Effect of Medicinal Plants in the Treatment of Primary dysmenorrhea in Iran: A Review Article

Document Type : Review Article


1 M.Sc. of Midwifery, Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran

2 Assistant Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical sciences, Tehran, Iran.


Introduction: Primary dysmenorrhea is a common problem in women of reproductive age that effect their quality of life and social activities. Since today using of medicinal plants for treatment of primary dysmenorrhea has been addressed, so this study was performed with aim to determine the effect of medicinal plants in treatment of primary dysmenorrhea as a review article in Iran.
Methods: This is a review study. The information about the effect of plants in treatment of primary dysmenorrhea was searched from databases of MedLib, Magiran, Google scholar, IranMedex, SID, PubMed, and Scopus without time limitation. Then, the articles which obtained the score of >3 with Jadad criteria were entered to the study. Data were analyzed qualitatively.
Results: In this study, a total of 16 different types of medicinal plants were studied in 35 clinical trials which had inclusion criteria were evaluated. Most of the medicinal herbs reviewed in the studies had flavonoid compounds with analgesic and anti-inflammatory effect that had desirable effect on dysmenorrhea pain relief. The majority of these plants have minimal or no side effects, because the methodology of the studies was heterogeneous in terms of quality, so performing a meta-analysis was impossible. 
Conclusion: Given that an increasing number of articles with acceptable credit and positive results have evaluated the fennel, so this plant can be safely used in the relief of pain in primary dysmenorrhea. 


  1. Joshi T, Kural MR, Agrawal DP, Noor NN, Patil A. Primary dysmenorrhea and its effect on quality of life in young girls. Int J M Sci Pub Health 2015; 4(3):381-5.
  2. Weissman AM, Hartz AJ, Hansen MD, Johnson SR. The natural history of primary dysmenorrhoea: a longitudinal study. BJOG 2004; 111(4):345-52.
  3. Jonatan S, Berek J. Novak's Gynecology. 14th ed. New York: Lippincott Williams and Wilkins Publishers; 2012.
  4. Sultan C, Gaspari L, Paris F. Adolescent dysmenorrhea. Endocr Dev 2012; 22:171-80.
  5. Ju H, Jones M, Mishra G. The prevalence and risk factors of dysmenorrhea. Epidemiol Rev 2014; 36:104-13.
  6. Rehman H, Begum W, Tabasum H, Anjum F. Primary Dysmenorrhea: A Review with Special Reference to Unani Concepts. J Unani Siddha Homeopat 2014; 1(1):29-37.
  7. Kalvandi R, Alimohammadi S, Pashmakian Z, Rajabi M. The effects of medicinal plants of melissa officinalis and salvia officinalis on primary dysmenorrhea. J Hamadan Univ Med Sci 2014; 21(4):105-11.
  8. Charu S, Amita R, Sujoy R, Thomas GA. Dysmenorrhea on quality of life of medical students. Int J Collaborat Res Med 2012; 4(4):275-93.
  9. Wang L, Wang X, Wang W, Chen C, Ronnennberg AG, Guang W, et al. Stress and dysmenorrhoea: a population based prospective study. Occup Environ Med 2004; 61(12):1021-6.
  10. Tavallaee M, Joffres MR, Corber SJ, Bayanzadeh M, Rad MM. The prevalence of menstrual pain and associated risk factors among Iranian women. J Obstet Gynaecol Res 2011; 37(5):442-51.
  11. Faramarzi M, Salmalian H. Association of psychologic and nonpsychologic factors with primary dysmenorrhea. Iran Red Crescent Med J 2014; 16(8):e16307.
  12. Bettendorf B, Shay S, Tu F. Dysmenorrhea: contemporary perspectives. Obstet Gynecol Surv 2008; 63(9):597-603.
  13. Grandi G, Ferrari S, Xholli A, Cannoletta M, Palma F, Romani C, et al. Prevalence of menstrual pain in young women: what is dysmenorrhea? J Pain Res 2012; 5:169-74.
  14. Johnston L. Menstrual pain (dysmenorrhoea). Profession Nurs Today 2014; 18(1):4-13.
  15. Zangene M, Veisi F, Nankali A, Rezaei M, Ataee A. Evaluation of the effects of oral vitamin-D for pelvic pain reduction in primary dysmenorrhea. Iran J Obstet Gynecol Infertil 2014; 16(88):14-20.
  16. French L. Dysmenorrhea. Am Fam Physician 2005; 71(2):285-91.
  17. Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. Br Med J 2006; 332(7550):1134-8.
  18. Reyhani T, Jafarnejad F, Behnam HR, Ajam M, Baghaei M. The effect of brisk walking on primary dysmenorrhea in girl students. Iran J Obstet Gynecol Infertil 2013; 16(46):14-9.
  19. Ortiz MI. Primary dysmenorrhea among Mexican university students: prevalence, impact and treatment. Eur J Obstet Gynecol Reprod Biol 2010; 152(1):73-7.
  20. Serajadini M. Herbal medicine in ancient Iran. J Med History 2010; 2(2):11-33.
  21. Ameri F, Vahabi MR, Khatoonabadi SA, Andalibi L. On the relevance of medicinal plants consumers in Iran: investigating statistics for consumers, states of consumption, informative and source area. Teb Tazkiyeh 2013; 22(3):37-42.
  22. Zhu X, Proctor M, Bensoussan A, Wu E, Smith CA. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev 2008; 2:CD005288.
  23. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015; 4(1):1.
  24. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17(1):1-12.
  25. Mahfouz SA, Sharaf-Eldin MA. Effect of mineral vs. biofertilizer on growth, yield, and essential oil content of fennel (Foeniculum vulgare Mill.). Int Agrophysics 2007; 21(4):361-6.
  26. Choi EM, Hwang JK. Antiinflammatory, analgesic and antioxidant activities of the fruit of Foeniculum vulgare. Fitoterapia 2004; 75(6):557-65.
  27. Birdane FM, Cemek M, Birdane YO, Gülçin I, Büyükokuroğlu ME. Beneficial effects of Foeniculum vulgare on ethanol-induced acute gastric mucosal injury in rats. World J Gastroenterol 2007; 13(4):607-11.
  28. 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. Iran J Nurs Midwifery Res 2014; 19(6):581-4.
  29. Bokaie M, Farajkhoda T, Enjezab B, Khoshbin A, Mojgan KZ. Oral fennel (Foeniculum vulgare) drop effect on primary dysmenorrhea: effectiveness of herbal drug. Iran J Nurs Midwifery Res 2013; 18(2):128-32.
  30. Omidvar S, Esmailzadeh S, Baradaran M, Basirat Z. Effect of fennel on pain intensity in dysmenorrhoea: A placebo-controlled trial. Ayu 2012; 33(2):311-3.
  31. Moslemi L, Bekheradi R, Hasani S, Khaleginejad K. Effect of fennel on primary dysmenorrhea. J Family Health 2013; 1(4):15-20.
  32. Moslemi L, Bekhradi R, Galini Moghaddam T, Gholamitabar Tabari M. Comparative effect of fennel extract on the intensity of primary dysmenorrhea. African J Pharm Pharmacol 2012; 6:1770-3.
  33. Delaram M, Forouzandeh N. The effect of fennel on the primary dysmenorrhea in students of Shahrekord university of medical sciences. Sci Med J 2011; 10(2):81-8.
  34. Tork Zahrani SH, Akhavan Amjadi M, Mojab F, Alavi Majd H. Clinical effect of Foeniculum vulgare extract on primary dysmenorrhea. J Reproduct Infertil. 2007; 8:45-51.
  35. Nazarpoor S, Azimi H. The comparison Fenelin and Mefenamic acid on primary dysmenorrhea. J Mazandaran Univ Med Sci 2007; 17(61):54-61.
  36. Modaress Nejad V, Motamedi B. Comparison between the pain-relief effect of fennel and mefenamic acid on primary dysmenorrhea. J Rafsenjan Univ Med Sci 2006; 5(1):1-6.
  37. Saxena M, Shakya A, Sharma N, Shrivastava S, Shukla S. Therapeutic efficacy of Rosa damascena Mill. on acetaminophen-induced oxidative stress in albino rats. J Environ Pathol Toxicol Oncol 2012; 31(3):193-201.
  38. Boskabady MH, Shafei MN, Saberi Z, Amini S. Pharmacological effects of Rosa damascena. Iran J Basic Med Sci 2011; 14(4):295-307.
  39. Bani S, Hasanpour S, Mousavi Z, Mostafa Garehbaghi P, Gojazadeh M. The effect of Rosa damascena extract on primary dysmenorrhea: A double-blind cross-over clinical trial. Iran Red Crescent Med J 2014; 16(1):e14643.
  40. Hashemi VH, Ghanadi A, Mosavi D. Analgesic and antiinflammatory effects of total extract, flavonoid fraction and volatile oil of Salvia hydrangea. J Res Med Sci 2000; 5(4):3-5.
  41. McKay DL, Blumberg JB. A review of the bioactivity and potential health benefits of peppermint tea (Mentha piperita L.). Phytother Res 2006; 20(8):619-33.
  42. Hawthorn M, Ferrante J, Luchowski E, Rutledge A, Wei X, Triggle D. The actions of peppermint oil and menthol on calcium channel dependent processes in intestinal, neuronal and cardiac preparations. Aliment Pharmacol Ther 1988; 2(2):101-18.
  43. Amoueeroknabad M, Sarafraz N. Effect peppermint extract on primary dysmenorrhea compared with ibuprofen: a randomized clinical trial. Qom Univ Med Sci 2011; 5(3):37-41.
  44. Biniaz V. A review of the world-wide researches on the therapeutic effects of ginger during the past two years. Jentashapir J Health Res 2013; 4(4):333-7.
  45. Khayat S, Kheirkhah M, Behboodi Moghadam Z, Fanaei H, Kasaeian A, Javadimehr M. Effect of treatment with ginger on the severity of premenstrual syndrome symptoms. ISRN Obstet Gynecol 2014; 2014(4):792708.
  46. Grzanna R, Lindmark L, Frondoza CG. Ginger-an herbal medicinal product with broad anti-inflammatory actions. J Med Food 2005; 8(2):125-32.
  47. Nasri S. A review of the use of analgesic drugs in Iran. J Tradition Med Islam Iran. 2012; 3(3):293-310.
  48. Shirvani MA, Motahari-Tabari N, Alipour A. The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet 2015; 29(6):1277-81.
  49. Kashefi F, Khajehei M, Tabatabaeichehr M, Alavinia M, Asili J. Comparison of the effect of ginger and zinc sulfate on primary dysmenorrhea: a placebo-controlled randomized trial. Pain Manag Nurs 2014; 15(4):826-33.
  50. Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med 2012; 12(1):92.
  51. Ozgoli G, Goli M, Moattar F, Valaie N. Comparing ginger with mefenamic acid and ibubrofen for the treatment of primary dysmenorrhea. Pejouhesh 2007; 31(1):61-5.
  52. Ataollahi M, Akbari SA, Mojab F, Alavi Majd H. The effect of wheat germ extract on premenstrual syndrome symptoms. Iran J Pharm Res 2015; 14(1):159-66.
  53. Atallahi M, Akbari SA, Mojab F, Alavi Majd H. Effects of wheat germ extract on the severity and systemic symptoms of primary dysmenorrhea: a randomized controlled clinical trial. Iran Red Crescent Med J 2014; 16(8):e19503.
  54. He Z, Chen R, Zhou Y, Geng L, Zhang Z, Chen S, et al. Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in China. Maturitas 2009; 63(1):99-103.
  55. Aghajani Delavar M, Naseri Amiri F, Hoseini H. The effect of Vitagnus castus on premenstrual syndrome. J Herbal drug 2001; 1(2):15-21.
  56. Golian Tehrani S, Bazzazian S, Bakhtiarian A, Ghobadzadeh M. Effects of calci soya balance and vitagnus on menopausal symptoms. Iran Red Crescent Med J 2014; 16(10):e13551.
  57. Shahhosseini Z, Amin G, Salehisurmagi M, Danesh M, Abedian K. Clinical assessment of anti-dysmenorrhea drops vitagnus. J Mazandaran Univ Med Sci 2005; 15(50):15-21.
  58. Shobeiri F, Zeraati F, Mansouri Z, Araghchian M, Nazari M. The comparative effect of herbal extract of vitagnus and mefenamic acid on primary dysmenorrhea. Zahedan J Res Med Sci 2012; 14(5):30-3.
  59. Entezari M, Hashemi M, Ashki M, Ebrahimian S, Bayat M, Azizi Saraji A, et al. Studying the effect Echinophora platyloba extract on bactira (Staphilococus aureus and Pseudomonas aeroginosa) and fungi (Candidia albicans, Aspergilus flavus and Aspergilus niger) in vitro. World J Med Sci 2009; 4(2):89-92.
  60. Asghari G, Abedi D, Jalali M, Farsi S. Antimicrobial activities and phytochemical composition of echinophora platyloba DC. Essential oils from Isfahan. J Essential Oil Bear Plant 2007; 10(1):76-82.
  61. Avijgan M, Mahboubi M. Echinophora platyloba DC. As a new natural antifungal agent. Asian Pacific J Trop Dis 2015; 5(3):169-74.
  62. Delaram M. Treatment of moderate to severe of premenstrual syndrome with echinophora platyloba. Zahedan J Res Med Sci 2014; 16(3):50-4.
  63. Delaram M, Sadeghiyan Z. The effect of echinophora-platyloba extract on primary of dysmenorrhea. Arak Med Univ J 2010; 13(3):61-7.
  64. Langmead L, Chitnis M, Rampton DS. Use of complementary therapies by patients with IBD may indicate psychosocial distress. Inflamm Bowel Dis 2002; 8(3):174-9.
  65. Qadir MI. Medicinal and cosmetological importance of Aloe vera. Int J Nat Ther 2009; 2:21-6.
  66. Rajasekaran S, Sivagnanam K, Subramanian S. Mineral contents of Aloe vera leaf gel and their role on streptozotocin-induced diabetic rats. Biol Trace Elem Res 2005; 108(1-3):185-95.
  67. Wynn RL. Aloe vera gel: update for dentistry. Gen Dent 2005; 53(1):6-9.
  68. Eamlamnam K, Patumraj S, Visedopas N, Thong-Ngam D. Effects of Aloe vera and sucralfate on gastric microcirculatory changes, cytokine levels and gastric ulcer healing in rats. World J Gastroenterol 2006; 12(13):2034-9.
  69. Boudreau MD, Beland FA. An evaluation of the biological and toxicological properties of Aloe barbadensis (miller), Aloe vera. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev 2006; 24(1):103-54.
  70. kazaeeian S, Navidian A, navabirigi SD. Evaluation Effects of oral Aloe vera gel on the intensity of primery dysmenorrhea. Iran J Med 2012; 1(1):35-40.
  71. Ramchoun M, Harnafi H, Alem C, Benlyas M, Elrhaffari L, Amrani S. Study on antioxidant and hypolipidemic effects of polyphenol-rich extracts from Thymus vulgaris and Lavendula multifida. Pharm Res 2009; 1(3):106-12.
  72. Salmalian H, Saghebi R, Moghadamnia AA, Bijani A, Faramarzi M, Nasiri Amiri F, et al. Comparative effect of thymus vulgaris and ibuprofen on primary dysmenorrhea: A triple-blind clinical study. Caspian J Intern Med 2014; 5(2):82-8.
  73. Direkvand-Moghadam A, Khosravi A. The impact of a novel herbal Shirazi Thymus Vulgaris on primary dysmenorrhea in comparison to the classical chemical Ibuprofen. J Res Med Sci 2012; 17(7):668-70.
  74. Irvani M. Clinical effects of Thymus vulgaris extract on primary dysmenorrheal. J Med Plant 2009; 8(2):54-60.
  75. Roozbahani N, Jabbari Z, Yazdi S. The comparison of Shirazi Thymus Vulgaris and Mefenamic acid effects on primary dysmenorrhea. Arak Med Univ J 2006; 8(3):23-7.
  76. Cicerale S, Lucas LJ, Keast RS. Antimicrobial, antioxidant and anti-inflammatory phenolic activities in extra virgin olive oil. Curr Opin Biotechnol 2012; 23(2):129-35.
  77. Ferrara LA, Raimondi AS, d'Episcopo L, Guida L, Russo AD, Marotta T. Olive oil and reduced need for antihypertensive medications. Arch Intern Med 2000; 160(6):837-42.
  78. Owen RW, Haubner R, Würtele G, Hull W, Spiegelhalder B, Bartsch H. Olives and olive oil in cancer prevention. Eur J Cancer Prev 2004; 13(4):319-26.
  79. Bennett SM, Hayes JE. Differences in the chemesthetic subqualities of capsaicin, ibuprofen, and olive oil. Chem Senses 2012; 37(5):471-8.
  80. Rezaeyan M, Abdali N, Araban M. Comparing analgesic effects of extra virgin olive oil and Ibuprofen on the intensity of primary dysmenorrhea: A crossover clinical trial. Iran J Nutr Sci Food Technol 2014; 9(2):67-74. (Persian).
  81. Mashhadi NS, Ghiasvand R, Hariri M, Askari G, Feizi A, Darvishi L, et al. Effect of ginger and cinnamon intake on oxidative stress and exercise performance and body composition in Iranian female athletes. Int J Prev Med 2013; 4(Suppl 1):S31-5.
  82. Allen RW, Schwartzman E, Baker WL, Coleman CI, Phung OJ. Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Ann Fam Med 2013; 11(5):452-9.
  83. Ranasinghe P, Pigera S, Premakumara GA, Galappaththy P, Constantine GR, Katulanda P. Medicinal properties of ‘true’cinnamon (Cinnamomum zeylanicum): a systematic review. BMC Complement Altern Med 2013; 13(1):275.
  84. Craig WJ. Health-promoting properties of common herbs. Am J Clin Nutr 1999; 70(3 Suppl):491s-9.
  85. Akhavaamjadi M, Mojab F, Shahbazzadegan S. Effect of cinnamon on primary dysmenorrhea and associated symptoms. J Ardabil Univ Med Sci 2009; 9(3):204-9.
  86. Jaafarpour M, Hatefi M, Khani A, Khajavikhan J. Comparative effect of cinnamon and Ibuprofen for treatment of primary dysmenorrhea: a randomized double-blind clinical trial. J Clin Diagn Res 2015; 9(4):1-7.
  87. Barton DL, Atherton PJ, Bauer BA, Moore DF Jr, Mattar BI, Lavasseur BI, et al. The use of valeriana officinalis (valerian) in improving sleep in patients who are undergoing treatment for cancer: a phase III randomized, placebo-controlled, double-blind study (NCCTG Trial, N01C5). J Support Oncol 2011; 9(1):24-31.
  88. Occhiuto F, Pino A, Palumbo DR, Samperi S, Pasquale R, Sturlese E, et al. Relaxing effects of Valeriana officinalis extracts on isolated human non‐pregnant uterine muscle. J Pharm Pharmacol 2009; 61(2):251-6.
  89. Karimian Z, Keramat A. Hot Flashes of Menopause and Herbal Medicine in Iran: A Systematic Review. Iran J Obstet Gynecol Infertil 2014; 17(111):1-11.
  90. Gilani AH, Khan AU, Jabeen Q, Subhan F, Ghafar R. Antispasmodic and blood pressure lowering effects of Valeriana wallichii are mediated through K+ channel activation. J Ethnopharmacol 2005; 100(3):347-52.
  91. Jenabi E, Asltugiri M, Hejrati P. Compare Valeriana Officinalis and mephnamic acid on primary dysmenorrhea. Iran J Obstet Gynecol Infertil 2012; 15(2):44-8.
  92. Dolatian M, Mirabi P, Mojab F, Alavi Majd H. Effect roots of Valeriana officinalis L (Valeriana Officinalis) on primary dysmenorrhea. J Reproduct Infertil 2009; 10(4):253-9.
  93. Farahani MD, Vakilian K, Seyyedzadeh N. Comparison of ginger and valerian on the severity of primary dysmenorrhea: a randomized triple blind clinical trial. Complement Med J Facul Nurs Midwifery 2013; 3(2):494-503.
  94. Basch E, Ulbricht C, Kuo G, Szapary F, Smith M. Therapeutic applications of fenugreek. Altern Med Rev 2003; 8(1):20-7.
  95. Snehlata HS, Payal DR. Fenugreek (Trigonella foenum-graecum L.): An overview. Int J Curr Pharm Rev Res 2012; 2(4):169-87.
  96. Neelakantan N, Narayanan M, de Souza RJ, van Dam RM. Effect of fenugreek (Trigonella foenum-graecum L.) intake on glycemia: a meta-analysis of clinical trials. Nutr J 2014; 13:7.
  97. Yassin SA. Herbal remedy used by rural adolescent girls with menstrual disorders. J Am Sci 2012; 8(1):467-73.
  98. Younesy S, Amiraliakbari S, Esmaeili S, Alavimajd H, Nouraei S. Effects of fenugreek seed on the severity and systemic symptoms of dysmenorrhea. J Reprod Infertil 2014; 15(1):41-8.
  99. Salamon I. Chamomile: a medicinal plant. The Herb, spice and medicinal plant. Digest 1992; 10:1-4.

100. Zaidi SA, Khatoon K, Aslam KM. Role of herbal medicine in Ussuruttams (Dysmenorrhoea). J Acad Indus Res. 2012; 1(3):113-7.

101. Singh O, Khanam Z, Misra N, Srivastava MK. Chamomile (Matricaria chamomilla L.): an overview. Pharmacogn Rev 2011; 5(9):82-95.

102. Modarres M, Mirmohammad AM, Oshrieh Z, Mehran A. Comparison of the effect of Mefenamic Acid and Matricaria Camomilla capsules on primary dysmenorrhea. J Babol Univ Med Sci 2011; 13(3):50-8.

103. Valadi A, Nasri S, Abbasi N, Amin G. Antinociceptive and anti-inflammatory effects of hydroalchoholic extract of anethum graveolens L. seed. J Med Plant 2010; 2(34):124-30.

104. Jana S, Shekhawat GS. Anethum graveolens: An Indian traditional medicinal herb and spice. Pharmacogn Rev 2010; 4(8):179-84.

105. Heidarifar R, Mehran N, Heidari A, Koohbor M, Mansourabad MK. Effect of Dill (Anethum graveolens) on the severity of primary dysmenorrhea in compared with mefenamic acid: A randomized, double-blind trial. J Res Med Sci 2014; 19(4):326-30.

106. Mohammadinia N, Rezaei MA, SalehianT, Dashipour AR. Comparing the effect of Anethum gravolens with mefenamic acid consumption on treatment of primary dysmenorrhea. J Shahrekord Univ Med Sci 2013; 15(5):57-64.

107. Haghiroalsadat F, Vahidi A, Sabour M, Azimzadeh M, Kalantar M, Sharafadini M. The indigenous cuminum cyminum L. of yazd province: chemical assessment and evaluation of its antioxidant effects. J Shahid Aadoughi Univ Med Sci 2011; 19(4): 472-81.

108. Sayyah M, Peirovi A, Kamalinejad M. Anti-nociceptive effect of the fruit essential oil of Cuminum cyminum L. in rat. Iran Biomed J 2002; 6(4):141-5.

109. Tavassoli F, Sharifian J, Mazlum R. The comparison Cumin and Mefenamic acid on primary dysmenorrhea. J Mashhad Univ Med 1999; 6(2):1-7.

110. Kooti W, Moradi M, Akbari SA, Sharafi-Ahvazi N, Asadi-Samani M, Ashtary-Larky D. Therapeutic and pharmacological potential of Foeniculum vulgare Mill: a review. J Herb Med Pharmacol 2015; 4(1):1-9.

111. Mirabi P, Alamolhoda SH, Esmaeilzadeh S, Mojab F. Effect of medicinal herbs on primary dysmenorrhoea-a systematic review. Iranian journal of pharmaceutical research. Intern J Produc Res2014; 13(3):757-67.

112. Sanogo R. Medicinal plants traditionally used in Mali for dysmenorrhea. Afr J Tradit Complement Altern Med 2011; 8(5 Suppl):90-6.

113. Rajith NP, Ambily DV, Dan VM, Devi PS, George V, Pushpangadan P. A survey on ethnomedicinal plants used for menstrual disorders in Kerala. Indian J Tradition Knowledge 2012; 11(3):453-60.

114. Daily JW, Zhang X, Kim DS, Park S. Efficacy of ginger for alleviating the symptoms of primary dysmenorrhea: a systematic review and meta‐analysis of randomized clinical trials. Pain Med 2015; 14(10):111.

115. Alcaraz M, Hoult JR. Actions of flavonoids and the novel anti-inflammatory flavone, hypolaetin-8-glucoside, on prostaglandin biosynthesis and inactivation. Biochem Pharmacol 1985; 34(14):2477-82.

116. Toker G, Küpeli E, Memisoğlu M, Yesilada E. Flavonoids with antinociceptive and anti-inflammatory activities from the leaves of Tilia argentea (silver linden). J Ethnopharmacol 2004; 95(2):393-7.

117. Özek M, Üresin Y, Güngör M. Comparison of the effects of specific and nonspecific inhibition of nitric oxide synthase on morphine analgesia, tolerance and dependence in mice. Life Sci 2003; 72(17):1943-51.

118. Basim A, Hojjati MR, Alibabaei Z, Fathpoor H. Evaluating the analgesic effect of Cucurbita maxima Duch hydro-alcoholic extract in rats using formalin test. J Shahrekord Univ Med Sci 2014; 16(4):88-94.