Paper on history of herbal fertility aids points to need for further research, expert says

A new study looks at historical herbal fertility treatments used in North America as a way to shed light on what might be worth further research today, as well as elucidate what herbs women are already using behind the scenes.

Fertility is one of the areas where traditional medicines have been used for centuries, with varying levels of success. It treads on one of the uneasy intersections between data on the actions of herbal ingredients and those of drugs. Herbs could potentially claim to support a healthy reproductive system, but without going the full on drug development route could not claim to help a couple plagued with infertility to conceive.

The paper, titled “Herbal fertility treatments used in North America from colonial times to 1900, and their potential for improving the success rate of assisted reproductive technology,” was published the journal Reproductive Biomedicine & Society Online. It was authored by researchers from Canada and the US.

The paper’s authors had a two pronged reason for undertaking this review. First, they said that there is evidence that women are already using herbs to try to improve their chances of conception, with or without their doctors’ knowledge.

And they said there is value to looking at the herbs that have been used in North America for centuries, either by being discovered here or being imported by settlers, or have links to Greek or Arabic texts to see if any offer hope to women seeking to conceive today.

As this is a historical review, the researchers cast as wide a net as possible. Nevertheless, they did try to separate the wheat from the chaff.

“An ethnomedicinal validation technique is used in this paper to identify traditional medicines with contemporary value. Validation includes examining the published phytochemical and pharmacological data to establish whether or not the reported folk use of plants is safe and effective (Lans et al., 2003). As this is a search for potential plant compounds to be used in future clinical trials and a historical study, exclusion criteria were not used in the validation process for the literature reviewed in this paper,” they wrote.

Colonial diaries among earliest sources

The paper covers the period from 1585 to 1900. Among the earliest sources used were diaries kept by Colonial period women, including information recorded by Abigail Adams, who relied on a Scottish text called Domestic Medicine by William Buchan. He mentioned the following herbs as being helpful in fertility: myrrh, Asarum, gentian, logwood, juniper berries, sarsaparilla, liquorice, pennyroyal, hemlock, and black and white hellebore.

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Information used in this study included data from a diary kept by Colonial period women, who relied on a Scottish text called Domestic Medicine by William Buchan. Photo: Wellcome Images / Wikimedia Commons (Wellcome Library, London)

Other early sources include enthnobotanical information recorded by one John Bartram and his son, William Bartram, who published a series of guides based on plant collecting trips across the eastern colonies of America and Ontario. These guides, including True Indian Physic, or Ipecacuanha, were published in the 1741 American Almanac in Philadelphia by John German and in Benjamin Franklin's 1741 Poor Richard's Almanac.

Another source examined in the paper were the activities of nineteenth century entrepreneur Lydia E. Pynkham, who marketed an herbal medicine. According to the authors, “Her vegetable compound and emmenagogues were sold to women with various ailments, including delayed menstruation, fallen womb and inflammation of the uterus (Frader and Stage, 1982; Young, 1980). The compound contained 20% alcohol, 8oz. unicorn root (Aletris farinosa), 6oz. of liferoot (Senecio aureus), 6oz. of black cohosh (Actaea racemosa), 6oz. of pleurisy root (Asclepias tuberosa) and 12oz. of fenugreek seeds (Trigonella foenum-graceum), all macerated.”

Antioxidant activity cited

Among the primary modes of action proposed by the authors for the effects of herbs on improving fertility chances are antioxidant activity. They also discuss the practice in Traditional Chinese Medicine of ‘rebalancing’ the body before a woman tries to conceive.

Among the herbs that the authors believe warrant further investigation for this application are Sweet flag (Acorus calamus), Black cohosh (Cimicifuga racemosa (L.) Nutt./Actaea racemosa L.), Angelica (Angelica archangelica), Blue cohosh (Caulophyllum thalictroides), Chelidonium majus (‘bai qu cai’ in TCM), Skullcap (Scutellaria baicalensis) and Liquorice (Glycyrrhiza uralensis).

Organization problems hamper message

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Liquorice was among the herbs that the authors believe warrant further investigation for its potential fertility benefits. Photo: Franz Eugen Köhler, Köhler's Medizinal-Pflanzen (1887)

The American Botanical Council has published a number of historical reviews on herbal lore in its periodical HerbalGram. ABC chief science officer Stefan Gafner, PhD, said this review is interesting and the use of herbs in fertility is an area worthy of greater attention from the herbal and natural products research community. But he said the review suffers from some organizational problems.

“The authors have done quite an impressive job in gathering information from a wide variety of sources – but it is often a bit difficult to follow the thread. The section on current data would have benefited from more clarity about what type of evidence there is: in vitro, animal, or human data,” Gafner told NutraIngredients-USA.

“As such, I found it challenging to figure out which plant species are best suited for herbal therapy adjuvant to in vitro fertilization, although the authors conclude that black cohosh (Actaea racemosa), chaste tree (Vitex agnus-castus), and black haw (Viburnum prunifolium) should be the most likely candidates,” he said.

More data needed

Gafner said using an enthnobotanical validation approach to look at historical material is an interesting approach, but needs solid modern clinical work to back it up.

“I would say that herbal treatments to increase fertility is a vastly understudied area. Some of the herbal medicines in the past may have addressed symptoms of malnutrition, a common reason for infertility in past centuries, and thus had an obvious benefit in the treatment of female infertility. Robust clinical data for most plants to support a benefit in enhancing fertility in the twenty-first century is lacking,” Gafner said.

“We can only hope that it will help to stimulate future research on the benefits of herbs in the area of women’s health, and infertility in particular,” he said.

Source: Reproductive Biomedicine & Society Online

2018 Apr; 5: 60–81.

“Herbal fertility treatments used in North America from colonial times to 1900, and their potential for improving the success rate of assisted reproductive technology”

Authors: Lans C, Taylor-Swanson L, Westfall R