Phytotherapy in obstetrics and gynecology

The versatility of medicinal herbal remedies and the safety of their use make phytotherapy indispensable in gynecology, obstetrics and perinatology, where the principal issues are harmlessness to the fetus with a very long duration of treatment, as well as obtaining several effects from a minimum amount of funds. In the vast majority of cases, the pregnant woman's body and the fetus do not need intensive therapy, but only in the prevention of violations of the adaptive-homeostatic reactions of the fetoplacental system. Moreover, such prevention is necessary against the background of the treatment of pregnancy complications and the development of fetoplacental insufficiency, with the risk of perinatal infection.

Plants have also been used for the treatment of gynecological diseases for a long time, and now their use in this area has received scientific justification. Phytotherapy is prescribed for various menstrual disorders (uterine bleeding, dysmenorrhea), for the treatment of premenstrual and menopausal syndromes, inflammatory diseases of the genitals, mastopathy and mastalgia and other pathological conditions. Thus, ergot alkaloids, quinine, morphine are used for menstrual cycle disorders (they belong to the regulators of the menstrual cycle of direct action). In cases of uterine bleeding, ergot preparations (methylergometrine, ergotamine) are used to reduce blood loss, and a decoction or infusion of dioecious nettle is used as hemostatic agents. In the treatment of primary (spasmodic) dysmenorrhea, herbal remedies with antispasmodic, analgesic, and hormone- mimetic effects are prescribed. It can be pharmacy chamomile, yarrow, viburnum, shepherd's bag, celandine, belladonna, henbane, abraham tree. Many plants have bactericidal activity, and this property is used in the treatment of inflammatory diseases of the mucous membranes, skin. Such properties are possessed by the flowers of chamomile pharmacy, calendula, infusion of sage medicinal.

The effectiveness of phytotherapeutic drugs has been tested by many clinical trials. Since phytopreparations practically do not cause side effects, they can be prescribed for a long time both as an independent treatment and in combination with other medications. Phytopreparations are also used for the treatment of premenstrual and menopausal syndromes.

Premenstrual syndrome develops a few days before the onset of menstruation and is manifested by both mental and somatic symptoms, which are expressed in fears, irritability, mood variability, drowsiness, headache, chest swelling, bloating and swelling of the legs. The main hormones that regulate the menstrual cycle throughout a woman's life, as well as the growth and development of mammary glands, are hormones of the pituitary gland, ovaries (estrogens and progesterone), thyroid gland, adrenal glands and other biologically active compounds. A big role belongs to prolactin, a hormone produced by the pituitary gland. Prolactin, together with estrogens and progesterone, controls the entire process of mammogenesis, providing both the formation of intra-organ structures and postpartum lactation. The role of prolactin is especially important during pregnancy, when the mammary gland is preparing for lactogenesis. Prolactin provides synthesis of proteins, carbohydrates and lipids of milk. After childbirth, the lactogenic effect of the hormone sharply increases. At the end of lactation, prolactin production decreases to the baseline level. A pathological increase in the level of this hormone outside of pregnancy and lactation can cause the development of mastopathy. Often there is not a permanent, but a so-called latent increase in prolactin levels, leading to the development of a symptom complex called premenstrual syndrome (tenderness and swelling of the mammary glands, especially in the second phase of the menstrual cycle or immediately before menstruation, as well as vegetative disorders, migraine-like headaches, swelling of the extremities, abdominal pain, flatulence). With the onset of menstrual bleeding, all these symptoms usually disappear. Hyperprolactinemia is also one of the causes of menstrual function disorders: irregular rhythm of menstrual bleeding, menorrhagia, oligo and amenorrhea, anovulation, insufficiency of the luteal phase. It was found that dopamine plays an important role in the development of hyperprolactinemia, therefore, it was assumed that the mild action of dopaminergic substances can be effective in the treatment of premenstrual syndrome.

Clinical experience shows that premenstrual and preclimacteric mastalgia can be successfully treated with extracts of Uyeh agnus castus containing dopaminergic components. Some fractions have been recognized that bind to recombinant dopamine receptors and suppress prolactin secretion almost equivalent to dopamine. Clinical studies have determined the clinical efficacy of Uyeh agnus castus extract in the treatment of premenstrual mastodynia.

Menopausal syndrome is understood as a set of complaints that are addressed by women over the age of 45. The most common disorders are poly and oligomenorrhea, dysfunctional bleeding, hot flashes, sweating, sleep disorders, depression. One of the main methods of treatment of menopausal disorders caused by estrogen deficiency is hormone replacement therapy. However, there are subjective and objective factors that reduce acceptability. These include contraindications for its implementation, a woman's subjective negative reaction to taking hormonal drugs, the possibility of side effects, as well as intolerance to certain drugs. Therefore, much attention has recently been paid to alternative methods of treating menopausal disorders.

Improving well-being with hot flashes and other menopausal complaints, protection from osteoporosis without side effects -this is what women in the menopausal period expect from an ideal drug. In the global pharmaceutical industry, research has been conducted for many years on the "improvement of estrogens", but nature has coped with this faster.

In extensive biomolecular studies on animals, estrogen effects have been demonstrated: no effect on the uterus, the ability to reduce the cholesterol level of low-density lipoproteins in the blood serum of rats after ovariectomy and osteosis-protective effect. In animal experiments, it was shown that the effectiveness of the extract of cimicifuga BC01055, used for the production of climadinone, is comparable to the effect of estradiol.

There are relatively few medicinal plants available for phytotherapy in this area. Their action can be considered as the action of hormone mimetics. The therapeutic effect of these medicinal plants is due to hitherto unknown "plant hormones" - substances similar to hormones, but not replacing hormones.

Thus, herbal medicines can be effectively used in various obstetric and gynecological pathologies. It is worth noting that the advantages of herbal remedies are good tolerability and a small number of contraindications; effectiveness comparable to chemotherapy drugs. Modern phytotherapy is becoming increasingly widespread in clinical practice, being an alternative to drug treatment. Phytopreparations can be prescribed for a long time as an independent treatment, or in combination with other medications, they practically do not cause side effects.

Phytotherapy is not only a scientifically based method of treatment and prevention of diseases, but also a method that has all the rights to creative development, taking into account modern trends in medicine.