Dear Ahmed,

The following publications cover the answer to your question:

1- CHINESE HERBAL THERAPY FOR UTERINE FIBROIDS

by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

CHINESE MEDICAL THEORY OF ABDOMINAL MASSES, SUCH AS FIBROIDS

The first depiction of uterine fibroids in the Chinese literature was in the Ling Shu (ca. 100 B.C.), which defined shijia, a stony tumor (shi = stone; jia = mass). From this text arose the general concept of abdominal masses as zhengjia, which denotes two types of masses: zheng refers to one in fixed position that is painful, and jia is a mass that can be moved, and only hurts when pressure is applied. These masses were described in the Ling Shu (1) scroll on water swellings, zheng corresponds to uterine masses and jia corresponding to intestinal masses (bracketed statements are inserted to aid explanation of the text):

Cold qi is a guest [that is, it takes residence there] in the outer [wall of the] intestines, and battles with the protective qi. The qi does not receive nourishment, and because cold qi and protective qi are tied together [in battle], indigestion comes from internal confusion. The sick qi then rises [e.g., upward flux of stomach qi], and sick flesh is born [below]. At the commencement of its birth, the mass is as large as a chicken's egg. Gradually, it increases its sized until it reaches the its conclusion with a shape like carrying a child. For a long time, that is, with years intervening, if the hand is then used to press [on the abdomen], it will feel solid, but if it is pushed, it will move [hence, it is due to an accumulation of stagnated qi]. The menstrual period will be in accord with the tides [i.e., will be regular]. [These are the symptoms when the intestines are affected…alternatively,] the abdominal masses begin in the middle of the womb. Cold qi is a guest at the mouth of the womb. The mouth of the womb is blocked and obstructed. Qi cannot penetrate. Sick blood should leak out but does not leak. The bleeding at times is detained and stops, day by day, [the womb] will increase in size so that the appearance will be like pregnancy. The menses do not respond to the tides [they are irregular].

Based on these concepts, one of the earliest methods of herb therapy for the uterine mass was to use the five ingredient formulation called Guizhi Fuling Wan (Cinnamon and Hoelen Formula), first described in the Jingui Yaolue (ca. 220 A.D.). The cold qi is dispelled by using cinnamon twig; the water stagnation is dispelled by hoelen (poria); the blockage and obstruction of blood flow is treated by the combination of persica, red peony, and moutan. In the Jingui Yaolue (2), the situation was described whereby menstrual bleeding would cease for three months, followed by incessant bleeding indicating that a mass had formed. This scenario is consistent with the concept that the womb is blocked and obstructed (hence the lack of bleeding), but then it develops a mass, which causes the incessant bleeding. The condition was distinguished from pregnancy, where menstrual bleeding would stop, and a mass would begin to form in the abdomen, but incessant bleeding would not follow. Guizhi Fuling Wan halts the incessant bleeding by removing the mass.

In the modern text Practical Therapeutics of Traditional Chinese Medicine (3), the distinction of the two mass types as understood today is presented:

Zheng describes solid masses (concretions) with defined physical form and fixed location, accompanied by pain in a specific location. In these cases, pathological changes have taken place in the visceral organs; thus, these patterns usually involve the blood. Jia, on the other hand, describes masses without a distinct physical form (conglomerations), manifesting and dispersing without apparent pattern. Accompanying pain is not fixed in location. In these cases, pathological changes have taken place in the bowel organs. Hence, these patterns involve qi. Despite the differences between zheng and jia, the two are closely related in terms of pathogenesis and are difficult to differentiate, hence the use of the compound term zhengjia.

An extensive review of the theoretical basis for the etiology and treatment of abdominal masses, including fibroids, is found in the Advanced Textbook of Traditional Chinese Medicine and Pharmacology (4); it is reproduced here with only slight editing. Gynecological examinations were not a practice in China until the recent introduction of modern techniques, so fibroids could not be specifically identified and differentiated during the development of the theories outlined here. Fibroids are now frequently diagnosed before they reach a size that causes pain, which had been one of the first signs of a problem for people lacking modern routine examinations and an integral part of the ancient description of the masses.

For the more serious and advanced stage masses described here, symptoms described, such as pain and loss of appetite (and accompanying weakness and weight loss), may not be presented as significant symptoms by patients today because analgesics and other therapies already have been skillfully employed to minimize those effects. Further, some of the cases included in the description may be cancers of the reproductive or abdominal organs, which produce severe systemic effects as they progress. The masses are here divided into two broad groups: qi masses (called ju; these are like the ones referred to asjia) and blood stasis masses (called ji; like those referred to as zheng). Parenthetical statements are added for explanation of the original text.

For more details see:

http://www.itmonline.org/arts/fibroids.htm

2- Natural Alternatives for Uterine Fibroids

Bioidentical Progesterone Cream (Progensa 20)

Bioidentical progesterone cream minimizes the size and frequency of uterine fibroids by balancing the excess estrogen levels.

Uterine Fibroid Formula (ProSoothe)

ProSoothe is an all natural herbal formula that significantly improves uterine fibroids and pelvic pain/cramps, irritability, tension, mood swings, acne, headaches, breast pain, bloating and weight gain.

Also found in this synergistic herbal formula is dandelion and vitex,(chaste tree) that helps the body remove exogenous,(external excess estrogen)from hormone therapy or contaminated food,(xenosteroids) which is a known cause of uterine fibroids.

Milk Thistle (Silymarin)

Beyond the treatment of liver disorders, everyday care of the liver lays a cornerstone for total body health. Naturopaths and others who look beneath the symptoms of an illness to its underlying cause, often discover that the liver has had a role to play. This is true across a vast range of different ailments including uterine fibroids.

Additional Information-Uterine Fibroids

Uterine Fibroid Options

Uterine Embolization

Recommended Herbs

Uterine Fibroids-Condition Treatments

For more details see:

http://www.womenlivingnaturally.com/articlepage.php?id=71

3- Cochrane Database Syst Rev. Author manuscript; available in PMC 2011 Aug 13.

Published in final edited form as:

Cochrane Database Syst Rev. 2009 Apr 15; (2): CD005292.

Published online 2009 Apr 15. doi:  10.1002/14651858.CD005292.pub2

PMCID: PMC3155698

NIHMSID: NIHMS307129

Herbal preparations for uterine fibroids

Jian Ping Liu,1 Hong Yang,1 Yun Xia,1 and Francesco Cardini2

Author information ► Copyright and License information ►

The publisher's final edited version of this article is available at Cochrane Database Syst Rev

This article has been updated. "Herbal preparations for uterine fibroids." in Cochrane Database Syst Rev, volume 4 on page CD005292.

See other articles in PMC that cite the published article.

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Abstract

Background

Uterine fibroids are the most common non-malignant growths in women of childbearing age. They are associated with heavy menstrual bleeding and subfertility. Herbal preparations are commonly used as alternatives to surgical procedures.

Objectives

To assess the benefits and risks of herbal preparations for uterine fibroids.

Search strategy

Authors searched following electronic databases: the Trials Registers of the Cochrane Menstrual Disorders and Subfertility Group and the Cochrane Complementary Medicine Field, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 3), MEDLINE, EMBASE, the Chinese Biomedical Database, the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), AMED, and LILACS. The searches ended on 31st December 2008.

Selection criteria

Randomised controlled trials comparing herbal preparations with no intervention, placebo, medical treatment or surgical procedures in women with uterine fibroids. We also included trials of herbal preparations with or without conventional therapy.

Data collection and analysis

Two review authors collected data independently. We assessed trial risk of bias according to our methodological criteria. We presented dichotomous data as risk ratios (RR) and continuous outcomes as mean difference (MD), both with 95% confidence intervals (CI).

Main results

We included two randomised trials (involved 150 women) with clear description of randomisation methods. The methodological risk of bias of the trials varied. There were variations in the tested herbal preparations, and the treatment duration was six months. The outcomes available were not the primary outcomes selected for this review, such as symptom relief or the need for surgical treatment; trials mainly reported outcomes in terms of shrinkage of the fibroids.

Compared with mifepristone, Huoxue Sanjie decoction showed no significant difference in the disappearance of uterine fibroids, number of patients with shrinking of uterine fibroids or average volume of uterine fibroids, but less effective than mifepristone on reducing average size of uterus (mean difference 23.23 cm3, 95% confidence interval 17.85 to 28.61). There was no significant difference between Nona Roguy herbal product and GnRH agonist in average volume of uterine fibroids or size of uterus. No serious adverse effects from herbal preparations was reported.

Authors’ conclusions

Current evidence does not support or refute the use of herbal preparations for treatment of uterine fibroids due to insufficient studies of large sample and high quality. Further high quality trials evaluating clinically relevant outcomes are warranted.

Medical Subject Headings (MeSH) Drugs, Chinese Herbal [therapeutic use], Gonadotropin-Releasing Hormone [therapeutic use], Hormone Antagonists [therapeutic use], Leiomyoma [*drug therapy], Mifepristone [therapeutic use], Phytotherapy [*methods], Plant Preparations [*therapeutic use], Randomized Controlled Trials as Topic

MeSH check words: Female, Humans

For more details see attached file.

Hoping this will be helpful,

Rafik

Thanks so much, sir

Thank  you so  much Rafik Karaman

It is amazing information 

Commiphora mukul-Guggul, Curcuma, longa, kanchanara-bauhinia-variegata, Ardrak- Ginger, Fenugreek seed, Pepper nigrum, Cinnamon. 

All right, I agree with above.

All right, I agree with above.

Dear Researchers, 

I have devised a simple model for selecting herbal agents/ Natural Plant products targeting a specific disease. I would like you to give it a try. Steps for employing 'Herbal Informatics' Approach are summarized below.

Steps for employing  Informatics based Herbal Bioprospection Approach

Step 1: Classical literature surge model

 A classical literature surge model can be utilized for selecting disease specific virulence factors/ concerning targets. Similarly, the database set of herbals can be selected with attributable factors as a) Ethnopharmacological importance of plant; b) Relevance of Herb in traditional medicine; c) Availability factor or cultural acceptability in localized regions; d) Any vedic literature supporting its use; e) Investigations/ prior experience on potential of the herb; f) Indirect indications, if any. At this step ultimately you choose the virulence factors of disease and a large database of herbal plants, by utilizing primary and secondary databases (Books, Journals, Web, Pubmed, Niscair, Any other source).

(# This is the most crucial step, because if you have selected the targets and herbals database carefully, then only this model would be highly reproducible.)

Step 2: Relevance factor linked binary matrix analysis

PubMed will be used as the assigned search engine for keyword hits analysis. A combination keyword converging ‘anti-disease activity and virulence factor’ will be entered in the query search box of PubMed. Observation based analysis of first 20 hits will be done for linking the relevance of each virulence factor with its direct significance in triggering the disease. Percentage relevance of each virulence factor will be evaluated using the following formula;

% Relevance = (No of relevant hits based on observational analysis X 100)/ Total No of Hits screened (n=20)

The scrutinization of primary database set of NPPs will be  done with respect to presence or absence of a given bioactivity parameter in the plants database, as reported in either traditional databases or PubMed search engine. Every plant will be given a score of 1 for the presence of linked inhibitory activity against each virulence factor. 

Step 3: Binary Matrix Analysis

Scores for each plant will be cumulatively added. Plants with scores ≥3 from previous step will be scrutinized finally.

(*There are 2 more matrices which could be taken into consideration i.e., Weightage matrix and Fuzzy Set Decision matrix. These 2 matrices are not necessary to be utilized while selecting the herbals via a classical approach. But, for advanced search, one might use these matrices as well. For further details, you might write back to me.)

Step 4: In silico biochemical and molecular activity prediction using

‘Mol Inspiration’

(Site URL for Online software of Bioactivity Prediction: http://www.molinspiration.com/)

• Preparation of ligand dataset

The 2D structures and the SMILES (Simplified Molecular-Input Line-Entry System) notation of predominant phyto-constituents of scrutinized herbals (~ Fuzzy Set Score of 1) will be obtained from Pubchem.

• Biological activity prediction

Canonical SMILES of each of the selected biologically active phytoconstituent

will be considered as the test set. Based on the analysis of large training set consisting of tens of thousands of the known biologically active compounds, computer program PASS will analyze the presence or absence of specific substructures in the test set in relation to the training set. Each substructure fragment will contribute towards a bioactivity score for each listed activity i.e., GPCR Ligand, Ion Channel modulator, Kinase inhibitor, Nuclear receptor ligand and Protease inhibitor. This provided a total molecule activity score (a number, typically between -3 and 3). Molecules with the highest activity score could probably be assigned to have the highest probability to be active as a therapeutic lead against the targeted disease.

Conclusion

As a final outcome, plants having a higher binary score, clubbed with a good bioactivity score might serve as probable therapeutic alternatives, which could be further tested at in vitro and in vivo levels. This herbal informatics approach will hence provide a scrutinized list of plants targeting a given disease and bioactivity scoring will moreover provide an insight into the plausible mechanistic aspects of the selected herbals.

Regards

Pallavi Thakur

Researcher

DRDO, Ministry of Defence

I totally agree with Pallavi,but herbal drugs which are not documented may not be found in these databases.Traditional medicine of Ayurveda has solutions for Uterine fibriods which have given positive results are as follows-

Neem(Azadhiricta indica)

Asoka(Saraca asoka)

Kasisa Bhasma(Incinerated calx of CuSO4)

Polyharbal formulations like 

Pushyanuga Churna

Ashokarishta.

In asymptomatic fibroid  'Guggulu ' (Commofora mukul ) also give result .it is beneficial also. We ,Ayurvedic people r doing treating this type by 'Uttarbasti ' therapy also.

This is great Ks Patel 

Dear Rafik thank you very much for the interesting information

I know and above is correct. Thanks.