About the Author(s)


Karishma Singh Email symbol
Department of Nature Conservation, Faculty of Natural Sciences, Mangosuthu University of Technology, Durban, South Africa

Roger Coopoosamy symbol
Department of Nature Conservation, Faculty of Natural Sciences, Mangosuthu University of Technology, Durban, South Africa

Alabi David symbol
Department of Nature Conservation, Faculty of Natural Sciences, Mangosuthu University of Technology, Durban, South Africa

Kuben Naidoo symbol
Department of Nature Conservation, Faculty of Natural Sciences, Mangosuthu University of Technology, Durban, South Africa

Citation


Singh, K., Coopoosamy, R., David, A. & Naidoo, K., 2024, ‘Unlocking nature’s secrets: Medicinal plants for enhanced female fertility’, Journal of Medicinal Plants for Economic Development 8(1), a258. https://doi.org/10.4102/jomped.v8i1.258

Review Article

Unlocking nature’s secrets: Medicinal plants for enhanced female fertility

Karishma Singh, Roger Coopoosamy, Alabi David, Kuben Naidoo

Received: 05 Apr. 2024; Accepted: 15 May 2024; Published: 09 July 2024

Copyright: © 2024. The Author(s). Licensee: AOSIS.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Infertility is a social challenge common among couples ranging from sub-Sahara, Asia and different parts of the world. Infertility occurs as result of malformation of the uterus, poor diet, illness, and continuous unprotected sexual activity.

Aim: To provide an update on medicinal plants used across regions in the world capable of healing female infertility.

Setting: This article provides a world overview of medicinal plant activity from different regions across the globe. The use of modern medicine is effective but often not at the reach of the majority.

Methods: The article summarises previous literature on the use of medicinal plants in female fertility treatments. Findings indicated the importance of traditional healers in woman’s infertility. The traditional healers used materials prepared from herbs. Herbs are derived from plants and plant extracts of various natural resources, including plant leaves, bark, flowers, roots, fruits, and berries.

Results: Female infertility has been proven to respond well to herbal-based therapy. Women’s infertility is a condition that is receiving more attention concerning medicinal herbs. Several kinds of plants have been used in different regions of the world to cure female infertility. The performance of the various medicinal plants depends on accumulation of bioactive ingredients.

Conclusion: Modern plants have shown potential in enhancing female fertility through their various therapeutic properties and bioactive compounds. Overall, while there is promise in using plants for female fertility holds promise, further research and clinical trials are necessary to establish their safety and effectiveness.

Contribution: These herbs can be used as an alternative or supplemental therapy for female infertility, and further research is required to determine their effectiveness and safety.

Keywords: infertility; medicinal plants; women’s health; traditional medicine; fertility.

Introduction

Infertility is recognised globally as a significant public health concern, imposing burdens on societies (Kochar et al. 2017). It affects numerous nations and healthcare systems. Infertility is a social and mental problem with high prevalence across the globe. Approximately one in every six individuals of reproductive age worldwide experiences infertility (Vander Borght & Wyns 2018). The occurrence of infertility has risen globally by 2.91%–3.70%, leading to an increase in disability-adjusted life years from 2.93% to 3.96% (Vander Borght & Wyns 2018). Higher socioeconomic indices correlate with increased infertility rates and disability-adjusted life probability among women (Zegers et al. 2009). In regions like South Asia, sub-Saharan Africa, North Africa, Middle-East, Central and Eastern Europe, and Central Asia, infertility presents significant challenges, often accompanied by social and cultural stigmas. Various reproductive issues, including leucorrhoea in Bangladesh, menstrual discomfort in Trinidad and Tobago, and womb issues in Bangladesh, contribute to the complexity of infertility (Hossain & Rahman 2015; Lans 2007).

Nutrition, infections, and uterine abnormalities are common factors in infertility-related issues, with conditions such as tubal infertility, cervical issues, and hormonal imbalances contributing to female infertility (Vander Borght & Wyns 2018). Fertility care encompasses prevention, diagnosis, and treatment, yet many countries lack access to such care, particularly those with poor and moderate incomes. Traditional medications and micronutrients play significant roles in treating female infertility (Abuzeid et al. 2014; El-Mansi et al. 2023). Chinese herbal medicine therapy has shown promise in enhancing fertility indicators, while antioxidants and vitamins are also utilised in infertility treatments (Jiang & Li 2017; Naseri et al. 2019; Silva et al. 2019). Researchers have debated the use of modern medication versus traditional medication because of issues like poor live birth rates and high costs. Consequently, infertile couples increasingly turn to complementary therapies like herbal medication, which offers phytoestrogenic, antioxidant, and nutritional benefits (Ascenzic et al. 2021; Miner et al. 2018).

Medicinal plants have been utilised for centuries to address various health conditions, including infertility. This review aims to provide an update of medicinal plants used across regions in the world capable of healing female infertility and compile a list of medicinal plant species historically used in various regions to boost female fertility.

Methodology

This review summarises previous research on the use of medicinal plants as a therapeutic in female fertility enhancement. The following keywords were employed to gather information from the literature: ‘medicinal plants’, ‘female fertility’, ‘traditional medicine’, ‘conventional medicine’, and ‘fertility therapies’. Scientific databases including Google Scholar, PubMed, Science Direct, as well as Research Gate were specifically used to source data. Furthermore, taxonomic verifications of the plants were validated by use of the database of plants1 for this review.

Infertility treatment in sub-Sahara

The popularity of traditional herbal medicine has grown, especially in African cultures, because of its compatibility with local beliefs and minimal adverse effects (Ralapanawe et al. 2023). Knowledge of herbal medicine is passed down orally through generations and sustained through observations, spiritual encounters, and narratives (Mokgobi 2014). Globally, up to 80% of the population relies on traditional medicines for basic healthcare needs, with therapeutic plants extensively used in developing countries like Cameroon, Uganda, and Nigeria (Agize, Demissew & Asfaw 2013; Jiofack et al. 2010; Kamatenesi-Mugisha et al. 2007; WHO 2003).

Herbal medicines encompass various plant materials for therapeutic purposes, utilised in human and occasionally animal health (Phua et al. 2009; WHO 2003). Women’s well-being is affected by infertility, particularly in sub-Saharan Africa, where over 30% of women are infertile according to the World Health Organization (WHO) data (Chimbatata & Malimba 2016). Despite the availability of Western medications, indigenous healing practices (IHPs) are widely used to manage infertility, with many women in Nigeria preferring traditional and spiritual healers over Western medicine (Sulyman et al. 2016).

Age-appropriate women have access to ongoing information about secure new Western treatments for infertility. However, they continue to use native practices. Many women in South Africa seek the advice of Indigenous Health Care Practitioners (IHCPs) for various issues related to the female reproductive system, including infertility (Joseph 2018). Some women use dual treatment and believe indigenous practitioners helped them. Traditional healers utilise 12 plant species for treating female reproductive issues: Bidens pilosa, Brachylaena discolour, Capsicum chinese, Chamaesyce prostrata, Cyperus papyrus, Elaeodendron transvaalense, Euphorbia ingens, Geigeria aspera var. aspera, Heteropyxis transvaalensis, Kleinia longiflora, Mundulea sericea, Pelargonium spp. Black South Africans’ culture heavily emphasises female fertility as it ensures the tribe’s survival and growth (Veale et al. 2014). James et al. (2018) reported women regaining fertility in Sierra Leone using IHCPs. These IHCPs have been utilised for treating infertility (Begashaw et al. 2017). A qualitative study in Sri Lanka indicated the use of herbs, food, and rituals since ancient times to manage infertility causes in women (Srishan et al. 2020). In Karnataka, India, cultural approaches to infertility therapy are prevalent, with women turning to herbal remedies and faith healing (Udgiri & Patil 2019). Ofosu-Budu and Hänninen (2021) highlighted unhealthy sexual behaviour and unintended pregnancies resulting in unlawful abortions, putting women at infertility risk. Infertile women in Ghana contact indigenous practitioners after hospitals cite unexplained infertility causes (Ofosu-Budu & Hänninen 2021). Indigenous practitioners remain crucial in disease prevention in Zimbabwe because of limited access to Western healthcare (Odmell, Mamimine & Kudakwashe 2018). Mdhluli (2019) posited that infertility may stem from demonic forces, prompting women to seek spiritual healers for prayers and holy water preparations to cast out curses leading to infertility.

Infertility cure in Mexico, Central and Latin America

Traditional medical practices have been integral to basic healthcare worldwide for millennia. Ancient civilisations like the Maya, Inca, and Aztecs in Mexico, as well as China’s Traditional Chinese Medicine (TCM) system, date back around 5000 years. Mexican Traditional Medicine (MTM) integrates ancient healing practices from these civilisations with African and Spanish-Catholic influences, emphasising harmony between physical, emotional, and mental health (Bogavac et al. 2017). Nahua women in northern Veracruz, Mexico, utilised approximately 80 plant species medicinally, with married women, particularly those with children, possessing extensive knowledge. Twenty-six plant species were used for reproductive health issues, including conception, menstruation, pregnancy, and the postpartum period. For instance, Priva lappulacea (L.) Pers. was used to prevent miscarriages, while a tea made from Hamelia patens Jacq. and Bombax ellipticum Kunth was used for sterilisation (Cabada et al. 2023; Castillo-Juárez 2009; Maduro 1983).

Korean Herbal Medicine (KHM) employs decoctions to treat infertility, often administered before or after procedures like in vitro fertilisation (IVF) or intrauterine insemination (IUI). Patients may receive KHM alongside ovulation-inducing drugs like clomiphene citrate, without additional traditional Korean medical practices such as acupuncture or cupping (Nandi et al. 2016). Examples of KHM remedies include Chokyungsoyo-san, Chokyungonshin-tang, and Guichulleekyung-tang. Moreover, Korean traditional medicine is used to address infertility concerns. Herbal decoctions, such as Chokyungsoyo-san, Chokyungonshin-tang, and Guichulleekyung-tang, are administered to patients before or after assisted reproductive procedures like IVF or IUI (Nandi et al. 2016). In some cases, these herbal remedies are combined with ovulation-inducing drugs like clomiphene citrate to enhance fertility outcomes.

In addition to Mexican and Korean traditional medicines, other cultures also rely on herbal remedies for reproductive health. For instance, Nahua women in northern Veracruz, Mexico use a variety of plants to address conditions related to conception, menstruation, pregnancy, and postpartum recovery (Cabada et al. 2023; Castillo-Juárez 2009). These traditional practices reflect a holistic approach to healthcare, emphasising the interconnectedness of physical, emotional, and mental well-being.

Traditional herbal plants for infertility cure

The utilisation of plant species holds significant promise for achieving equity in healthcare delivery and fostering national development through bioprospecting and the advancement of indigenous knowledge. The genus Syzygium, a member of the Myrtaceae family comprising 1200–1800 species, is extensively employed in traditional medical practices across Asia and globally, with therapeutic functions that play a vital role in healthcare systems worldwide (Akkol et al. 2021; Sánchez-Fernández et al. 2021). Particularly, Syzygium ssp. exhibits a wide geographic distribution from Africa to the Pacific, with diverse species utilised for treating various ailments with culturally acceptable and compatible properties, minimising negative side effects (Bari, Nassar & Aly 2021; Hoque et al. 2021). Notably, Syzygium cordatum Hochst ex C Krauss. leaf, root, and bark have shown efficacy in treating a range of conditions including stomach aches, diabetes, and venereal diseases (Dharani 2016).

Pomegranate (Punica granatum) is rich in beneficial compounds such as vitamin C, polyphenols, and phytoestrogens like genistein and daidzein, making it adaptable and effective in treating various health issues (Battineni, Boggula & Bakshi 2017). Similarly, extracts from Matricaria chamomilla, commonly known as chamomile, have demonstrated efficacy in enhancing reproductive health by modulating hormone levels and improving follicular development (Shoorei et al. 2018). Vitex agnus-castus, a herb from the Verbenaceae family, is utilised for treating menstrual issues and acne, with its isoflavones and flavonoids affecting hormone release and increasing endometrial blood flow (Amégbor et al. 2012; Goodarzi & Akbari 2016).

Ashwagandha, also known as Indian ginseng, offers benefits for women facing fertility challenges, with its oestrogenic properties and potential to restore hormonal balance (Nasimi et al. 2018). Red clover (Trifolium spp.) and Licorice (Glycyrrhiza glabra) contain phytoestrogenic chemicals that mimic hormone synthesis, providing relief from menopausal symptoms and addressing oestrogen-dependent disorders (Hidalgo et al. 2005; Ztürk et al. 2018). Moreover, plant extracts from Cinnamomum species, including cinnamon, offer safer alternatives to conventional treatments for conditions like endometriosis, with their antioxidant and anti-inflammatory properties (Ji et al. 2011). Fennel (Foeniculum vulgare) extracts have demonstrated efficacy in reducing uterine contractions and alleviating dysmenorrhoea, showcasing their potential to improve reproductive health (Sautour et al. 2004). Additionally, Nigella sativa extracts have shown promise in treating conditions like polycystic ovarian syndrome (PCOS) through their phytoestrogenic and flavonoid components, influencing hormonal pathways (Khani et al. 2021).

Incorporating these plant-based remedies into healthcare systems could provide holistic approaches to addressing reproductive health issues, leveraging the rich therapeutic potential of plants and indigenous knowledge for improved health outcomes. Bioprospecting and indigenous knowledge can promote equity in healthcare delivery and national development. Plant species will aid in their preservation and may lead to the discovery of beneficial substances useful in the treatment of infertility (See Table 1 and Table 2). The following plant has been found relevant. The genus Syzygium belongs to the family Myrtaceae. There are 1200–1800 species. These plants are a genus employed in the traditional medical practices of Asian nations, particularly in China, India, Bangladesh, and various regions across the globe. These plants have therapeutic or curative functions which have helped them attain a commanding role in health systems all over the world (Akkol et al. 2021; Sánchez-Fernández et al. 2021). Syzygium spp. has a wide geographic range that stretches from Africa and Madagascar to Asia and the Pacific (Perrie et al. 2013), with the highest levels of diversity occurring from Malaysia to Australia, where many species are poorly understood, and countless others have not been taxonomically depicted. These species are common elements in the upper and middle strata of eastern Australian rainforests (Hyland 1983). Syzygium spp. are useful for treating illnesses and may be used as ingredients to preserve health and conditions. These plants are culturally acceptable, compatible, and adapted to the human body with fewer negative side effects. Many nations across the globe rely on these plants as a major form of healthcare (Bari et al. 2021; Hoque et al. 2021). According to Dharani (2016), Syzygium cordatum Hochst ex C Krauss. leaf, root, and bark were found effective in curing stomachaches, abdominal pains, indigestion, diarrhoea, diabetes, venereal diseases, and infirmity. Pomegranate is high in vitamin C, water, and polyphenols such as anthocyanins, punicalagins, ellagic acids, and gallic acids.

TABLE 1: Population size, infertility, and fertility shortfall in 17 countries of sub-Saharan Africa.
TABLE 2: Medicinal plants used in female fertility practices.
TABLE 2 (Continues…): Medicinal plants used in female fertility practices.
TABLE 2 (Continues…): Medicinal plants used in female fertility practices.

A study conducted on Nahua women in Northern Veracruz, Mexico found that around 80 different medicinal plant species were used, with married women and mothers being particularly knowledgeable about most of these plants. Twenty-six of the plant species were used to treat conditions relating to reproductive health, including conception, menstruation, pregnancy, and the postpartum period. A herb called Priva lappulacea (L.) Pers. was utilised to stop miscarriages (Cabada et al. 2023; Castillo-Juárez 2009; Maduro 1983). To completely sterilise females, a tea made from Hamelia patens Jacq. [syn. Hamelia erecta] and Bombax ellipticum Kunth (Malvaceae) was consumed. A tea made from a different plant, Cydista potosina, was used for the same reason, and Hybanthus attenuatus (Humb. & Bonpl. ex Schult.) Schulze-Menz (Malpighiales) was said to make conception easier. The Natau women employed Tillandsia recurvata (Bromeliaceae), H. patens, Manilkara zapota (L.) P. Royen (Sapotaceae), Solanum nudum, and Persea americana as remedies for heavy menstruation (Cabada et al. 2023; Castillo-Juárez 2009; Maduro 1983).

It is worth noting that several of the therapeutic herbs used by women were recorded in pre-Columbian codices, indicating that they have been utilised in Mexico for more than 500 years. It was more widespread across a significant number of regions (Castillo-Juárez 2009). However, most of these plants lack any evidence supporting their usage during pregnancy in terms of safety or efficacy. Most of these herbs lack safety or effectiveness evidence for consumption through pregnancy or their delivery, with the exemption of ginger root and chrysanthemum. Besides, it was discovered in findings by Uganda and Yineger et al. (2007) in Ethiopia that many of the wild habitats are influenced by anthropogenic impacts and, as a result, shrink in size because of ever-increasing population pressure, resulting in the extinction of many medicinal species.

Conclusion

Infertility is a complex and multifaceted condition that can significantly impact the lives of individuals and couples trying to conceive and is prevalent in many parts of the world. Poor food, illness, curses, and unprotected sexual intercourse during periods were recognised as causes of infertility. The usage of current treatment was discovered to be expensive in most locations. The government offers little or no help for fertility care, necessitating victims’ visits to local practitioners. Traditional herbs are utilised as a treatment in many cultures around the world to treat a wide range of ailments, including infertility. Different cultures employ various extraction methods and procedures. These herbs’ bioactive ingredients aid in disease treatment. In other words, the bioactive element in plant species may be insufficient because of the increasing prevalence of industrial development and anthropogenic activities.

Acknowledgements

Competing interests

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Authors’ contributions

K.S., R.C., A.D. and K.N. contributed equally to this work. K.S. and A.D. conceptualised and wrote the manuscript. R.C. and K.N edited the manuscript and provided additional information where needed.

Ethical considerations

This article followed all ethical standards for research without direct contact with human or animal subjects.

Funding information

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Data availability

The authors confirm that the data supporting the findings of this study are available within the article.

Disclaimer

The views and opinions expressed in this article are those of the authors and are the product of professional research. It does not necessarily reflect the official policy or position of any affiliated institution, funder, agency, or that of the publisher. The authors are responsible for this article’s results, findings, and content.

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Footnote

1. http://www.theplantlist.org/.



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