Tumpat District, Kelantan, Malaysia. Southeast Asian J Trop Med Public Health 38(6):1150–1157Google Scholar
  61. Reinhold E (1990) Der Einsatz von Ginseng in der Gynäkologie. Natur-und GanzheitsMedizin 4:131–134Google Scholar
  62. Rindone JP, Murphy TW (2006) Warfarin-cranberry juice interaction resulting in profound hypoprothrombinemia and bleeding. Am J Ther 21(3):283–284CrossRefGoogle Scholar
  63. Sarma DN, Barrett ML, Chavez ML et al (2008) Safety of green tea extracts: a systematic review by the US Pharmacopeia. Drug Saf 31(6):469–484PubMedCrossRefGoogle Scholar
  64. Schultz H (2013a) Herbal supplements sales rose 5.5 % in US in 2102, ABC says. Nutraingredients-usa.com. Accessed 5 Feb 2014Google Scholar
  65. Schultz H (2013b) Supplement sales hit $11.5 B in U.S. report says. www.nutraingredients-usa.com/content/view/print/681603. Accessed 14 June 2014
  66. Shibata S, Tanaka O, Shoji J, Saito H (1985) Chemistry and pharmacology of Panax. In: Wagner H, Farnsworth NR (eds) Economic and medicinal plants research, vol 1. Academic, London/San Diego/New York, pp 217–284Google Scholar
  67. Srinivas NR (2013) Cranberry juice ingestion and clinical drug-drug interaction potentials; review of case studies and perspectives. J Pharm Pharm Sci 16(2):289–303PubMedGoogle Scholar
  68. Steel A, Adams J, Sibbritt D, Broom A, Frawley J, Gallois C (2014) The influence of complementary and alternative medicine use in pregnancy on labor pain management choices: results from a nationally representative sample of 1,835 women. J Altern Complement Med 20(2):87–97PubMedCrossRefGoogle Scholar
  69. Suvarna R, Pirmohamed M, Henderson L (2003) Possible interaction between warfarin and cranberry juice. BMJ 327(7429):1454PubMedCentralPubMedCrossRefGoogle Scholar
  70. Teschke R (2010) Black cohosh and suspected hepatotoxicity: inconsistencies, confounding variables, and prospective use of a diagnostic causality algorithm. A critical review. Menopause 17:426–440PubMedCrossRefGoogle Scholar
  71. Teschke R, Bahre R, Genthner A et al (2009) Suspected black cohosh hepatotoxicity, challenges and pitfalls of causality assessment. Maturitas 64:110–115CrossRefGoogle Scholar
  72. Teschke R, Schmidt-Taenzer W, Wolff A (2011) Spontaneous reports of assumed herbal hepatotoxicity by black cohosh: is the liver-unspecific Naranjo scale precise enough to ascertain causality? Pharmacoepidemiol Drug Saf 20:567–582PubMedCrossRefGoogle Scholar
  73. Thavanesan N (2011) The putative effects of green tea on body fat: an evaluation of the evidence and a review of the potential mechanisms. Br J Nutr 106(9):1297–1309PubMedCrossRefGoogle Scholar
  74. Tsai HH, Lin HW, Lu YH et al (2013) A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines. PLoS One 8(5):e64255PubMedCentralPubMedCrossRefGoogle Scholar
  75. Upton R (2010) Dong quai. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD (eds) Encyclopedia of dietary supplements, 2nd edn. Informa Healthcare, New York, pp 208–216CrossRefGoogle Scholar
  76. Wang CC, Cheng KF, Lo WM et al (2013) A randomized, double-blind, multiple-dose escalation study of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) for moderate to severe menopausal symptoms and quality of life in postmenopausal women. Menopause 20(2):223–231PubMedGoogle Scholar
  77. WHO (1999a) Radix ginseng, vol 1, WHO monographs on selected medicinal plants. World Health Organization, Geneva, pp 168–182Google Scholar
  78. WHO (1999b) Flos chamomillae, vol 1, WHO monographs on selected medicinal plants. World Health Organization, Geneva, pp 86–94Google Scholar
  79. WHO (1999c) Radix valeriana, vol 1, WHO monographs on selected medicinal plants. World Health Organization, Geneva, pp 267–276Google Scholar
  80. WHO (2009a) Fructus macrocarponii, vol 4, WHO monographs on selected medicinal plants. World Health Organization, Geneva, pp 149–166Google Scholar
  81. WHO (2009b) Fructus agni casti, vol 4, WHO monographs on selected medicinal plants. World Health Organization, Geneva, pp 9–29Google Scholar
  82. Wiklund IK, Mattsson LA, Lindgren R et al (1999) Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group. Int J Clin Pharmacol Res 19(3):89–99PubMedGoogle Scholar
  83. World Health Organization (WHO) (2013) WHO traditional medicine strategy 2014–2023. WHO, GenevaGoogle Scholar
  84. Wu AH, Spicer D, Stanczyk FZ et al (2012) Effect of 2-month controlled green tea intervention on lipoprotein cholesterol, glucose, and hormone levels in healthy postmenopausal women. Cancer Prev Res (Phila) 5(3):393–402CrossRefGoogle Scholar
  85. Yi SW, Sull JW, Hong JS, Linton JA, Ohrr H (2009) Association between ginseng intake and mortality: Kangwha cohort study. J Altern Complement Med 15(8):921–928PubMedCrossRefGoogle Scholar
  86. Yu SM, Ghandour RM, Huang ZJ (2004) Herbal supplement use among US women, 2000. J Am Med Womens Assoc 59(1):17–24PubMedGoogle Scholar
  87. Yuan CS, Wei G, Dey L et al (2004) Brief communication: ginseng reduces warfarin’s effect in healthy patients: a randomized, controlled Trial. Ann Intern Med 141(1):23–27PubMedCrossRefGoogle Scholar
  88. Zimmerman R, Witte A, Voll RE et al (2010) Coagulation activation and fluid retention associated with the use of black cohosh: a case study. Climacteric 13:187–191CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Clinical AnatomyCity Colleges of Chicago and Rush UniversityChicagoUSA
  2. 2.Department of Pharmacy Practice, Rm 122, PAHO/WHO Collaborating Centre for Traditional Medicine, College of PharmacyUniversity of IllinoisChicagoUSA

Personalised recommendations