Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 10 2 2025 06 30 121 129 Asma Ahmadzadeh Heshmati Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran AND Department of Traditional Medicine, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran Tayebeh Naderi Obstetrics and Gynecology Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran Maryam Rameshk Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran Tania Dehesh Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran Haleh Tajadini Department of Traditional Medicine, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran AND Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran Pegah Arfae Fathollahkhani Valie-Asr Hospital, Rafsanjan University of Medical Sciences, Anar, Iran Mohadese Kamali Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran AND Department of Traditional Medicine, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran 2024 08 02 2025 03 17 Use of traditional medicinal plants offers an effective non-surgical treatment for menorrhagia with a prevalence of 19.2% in Iran. Thus, Commiphora mukul (Hook. ex Stocks) Engl. (guggul) was investigated in this study. This was a randomized, triple-blind clinical trial. The participants were 24 patients suffering from menorrhagia. Group A received 250 mg of mefenamic acid; while group B received 250 mg of guggul capsules, both administered three times a day for three cycles. The primary outcomes were the pictorial blood loss assessment chart (PBAC) score and menstrual duration, which assessed the volume of bleeding. The secondary outcome was the safety of the drug. Demographically, there was no significant difference between the guggul and mefenamic acid groups. In both groups, the number of days of bleeding decreased, but there was no significant difference between the two groups (p = 0.353). Similarly, there was no significant difference in PBAC scores between the groups (p = 0.604), although the guggul group showed a significant decrease over time (p < 0.001). The results indicate that guggul may be as effective as mefenamic acid in reducing the volume and duration of menstrual bleeding in women with menorrhagia. No side effects were observed during the treatment period. Therefore, the herbal product guggul could be considered a safe and effective remedy for decreasing the volume and duration of menstrual bleeding in patients with menorrhagia. It is recommended that these findings be confirmed through multicenter clinical trials with higher precision. https://jtim.tums.ac.ir/index.php/jtim/article/view/1697