The effect of green tea on inflammatory mediators: A systematic review and meta‐analysis of randomized clinical trials

Catechin in green tea might be able to reduce inflammatory mediators; therefore, in this study, we aimed to indicate green tea effects on inflammatory mediators such as tumor necrosis factor‐alpha (TNF‐α), C‐reactive protein (CRP), and interleukin‐6 (IL‐6). The advanced search methods of electronic databases were used to find randomized clinical trials that assessed green tea effect on inflammatory mediators among adult population. Google Scholar, PubMed/Medline, EMBASE, SCOPUS, and ISI Web of Science were searched until January 2019. Delphi checklist was used for assessing the quality of included articles. Mean changes in serum inflammatory biomarkers were calculated by subtracting endpoint values from the baseline in each study arm. Then the effect size for each selected study was estimated as the difference between mean changes in the intervention and control groups. We included 16 articles in our meta‐analysis and 17 articles in systematic review. Our results indicated that green tea could not significantly decrease serum CRP levels and significantly increased IL‐6 and significantly decreased TNF‐α levels. In conclusion, green tea might not be able to change inflammatory mediators especially in diseases with low inflammation, but scientists who want to assess green tea effect on inflammatory mediators should perform their study on patients with high inflammation. Studies exclusive on male or female and considering nutrients intake as a confounding factor are a necessity.     

Slimming and Appetite‐Suppressing Effects of Caraway Aqueous Extract as a Natural Therapy in Physically Active Women

Following the current ‘Globesity’ trend, there is an increasing demand for alternative natural therapies for weight management. Numerous phytoconstituents reduce body weight through suppressing appetite and reducing food intake. Caraway (Carum carvi L.) is one of the medicinal plants that is traditionally used for weight loss. In this study, the appetite‐suppressing effects of caraway aqueous extract (CAE) on 70 aerobically trained, overweight, and obese women were examined in a triple‐blind, placebo‐controlled, clinical study. Subjects were randomly allocated into placebo and experimental groups and consumed either 30 mL/day of CAE or placebo without changing their diet or physical activity over a period of 90 days. Calorie and macronutrient intake and anthropometric indices were measured before and after the intervention. In addition, appetite changes were assessed through a visual analog scale and an ad libitum pizza test. After the intervention, the results showed a significant reduction in appetite levels and carbohydrate intake of the experimental group compared with the placebo group. All of the anthropometric indices were reduced significantly in CAE compared with placebo group (p < 0.01). These preliminary outcomes suggest that a dietary CAE might be effective in weight management of physically active, adult females, reducing their body size and hunger level. Copyright © 2016 John Wiley & Sons, Ltd.     

Protective role of tea polyphenols in combination against radiation-induced haematopoietic and biochemical alterations in mice

The purpose of this study was to investigate the radioprotective effects of tea polyphenols (TPs) in various combinations against radiation‐induced damage in mice. Mice were divided into different groups: non‐irradiated control, irradiated control, amifostine (43.6 mg/kg, i.v. 30 min before irradiation; positive control) and various combinations of tea polyphenols in different doses. The radioprotective effect on the haematopoietic system, serum cytokines and endogenous antioxidant enzymes were studied. TP50, containing approximately 50% of (‐)‐epigallochatechin‐3‐gallate in addition to other catechins, showed the greatest radioprotective effect against radiation‐induced changes in haematological parameters (red blood cell count, white blood cell count and haemoglobin), and maintained the spleen and thymus indices unchanged (spleen or thymus weight/body weight × 1000). Tea polyphenols also significantly decreased radiation‐induced lipid peroxidation (malondialdehyde levels), elevated endogenous antioxidant enzymes (superoxide dismutase) and reduced the serum cytokines which were elevated in radiation‐induced toxicity. This evidence shows the potential of tea polyphenols, particularly in the combination found in TP50, as radioprotectors in mice, especially regarding recovery of the haematopoietic system, antioxidant potential activity and reduction of inflammatory cytokines. Copyright © 2011 John Wiley & Sons, Ltd.     

A randomized,triple‐blind,placebo‐controlled clinical trial,evaluating the sesamin supplement effects on proteolytic enzymes,inflammatory markers,and clinical indices in women with rheumatoid arthritis

Inflammation is one of the main characteristics of rheumatoid arthritis. Based on the antiinflammatory properties of sesame, this study was conducted to evaluate the sesamin supplement effects on serum levels of some proteolytic enzymes, inflammatory biomarkers, and clinical indices in women with rheumatoid arthritis. In this randomized, triple‐blind, placebo‐controlled clinical trial, 44 patients were randomly divided in intervention and control groups. Patients received 200‐mg/day sesamin supplement or placebo in the intervention and control group for 6 weeks. Serum levels of proteolytic enzymes (hyaluronidase, aggrecanase, and matrix metalloproteinases‐3) and inflammatory biomarkers (hs‐CRP, IL‐1β, IL‐6, TNF‐α, and cyclooxygenase‐2) were measured with enzyme‐linked immunosorbent assay method at the beginning and end of the study. After intervention, serum levels of hyaluronidase and matrix metalloproteinases‐3 decreased significantly in sesamin group. Also, serum levels of hs‐CRP, TNF‐α, and cyclooxygenase‐2 in intervention group were significantly decreased in intervention group compared with placebo group. Sesamin supplementation also caused a significant reduction in the number of tender joints and severity of pain in these patients. According to the results, it seems that the sesamin by reducing inflammatory mediators can relieve clinical symptoms and pathological changes that caused by inflammatory impairment in patients with rheumatoid arthritis.     

Effect of aqueous extracts of black and green teas in arsenic‐induced toxicity in rabbits

Arsenic causes oxidative stress in the body. Its administration (3 mg/kg/day) for 14 days in rabbits resulted in a significant reduction of whole blood glutathione (GSH), and elevation of thiobarbituric acid reactive substances (TBARS) and the index of nitrite/nitrate (NOx) levels. These are the markers of oxidative stress. Both black tea (BT) and green tea (GT) (Camellia sinensis), when administered to the arsenic‐treated rabbits for 14 days, caused a significant elevation of the depleted GSH level to 53.12% and 57.47%, respectively. On the contrary, in the placebo group the level was 26.59%. The BT and GT reduced the elevated TBARS level to 43.27% and 62.28%, respectively, whereas the corresponding level in the placebo groups was 21.24%. The NOx levels were also reduced to 63.62%, 67.67% and 58.94% in BT, GT and the placebo groups, respectively. When arsenic and black tea were given concurrently to another group the results were even more pronounced. The polyphenol components of black and green tea were 27.69% and 29.71% of the dry weight of the total extracts, respectively. These results indicated that arsenic‐induced toxicities in rabbits were significantly reversed by the black and green tea polyphenols. The greater activity of green tea than that of black tea correlates with the slightly higher content of polyphenols in green tea. Copyright © 2009 John Wiley & Sons, Ltd.     

The effect of green tea ointment on episiotomy pain and wound healing in primiparous women: A randomized,double‐blind,placebo‐controlled clinical trial

The delayed healing of episiotomy wound and its associated pain is a major problem in obstetrics. Because green tea has analgesic and wound‐healing properties, the present study was conducted to determine the effect of green tea ointment on episiotomy pain and wound‐healing. The green tea extract was also standardized by measuring its Phenolic and flavonoid compounds, antioxidant activity, and one of its active components, that is, Epigallocatechin gallate. The present clinical trial was conducted on 99 primiparous women visiting Afzalipour Hospital in Kerman in 2015. The subjects were randomly divided into 3 groups, including a green tea ointment group, a placebo ointment group, and a routine care group. The 2 ointment groups smeared 2 cm of the green tea or placebo ointments onto their sutured area twice daily for a total of 10 days. The severity of pain was assessed in the subjects using the visual pain scale and wound‐healing using the Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) scale before the intervention and on the 5th and 10th days after delivery. To standardize the extract, Epigallocatechin gallate was measured by high‐performance liquid chromatography (HPLC). Phenolic and flavonoid compounds, as well as antioxidant activity of the extract were also determined by spectrometry methods. Before the intervention, no significant differences were observed between the 3 groups in terms of their personal and obstetric details (p > .05), the severity of pain (p = .118), and the REEDA score (p = .212). On the 5th and 10th days after delivery, the severity of pain was significantly lower in the green tea group than in the other 2 groups (p < .0001). The mean REEDA score on the 5th and 10th days showed a better and faster healing in the green tea group compared to the other 2 groups (p < .0001). Total content of phenolic and flavonoids contents of green tea were 74.2 mg/g Gallic acid equivalent and 16.3 mg/g Rutin equivalent, respectively, and its antioxidant capacity was 46% of b‐carotene. Green tea ointment appears to be effective in relieving episiotomy pain and improving wound‐healing in this study. Further studies are recommended to be conducted on the effectiveness and safety of the different doses of green tea ointment.     

Camellia sinensis Mediated Enhancement of Humoral Immunity to Particulate and Non‐particulate Antigens

The most common drinking beverage in large portion of the world is Camellia sinensis (green tea). In the present study, we evaluated the adjuvant effect of green tea and tea polyphenols to particulate and non‐particulate antigens. BALB/c mice were immunized with particulate and non‐particulate antigens. Modulation of immunoglobulin‐secreting splenocytes, IgG‐mediated and IgM‐mediated immunity, was evaluated by hemolytic plaque assay and enzyme‐linked immunosorbent assay, respectively. Dose‐dependent response of tea polyphenols was also assayed. Phenolic content was measured in crude preparations of green tea. We observed a stimulatory effect of green tea preparations on humoral immune response mediated by the increased number of antibody‐secreted cells in spleen. A significant increase in IgM‐mediated and IgG‐mediated immune response to non‐particulate antigen was also observed in green tea‐treated animals. A dose‐dependent adjuvant effect was seen in the case of tea polyphenols for a longer period of time compared with crude tea preparations. This study indicates polyphenols as major constituents responsible for the enhanced and sustained adjuvant activity of green tea. We suggest that tea polyphenols might be considered for real‐life evaluation during adjuvant‐mediated vaccination trial programs. Copyright © 2015 John Wiley & Sons, Ltd.     

Effect of Zingiber officinale Supplementation on Obesity Management with Respect to the Uncoupling Protein 1 ‐3826A>G and ß3‐adrenergic Receptor Trp64Arg Polymorphism

The present study aimed to investigate the effect of ginger (Zingiber officinale) supplementation on some obesity‐associated parameters, with nutrigenetics approach. Accordingly, 80 eligible obese women (aged 18–45 years) were randomly assigned to receive either ginger (2‐g ginger rhizomes powder as two 1‐g tablets per day) or placebo supplements (corn starch with the same amount) for 12 weeks. Subjects were tested for changes in body weight, body mass index, waist and hip circumferences, body composition, appetite score, and dietary intake. Moreover, participants were genotyped for the ‐3826A>G and Trp64Arg polymorphisms of uncoupling protein 1 and ß3‐adrenergic receptor genes, respectively. Over 12 weeks, ginger supplementation resulted in a slight but statistically significant decrease in all anthropometric measurements and total appetite score as compared with placebo group, which were more pronounced in subjects with the AA genotype for uncoupling protein 1 and Trp64Trp genotype for ß3‐adrenergic receptor gene. However, there was no significant difference in changes of body composition and total energy and macronutrients intake between groups. In conclusion, our findings suggest that ginger consumption has potential in managing obesity, accompanying with an intervention–genotype interaction effect. However, further clinical trials need to explore ginger's efficacy as an anti‐obesity agent in the form of powder, extract, or its active components. Copyright © 2015 John Wiley & Sons, Ltd.     

不同茶叶及茶多酚对高脂饲料致大鼠脂肪肝的影响

目的:考察不同产地绿茶、红茶以及绿茶多酚对高脂饲料致大鼠脂肪肝的影响.方法:大鼠喂饲高脂饲料制备大鼠脂肪肝模型,喂饲含不同茶叶或茶多酚的高脂饲料,观察体重变化、睾丸脂肪垫重量、血清TG和TC、肝脏脂肪性变、肝匀浆甘油三酯和胆固醇含量.结果:各受试物组睾丸脂肪垫重量均较模型对照组减轻,云南绿茶组和四川绿茶组肝匀浆甘油三酯和胆固醇均明显低于模型对照;茶多酚组肝匀浆甘油三酯也明显低于模型对照组,但高于云南绿茶组和四川绿茶,茶多酚组肝匀浆胆固醇低于模型对照组,但明显高于云南绿茶组和四川绿茶组;云南红茶组肝匀浆甘油三酯和胆固醇与模型对照组相当.结论:云南绿茶和四川绿茶均对高脂饲料致大鼠脂肪肝的形成有明显抑制作用;茶多酚也有一定作用;但云南红茶作用不明显.     

Antiobesity Effects of Chinese Black Tea (Pu‐erh Tea) Extract and Gallic Acid

The antiobesity effects of Chinese black tea (Pu‐erh tea) and of gallic acid (GA) were investigated using in vitro and in vivo assays. Chinese black tea extract (BTE) and GA inhibited pancreatic lipase activity in a dose‐dependent manner in vitro; the IC(inhibitory concentration)₅₀ values were 101.6 and 9.2 µg/mL, respectively. Black tea extract (50, 100 mg/kg body weight (b.w.)) and GA (15, 45 mg/kg b.w.) significantly suppressed the elevation of blood triglyceride after oral administration of a corn oil emulsion (8 mL oil/kg b.w.) to male ddY mice. Moreover, the antiobesity effects of BTE and GA were also evaluated in a mouse model of diet‐induced obesity. Female ddY mice were divided into seven groups; normal diet (ND) group, high fat diet (HFD) group, BTE (0.2% and 0.6% of diets) groups, and GA (0.007%, 0.02% and 0.1% of diets) groups; the experimental groups were fed the test diets for 12 weeks. The BTE 0.6% and GA 0.1% groups showed significant suppression of weight gain. The weight of parametrial adipose tissue was strongly correlated with the body weight. These results suggest that GA contributes to the antiobesity effect of BTE as an active constituent by inhibiting pancreatic lipase activity. Copyright © 2011 John Wiley & Sons, Ltd.     

补肾化痰汤联合西药治疗生育期多囊卵巢综合征临床研究

目的:观察补肾化痰汤联合西药治疗生育期多囊卵巢综合征(PCOS)疗效。方法:选择符合入选标准的PCOS患者96例,随机分为观察组及对照组各48例。对照组周期性应用去氧孕烯炔雌醇片(妈富隆),观察组在对照组的基础上联合应用补肾化痰汤,两组患者均于月经周期结束后口服来曲唑促排卵治疗。治疗3个周期后观察两组患者用药前后体质量、体质量指数(BMI)、各生殖激素水平的变化及促排卵治疗后两组子宫内膜厚度、卵泡发育情况及排卵率、妊娠率的差异。结果:两组患者用药前后体质量、BMI、各生殖激素水平比较差异有统计学意义(P0.05),两组患者促排卵后子宫内膜厚度、优势卵泡率、排卵率及妊娠率等方面比较差异有统计学意义(P0.05)。结论:补肾化痰汤联合妈富隆、来曲唑治疗PCOS具有降低体质量、月经恢复正常、不良反应少、卵泡发育好、子宫内膜厚度适宜、排卵率和妊娠率高的效果。     

Beneficial metabolic effects of the Malaysian herb Labisia pumila var. alata in a rat model of polycystic ovary syndrome

Aim of the study

New options are needed to prevent and treat metabolic disorders associated with polycystic ovary syndrome (PCOS). Labisia pumila var. alata (LPva)—a Malaysian herb thought to have phytoestrogenic effects—has shown promise in reducing body weight gain in ovariectomized rats. In this study, we investigated the effect of LPva on body composition and metabolic features in female rats treated continuously with dihydrotestosterone, starting before puberty, to induce PCOS.

Material and methods

At 9 weeks of age, the PCOS rats were randomly subdivided into two groups; PCOS LPva and PCOS control. PCOS LPva rats received a daily oral dose of LPva (50 mg/kg body weight), dissolved in 1 ml of deionised water, for 4–5 weeks. PCOS controls received 1 ml of deionised water on the same schedule.

Results

LPva increased uterine weight (27%) and insulin sensitivity (36%) measured by euglycemic hyperinsulinemic clamp. Plasma resistin levels were increased and lipid profile was improved in LPva rats. In adipose tissue, LPva decreased leptin mRNA expression but did not affect expression of resistin and adiponectin. No effects on body composition, adipocyte size, or plasma leptin levels were observed.

Conclusion

LPva increases uterine weight, indicating estrogenic effects, and improves insulin sensitivity and lipid profile in PCOS rats without affecting body composition.     

The effect of concentrated pomegranate juice consumption on risk factors of cardiovascular diseases in women with polycystic ovary syndrome: A randomized controlled trial

Polycystic ovary syndrome (PCOS) is associated with insulin resistance and dyslipidemia. Pomegranate juice is a rich source of polyphenols that may improve blood pressure, lipid profile, and other risk factors of cardiovascular diseases (CVDs). No study has examined the effects of pomegranate juice consumption on the clinical outcomes of PCOS. This study aimed to examine the effects of concentrated pomegranate juice (CPJ) consumption on risk factors of CVDs in women with PCOS. In this randomized clinical trial, 44 PCOS women with an age range of 18–40 years and body mass index (BMI) of ≥25 kg/m² were recruited. They were randomly allocated to the CPJ (n = 22) and control (n = 22) groups, and followed for 8 weeks. Anthropometric measures, blood pressure, and biochemical parameters were measured at baseline and at the end of the trial. Compared with the control group, CPJ consumption significantly reduced systolic (?9.77 ± 1.46 vs. ?1.18 ± 1.46 mmHg, p < .001) and diastolic (?3.87 ± 1.36 vs. 0.30 ± 1.36 mmHg, p = .05) blood pressure, serum triglyceride (TG) levels (?7.82 ± 6.32 vs. 16.63 ± 6.32 mg/dl, p = .01), TG/high‐density lipoprotein‐cholesterol (HDL‐C) ratio (?0.39 ± 0.24 vs. 0.66 ± 0.24, p = .007), and increased serum concentrations of low‐density lipoprotein‐cholesterol (LDL‐C) (6.03 ± 2.47 vs. ?1.98 ± 2.47 mg/dl, p = .04) and HDL‐C (1.93 ± 1.10 vs. ?1.78 ± 1.10 mg/dl, p = .03). These findings were obtained after taking baseline measurements and potential confounders into account. No adverse event or complication was reported due to CPJ consumption throughout the study. We found that CPJ consumption has a beneficial effect on blood pressure, serum concentrations of TG and HDL‐C, and TG/HDL‐C ratio in women with PCOS. However, this juice could increase serum LDL‐C levels in these patients. This trial was registered at www.irct.ir as IRCT20191109045383N1.     

The effect of Cornus mas fruit extract consumption on lipid profile,glycemic indices,and leptin in postmenopausal women— A randomized clinical trial

Menopause, which occurs following a declined ovarian activity and reduced estrogen levels, can lead to long‐term changes in lipid and glycemic profiles and increases the risk of cardiovascular disease and osteoporosis. Cornelian cherry (Cornus mas) is rich in phytochemicals and antioxidants, which appears to be useful in reducing the postmenopausal complications. This interventional, double‐blinded, randomized clinical trial carried out on 84 menopaused women aged 45–60 years old. They were randomly divided into two groups. The treatment group received three capsules of 300 mg of Cornus mas extract (CME), and control group received three capsules of 300 mg of starch powder per day for 8 weeks. Then, BMI, waist circumference, glycemic indices, lipid profile, serum apoproteinase, apoprotein B100, fibrinogen, and leptin were measured. The dietary intakes were evaluated using 24‐hr dietary recall questionnaire. The consumption of CME in comparison with the control group resulted in a significant reduction in weight, body mass index, waist circumference, LDL to HDL ratio, total cholesterol to HDL ratio, and fibrinogen. There was also a significant increase in HDL and ApoA1 levels in the treatment group. Furthermore, there was a significant decrease in BMI, waist circumference, fasting insulin, and insulin resistance index after 8 weeks of using CME. Summing up the results, it can be concluded that CME can have possible effects on decreasing BMI, waist circumference, and improving some aspects of lipid profile and glycemic indices in postmenopausal women.     

妇科千金片联合克罗米芬治疗多囊卵巢综合征合并不孕的疗效观察

目的:观察妇科千金片联合克罗米芬治疗多囊卵巢综合征(Polycystic Ovarian Syndrome,PCOS)合并不孕的疗效及对炎性反应及氧化应激反应的影响。方法:选取2014年1月至2016年6月西南医科大学附属中医院收治的PCOS合并不孕患者96例,随机分为观察组和对照组,每组48例,对照组给予克罗米芬治疗,观察组在对照组基础上给予妇科千金片治疗,疗程为3个月经周期。观察2组治疗前后临床症状体征、卵巢变化、机体性激素水平、月经恢复、排卵及妊娠情况;记录2组治疗前后炎性反应及氧化应激反应相关指标的变化。结果:观察组治疗后体质量指数(BMI)、腰臀比(WHR)、多毛评分及卵巢体积均较治疗前显著降低(P0.05),观察组改善情况均显著优于对照组(P0.05);2组治疗后血清睾酮(T)、促黄体生成素(LH)、促卵泡刺激素(FSH)以及LH/FSH比值均显著降低,观察组上述指标均低于对照组(P0.05);观察组治疗后月经恢复情况、宫颈黏液评分、子宫内膜厚度、排卵及妊娠率均优于对照组、流产率低于对照组(P0.05)。2组治疗后血清白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、超氧化物歧化酶(SOD)活性、谷胱甘肽过氧化物酶(GSH-Px)和丙二醛(MDA)水平均显著改善,观察组改善情况优于对照组(P0.05)。结论:妇科千金片联合克罗米芬治疗能够显著PCOS患者的临床症状体征,调节机体性激素,并促进排卵及妊娠,其机制可能与抑制机体炎性反应及氧化应激反应有关。     

Effects of green tea or green tea catechin on liver enzymes in healthy individuals and people with nonalcoholic fatty liver disease: A systematic review and meta‐analysis of randomized clinical trials

The therapeutic potential of green tea as a rich source of antioxidants and anti‐inflammatory compounds has been investigated by several studies. The present study aimed to systematically review and analyze randomized clinical trials (RCTs) assessing the effects of green tea, catechin, and other forms of green tea supplementation on levels of liver enzymes. PubMed, SCOPUS, EMBASE, and Cochrane databases were searched until February 2019. All RCTs investigating the effect of green tea or its catechin on liver enzymes including alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and bilirubin were included. A total of 15 RCTs were included. The overall effect of green tea on liver enzymes was nonsignificant (ALT [Standardized mean difference (SMD)= ?0.17, CI ?0.42 to 0.08, p = .19], AST [SMD = ?0.07, CI ?0.43 to 0.29, p = .69], and ALP [SMD = ?0.17, CI ?0.45 to 0.1, p = .22]). However, subgroup analyses showed that green tea reduced the levels of liver enzymes in participants with nonalcoholic fatty liver disease (NAFLD) but in healthy subjects, a small significant increase in liver enzymes was observed. In conclusion, the results of this study suggest that the effect of green tea on liver enzymes is dependent on the health status of individuals. While a moderate reducing effect was observed in patients with NAFLD, in healthy subjects, a small increasing effect was found.     

康妇炎胶囊保留灌肠配合护理干预不孕症患者盆腔炎护理研究

目的:观察康妇炎胶囊保留灌肠配合护理干预治疗不孕症患者盆腔炎的临床效果.方法:将89例因盆腔炎导致的不孕症患者分为2组,对照组44例予以康妇炎胶囊保留灌肠配合常规护理干预,观察组45例在对照组的基础上予以综合护理干预.对比2组干预前后炎症因子水平、主要临床症状以及干预后各项转归指标变化情况.结果:2组干预后炎症因子水平...     

Spearmint herbal tea has significant anti‐androgen effects in polycystic ovarian syndrome. a randomized controlled trial

Hirsutism in polycystic ovarian syndrome (PCOS), consequent to elevated androgen levels leads to significant cosmetic and psychological problems. Recent research in Turkey has shown that spearmint tea has antiandrogenic properties in females with hirsutism. No research has yet been undertaken to assess whether a reduction in androgen levels brought about by spearmint tea, translates to a clinical improvement in the degree of hirsutism. This study was a two centre, 30 day randomized controlled trial. Forty two volunteers were randomized to take spearmint tea twice a day for a 1 month period and compared with a placebo herbal tea. At 0, 15 and 30 days of the study serum androgen hormone levels and gonadotrophins were checked, the degree of hirsutism was clinically rated using the Ferriman‐Galwey score and a questionnaire (the modified DQLI = Dermatology Quality of Life Index) was used to assess improvements in the level of self‐reported hirsutism. Forty one of 42 patients completed the study. Free and total testosterone levels were significantly reduced over the 30 day period in the spearmint tea group (p < 0.05). LH and FSH also increased (p < 0.05). Patient's subjective assessments of their degree of hirsutism scored by the modified DQLI were significantly reduced in the spearmint tea group (p < 0.05). There was, however, no significant reduction in the objective Ferriman‐Galwey ratings of hirsutism between the two trial groups over the trial duration (p = 0.12). There was a clear and significant alteration in the relevant hormone levels. This is associated clinically with a reduction in the self‐reported degree of hirsutism but unfortunately not with the objectively rated score. It was demonstrated and confirmed that spearmint has antiandrogen properties, the simple fact that this does not clearly translate into clinical practice is due to the relationship between androgen hormones and follicular hair growth and cell turnover time. Simply put, the study duration was not long enough. The original studies from Turkey were in fact only 5 days long. The time taken for hirsutism to resolve is significant and a much longer future study is proposed as the preliminary findings are encouraging that spearmint has the potential for use as a helpful and natural treatment for hirsutism in PCOS. Copyright © 2009 John Wiley & Sons, Ltd.     

Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial

Polycystic ovary syndrome (PCOS) is a common, complex reproductive endocrinopathy characterized by menstrual irregularities, hyperandrogenism and polycystic ovaries. Lifestyle modification is a first‐line intervention; however, there are barriers to success for this form of self‐care, and women often seek adjunct therapies including herbal medicines. This pragmatic, randomized controlled trial, delivered in communities of Australia in overweight women with PCOS, compared the effectiveness and safety of a lifestyle intervention plus herbal medicine against lifestyle alone. All participants were helped to construct a personalized lifestyle plan. The herbal intervention consisted of two tablets. Tablet 1 contained Cinnamomum verum, Glycyrrhiza glabra, Hypericum perforatum and Paeonia lactiflora. Tablet 2 contained Tribulus terrestris. The primary outcome was oligomenorrhoea/amenorrhoea. Secondary outcomes were hormones; anthropometry; quality of life; depression, anxiety and stress; pregnancy; birth outcomes; and safety. One hundred and twenty‐two women gave their consent. At 3 months, women in the combination group recorded a reduction in oligomenorrhoea of 32.9% (95% confidence interval 23.3–42.6, p < 0.01) compared with controls, estimated as a large effect (η_p² = 0.11). Other significant improvements were found for body mass index (p < 0.01); insulin (p = 0.02) and luteinizing hormone (p = 0.04); blood pressure (p = 0.01); quality of life (p < 0.01); depression, anxiety and stress (p < 0.01); and pregnancy rates (p = 0.01). This trial provides evidence of improved effectiveness and safety for lifestyle intervention when combined with herbal medicines in women with PCOS. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd