A Comparison of the Effect of Ajwain (Trachyspermum ammi (L.) Sprague) and Mefenamic Acid for Alleviating the Symptoms of Primary Dysmenorrhea: An Open-Label Randomized Controlled Trial
Abstract
Trachyspermum ammi (L.) Sprague (commonly known as ajwain) contains ingredients that attenuate menstrual problems, especially cramping. In this study, we evaluated the impact of ajwain on the pain intensity in a sample of Iranian female college students with primary dysmenorrhea (PD) in comparison to mefenamic acid (MFA). This study was an open-label, randomized, parallel-group clinical trial conducted in the university dormitories in Tehran, Iran, from September 2018 to May 2019. Seventy patients were randomly assigned to two groups of ajwain and MFA. The participants in the ajwain group were treated with a 500 mg ajwain capsule three times a day for seven days, from the 26th cycle day to the 3rd day of the menstrual cycle, for three consecutive cycle periods. The other group received MFA capsules with the first dose of 500 mg and then 250 mg every eight hours, if necessary, from the first day of the menstrual cycle. The two groups were compared in terms of the pain intensity by the visual analog scale (VAS) in pre-intervention cycle and three consecutive cycles during the study. Maximum pain intensity, mean pain, and duration of pain after the intervention were significantly reduced in both groups. The mean VAS score significantly decreased in the ajwain group compared to the MFA group post-intervention (p < 0.02). Moreover, passing blood clots was significantly reduced in the ajwain group (p < 0.03). The findings of this study suggest that ajwain may be effective in pain relief in PD without adverse effects.
Abreu-Sánchez A, Ruiz-Castillo J, Onieva-Zafra MD, Parra-Fernández ML, Fernández-Martínez E. Interference and impact of dysmenorrhea on the life of Spanish nursing students. Int J Environ Res Public Health 2020;17:6473.
Armour M, Parry K, Manohar N, Holmes K, Ferfolja T, et al. The prevalence and academic impact of dysmenorrhea in 21,573 young women: a systematic review and meta-analysis. J Women's Health 2019;28:1161-1171.
Pakniat H, Chegini V, Ranjkesh F, Hosseini MA. Comparison of the effect of vitamin E, vitamin D and ginger on the severity of primary dysmenorrhea: a single-blind clinical trial. Obstet Gynecol Sci 2019;62:462-468.
Femi-Agboola DM, Sekoni OO, Goodman OO. Dysmenorrhea and its effects on school absenteeism and school activities among adolescents in selected secondary schools in Ibadan, Nigeria. Niger Med J 2017;58:143-148.
Jaafarpour M, Hatefi M, Najafi F, Khajavikhan J, Khani A. The effect of cinnamon on menstrual bleeding and systemic symptoms with primary dysmenorrhea. Iran Red Crescent Med J 2015;17(4):e27032.
Xing R, Yang J, Wang R, Wang Y. Extracorporeal shock wave therapy for treating primary dysmenorrhea: a randomized controlled trial. Medicine 2021;100:e23798.
Schoep ME, Adang EM, Maas JW, De Bie B, Aarts JWM, et al. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32748 women. BMJ Open 2019;9:e026186.
Shirvani MA, Motahari-Tabari N, Alipour A. The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet 2015;291:1277-1281.
Iacovides S, Avidon I, Baker FC. What we know about primary dysmenorrhea today: a critical review. Hum Reprod Update 2015;21:762-778.
Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti‐inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev 2015;2015:CD001751.
Wong CL, Farquhar C, Roberts H, Proctor M. Oral contraceptive pill as treatment for primary dysmenorrhoea. Cochrane Database Syst Rev 2009;2009:CD002120.
Xu Y, Yang Q, Wang X. Efficacy of herbal medicine (cinnamon/fennel/ginger) for primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. J Int Med Res 2020;48.
Mirabi P, Alamolhoda SH, Esmaeilzadeh S, Mojab F. Effect of medicinal herbs on primary dysmenorrhoea-a systematic review. Iran J Pharm Res 2014;13:757-767.
Kamalinejad M, Sarmadian H, Shokouhi F, Dadmehr M, Bahrami M, et al. The clinical efficacy of Tiban syrup as adjuvant treatment in patients with COVID-19: a randomized, double blind clinical trial. Iran J Pharm Sci 2021;17:49-62.
Anwar S, Ahmed N, Habibatni S, Abusamra Y. Ajwain (Trachyspermum ammi L.) oils. In: Essential Oils in Food Preservation, Flavor and Safety. Elsevier. United Kingdom 2016; pp 181-192.
Tariq A, Adnan M, Iqbal A, Sadia S, Fan Y, et al. Ethnopharmacology and toxicology of Pakistani medicinal plants used to treat gynecological complaints and sexually transmitted infections. S Afr J Bot 2018;114:132-149.
Abhishek Biswal R, Pazhamalai V. Thymol. In: Mushtaq M, Anwar F, eds. A Centum of Valuable Plant Bioactives: Academic Press 2021; pp 275-290.
Mathur R, Mathur S. Impact of intervention with ginger aliquot and ajwain powder on dysmenorrhoea in young adult women (14-25 years) of ajmer city (rajasthan). Asian J Home Sci 2016;11:350-360.
Korani M, Jamshidi M. The effect of aqueous extract of trachyspermum ammi seeds and ibuprofen on inflammatory gene expression in the cartilage tissue of rats with collagen-induced arthritis. J Inflamm Res 2020;13:133-139.
Andersch B, Milsom I. An epidemiologic study of young women with dysmenorrhea. Am J Obstet Gynecol 1982;144:655-660.
Bokaie M, Farajkhoda T, Enjezab B, Khoshbin A, Mojgan KZ. Oral fennel (Foeniculum vulgare) drop effect on primary dysmenorrhea: effectiveness of herbal drug. Iran J Nurs Midwifery Res 2013;18:128-132.
Shirvani MA, Motahari-Tabari N, Alipour A. The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet 2015;291:1277-1281.
Direkvand-Moghadam A, Khosravi A. The impact of a novel herbal Shirazi Thymus Vulgaris on primary dysmenorrhea in comparison to the classical chemical Ibuprofen. J Res Med Sci 2012;17: 668-670.
Heidarifar R, Mehran N, Heidari A, Tehran HA, Koohbor M, et al. Effect of dill (anethum graveolens) on the severity of primary dysmenorrhea in compared with mefenamic acid: a randomized, double-blind trial. J Res Med Sci 2014;19:326-330.
Bani S, Hasanpour S, Mousavi Z, Garehbaghi PM, Gojazadeh M. The effect of Rosa Damascena extract on primary dysmenorrhea: a double-blind cross-over clinical trial. Iran Red Crescent Med J 2014;16:e14643.
Jenabi E, Asltugiri M, Hejrati P. Compare Valeriana Officinalis and mephnamic acid on primary dysmenorrhea. Iran J Obstet Gynecol Infertil 2012;15:44-48.
Shobeiri F, Zeraati F, Mansouri Z, Araghchian M, Nazari M. The comparative effect of herbal extract of vitagnus and mefenamic acid on primary dysmenorrhea. Zahedan J Res Med Sci 2012;14:30-33.
Modarres M, Ali M, Oshrieh Z, Mehran A. Comparison of the effect of Mefenamic Acid and Matricaria Camomilla Capsules on primary dysmenorrhea. J Babol Univ Medical Sci 2011;13:50-58.
Dehkordi ZR, Rafieian-Kopaei M, Hosseini-Baharanchi F. A double-blind controlled crossover study to investigate the efficacy of salix extract on primary dysmenorrhea. Complement Ther Med 2019;44:102-109.
Speroff L FM. Clinical gynecologic endocrinology and infertility. Lippincott Williams and Wilkins 2011.
Thangam C, Dhananjayan R. Antiinflammatory potential of the seeds of Carum copticum Linn. Indian J Pharmacol 2003;35:388-391.
Chung I-m, Khanh TD, Lee O-k, Ahmad A. Chemical constitutents from ajwain seeds (Trachyspermum ammi) and inhibitory activity of thymol, lupeol and fatty acids on barnyardgrass and radish seeds. Asian J Chem 2007;19:1524-1534.
Yu Y-M, Chao T-Y, Chang W-C, Chang MJ, Lee M-F. Thymol reduces oxidative stress, aortic intimal thickening, and inflammation-related gene expression in hyperlipidemic rabbits. J Food Drug Anal 2016;24:556-563.
Kazemi M. Anti-inflammatory activity of the essential oils of Trachyspermum ammi Sprague seeds. Bangl J Bot 2016;45:291-296.
Hotta M, Nakata R, Katsukawa M, Hori K, Takahashi S, et al. Carvacrol, a component of thyme oil, activates PPARα and γ and suppresses COX-2 expression. J Lipid Res 2010;51:132-139.
Aristatile B, Al-Assaf AH, Pugalendi KV. Carvacrol suppresses the expression of inflammatory marker genes in D-galactosamine-hepatotoxic rats. Asian Pac J Trop Med 2013;6:205-211.
Files | ||
Issue | Vol 8, No 2, 2023 | |
Section | Research Article(s) | |
DOI | https://doi.org/10.18502/tim.v8i2.13078 | |
Keywords | ||
Primary dysmenorrhea Pain relief Traditional medicine Persian Medicine Trachyspermum ammi |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |