Reviewed: 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):41-48.
Painful cramps that occur during menstruation are known as dysmenorrhea, and they can negatively affect a woman’s quality of life. Pain medication is a primary treatment, but commonly used non-steroidal anti-inflammatory drugs (NSAIDs) are associated with certain adverse side effects. Fenugreek (Trigonella foenum-graecum, Fabaceae) has been used traditionally for pain during menstruation and to induce childbirth,1 and studies have shown that the plant has anti-inflammatory, antioxidant, carminative (flatulence-relieving), hypoglycemic, and hypolipidemic properties. This randomized, double-blind, placebo-controlled trial investigated the impact of fenugreek consumption in women with moderate-to-severe dysmenorrhea.
Unmarried female students were enrolled in this study and matched for age, onset of first menstrual cycle and dysmenorrhea symptoms, and body mass index (BMI). Excluded subjects had diseases that could affect fenugreek absorption or utilization — such as diabetes, chronic hypertension, or infectious diseases — or had irregular menstruation, endometriosis, a history of conventional pharmaceutical use, acute stress, or symptoms of vaginal infection. Patients who did not comply with the treatment protocol also were excluded.
Fenugreek seeds (procured from Zardband Pharmaceuticals; Tehran, Iran) were ground and transferred to capsules (900 mg). Placebo capsules contained potato (Solanum tuberosum, Solanaceae) starch. If pain medication was necessary, patients were instructed to take these drugs one hour or more after consumption of the treatment or placebo and to report the severity of pain. During the first three days of menstruation, patients were instructed to take two to three capsules, three times per day, for a maximum total of 2,700 mg per day, for two consecutive menstrual cycles.
Patients used a checklist to report additional medication taken for pain, the severity of pain, and menstruation symptoms. A visual analog scale (VAS) was used to assess pain during the first three days of menstruation. A score of 1-2 indicated mild pain, 3-7 was moderate, and 8-10 was severe. Associated systemic symptoms such as fatigue, diarrhea, syncope (fainting), nausea, vomiting, lack of energy, headache, and mood swings were scored from 0-3.
In total, 106 patients were enrolled, with 101 completing the protocol (51 in the fenugreek group; 50 in the placebo group). Reasons for dropouts or exclusions were not disclosed. At baseline, no significant differences were noted in overall age, age of menstruation or dysmenorrhea onset, pain severity, or BMI. At the end of the study, pain severity significantly decreased in both groups after the second cycle as compared to baseline. In the fenugreek group, baseline pain was measured at 6.4 ± 1.83 and decreased to 3.25 ± 1.25 (P<0.001) after the second menstrual cycle. In the placebo group, baseline pain was measured at 6.14 ± 1.89 and decreased to 5.96 ± 1.87 (P=0.016) after the second menstrual cycle.
After each cycle, pain severity in the fenugreek group also was significantly less than in the placebo group (P<0.001 for both). After the first cycle, the fenugreek group had scores of 4.32 ± 1.50, and the placebo group rated 6.03 ± 1.78. After the second cycle, pain severity in the fenugreek group was 3.25 ± 1.25, and the placebo group was 5.96 ± 1.87. In the fenugreek group, duration of pain decreased significantly (P=0.01). In contrast to placebo, fenugreek also reduced dysmenorrhea-associated systemic symptoms, including nausea, vomiting, lack of energy, headache, diarrhea, mood swings, syncope, and fatigue (P<0.001). Lastly, the average use of pain medication in the fenugreek group significantly decreased at the study’s endpoint as compared to the placebo group (P<0.001).
Overall, fenugreek consumption reduced both duration and pain severity of dysmenorrhea in otherwise healthy women. Those taking fenugreek used less pain medication and reported no adverse side effects. The effectiveness of fenugreek in reducing symptoms of dysmenorrhea in this study highlights the need for future studies to compare fenugreek with anti-inflammatory medications.
—Amy C. Keller, PhD
- Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: American Botanical Council and Newton, MA: Integrative Medicine Communications; 2000.