In this module we cover the following topics:
Herbs for treatment of infertility in women
Phytoestrogens and their use in treating the effects of the
Two of the widely used herbal medicines for treatment of infertility
In previous modules we have looked at the principles of herbal therapy and we have learnt about the vital steps towards symptom evaluation of illnesses and tactics used for treatment. In an earlier module, we were also introduced to pregnant clients, as they are a good source of minerals, vitamins and
women, children and the elderly and we also studied the most commonly used herbs for those conditions. In this and subsequent modules, we will turn our attention towards specific patient groups or illnesses. The study of women’s illnesses is extremely important. This is because these illnesses are commonly experienced by most women. It
is also important because special care and sensitivity is required during their treatment. Herbal therapy is suitable for several of these illnesses, particularly because of its relatively mild effects. In this module, we will cover the most common illnesses that women suffer, and we will look at how to treat these illnesses. WHY WOMEN REQUIRE SPECIAL CARE
Plant-based medicines play an important role in the lives of many women. This is because herbal remedies fulfil a woman’s desire to deal with her health problems in a more sensitive manner, with minimal side effects. Women of child-bearing age in particular often prefer herbal remedies. This is due to the large number of modern medicines that can be harmful to a mother’s unborn baby. Many expectant mothers seek gentler forms of medication, often provided by herbal remedies. EXERCISE 5.1
Why are herbal remedies even better suited for women’s illnesses? Give two reasons: 1. 2. Two suggested answers to this exercise can be found at the end of the module.
COMMON ILLNESSES IN WOMEN
There are several common illnesses suffered by women. Infertility for instance is suffered by a significant number of women of child- bearing age. Herbal medicines may help induce fertility in some cases. For pregnant women there are several herbs that can be taken to help treat problems suffered during pregnancy, such as nausea. Plus they can help maintain the expectant mother’s emotional balance and restore her energy. Herbs can also help with another common problem suffered by women: hormonal imbalance. For menopausal women herbs can prove helpful in reducing the side effects felt due to disturbances in hormonal levels. A common issue in treating women’s illnesses is the hormonal balance, particularly estrogen levels. Disturbance in the hormonal levels cause several undesirable effects in pre and post-menopause. Some herbs have been shown to be very effective in treating these conditions. INFERTILITY
Infertility is a problem suffered by many couples around the world. It can be a particularly difficult problem to come to terms with and cause difficulties within a relationship. In some cases however, the use of herbal remedies may improve an individual’s fertility. Infertility can be suffered by both males and females. However, as this module is about illnesses suffered by women, we shall focus on how to treat them with herbal remedies. HOW DO FERTILITY HERBS WORK? TREATMENT MECHANISM
There are several fertility problems suffered by women that can be treated by herbal remedies. These include:
And many other unknown causes of fertility impairment
Anovulation occurs when the egg is not released from the ovary during ovulation. This failure in ovulation can occur due to hormonal imbalances. The Luteal phase occurs after ovulation. It is when progesterone is produced causing the lining of the uterus to thicken. Infertility can be caused when this phase does not function properly. PHYTOESTROGENS
The herbs used for women suffering from infertility are employed because of their ‘hormone-like’ constituents. These are organic compounds which share many similarities with natural hormones found in the human body. Due to their similar structure, the herbs can trigger the actions that the hormones normally would. Therefore, the women’s fertility should function normally. These herbs actually contain multiple natural compounds, giving the herbs a unique ‘synergistic’ effect. EXERCISE 5.2
Tick the box(es) next to the most appropriate answer(s) for each question from the options given: What is the most common mechanism for action of herbal medicines that are used for treating infertility?
Herbal medicines often have phytoestrogens that have a hormone like property and can perform functions that mimic the action of hormones in the body.
Herbal medicines provide you with the hormones that are deficient in the body.
The use of herbal medicines for improving fertility is not proven; moreover it can lead to newer complications. The action mechanism for herbal medicines in improving fertility has never been understood.
The answer to this exercise can be found at the end of the module.FERTILITY HERBS
AGNUS CASTUS (ALSO KNOWN AS VITEX OR CHASTE BERRIES) Agnus Castus is useful for helping women with fertility problems. They come in berry form. Agnus Castus is progesteronic and is one of the most important herbs for regulating female hormones. Plus they:
Balance the production of hormones by the ovaries throughout the
Help regulate irregular and absent menstrual cycles
You can also suggest agnus castus to client that are suffering the symptoms of pre-menstrual syndrome. In particular it helps reduce breast swelling, tenderness, irritability, depression, and acne. When a client has low levels of progesterone, agnus castus could help. This herb helps by creating a hormone surge, which results in ovulation taking place. Once your client has identified that they are pregnant, they should immediately stop using agnus castus. This is because the herb causes dilation of blood vessels. This herb should not be taken along with other fertility medications, even though this herb is considered safe. Agnus Castus comes in the forms of tablets and tinctures. Agnus Castus has proved itself to be a very useful herb for hormone problems for thousands of years. It is in fact one of the most clinically studied herbs, tested for its ability to regulate female hormones. Agnus castus has the benefit that it does not produce any of the side effects that a client might suffer if they were to use synthetic hormones. Unlike synthetic hormones, agnus castus works alongside the body’s natural hormone production rather than take over from it.
What is the herb Agnus Castus widely used for? Give two uses: 1. 2. The answer to this exercise can be found at the end of the module.
BLACK COHOSH This is discussed in detail in a later section of this module, on treat- ment of menopause syndrome. DONG QUAI (ANGELICA SINENSIS) You can suggest Dong quai to female clients who have fertility problems. This herb helps level the hormones so that ovulation results. However, this herb does not contain phytoestrogens. This herb is also useful for improving the client’s metabolism within their uterus and ovaries. This results in a stronger and more receptive uterine lining. If your client becomes pregnant they should stop taking Dong Quai immediately as it causes blood vessel dilation and stimulates and relaxes the uterine muscles, which could have serious adverse effects on mother and baby. Always be careful when suggesting the dosages of herbs a client should take. Sometimes taking too high a dosage of a herb can produce problems for a client. Ask your clients to make a journal detailing how the herbs made them feel etc. HERBS DURING PREGNANCY AND NURSING
During pregnancy women often suffer common symptoms. These include:
Herbal remedies that can help these conditions are easily available. Taking certain herbs during pregnancy can benefit the client in many ways. For example, they:
Provide a good source of the vitamins and minerals required by the
Have minimal side effects (however, always make sure you check
the safety of taking certain herbs before suggesting them to pregnant clients)
Some of the herbs recommended during pregnancy are: NETTLE LEAVES (URTICA DIOICA) Nettle leaves will benefit your pregnant clients, as they are a good source of minerals, vitamins and iron. These are all required during the child-bearing months. Nettle leaves also assist the uterine muscles, providing nourishment. They can also increase the flow of milk and improves its quality. Other uses of nettle leaves include its ability to reduce seasonal allergies and it also acts as a mild diuretic. RASPBERRY LEAVES (RUBUS IDEAUS) Raspberry leaves are especially beneficial for pregnant clients. For instance, they:
Strengthen the uterine muscles (helps during labour)
Are high in calcium, magnesium and iron
This herb should be used in the third trimester of pregnancy to tone the uterus ready for the birth. Once the pregnancy is over, the client can continue to use take raspberry leaves, as they slow down the bleeding, continue to improve the tone of the uterus, and increase breast milk production. OAT STRAW (AVENA SATIVA) Oat straw is also useful for your pregnant clients. It provides a good source of calcium and magnesium, plus it helps the nervous system relax. Oat straw can also be used in a bath. This will help the client relax, plus it will sooth the itch of their growing belly. DANDELION ROOT (TARAXACUM OFFICINALE - RADIX) Dandelion root is a useful tonic that nourishes the client’s body. Other benefits of dandelion root include:
Good source of vitamin A, calcium, iron and potassium
Dandelion root is a diuretic which is also good for the liver. The liver plays an important part in breaking down hormones that the body no longer needs after the birth has taken place. ALFALFA (MEDICAGO SATIVA) Alfalfa is particularly useful during the last three months of pregnancy if taken as a food within the diet as it reduces bleeding. This herb also provides much needed trace minerals and vitamin K. Vitamin K is especially useful for blood clotting. Alfalfa helps in the production of breast milk.
When suggesting this herb, also ensure that the client is not on any other medication as large doses of this herb may have interactive properties. OTHER HERBS THAT CAN BE USED DURING PREGNANCY Morning sickness and nausea can be reduced by using herbs such as German chamomile and ginger. However, they must be taken in small quantities only. Stretch marks can be reduced by rubbing aloe vera over the stomach, but Aloe juice should not be ingested during pregnancy as it is contra- indicated. PREGNANCY PRECAUTIONS Make it clear to your clients that they should not self-administer herbs during pregnancy without first discussing it with their doctor and herbalist. Extreme caution is required when suggesting herbs to pregnant clients. Never suggest a herb unless you are 100% certain that it is safe for the client to take. So ensure you do thorough research. All herbal remedies should be avoided during the first 3 months of pregnancy. Goldenseal, Pennyroyal and Sage should not be taken by pregnant women. ROLE OF HORMONES IN A WOMAN’S BODY AND HORMONAL IMBALANCE
As many of the illnesses discussed in this module relate to female hormones, it is important that you understand the roles of these hormones. There are two hormones that are particularly important to the female reproductive organs. These are:
ESTRONE This estrogen is one of three naturally occurring estrogens within the body – the other two being estradiol and estriol. Estrone plays a large role during the menopause. A Post-menopausal woman will have a particularly high amount of estrone in her body. PROGESTERONE Progesterone is an important element of the female reproductive cycle. It is produced by the adrenal glands and ovaries. Progesterone’s role in the reproductive cycle is to line the uterus so that it is ready for implantation of a fertilized egg. It also helps maintain the uterus during pregnancy. This hormone also helps the brain function properly. When proper levels of progesterone are maintained the client will feel calm and possess a sense of well-being. It is quite common for a woman to suffer some sort of hormonal imbalance during her life. Two of the most prevalent hormone imbalances experienced by a woman are premenstrual syndrome and the menopause. The menopause normally occurs in women between the ages of 40 to 60. When this happens, there is a reduction in estrogen and progester-one in the body. At this point in the woman’s life menstruation comes to a permanent end. The symptoms suffered during the menopause are:
Traditionally, women are given estrogen replacement therapy or hormone replacement therapy when they go through the menopause. These forms of therapy offer both disadvantages as well as advantages. On one hand they help to diminish some of the symptoms, reduce the chances of osteoporosis, and minimise the risk of cardiovascular disease. However, on the other hand, they can increase the risk of breast cancer. PHYTOESTROGENS
Many people do not want to risk using estrone or hormone replacement therapy, so instead they look to phytoestrogens. Phytoestrogen chemicals found in plants perform the same actions as estrogen. Phytoestrogens are found in many foods. Grains, beans, nuts, seeds, seed oils, berries, fruits, vegetables, and roots - contain phytoestrogens. It is also found in soy foods. HOW DO PHYTOESTROGENS ACT IN THE BODY?
These hormone-like structures act like copies of estrogen. Phytoestrogens can either have the same effect as estrogen or they can block the estrogen’s effects. At low doses they act as estrogen. However, be careful, as in higher doses they block the estrogen effect. PRECAUTIONS WITH PHYTOESTROGENS Never suggest that your client should take phytoestrogens in high doses. A high dose can increase the risk of breast cancer. However, a moderate dietary dose will not produce adverse effects and is actually good for your health. As suggested earlier in this module phytoestrogens should not be given to pregnant women or nursing mothers in large doses.
HERBS CONTAINING PHYTOESTROGENS Phytoestrogens are found in many different forms in different types of plants. Within these plants, minerals work alongside other constituents to aid the body in modifying phytoestrogens so that they maintain safe levels. EXERCISE 5.4
List the possible reasons for infertility in women. The answers to these questions can be found at the end of the module. MENOPAUSE
A natural menopause is a process that can take place over many years; it is not a one-time occurrence, however women can be subjected to surgical menopause which can occur at any age. The natural menopause can begin when a woman is in her 30s (rare) until her 50s or 60s. During the menopause a woman may be going through a natural or surgical process, which changes her hormonally, physically and psychologically. It begins when the ovaries start to produce less estrogen and progesterone. This reduces the fertility of their eggs. As time passes, the menstrual periods no longer occur and fertility is lost. In the surgical menopause process she may have had her ovaries removed along with her uterus. You will need to ascertain which type of menopause she is experiencing. The menopause is generally divided into two phases. These are: 1. Perimenopause – During this phase the woman continues to ovulate. However, she will begin to suffer from the symptoms of the menopause. Hormonal levels are irregular, rising and falling unevenly.
This results in irregular, heavier or lighter periods. This phase can last for 5 years or more. 2. Postmenopause – During this phase the woman will no longer have her periods. It begins when she hasn’t had a period for over 12 months. After this, the ovaries do not produce estrogen or progesterone and no egg is released. EXERCISE 5.5
Tick the box next to the most appropriate answer for each question from the options given: The major cause for the symptoms experienced by women around the menopause phase is:
Decreased production of progesterone and other estrogens.
Decreased production of progesterone, and increased production
of estrogen, thus leading to an imbalance.
Decreased production of estrogen and increased production of
progesterone leading to imbalance in the hormonal levels in the woman’s body.
The answer to this exercise can be found at the end of the module. HERBAL REMEDIES FOR MENOPAUSE
You can suggest a number of herbal remedies to your female clients that they can use during their transition to and through the menopause. These remedies provide a safe way to reduce the impact of the menopause. Some of the commonly used herbal medicines are as follows: BLACK COHOSH (ACTAEA RACEMOSA) Black cohosh can be used to treat a number of symptoms suffered by women during the menopause. For instance, it:
Reduces night sweats and occasional sleeplessness
When a client’s progesterone levels are too high, black cohosh should be taken. It is also used to stimulate the uterus. Research suggests that black cohosh is comparatively safe in standard dosage. It does not produce side effects like hormone replacement can. Plus, it does not affect hormone levels or specific cell lines associated with some female cancers. Black cohosh should not be taken during pregnancy or while breast-feeding. You should not use black cohosh for more than 6 months. Anyone with heart disease should not use black cohosh. The sedative properties of black cohosh make it possible to be used for other problems, such as treating high blood pressure, tinnitus (ringing in the ears), whooping cough and asthma. ST JOHN'S WORT (HYPERICUM PERFORATUM) This herb helps in relieving anxiety and mood disturbances during the menopause. It is also effective in cases of mild depression. St. John’s Wort is not suitable for use where the depression is severe and caution should be given to its use when the client is likely to be exposed to strong sunshine as it can make the skin photosensitive. An important factor to note in the use of St. John’s Wort is that it is known to interact with a large majority of other orthodox medicines, including Contraceptives, HRT, vitamins and mineral supplements. So caution must be used when recommending this to clients, especially if they are taking other medicines. AGNUS CASTUS -VITEX (CHASTE TREE) Covered earlier in greater detail.
DONG QUAI (ANGELICA SINENSIS) Dong quai can benefit women going through the menopause as it helps correct their hormonal imbalances. It has tonic and regulatory effects on the female reproductive system and is used for its ability to relieve pain, hot flashes, dizziness, sleep- lessness and osteoporosis. The possible side effects of dong quai are dermatitis or gastric upset and possible interaction with HRT. EXERCISE 5.6 Given below is a list of common illnesses for women. The other list is of some terms that are associated with a specific ailment – it could be a cause of the ailment or a treatment method or a herb prescribed for treatment. Match the illness with its associated term. No Common Illnesses or Code Associated term conditions The answer to this exercise can be found at the end of the module.SUMMARY
1. You understand why the treatment of women’s illnesses requires
2. You are aware of the common illnesses that women suffer.
3. You know of herbs that can be used for treatment of infertility in
4. You know of herbs that can be given to pregnant and nursing
5. You know what Phytoestrogens are, and you know how they can
6. You are aware of herbal medicines for treatment of infertility and
Ruth and Jack have come to you for advice as Ruth has recently discovered that she is pregnant. They were hoping that you might be able to provide some herbal remedies for some of the problems that Ruth has been experiencing over the last few weeks. They would also like to know of any other herbs that might be helpful in the future. Ruth and Jack are very cautious regarding what Ruth takes during pregnancy because like any new parents, they do not want to harm their baby. This is why they would like to use herbal remedies rather than orthodox drugs. Remember, herbal remedies may well often be the safest form of medicine, but with a pregnant client you must be very careful about what you administer. Ruth is suffering from bouts of morning sickness and nausea and would like to know how to reduce the impact of these problems. She would also like to know how she could minimise the occurrence of stretch marks. Ruth has also found that she is often very tired, and she lacks the energy she had before she became pregnant. As this is Ruth and Jack’s first child they are both very anxious. They would like to know what other herbs Ruth could use to prepare her body for the pregnancy. Your task
Write some notes for yourself suggesting some herbs that Ruth could use to reduce the impact of the problems that she is currently suffering from. Also suggest what other herbs Ruth could take that will help her throughout the pregnancy. Be sure to emphasise why Ruth should use these herbs that you suggest. EXERCISE ANSWERS
EXERCISE 5.1 Herbal remedies are even better suited for women’s illnesses because: - Drugs that have adverse effects can have a detrimental effect on the
embryo of a pregnant woman or on an infant being nursed by her mother and this can lead to serious consequences. Herbal medicines are likely to be safer.
- Herbal medicines can save women from cancers. (May be true in
some instances, but this is not proven and in any case it is not universal.)
EXERCISE 5.2 What is the most common mechanism for action of herbal medicines that are used for treating infertility?
- Herbal medicines often have phytoestrogens that have a hormone
like property and can perform functions that mimic the action of hormones in the body.
EXERCISE 5.3 Agnus Castus is a herb widely used for: - Improving fertility
- Increasing milk flow in a mother that is nursing her infant EXERCISE 5.4 List the possible reasons for infertility in women. The main reasons for infertility are:
Physical impairment such as obstruction in fallopian tubes,
abnormal placement of the uterus lining and other tissues (endometriosis), tumours or cysts in the reproductive area.
EXERCISE 5.5 The major cause for the symptoms experienced by women around the menopause phase is: -
Decreased production of progesterone and other estrogens.
EXERCISE 5.6 No Common Illnesses or Code Associated term conditions
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