The treatment protocol for secondary oligoamenorrhea in women of reproductive age from the perspective of Persian medicine and conventional medicine

Document Type : Review Article

Authors

1 Assistant professor of Persian Medicine, Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.

2 Associate professor, Department of Persian Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 M.Sc. of Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

4 Assistant professor, Department of History of Medicine, School of Traditional Medicine, Babol University of Medical Sciences, Babol, Iran.

5 Assistant professor of Persian Medicine, Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran. Assistant professor, Department of Persian Medicine, Faculty of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran.

Abstract

Introduction: One of the common problems of women in reproductive age is abnormal cessation or reduction of menstrual bleeding, which causes many complications and reduces the quality of life. The present study was conducted with aim to provide a treatment protocol of oligoamenorrhea (secondary amenorrhea, oligomenorrhea) within the framework of the basics of evidence-based Persian medicine and conventional medicine.
Methods: In this study, information was collected in the form of narrative review by searching the contents related to cessation or reduction of menstrual bleeding from various Persian medical sources and searching in databases of Pubmed, Web of science, Google scholar, Iranmedex, SID, Magiran with related keywords in order to find evidence and documents. In the next stage, 10 sessions of group discussions on the topic of explanation and interpretation of menstrual disorders in Persian medicine and conventional medicine were held with the presence of experts in the field of Persian medicine and obstetrics and gynecology. Finally, consolidated treatment was presented in the form of a treatment protocol with emphasis on clinical evidences.
Results: The principles of oligoamenorrhea treatment in Persian medicine include lifestyle modification, specially nutrition, physical activity, mental and sleep health, use of herbal medicines, and manual operations (which can be integrated with the treatment steps of some causes of this disorder in conventional medicine.
Conclusion: Considering the existence of some problems in olioamenorrhea treatment in conventional medicine, the use of Persian traditional medicine in the treatment of oligoamenorrhea along with the protocols of conventional medicine can be helpful in the control and management of this disorder.

Keywords


  1. Taylor HS, Pal L, Sell E. Speroff's clinical gynecologic endocrinology and infertility. Lippincott Williams & Wilkins; 2019.
  2. Marnach ML, Laughlin-Tommaso SK. Evaluation and management of abnormal uterine bleeding. InMayo Clinic Proceedings 2019; 94(2):326-335.
  3. Moini Jazani A, Hamdi K, Tansaz M, Nazemiyeh H, Sadeghi Bazargani H, Fazljou SM, et al. Herbal medicine for oligomenorrhea and amenorrhea: a systematic review of ancient and conventional medicine. BioMed research international 2018; 2018.
  4. Samani RO, Hashiani AA, Razavi M, Vesali S, Rezaeinejad M, Maroufizadeh S, et al. The prevalence of menstrual disorders in Iran: A systematic review and meta-analysis. International journal of reproductive biomedicine 2018; 16(11):665.
  5. Marconi AM, Lania A, Miozzo MR, Priori A, Vegni E, Garzia E, editors. Functional hypothalamic amenorrhea seen from different perspectives. Frontiers Media SA; 2023.
  6. Master-Hunter T, Heiman DL. Amenorrhea: evaluation and treatment. American family physician 2006; 73(8):1374-82.
  7. Deligeoroglou E, Athanasopoulos N, Tsimaris P, Dimopoulos KD, Vrachnis N, Creatsas G. Evaluation and management of adolescent amenorrhea. Annals of the New York Academy of Sciences 2010; 1205(1):23-32.
  8. Welt CK, Barbieri RL, Geffner ME. Evaluation and management of secondary amenorrhea. Waltham, MA: UpToDate; 2020.
  9. Reindollar RH, Novak M, Tho SP, McDonough PG. Adultā€onset amenorrhea: A study of 262 patients. International Journal of Gynecology & Obstetrics 1987; 25(4):347-.
  10. Welt CK, Barbieri RL, Geffner ME. Epidemiology and causes of secondary amenorrhea. Waltham, MA: UpToDate; 2019.
  11. Hameed HA, Waris Nawab S. Avicenna [The Canon of Medicine]. New Delhi: Jamia Hamdard Printing Press; 1998.
  12. Chashti MA. Exir-e-Aazam. Research institute for islamic and complementary medicine. Tehran: Tehran University of Medical Sciences; 2004. (Persian).
  13. Mokabberi Nezhad R, Zafarghandi N. Etiology and semiology of amenorrhea in the traditional Iranian medicine. Journal of Islamic and Iranian Traditional Medicine 2012; 3(1):19-30.
  14. Tabarai Arani M, Bioos S, Tansaz M, Mokaberinejad R, Jafari Dehkordi E, Akhtari E, et al. Uterus Complications of Amenorrhea and Oligomenorrhea (Ehteebas Tams) in Iranian Traditional Medicine. Med Hist J 2012; 4(12):125-38.
  15. Ackerman K, Madhusmita M. Functional hypothalamic amenorrhea: evaluation and management. UpToDate. Waltham, MA: UpToDate Inc; 2019.
  16. Ramanayake RP, Basnayake BM. Evaluation of red flags minimizes missing serious diseases in primary care. Journal of family medicine and primary care 2018; 7(2):315.
  17. Fritz MA, Speroff L. Clinical Gynecologic Endocrinology and Infertility. 8nd Philadelphia: Lippincott Williams & Wilkins; 2011.
  18. Choopani R, Emtiazi M, Tansaz M, Khodadoost M. Semiology and diagnosis in Iranian traditional medicine. Tehran, Farazandish Sabz Pub; 2009.
  19. Kamaneh SA, Mojahedi M, Mozafari O, Memariani Z, Saravani M. Cardiotonic Medicines (Mofarrehs) and Their Mechanism of Action in Persian Medicine. Journal of Babol University of Medical Sciences 2019; 21(1):320-30.
  20. Falahat F, Tavakkoli M, Mokaberinejad R, Ayati S, Feyzabadi Z. Natural treatments of oligomenorrhea based on persian medicine. Iran J Obstet Gynecol Infertil 2018; 21(Supplement):55-66.
  21. Ghadami YE, Ghaffari F, Rabbani M, Rastegari SM. Catarrh in Persian traditional medicine; 2012
  22. Saeidi A, Mokaberinejad R, Bioos S, Darvish–Mofrad-Kashani Z, Tabarrai M, Mojahedi M, et al. Diagnostic Protocol of Warm and Cold Uterine Temperaments Based on Persian Medicine: A Qualitative Study. wComplementary Medicine Journal 2021; 11(3):236-55.
  23. Arzani M. Tebb-E-Akbari. 2nd Institute of Medical History, Islamic and Complementary Medicine, Iran University of Medical Sciences; 2005.
  24. Rezaeizadeh H, Alizadeh M, Naseri M, Shams AM. The traditional Iranian medicine point of view on health and disease; 2009.
  25. Jorjani E. Aghrazotebie va Almabahesolalaiieh. Tehran: Tehran University of Medical Sciences; 2006.
  26. Pasalar M, Choopani R, Mosaddegh M, Kamalinejad M, Mohagheghzadeh A, Fattahi MR, et al. Efficacy of jollab in the treatment of depression in dyspeptic patients: a randomized double-blind controlled trial. Journal of Evidence-Based Complementary & Alternative Medicine 2015; 20(2):104-8.
  27. Aghili Khorasani MH. Makhzan ahadvieh. Tehran: University of Medical Sciences; 2005.
  28. Gruenwald J, Brendler T, Jaenicke C. PDR for herbal medicines. Thomson, Reuters; 2007.
  29. Rhazes M, Al-havi Tehran I. International Academy of Medical Sciences; 2005. Original work published 10th century.
  30. Moradi Dehnavi H, Pakzad A, Fakhari Zavare M. Designing Dietary Measures Based on Persian Medicine for Individuals with Cold and Dry Temperament. Qom University of Medical Sciences Journal 2021; 14(11):61-8.
  31. Malekirad AA, Mojtabaee M. Investigating the Effect of Milk - Dodder on Emotional, Cognitive, Behavioral and Physical Components of Anxiety . CMJA 2018; 8(1):2218-23.
  32. Tansaz M, Bahman M, Mokaberinejad R, Adhami S, Choopani R. The effect of combined administration of Onsoli syrup and Samgh capsule (Persian Medicine Products) on clinical and laboratory symptoms in women with polycystic ovary syndrome (A pilot study). Iran J Obstet Gynecol Infertil 2022; 25(9):1-10.
  33. Nouri F, Naseri M, Esfahani M, Mohammadi Farsani G, Abdi S, Faghihzadeh S, et al. Presentation of specific dietary intervention based on Traditional Persian Medicine for the treatment of cold and wet mal-temperament. Daneshvar Medicine 2020; 25(5):63-70.
  34. Ibn-sina AH. Al-Ghanun fi Al-teb. Lebanon: Al-Elmi Lel-Matbuat; 2005.
  35. Salehi M, Setayesh M, Mokaberinejad R. Treatment of recurrent ovarian cysts and primary infertility by Iranian traditional medicine: a case report. Journal of Evidence-Based Complementary & Alternative Medicine 2017; 22(3):374-7.
  36. Shirooye P, Hamzeloo-Moghadam M, Hashem-Dabaghian F, Mokaberinejad R. Comparison of local effects of ginger oil with oral ginger on associated symptoms of primary dysmenorrhea: randomized clinical trial. Iran J Obstet Gynecol Infertil 2017; 20(8):61-9.
  37. 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. Journal of Obstetrics and Gynaecology 2019; 39(5):652-8.
  38. Asghari M, Sabet Z, Davati A, Kamalinejad M, Soltaninejad H, Naseri M. Investigation and comparison of Ziabites disease, in Iranian traditional medicine and diabetes disease, in classical medicine. Med Hist J 2012; 3(9):11-37.
  39. Saghafi F, Mirzaie F, Gorji E, Nabimeybodi R, Fattahi M, Mahmoodian H, et al. Antibacterial and anti-Trichomonas Vaginalis effects of Rosa Damascena mill petal oil (a persian medicine product), aqueous and hydroalcoholic extracts. BMC Complementary Medicine and Therapies 2021; 21(1):1-0.
  40. Yavari M, Rouholamin S, Tansaz M, Esmaeili S. Herbal treatment of oligomenorrhea with Sesamum indicum L.: a randomized controlled trial. Galen Medical Journal 2016; 5(3):114-21.
  41. Bahman M, Hajimehdipoor H, Bioos S, Hashem-Dabaghian F, Afrakhteh M, Tansaz M. Effect of Aslagh Capsule, a Traditional Compound Herbal Product on Oligomenorrhea in Patients with Polycystic Ovary Syndrome: A Three-Arm, Open-label, Randomized, Controlled Trial. Galen Medical Journal 2019; 8:e1261.
  42. Jazani AM, Nazemiyeh H, Tansaz M, Bazargani HS, Fazljou SM, Azgomi RN, et al. Celery plus Anise versus metformin for the treatment of oligomenorrhea in the polycystic ovary syndrome: a tripleblind randomized clinical trial: Tabriz University of Medical Sciences. Iranian Red Crescent Medical Journal 2018; 20(5).
  43. 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. International Journal Of Pharmaceutical Sciences And Research 2018; 9(11):4716-22.
  44. Naeimi SA, Hajimehdipoor H, Saber S. Comparing the effect of Nigella sativa oil soft gel and placebo on oligomenorrhea, amenorrhea and laboratory characteristics in patients with polycystic ovarian syndrome, a randomized clinical trial. Research journal of pharmacognosy 2020; 7(1):49-59.
  45. Bashtian MH, Emami SA, Mousavifar N, Esmaily HA, Mahmoudi M, Poor AH. Evaluation of fenugreek (Trigonella foenum-graceum L.), effects seeds extract on insulin resistance in women with polycystic ovarian syndrome. Iranian journal of pharmaceutical research: IJPR 2013; 12(2):475.
  46. 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). International journal of medical sciences 2015; 12(10):825.
  47. Rahimi R, Ardekani MR. Medicinal properties of Foeniculum vulgare Mill. in traditional Iranian medicine and modern phytotherapy. Chinese journal of integrative medicine 2013; 19:73-9.
  48. 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 Journal of Pharmaceutical Sciences 2012; 20:1-8.
  49. Mokaberinejad R, Akhtari E, Tansaz M, Bioos S, Kamalinejad M, Zafarghandi N, et al. Effect of mentha longifolia on fsh serum level in premature ovarian failure. Open Journal of Obstetrics and Gynecology 2014; 2014.
  50. Parveen R, Shameem I. Effect of wet cupping (Hijamat Bil Shurt) in the management of secondary amenorrhea (Ehtebas Tams Sanwi). Res Rev J Unani Siddha Homeopathy 2014; 1:12-9.
  51. Meyari A, Tehrani FR, Tansaz M, Mokaberinejad R, Biglarkhani M. Wet Cupping and Phlebotomy in Management of Oligo/Amenorrhea: View of Persian Medicine. Traditional and Integrative Medicine 2020: 97-103.
  52. Meyari A, Tansaz M, Ramezani Tehrani F, Mokaberinejad R, Biglarkhani M, et al. Wet-cupping on calf muscles in polycystic ovary syndrome: a quasi-experimental study. Journal of Complementary and Integrative Medicine 2021; 19(2):441-7.
  53. Nabimeybodi R, Tansaz M, Meyari A, Bahman M, Shiroye P. Phlebotomy applications in uterine diseases. Journal of Islamic and Iranian Traditional Medicine 2016; 7(2):139-46.
  54. World Health Organization. WHO traditional medicine strategy: 2014-2023. World Health Organization; 2013.
  55. Riaz Y, Parekh U. Oligomenorrhea. InStatPearls [Internet] 2021 Dec 28. StatPearls Publishing.
  56. Cho IY, Chang Y, Kang JH, Kim Y, Sung E, Shin H, et al. Long or irregular menstrual cycles and risk of prevalent and incident nonalcoholic fatty liver disease. The Journal of Clinical Endocrinology & Metabolism 2022; 107(6):e2309-17.
  57. Stempak-Droissart T, Rousset-Jablonski C, Spritzer PM, Lalhou N, Larger E, Pichard C, et al. Impact of vascular liver disease on the menstrual cycle and metabolic status in premenopausal women. Clinics and Research in Hepatology and Gastroenterology 2022; 46(1):101756.
  58. Coutinho LM, Clemenza S, Campana D, Petraglia F. The Menstrual Disorders Related to Systemic Diseases. Female Reproductive Dysfunction 2020: 85-94.
  59. Haghighi L, Razzaghi Z. The Reiationship OF The Body Mass Index (BMI) With Hirsutism And Mestural Pattern. Razi Journal of Medical Sciences 2001; 7(22):257-61.
  60. Gibson ME, Fleming N, Zuijdwijk C, Dumont T. Where have the periods gone? The evaluation and management of functional hypothalamic amenorrhea. Journal of clinical research in pediatric endocrinology 2020; 12(Suppl 1):18.
  61. Visuvanathan T, Than LT, Stanslas J, Chew SY, Vellasamy S. Revisiting Trigonella foenum-graecum L.: Pharmacology and Therapeutic Potentialities. Plants 2022; 11(11):1450.
  62. Hannan MA, Rahman MA, Sohag AA, Uddin MJ, Dash R, Sikder MH, et al. Black cumin (Nigella sativa L.): A comprehensive review on phytochemistry, health benefits, molecular pharmacology, and safety. Nutrients 2021; 13(6):1784.
  63. Anka ZM, Gimba S, Nanda A, Salisu L. Phytochemistry and pharmacological activities of Foeniculum vulgare. IOSR J. Pharm 2020; 10:1-10.
  64. Mulukuri NS, Kumar PP. Apium graveolens L.(Family: Apiaceae). InBioactives and Pharmacology of Medicinal Plants 2023:221-236. Apple Academic Press.
  65. Ghasemi V, Vahedi M. Comparison effect of herbals tea containing fenugreek seed and fennel seed on the signs of breast milk sufficiency in iranian girl infants with 0-4 months of age. Journal of Medicinal Plants 2018; 17(68):166-74.
  66. Sohrabvand F, Nazem E, Tansaz M, Keshavarz M, Dabaghian FH, Nasrabady AN, et al. Investigation of the personal and uterine humor in infertile women referred to Vali-e-As hospital of Tehran, Iran in 2012. Iran J Obstet Gynecol Infertil 2014; 17(94):10-19.
  67. Sultana A, Rahman K. Evaluation of general body temperament and uterine dystemperament in amenorrhoea: A cross-sectional analytical study. Journal of Complementary and Integrative Medicine 2021; 19(2):455-65.