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Nabimeybodi, N., Nokhostin, F., Zareshahi, R., Kamalinejad, M., Akhundimeybodi, H., Madadizadeh, F., Meybodi, M. N., Mazraeno, N. S., & Nabimeybodi, R. (2024). The effect of Henna (Lawsonia inermis) vaginal suppository combined with antibiotic therapy in the treatment of cervicitis: An RCT. International Journal of Reproductive BioMedicine (IJRM), 22(4), 269–282. https://doi.org/10.18502/ijrm.v22i4.16388
https://doi.org/10.18502/ijrm.v22i4.16388
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authors
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Naeemeh Nabimeybodi
Naeemeh Nabimeybodi
Department of Persian Medicine, School of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd, Iran.
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Fahimeh Nokhostin
Fahimeh Nokhostin
Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Rahele Zareshahi
Rahele Zareshahi
Department of Pharmacognosy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Mohammad Kamalinejad
Mohammad Kamalinejad
School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hedayat Akhundimeybodi
Hedayat Akhundimeybodi
Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran.
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Farzan Madadizadeh
Farzan Madadizadeh
Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Mohsen Nabi Meybodi
Mohsen Nabi Meybodi
Department of Pharmaceutics, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Narges Seifi Mazraeno
Narges Seifi Mazraeno
Department of Midwifery, Islamic Azad University, Meybod Branch, Yazd, Iran.
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Razieh Nabimeybodi
Razieh Nabimeybodi
Department of Persian Medicine, School of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd, Iran.
Published Date
- Jun 8, 2024
The effect of Henna (Lawsonia inermis) vaginal suppository combined with antibiotic therapy in the treatment of cervicitis: An RCT
Abstract
Background: Cervicitis is a prevalent gynecologic disease, which does not usually respond to conventional treatments. Long-term cervicitis can cause serious health problems such as inflammation, infertility, and cancer. Henna oil, an herbal product in Persian medicine, is recommended for uterine diseases like cervicitis.
Objective: This study aims to evaluate the efficacy of Henna oil as a vaginal suppository in combination with an antibiotic regimen in the treatment of cervicitis.
Materials and Methods: This randomized placebo-controlled trial, included 92 nonmenopausal women with cervicitis at the Baqaipur Clinic of Shahid Sadoughi hospital in Yazd and the Persian Medicine Health Center in Ardakan, Yazd, Iran. Participants were further divided into either the Henna oil vaginal suppository group or the placebo group (n = 46/each group). During the study, the antibiotic treatment was administered to both groups. Cervicitis symptoms were compared between the groups and within each group. Results: Of 92 included individuals, 41 in each group completed the study.
Results: revealed that significant differences were observed in some outcomes, including vaginal discharge (p < 0.001), cervical ulcer size (p < 0.001), dyspareunia (p = 0.046), and postcoital bleeding (p < 0.001), indicating that the treatment was more effective in the henna group compared to the placebo group.
Conclusion: Findings supported that the vaginal suppository of Henna oil in combination with antibiotic therapy could be effective in the improvement of clinical symptoms of cervicitis regardless of its pathology.
Key words: Lawsonia inermis, Persian+traditional medicine, Uterine cervicitis, Infertility, Vaginal suppository, Clinical trial.
References
[1] Duan X-M, Xu Y-Sh, Li X-Q, Ma X-Y, Zhao J-T, Li G-K, et al. To explore the therapeutic effect of Kangfuxiaomi shuan II on cervicitis in rats. Acta Cir Bras 2021; 36: e361006.
[2] Ortiz-de la Tabla V, Gutiérrez F. Cervicitis: Etiology, diagnosis and treatment. Enferm Infecc Microbiol Clin 2019; 37: 661–667.
[3] Zhang X, He M, Lei S, Wu B, Tan T, Ouyang H, et al. An integrative investigation of the therapeutic mechanism of Ainsliaea fragrans Champ. in cervicitis using liquid chromatography tandem mass spectrometry based on a rat plasma metabolomics strategy. J Pharm Biomed Anal 2018; 156: 221–231.
[4] Nabimeybodi R, Meyari A, Vahiddastjerdi M, Hajimehdipoor H, Ghasemi E, Bioos S, et al. The effect of flixweed-honey vaginal product on cervicitis: A clinical trial. Res J Pharmacognos 2018; 5: 41–49.
[5] Zhou Q, Zhang F, Sui L, Zhang H, Lin L, Li Y. Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology on the detection of vaginal intraepithelial neoplasia. Cancer Manag Res 2020; 12: 5987–5995.
[6] Ma F, Liu J, Lv X, Liu HZ, Yang PC, Ning Y. Characterization of allergic inflammation in chronic uterine cervicitis. Clin Exp Immunol 2022; 207: 44–52.
[7] Saghafi F, Nabi-meybodi R, Doosthoseini Z, Javaheri A, Zareshahi R. Efficacy of topical rose (Rosa damascena) oil for treatment of cervicitis: A randomised clinical trial. J Herbal Med 2023; 42: 100734.
[8] Nabimeybodi R, Zareshahi R, Tansaz M, Dastjerdi MV, Hajimehdipoor H. Scientific evaluation of medicinal plants used for the treatment of cervicitis (Qorohe- Rahem) in Iranian traditional medicine. Iran J Pharm Res 2019; 18: 1884.
[9] Khazaeli P, Mehrabani M, Mosadegh A, Bios S, Zareshahi R. Formulation, physiochemical, and microbial assay of Henna oil vaginal suppository formulated with polyethylene glycol bases. Iran J Med Sci 2020; 45: 207.
[10] Zargaran A, Borhani-Haghighi A, Salehi-Marzijarani M, Faridi P, Daneshamouz S, Azadi A, et al. Evaluation of the effect of topical chamomile (Matricaria chamomilla L.) oleogel as pain relief in migraine without aura: A randomized, double-blind, placebo-controlled, crossover study. Neurol Sci 2018; 39: 1345–1353.
[11] Ibn-e-Sina A. The canon of medicine. Beirut, Lebanon: Alaalami Beirut lib Press; 2005.
[12] Supian FNA, Osman NI. Phytochemical and pharmacological activities of natural dye plant, Lawsonia inermis L.(Henna). J Young Pharm 2023; 15: 201–211.
[13] Ghasemi Dehkordi NS, Ghanadi A, Amanzade Y, Azadbakht M, Asghari G, Amin G, et al. [Iranian herbal pharmacopoeia]. Tehran: Ministry of health and medical education, food and drug administration; 2002. (In Persian)
[14] Convention USP. United States Pharmacopeia and National Formulary (USP 41-NF 36); 2020. Available at: https://www.uspnf.com.
[15] Zahid S, Rehman H, Raza A, Kousar F. Effect of Unani formulation in cervicitis (Warme-unqur-rahm): A singleblind randomized placebo-controlled trial. Altern Integr Med 2016; 5: 100023.
[16] Yaralizadeh M, Abedi P, Nezamivand Chegini S, Yaralizadeh M, Hormozie L, Hejazi ZA, et al. Comparing the effects of two cream formulations, Henna (Lawsonia inermis) and clotrimazole, on vaginal candidiasis: A randomized controlled trial. Jundishapur J Nat Pharm Prod 2022; 17: e118510.
[17] Ahmed Z, Rahman T, Sarker S. Determination of antimicrobial properties of Trifala, Java Plum, Cinnamon, Henna and Cumin. Innova Microbiol Biotechnol 2021; 2: 15–27.
[18] Pasandi Pour A, Farahbakhsh H. Lawsonia inermis L. leaves aqueous extract as a natural antioxidant and antibacterial product. Nat Product Res 2020; 34: 3399– 3403.
[19] Hashmi Sh, Begum W, Sultana A. Efficacy of sphaeranthus indicus and cream of Lawsonia inermis in cervical erosion with cervicitis. Eur J Integr Med 2011; 3: e183-e188.
[20] Schneider MP, Vitonis AF, Fadayomi AB, Charlton BM, Missmer SA, DiVasta AD. Quality of life in adolescent and young adult women with dyspareunia and endometriosis. J Adolesc Health 2020; 67: 557– 561.
[21] Lavari N, Ostadrahimi N, Rahimi R, Raei M, Abbassian A. The effect of a topical formulation from Lawsonia inermis L. (henna) on pain intensity in patients with chronic sciatica: A randomized double-blind clinical trial. J Ethnopharmacol 2023; 313: 116519.
[22] Niazi M, Mehrabani M, Namazi MR, Salmanpour M, Heydari M, Karami MM, et al. Efficacy of a topical formulation of henna (Lawsonia inermis L.) in contact dermatitis in patients using prosthesis: A double-blind randomized placebo-controlled clinical trial. Complement Ther Med 2020; 49: 102316.
[23] Ali Talab T, Alfuraiji N, Al-Snafi AE. The analgesic and anti-inflammatory effect of Lawsone isolated from Lawsonia inermis. ScienceRise: Pharm Sci 2022; 1: 77– 84.
[24] Al-Snafi A. A review on Lawsonia inermis: A potential medicinal plant. Int J Curr Pharm Res 2019; 11: 1–13.
[25] Hekmatpou D, Ahmadian F, Eghbali M, Farsaei S. Henna (Lawsonia inermis) as an inexpensive method to prevent decubitus ulcers in critical care units: A randomized clinical trial. J Evid Based Integr Med 2018; 23: 2515690X18772807.
[26] Niazi M, Parvizi MM, Saki N, Parvizi Z, Mehrbani M, Heydari M. Efficacy of a topical formulation of Henna (Lawsonia inermis) on the itch and wound healing in patients with epidermolysis bullosa: A pilot singlearm clinical trial. Dermatol Pract Concept 2022; 12: e2022115.
[27] Elzayat EM, Auda SH, Alanazi FK, Al-Agamy MH. Evaluation of wound healing activity of henna, pomegranate and myrrh herbal ointment blend. Saudi Pharm J 2018; 26: 733–738.
[28] Liu C, Zhang Y, Kong S, Tsui I, Yu Y, Han F. Applications and therapeutic actions of complementary and alternative medicine for women with genital infection. Evid Based Complement Altern Med 2014; 2014: 658624.
[29] Latafat T, Siddiqui M, Jafri S. A clinical study of Marham Dakhlion on chronic cervictis and cervical erosion. Anc Sci Life 1992; 11: 158.
[2] Ortiz-de la Tabla V, Gutiérrez F. Cervicitis: Etiology, diagnosis and treatment. Enferm Infecc Microbiol Clin 2019; 37: 661–667.
[3] Zhang X, He M, Lei S, Wu B, Tan T, Ouyang H, et al. An integrative investigation of the therapeutic mechanism of Ainsliaea fragrans Champ. in cervicitis using liquid chromatography tandem mass spectrometry based on a rat plasma metabolomics strategy. J Pharm Biomed Anal 2018; 156: 221–231.
[4] Nabimeybodi R, Meyari A, Vahiddastjerdi M, Hajimehdipoor H, Ghasemi E, Bioos S, et al. The effect of flixweed-honey vaginal product on cervicitis: A clinical trial. Res J Pharmacognos 2018; 5: 41–49.
[5] Zhou Q, Zhang F, Sui L, Zhang H, Lin L, Li Y. Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology on the detection of vaginal intraepithelial neoplasia. Cancer Manag Res 2020; 12: 5987–5995.
[6] Ma F, Liu J, Lv X, Liu HZ, Yang PC, Ning Y. Characterization of allergic inflammation in chronic uterine cervicitis. Clin Exp Immunol 2022; 207: 44–52.
[7] Saghafi F, Nabi-meybodi R, Doosthoseini Z, Javaheri A, Zareshahi R. Efficacy of topical rose (Rosa damascena) oil for treatment of cervicitis: A randomised clinical trial. J Herbal Med 2023; 42: 100734.
[8] Nabimeybodi R, Zareshahi R, Tansaz M, Dastjerdi MV, Hajimehdipoor H. Scientific evaluation of medicinal plants used for the treatment of cervicitis (Qorohe- Rahem) in Iranian traditional medicine. Iran J Pharm Res 2019; 18: 1884.
[9] Khazaeli P, Mehrabani M, Mosadegh A, Bios S, Zareshahi R. Formulation, physiochemical, and microbial assay of Henna oil vaginal suppository formulated with polyethylene glycol bases. Iran J Med Sci 2020; 45: 207.
[10] Zargaran A, Borhani-Haghighi A, Salehi-Marzijarani M, Faridi P, Daneshamouz S, Azadi A, et al. Evaluation of the effect of topical chamomile (Matricaria chamomilla L.) oleogel as pain relief in migraine without aura: A randomized, double-blind, placebo-controlled, crossover study. Neurol Sci 2018; 39: 1345–1353.
[11] Ibn-e-Sina A. The canon of medicine. Beirut, Lebanon: Alaalami Beirut lib Press; 2005.
[12] Supian FNA, Osman NI. Phytochemical and pharmacological activities of natural dye plant, Lawsonia inermis L.(Henna). J Young Pharm 2023; 15: 201–211.
[13] Ghasemi Dehkordi NS, Ghanadi A, Amanzade Y, Azadbakht M, Asghari G, Amin G, et al. [Iranian herbal pharmacopoeia]. Tehran: Ministry of health and medical education, food and drug administration; 2002. (In Persian)
[14] Convention USP. United States Pharmacopeia and National Formulary (USP 41-NF 36); 2020. Available at: https://www.uspnf.com.
[15] Zahid S, Rehman H, Raza A, Kousar F. Effect of Unani formulation in cervicitis (Warme-unqur-rahm): A singleblind randomized placebo-controlled trial. Altern Integr Med 2016; 5: 100023.
[16] Yaralizadeh M, Abedi P, Nezamivand Chegini S, Yaralizadeh M, Hormozie L, Hejazi ZA, et al. Comparing the effects of two cream formulations, Henna (Lawsonia inermis) and clotrimazole, on vaginal candidiasis: A randomized controlled trial. Jundishapur J Nat Pharm Prod 2022; 17: e118510.
[17] Ahmed Z, Rahman T, Sarker S. Determination of antimicrobial properties of Trifala, Java Plum, Cinnamon, Henna and Cumin. Innova Microbiol Biotechnol 2021; 2: 15–27.
[18] Pasandi Pour A, Farahbakhsh H. Lawsonia inermis L. leaves aqueous extract as a natural antioxidant and antibacterial product. Nat Product Res 2020; 34: 3399– 3403.
[19] Hashmi Sh, Begum W, Sultana A. Efficacy of sphaeranthus indicus and cream of Lawsonia inermis in cervical erosion with cervicitis. Eur J Integr Med 2011; 3: e183-e188.
[20] Schneider MP, Vitonis AF, Fadayomi AB, Charlton BM, Missmer SA, DiVasta AD. Quality of life in adolescent and young adult women with dyspareunia and endometriosis. J Adolesc Health 2020; 67: 557– 561.
[21] Lavari N, Ostadrahimi N, Rahimi R, Raei M, Abbassian A. The effect of a topical formulation from Lawsonia inermis L. (henna) on pain intensity in patients with chronic sciatica: A randomized double-blind clinical trial. J Ethnopharmacol 2023; 313: 116519.
[22] Niazi M, Mehrabani M, Namazi MR, Salmanpour M, Heydari M, Karami MM, et al. Efficacy of a topical formulation of henna (Lawsonia inermis L.) in contact dermatitis in patients using prosthesis: A double-blind randomized placebo-controlled clinical trial. Complement Ther Med 2020; 49: 102316.
[23] Ali Talab T, Alfuraiji N, Al-Snafi AE. The analgesic and anti-inflammatory effect of Lawsone isolated from Lawsonia inermis. ScienceRise: Pharm Sci 2022; 1: 77– 84.
[24] Al-Snafi A. A review on Lawsonia inermis: A potential medicinal plant. Int J Curr Pharm Res 2019; 11: 1–13.
[25] Hekmatpou D, Ahmadian F, Eghbali M, Farsaei S. Henna (Lawsonia inermis) as an inexpensive method to prevent decubitus ulcers in critical care units: A randomized clinical trial. J Evid Based Integr Med 2018; 23: 2515690X18772807.
[26] Niazi M, Parvizi MM, Saki N, Parvizi Z, Mehrbani M, Heydari M. Efficacy of a topical formulation of Henna (Lawsonia inermis) on the itch and wound healing in patients with epidermolysis bullosa: A pilot singlearm clinical trial. Dermatol Pract Concept 2022; 12: e2022115.
[27] Elzayat EM, Auda SH, Alanazi FK, Al-Agamy MH. Evaluation of wound healing activity of henna, pomegranate and myrrh herbal ointment blend. Saudi Pharm J 2018; 26: 733–738.
[28] Liu C, Zhang Y, Kong S, Tsui I, Yu Y, Han F. Applications and therapeutic actions of complementary and alternative medicine for women with genital infection. Evid Based Complement Altern Med 2014; 2014: 658624.
[29] Latafat T, Siddiqui M, Jafri S. A clinical study of Marham Dakhlion on chronic cervictis and cervical erosion. Anc Sci Life 1992; 11: 158.