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Herbs, Fertility & Contraception
This fundamentally important area of human life is not only an expression of mystery and miracle, but impacts directly on the future of life on this planet under the pressure of the population explosion. Before exploring some of the ways in which Phytotherapy may contribute, let's focus on research into potential herbal tools for population control.
Great attention is being given to plants with anti-fertility properties. These may act through effects upon sperm motility and viability, implantation of the fertilized egg or a rejection effect within the uterus. The biochemistry of these different pathways is complex, and the study of plants having such effects is revealing new mechanisms all the time. I must point out, however, that I am not aware of any plant presently available in North America or Europe that is a safe or effective contraceptive.
Zoapatle
The planetary crisis that is upon us has the population explosion as a major component, and the W.H.O. has put great attention on the search for a safe, cheap and socially acceptable form of contraception. Part of this vital work has focused upon folk use of anti-fertility herbs. Very recent published work has highlighted the Mexican plants known as Zoapatle.1 All the work referred to in this section has been published since 1981.
Zoapatle is a decoction made from Montanoa tomentosa which has been used as an oral contraceptive in traditional Mexican medicine for centuries. Records of the use of this fascinating herb go back to Spanish reports of 1529, though of course its use goes back a lot further. Many historical, biological, ethnobotanical, agricultural, clinical and chemical studies have been done, mostly by Mexican scientists. It is perhaps because this excellent Mexican research was published in Spanish it was largely ignored in Europe and America until recently.2
Attempts to identify the nature of the plants activity have shown a great variation of effects on the uterus among wild plants. This should remind the us that there is great ecological variation in all plant's biological activity. Nature is diverse and variable, not a standardized factory any more than people are! Much of the research has focussed upon establishing standards for optimum environmental conditions and effectiveness of different varieties. After some confusion about different species it has been established that both Montanoa tormentosa and M. frutescens and should be the primary focus of research.
Zoapatle has been used in Mexico for the last 5 centuries for the induction of labor, treatment of post-partum bleeding problems, and as a menses inducer. Today, it is sold in street markets, and its long documented history of use could be taken as indirect evidence of a lack of toxicity. This assumption that the herbalist often makes, has for once been confirmed by rigorous pharmacological and clinical studies. The empirical observations of the therapist and the witness of history are augmented by the toxicologists findings that Montanoa is completely safe.3
Its antifertility characteristics are being explored as the possible starting point development of a new oral contraceptive agent which works by stimulating an evacuation of the implanted egg in the uterus. A confusingly ambivalent uterine response to Zoapatle leaves aqueous extract was found, the plant stimulating different responses at different times. This is due to different activity depending upon the phase of oestrous cycle or stage of pregnancy, the hall mark of a primary normalizing remedy.4
Research into the chemistry and physiology of the herbs activity indicate it does not work in the oestrogenic way that formulations such as the birth control `pill' do. Zoapatle seems possess a quite unique antifertility activity.5
In laboratory tests the species usually described, Montanoa tomentosa, did not influence sperm motility or viability, but Montanoa frutescens had immediate and constant inhibitory effect upon motility and decreased cell viability.6 When administered intra-uterinly in laboratory rats, markedly different results were obtained depending which species was used. Montanoa frutescens produced an almost total inhibition of implantation sites, whilst Montanoa tomentosa prepared and administered in the same fashion, did not inhibit the number of implants at all.7
When the Zoapatle was prepared from Montanoa tomentosa it did not alter the normal structures changes of the uterine by days 5 and 8 of pregnancy in the rat. On the other hand, Zoapatle made from Montanoa frutescens caused profound alterations on those structures. These included loss of epithelial lining, thickened blood vessels and alterations in endometrial stroma cells. These morphological changes fit in with the anti-implantation effect found with experimental administration of Zoapatle.8
The chemical basis of this activity is starting to be found. A number of unique biochemicals are being found, such as Kaurenoic acid, Kauradienoic acid (its mixture), Zoapatanol and Montanol. Kaurene compounds appear to be several times more potent than Montanol and Zoapatanol in their activity on the uterus.9
A review of recent published material reveals many patents dealing with the isolation, characterization and total synthesis of some of Zoapatle's constituents. It is clear that this Mexican herb is being seen by both scientists and the drug industry as a new, safe, reliable, inexpensive and, potentially, a widely used contraceptive agent.
Chinese research
The People's Republic of China is at the forefront of this research. Chinese scientists have capitalized on the rich flora and the ethnomedical experience in China, in their pursuit of fertility regulating agents from natural products. Discoveries range from anti-implantation agents to abortifacient and pregnancy-terminating compounds, as well as a male contraceptive. Much of the excellent research is filled with a quality of social concern and relevance that western institutions could benefit from. It is to be hoped that further research and collaboration of this quality will take place to help solve the problem of the population explosion.10
Indian research
Ayurvedic medicine from the Indian sub-continent is suggesting important leads for researchers in this field. Ancient Indian literature abounds with information on large numbers of plants reputed to have sterilizing, contraceptive and abortifacient properties. Scholars of Ayurveda have also mentioned several plants in their Ayurvedic treatises. A number of these preparations are still being used by Ayurvedic physicians all over India, who claim their effectiveness but are unable or unwilling to produce data.
The traditional remedy .Avrodhak (Lawsonia inermis) appears to have some contraceptive value under laboratory conditions, preventing pregnancy in 60% of the animals tested. None of the treated animals showed loss in body weight or abnormal estrus cycles. However, rats administered a high dose of Avrodhak failed to regain fertility up to 2 months after drug withdrawal.11
Hibiscus rosa sinensis
An herbal remedy with an ancient history is currently receiving attention as a potential tool in population control. Hibiscus rosa sinensis is a common ornamental plant cultivated widely throughout India and Burma. Flowers of this plant are said to possess anti-fertility property by ancient Ayurvedic texts. Traditional use of the flowers in Kerala (Southern India) is for its emmenagogue and contraceptive action.
A problem common to pharmacological studies of plant remedies is the proper identification of most therapeutically active part of the plant, the best ecological conditions to grow or collect it from and the season variations. The Indian research team have found that only the flowers showed significant activity. This anti-fertility action was maximum during winter followed by spring then rainy and minimum in summer season.12
Much modern research has shown the flowers to have a post-coital anti-fertility activity. An example is a study undertaken in 1976 that indicated that the H. rosa sinensis flowers possess significant antifertility activity with the effects dependant upon the dose, duration of the treatment and the stage of the pregnancy. The presence of potent anti-estrogenic activity in the flower portion may be the responsible factor in terminating pregnancy.
An antifertility agent can work by any one or combination of factors. These can include, rapid expulsion of the fertilized ova from the fallopian tube or by the tube locking mechanism; as a blastocyst-toxic agent; by the inhibition of implantation due to a disturbance in estrogen-progesterone balance; or through foetal absorption or abortion, perhaps due to lack of supply of nutrients to the uterus and thus to the embryo.
In the light of above observations, it seems probable that the maximum anti-fertility activity occurs via inhibition of implantation. A restriction of oestrogen levels, which is indispensable for implantation, is considered a probable cause in termination of pregnancy. The researchers demonstrated that the herbal extract possesses potent anti-estrogenic property. On the basis of present evidences it seems probable that, the treatment alters, in one way or other, the delicate estrogen-progesterone balance, resulting in termination of pregnancy.13
Not only does H. rosa sinensis have an impact on female reproduction but also on that of males. Extracts of the flowers also affect the generation of sperm as well as the endocrine function of the testes themselves. The herbs' effect upon the male reproductive system has been studied in rats by observation of changes in weight, histology and endocrine functions.
In trying to find how the herb works, the researchers have suggested that it may be due to the inhibition of synthesis or the release of gonadotropins from the pituitary gland, a direct inhibitory effect of tested or hormonal activity. The extract given to young male rats caused a reduction in the weights of the testes, accessory reproductive organs and pituitary gland. There was a marked decrease in levels of the gonadotrophin hormones. After stopping the administration of the herb, spermatogenesis and secretory activity of accessory sex organs started again, thus indicating that the plants effects are transient.
Hormonal activity is a totally integrated process, so it is important to look at any possible wider endocrine impact. The thyroid and adrenal are apparently unaffected. This suggests that the inhibitory effects of H. rosa sinensis on spermatogenesis are selective, mediated via the pituitary gland, without affecting pituitary-adrenal and pituitary-thyroid function.
Though effective in affecting spermatogenesis the use of H. rosa sinensis as a male contraceptive is unlikely due to probable reduction of libido because it suppresses endocrine activity of the testis. Although, the effects are reversible, persistent daily therapy would be needed because of the rapidity by which pituitary function could recover.14 Such a herbal remedy having a potent antifertility activity in women and reversible anti-spermatogenic effect in men offers the potential of a safe and acceptable aid in the drive to controlling population growth.
The Malvacaea family contains other potential anti-fertility plants. Malvaviscus conzattii is another Indian ornamental plant whose flower closely resembles that of Hibiscus rosa sinensis..
There is a marked anti-spermatogenic activity in the flowers of Malvaviscus conzattii. In more animal experiments the testes were damaged and a reduction in male sex hormones production was reflected by the atrophy of the accessory organs. Along with atrophy of the gonadal glands, a significant reduction in levels of protein and sialic acid of testes, epididymis and seminal vesicles was also recorded, since protein anabolism is dependent on androgenic production and also sialic acid and protein contents of the sex accessories reflect changes in testicular androgen production. The genital degenerative changes were found to be more pronounced when the results were observed after oral administration of 50 doses. The drug administration resulted in mass atrophy of the spermatogenic elements and the testicular stages were left with only 1-2 cell layers.
Changes in testicular cholesterol level are physiologically important as cholesterol is involved in spermatogenesis and is responsible for androgen synthesis. In the study of the herbs impact on the treated animals, tissue changes paralleled increased cholesterol level in the testes.15
Dried berries of another Indian herb, Embelia ribes, have a tradition reputation for an anti-fertility activity. One of its active components, embelin has been documented to possess significant anti-implantation activity in rats but its hormonal activity is still controversial. Studies show that embelin is a potent oral contraceptive of plant origin which possesses 85.71% anti-implantation activity in rats when administered at 50 mg/kg for 7 days and also inhibits pregnancy at single dose regimen. Embelin is also known as embelic acid or to be chemically accurate 2, 5-dihydroxy-3-undecyl-2, 5-cyclohexadiene-1, 4-benzoquinone. The ammonium salt is used in medicine as an anthelmintic.16 Embelin inhibited pregnancy and also possesses anti-estrogenic and weak progestational activity. From this it is possible that administration of embelin may cause a disturbance in the hormonal levels and thus prevent implantation, since specific hormonal equilibrium of estrogen and progesterone is required for egg implantation. Another suggestion is that it produces a change in the uterine environment which inhibits or interferes in the process of implantation. It may also have a direct action on the hypothalamus and releasing factors, interfering thereby with the secretion of gonadotropins.17
We are re-discovering the profound relationship that exists between plants and humanity. As the old rapport is renewed in a new context, many insoluble human problems will resolve. Inviting Gaia to point the way will open many doors. Wether it be auto-immune disease, stress, arthritis or even population explosion, the future looks bright indeed.
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