Traditional Herbal Remedies Used in women’s Health Care in Italy: a Review

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Traditional Herbal Remedies Used in women’s Health Care
in Italy: a Review
Riccardo Motti
1
&Giuliano Bonanomi
1
&Stefano Emrick
1
&Virginia Lanzotti
1
#Springer Science+Business Media, LLC, part of Springer Nature 2019
Keywords Ethnobotany .Ethnopharmacology .Herbal remedies .Phytotherapy .Womens’shealthcare .Italy
Introduction
In recent decades a significant increase in the use of herbal
drugs and alternative medicine has been reported in Europe,
Australia, and the USA (Nordeng and Havnen 2004). The use
of plants and their products to treat medical disorders is known
as herbal medicine and is considered a branch of folk or tra-
ditional medicine (Gasparetto et al. 2012). Ethnobotany, de-
fined as scientific investigation of interrelation between peo-
ple and plants, relies on multidisciplinary approaches
(Soejarto et al. 2009; Sharma and Kumar 2013) and plays a
key role in the expanding knowledge of plants used in tradi-
tional medicine through pharmacological analysis of tradition-
al plant medicine. Indeed, there are many examples where
scientific analysis has provided objective evidence to validate
local ecological knowledge (LEK) of medicinal plant uses
(Cotton 1996). Consequently, ethnopharmacology is defined
as an interdisciplinary scientific exploration of bioactive
agents traditionally used by populations throughout the world
(Ghorbani et al.,2006). In recent decades, ethnobotanical and
ethnopharmacological surveys have received increasing atten-
tion, especially in Italy (e.g., Cornara et al. 2014;Belliaand
Pieroni 2015; Vitalini et al. 2015;Fortiniet al. 2016; Savo
et al. 2019).
Women experience physiologically specific conditions
such as the menstrual cycles, pregnancy, childbirth, and
breastfeeding that can adversely affect their health and quality
of life in reproductive age. Menses, for example, are one of the
most important aspects of the female reproductive cycle, and
in many cases are associated with disorders that can have a
significant impact on women’s health status, quality of life,
social integration, and access to education (Harlow and
Campbell 2004; van Andel et al. 2014).
Women play an important role in plant management as
home gardeners, herbalists, seed custodians, and informal
plant breeders (Howard 2005). Furthermore, they frequently
use herbal drugs to treat health problems, such as menstrual
disorders, infertility, discomfort and dysfunctions of pregnan-
cy, labour, urogenital diseases, and menopause (e.g., Beal
1998;Murphyet al. 1999;Hallet al. 2011). Since medicinal
plants have been shown to play a key role in treatments related
to women’s healthcare in Italian rural communities,
ethnopharmacological studies could contribute to evaluation
of their effectiveness and/or safety. In recent decades, the use
of folk medicine for women’s health conditions has been ex-
tensively studied worldwide (e.g., Balick et al. 2000;
Steenkamp 2003; Srithi et al. 2012; van Andel et al. 2014;
de Wet and Ngubane 2014; de Boer and Cotingting 2014;
Johnson et al. 2016; Yazbek et al. 2016). At the same time,
little is known about the prevalence and patterns of
phytotherapy used by women in Italy (e.g., Baccini et al.
2008;Lapiet al. 2008;Cuzzolinet al. 2010;Masulloet al.
2015). In this regard, the literature in Italy lacks the coverage
of some important issues concerning what plants are used to
treat women’s disorders, and little is known about the phar-
macological properties those that have been identified.
In this context, we review the available literature and sum-
marize the pharmacological activity of some plants used in
folk medicine in Italy In order to highlight the use of wild
and cultivated plants specifically for the treatment of women’s
disorders. Several Italian regions maintain rural traditions and
are among the most extensively studied areas of Europe re-
garding medicinal plant uses. Herbal remedies are used in
rural communities mainly by local practitioners or by patients’
relatives who may be knowledgeable about medicinal plants
(Motti et al. 2018). The main topics we address through this
review are: identification of the most frequently used plant
*Riccardo Motti
motti@unina.it
1
Department of Agricultural Sciences, University of Naples Federico
II, Via Università 100, 80055 Portici, Naples, Italy
Human Ecology
https://doi.org/10.1007/s10745-019-00125-4

species in Italy for women’s health care; the most common
preparation and phytotherapy methods; which plants have
been tested for effectiveness of their pharmacological proper-
ties in treating the specific disorders; how many of these plants
are potentially toxic; and the most frequently reported
women’s disorders for which phytotherapy is used.
Materials and Methods
We searched both national and international journals pub-
lished from 1963 to 2017 for articles on the use of wild and
cultivated plants in Italian folk medicine. We used online ver-
sions of the Science Citation Index, Elsevier Journal Finder,
Blackwell Synergy, ISI web of knowledge, Scopus, and
Google Scholar using the key words: ethnopharmacology,
ethnobotany, herbal remedies, phytotherapy, Italy, and folk
plant-based remedies. Further articles and books were identi-
fied from the references of these papers. The criteria for article
selection were defined a priori to avoid personal bias. Only
articles containing references to the use of phytotherapy for
women’s healthcare were included. We used the same elec-
tronic databases to survey phytochemical and clinical studies
supporting the effectiveness of plants for each use report and,
finally, data on the possible toxicity of each species. Based on
the results obtained we drafted a check list reporting the fol-
lowing data: plant name, plant part(s) used, preparation, ad-
ministration method, uses, references, phytochemical and/or
clinical studies, and toxicological data.
Plant nomenclature follows Conti et al. (2005,2007)and
Bartolucci et al. (2018). Families are organised based on APG
IV (Chase et al. 2016) for angiosperms. When helpful, due to
the recent changes in nomenclature, synonyms are reported in
parentheses.
The categories used to search the Italian ethnobotanical
literature were pregnancy, menstrual disorders, breastfeeding,
cystitis, menopause disorders, vaginal infections, contracep-
tive, and abortion. Plantsused for cosmeticpurposes were also
taken into consideration.
To classify the ailments we used a symptom-based nosolog-
ical approach, a categorization that is widely used in ethnobo-
tanical research (e.g., Heinrich et al. 1998;Gonzálezet al.
2010; Yabesh et al. 2014). For menstrual disorders we followed
the categories defined by Harlow and Campbell (2004).
Results and Discussion
We identified a total of 107 articles and books, of which 74
contain reports of medicinal plants used specifically for the
treatment of women’s health conditions. Based on the litera-
ture review, we documented 197 plant species distributed in
61 families as being used by traditional healers in Italy to treat
women’s conditions and disorders (Table 1). Asteraceae
(12.1%) is the most frequently cited family (Fig. 2), followed
by Lamiaceae (10.6%), and Rosaceae (9.6%).
As we anticipated, local practitioners mainly use indige-
nous plants to treat women’s ailments. However, introduced
species are also occasionally employed, for example, Aloe
vera (L.) Burm.f. and Coffea arabica L. Overall, 306 medic-
inal and 33 cosmetic uses were reported for the 197 taxa
considered.
In all, 15 species are reported to have four or more uses.
Adiantum capillus-veneris is the most commonly reported
species (Fig. 1), being cited for nine uses, followed by
Petroselinum crispum (Mill.) A. W. Hill. (7), Malva sylvestris
L. and Urtica dioica L. (6).
Flowers (34.5%) were the most frequently used plant parts,
followed by roots (15.6%), leaves (15.4%), and seeds (6.9%).
The remaining parts (including, for example, tubers, galls, and
buds) accounted for 26.0% overall; leaving 1.6% of plant parts
not mentioned by any authors.
According to the reported data, decoction (44.2%), infu-
sion (21.9%), and raw (21.3%) are the most frequent prepara-
tion methods used. Macerate and tincture accounted for 7.3%,
leaving 5.3% unreported. The most common administration
method used for a wide range of disorders is oral (61.7%).
Topical administration (31.2%) is generally used for vaginal
diseases, breastfeeding problems, such as mastitis and fis-
sures, and for cosmetics. On the basis of our literature findings
regarding phytochemical properties and/or clinical trials relat-
ed to each use-report (except cosmetics) it emerged that vali-
dating studies are obtained in about 30% of cases.
Overall seven main ailment categories were identified.
Herbal remedies for menstrual-cycle complaints are by far
the most commonly reported (34.8%), of which the majority
of remedies (52.1%) involve treatments for dysmenorrhoea.
Dysmenorrhoea is a common menstrual complaint with a
major impact on women’s quality of life, work productivity,
and their overall health (Ju et al. 2014), affecting from 45 to
95% of menstruating women (Iacovides et al. 2015).
Dysmenorrhoea is usually treated with non-steroidal anti-in-
flammatory medications with the addition of oral contracep-
tive pills, if necessary (Coco 1999). About 25% of affected
women do not respond to such treatments (Mirabi et al. 2014).
Among the mostcommonly used herbal remediesfor dysmen-
orrhoea disorders are chamomile (Matricaria chamomilla L.),
maidenhair fern (Adiantum capillus-veneris L.), yarrow
(Achillea millefolium L.), and laurel (Laurus nobilis L.), taken
orally, as an infusion or decoction. Chamomile is a widely
used traditional herbal drug whose extract has anti-inflamma-
tory, sedative, and antispasmodic effects. Many studies ad-
dressed the components responsible for these observed effects
(Avallone et al. 2000), identifying the most important as ses-
quiterpenes and flavonoids, which have been studied exten-
sively (Švehlíková and Repčák 2006). Consequently, it has
Hum Ecol

Table 1 Traditionally used plants for women's health care in Italy
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Acer campestre L. (Aceraceae) Bark Decoction Oral Oligomenorrhea,
dysmenorrhea Arcidiacono et al.,2007 Effective against pains, the
activities of these
species can be
attributed to flavonoids
and tannins.
(Bi et al.,2016)
Not reported
Acer opalus subsp. obtusatum
(Waldst. & Kit. ex Willd.)
Gams (Aceraceae)
Bark Decoction Oral Oligomenorrhea,
dysmenorrhea Arcidiacono et al.,2007 See A. campestre Not reported
Achillea ligustica All.
(Asteraceae) Leaves Raw Topical Emmenagogue Bruni et al.,1997 Estrogenic activity due
to luteolin V and
apigenin VI (Saeidnia
et al.,2011)
Not reported
Achillea millefolium
L. (Asteraceae) Leaves, flowers Infusion, decoction,
tincture Oral Dysmenorrhea De Feo et al.,1992b;
Vitalini et al.,2013;
Dei Cas et al.,2015,
Analgesic activity
due to sesquiterpene
lactones, dicaffeoylquinic
acids and flavonoids
(Nemeth and
Bernath, 2008).
Not reported
Aerial parts Decoction Oral Irregular cycle,
menorrhagia Dei Cas et al.,2015 See A. ligustica
Not reported Infusion Oral Emmenagogue Guarino et al.,2008 See A. ligustica
Flowers Decoction Topical To “clean”the
skin Pieroni et al.,2004a No data found
Leaves, flowers Decoction Oral Menopause
disorders Vit alini et al.,2015 See A. ligustica
Achillea moschata Wulfen
(Asteraceae) Flowers Infusion Topical Vaginitis Vitalini et al.,2013 No data found Not reported
Flowers Infusion Oral Dysmenorrhea See A. ligustica See A. millefolium
Adiantum capillus-veneris
L. (Pteridaceae) Leaves Decoction Oral Emmenagogue Barone, 1963;
Amico and Sorce, 1997;
Bruni et al.,1997;
Aleo et al.,2014
No data found Not reported
To regulate
menstrual
cycle
Loi et al.,2004; De Natale
and Pollio, 2007;
Guarino et al.,2008;
Forgione et al.,2008;
Di Sanzo et al.,2013
No data found
Dysmenorrhea Bruni et al.,1997;Loi
et al.,2004; Passalacqua
et al.,2007;Idolo
et al.,2010
Analgesic and
anti-inflammatory effects
due to triterpenes.
The plant ethanolic
has displayed
significant
anti-inflammatory activity.
(Haider et al.,2011;
Al-Snafi, 2015a;
Dehdari and
Hajimehdipoor, 2018)
Amenorrhea Loi et al.,2004 No data found
To help
pregnancy Barone, 1963; Cornara
et al.,2014 No data found
Aerial parts Not reported Not reported To enhance
uterine
contractions
during
delivery
Pieroni and Quave, 2005 No data found
Decoction Oral Sedative after
childbirths Passalacqua et al.,2007;
Guarino et al.,2008 No data found
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxic ity
Abortive Amico and Sorce, 1997;Uncini
Manganelli et al.,2002;
De Natale and Pollio, 2007;
Forgione et al., 2008;Savo
et al.,2011;Letoet al.,
2013; Tuttolomondo
et al.,2014c
No data found
Oral Frigidness Ballero and Fresu, 1993 No data found
Alcea rosea
L. (Malvaceae) Leaves Decoction Oral Cystitis Motti and Motti, 2017 Antimicrobial activities of
n-hexane, methanol,
ethanol, ethyl acetate
and water extracts
(Al-Snafi, 2013)
Not reported
Alchemilla alpina group
(Rosaceae) Leaves Infusion Oral Menopause
disorders,
dysmenorrhea
Vitalini et al.,2013 No data found Not reported
Alchemilla vulgaris
group (Rosaceae) Leaves Infusion Oral Menopause
disorders,
dysmenorrhea
Vitalini et al.,2013 No data found Not reported
Alchemilla xanthochlora
Rothm. (Rosaceae) Aerial parts Raw Topical Dysmenorrhea Bellia and Pieroni, 2015 No data found Not reported
Leaves Infusion Oral Dysmenorrhea Vitalini et al.,2015 No data found
Allium ampeloprasum
L. (Amaryllidaceae) Bulbs Decoction Oral Galactofuge Bellia and Pieroni, 2015 No data found Not reported
Allium cepa
L. (Amaryllidaceae) Bulbs Cooked, raw Oral Galactagogue Pieroni et al.,2004b; Guarino
et al.,2008;Montesano
et al.,2012; Menale
et al.,2016
No data found Not reported
Raw Cystitis Fortini et al.,2016 Essential oils extracts
were found to inhibit
bacterial growth (Benkeblia,
2004;Bakhtet al.,2013).
Topical Dysmenorrhea Leporatti and Pavesi, 1990 Analgesic and
anti-inflammatory activity
duetohighflavonoid,
thiosulphinate and cepaene
content (Ali et al.,2000;
García-Herrera et al.,2014).
Decoction Vaginal
infections Cornara et al.,2009 Antifungal activity due
to saponins (Lanzotti, 2005)
Mastitis De Feo et al.,1992b Essential oils extracts were
found to inhibit bacterial
growth (Benkeblia, 2004;
Bakht et al.,2013).
Aloe vera (L.) Burm.
f. (Asphodelaceae) Leaves Raw Topical To make
babies stop to
suck
their mothers’
milk
Savo et al.,2011 This practice is probably
due to the bitter taste
of Aloe juice
Aloysia citriodora
P. Palau ( = Lippia
triphylla (L’Hér.)
Kuntze)
Leaves and flowers Raw Topical Perfume Pieroni et al.,2004a
Leaves Infusion Oral Dysmenorrhea Bellia and Pieroni, 2015 No data found
Althaea officinalis
L. (Malvaceae) Flowers Infusion Oral Cystitis Menale and Muoio, 2014 Antibacterial effects
(Ozturk and Ercisli, 2007;
Jafari-Sales et al.,2015)
Anagyris foetida
L. (Fabaceae) Leaves Infusion Oral Emmenagogue Loi et al.,2002 No data found
Seeds Raw Oral Galactagogue No data found
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Anethum graveolens
L. (Apiaceae) Menale et al.,2006
Anthemis arvensis L. subsp.
incrassata (Loisel.)
Nyman (Asteraceae)
Flowers Decoction Oral Dysmenorrhea Menale et al.,2016 No data found
Anthemis cotula
L. (Asteraceae) Flowers Infusion Oral Labor pains Barbagallo et al.,1979 No data found
Arctium lappa
L. (Asteraceae) Roots Decoction Oral Dysmenorrhea Menale et al.,2006 Anti-inflammatory effects
due to triterpenes
(Akihisa et al.,1996;
Lin et al.,1996;
Jeelani and Khuroo, 2012)
Aristolochia tyrrhena
E.Nardi & Arrigoni
(Aristolochiaceae)
Whole plant Infusion Oral Emmenagogue Ballero and Fresu, 1993 No data found
Artemisia absinthium
L. (Asteraceae) Aerial parts Decoction Topical Vaginal washing Cornara et al.,2014 No data found
Whole plant Raw Galactofuge Leporatti and Corradi, 2001 No data found
Flowers, leaves Decoction Oral Emmenagogue Leporatti et al.,1985 No data found
Leaves Infusion Abortive Maccioni et al.,2004 No data found
Dysmenorrhea Coassini Lokar et al.,1983 Themethanolicextract
of A. absinthium shows
significant analgesic effect
(Ahmad et al.,1992) Flavonoids,
phenolic and tannin contents
has significantly high
concentration in this species
(Singh et al.,2012)
Artemisia vulgaris
L. (Asteraceae) Aerial parts Infusion Oral Dysmenorrhea Bellia and Pieroni, 2015 Presence of chamazulene,
a substance with
anti-inflammatory properties
(Sacco et al.,1983).
Terpenoids, flavonoids,
coumarins, caffeoylquinic acids,
sterols and acetylenes
constitute major classes of
phytoconstituents of the
genus (Bora and Sharma,
2011).
Leaves and roots Not reported Oral Emmenagogue Guarino et al.,2008 No data found
Arundo donax L. (Poaceae) Rhizome Decoction Oral Galactofuge Passalacqua et al.,2007 No data found
Dysmenorrhea Pagni and Corsi, 1979 No data found
Asparagus acutifolius
L. (Asparagaceae) Roots Decoction Oral After childbirth
to relieve the
pains
of uterine
contractions
Guarino et al.,2008 No data found
Asplenium ceterach
L. subsp. ceterach
(=Ceterach officinarum
Willd.) (Aspleniaceae)
Leaves Decoction Oral Abortive.
Regulator
of menses
De Natale
and Pollio, 2007 No data found
leaves Decoction Oral Dysmenorrhea Passalacqua et al.,2007 Phenolic compounds,
flavonoids, xanthones
possess anti inflammatory
properties (Berk et al.,2011;
Živkovićet al.,2017).
Asplenium trichomanes
L. (Aspleniaceae) Aerial parts Not reported Not reported Emmenagogue Guarrera et al.,2008 Extracts obtained from
A. trichomanes
possess weak
estrogenic activityin vitro
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
(Dall’Acqua et al.,2009).
To enhance
uterine
contractions
during
delivery
Pieroni and Quave, 2005 No data found
Aurinia saxatilis (L.) Desv.
subsp. megalocarpa
(Hausskn.)
T.R.Dudley (Brassicaceae)
Whole plant Decoction Topical Vaginal
infections De Feo et al.,1992a No data found
Avena sativa L. (Poaceae) Seeds Decoction Oral Post-pregnancy Menale et al.,2016 No data found
Galactagogue Maxia et al.,2008 No data found
Bellis perennis
L. (Asteraceae) Flowers Infusion Oral Menorrhagia Guarino et al.,2008 No data found
Beta vulgaris
L. (Chenopodiaceae) Aerial parts Decoction Oral To induce
childbirth Dei Cas et al.,2015 No data found
Roots Raw Galactagogue Vitalini et al.,2015 No data found
Leaves Raw Topical Galactofuge Cornara et al.,2009 No data found
Betula pendula
Roth (Betulaceae) Branches, bark,
leaves Not reported Not reported Against cellulite Dei Cas et al.,2015 Triterpenoids, diarylheptanoids,
phenylbutanoids, lignans,
phenolics and flavonoids
possess anti-inflamatory
effects. (Elio et al.,2014;
Rastogi et al.,2015)
Borago officinalis
L. (Boraginaceae) Aerial parts Cooked Oral Galactagogue Pieroni et al.,2004b;
Pieroni and
Quave, 2005;
Montesano et al.,2012
No data found
Not reported Not reported Post-partum
depurative Pieroni and Quave, 2005 No data found
Leaves Decoction Topical Mastitis De Feo et al.,1992b
Brassica oleracea
L. (Brassicaceae) Leaves Raw, roasted Topical Mastitis Pieroni et al.,2004a; Pieroni
and Quave, 2005;
Montesano et al.,2012
Cabbage extracts shows high
anti-inflammatory value
due to phenols,
glucosinolates and
flavanoids (Rokayya
et al.,2013; Ravikumar, 2015
Brassica montana Pourret
(Brassicaceae) Not reported Not reported Not reported Galactagogue Guarino et al.,2008 No data found
Brassica oleracea
L. var. sabauda
(Brassicaceae)
Leaves Raw Topical Galactofuge Scortegagna, 2016 No data found
Calendula officinalis
L. (Asteraceae) Flower heads and
leaves Not reported Not reported Against ovarian
inflammatiom Dei Cas et al.,2015 Phytochemicals such
as terpenoids, flavonoids,
coumarins, quinones,
volatile oil, carotenoids
with anti inflammatory
properties (Muley
et al.,2009; Jan and
John, 2017
Flowers Infusion, decoction Oral Dysmenorrhea Uncini Manganelli et al.,2002;
Bellia and Pieroni, 2015 See above
Decoction Oral Emmenagogue Leporatti and Corradi, 2001;
Uncini Manganelli et al.,2002;
Camangi and Tomei, 2003
No data found
Infusion Oral To regulate
menstrual
cycle
Menale et al.,2016 No data found
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Decoction Topical Skin toner; to
heal skin tears Pieroni et al.,2004a No data found
Cannabis sativa
L. (Cannabaceae) Leafy branches Decoction Topical To make girls’
hair
grow rapidly
Guarrera et al.,2005a No data found
Capsella bursa-pastoris
(L.) Medicus
(Brassicaceae)
Aerial parts Decoction Oral To regulate
menstrual
cycle. Post
partum to
avoid the risk
of
bleeding.
Camangi and Tomei, 2003 The treatment of
menorrhagia and metrorrhagia
seem to be mediated
throughanincreased
contraction of smooth
muscles and uteromimitic
effect. (Al-Snafi, 2015b)
Contraindicated
in pregnancy
(Bessette, 2001)
Aerial parts, whole
plant Raw, decoction,
infusion Topical, Oral Menorrhagia Coassini Lokar et al.,1983;
Guarino et al.,2008;Vitalini
et al.,2013;DeiCaset al.,2015
See above
Aerial parts Infusion Oral Emmenagogue Coassini Lokar and Poldini, 1988 See above
Carum carvi
L. (Apiaceae) Seeds Decoction Oral Galactagogue Vitalini et al.,2015 Seeds contain
numerous volatile oils,
the most prominent
being carvone, carvacrol,
carvenone and limonene
(Agrahari and Singh, 2014;
Ali-Shtayeh et al.,2015)
Not reported
Infusion Dysmenorrhea Coassini Lokar et al.,1983 Carvone acts as a
blocker of voltage
dependent Ca channels
(Agrahari and Singh, 2014).
The plant is recommended
to be avoided during
pregnancy because it
may cause uterine
contractions, miscarriage
or premature labor
(Ali-Shtayeh et al.,2015).
Castanea sativa
Miller (Fagaceae) Fruits Decoction Topical To enhance the
colour of
light hair and
give a brown
gloss
Pieroni et al.,2004a
Boiled Topical Emollient; to
whiten
facial skin
Pieroni et al.,2004a
Centranthus ruber (L.)
DC. (Valerianaceae) Leaves Infusion Oral Menopause
diseases Menale et al.,2016 No data found Not reported
Not reported Decoction Oral After childbirth
to
relieve the
pains of
uterine
contractions
Guarino et al.,2008 No data found
Flowers Infusion Topical To make blonde
hair Camangi and Tomei, 2003
Chelidonium majus
L. (Papaveraceae) Whole plant Decoction Oral Abortive Idolo et al.,2010 No data found Possible hepatotoxicity
(Gilca et al.,2010)
Cichorium intybus
L. (Asteraceae) Roots Decoction Oral Cystitis Menale and Muoio, 2014 Oxalic acid, succinic
acid, quinic acid, and
shikimic acid show
antibacterial activity
Not reported
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
(Petrovic et al.,2004;
Street et al.,2013)
Leaves Cooked Oral Galactagogue Menale et al.,2016 No data found
Cistus creticus L. subsp.
eriocephalus (Viv.)
Greuter & Burdet
(Cistaceae)
Resin Raw Oral Emmenagogue Ballero and Fresu, 1993 No data found Not reported
Cistus monspeliensis
L. (Cistaceae) Resin Raw Oral Emmenagogue Ballero and Fresu, 1993 No data found Not reported
Citrus bergamia Risso
et Poit. (Rutaceae) Fruits (essential oil) Raw Topical Contraceptive Passalacqua et al.,2007 No data found Bergapten, citropten,
bergamotene, and
other furocoumarins
may cause
phototoxic
effects (Keilovà
et al., 2007)
Anomalous
vaginal
secretions
Passalacqua et al.,2007 Essential oil is
a potential source
of natural antimicrobials
that are active against
Gram‐negative bacteria
(Navarra et al.,
2015;Mandalariet al.,
2007)
Citrus limon (L.) Burm.
f. (Rutaceae) Fruit juice Raw Topical To give a special
gloss to the
hair
(mixed with
olive oil).
To whiten the
skin
of the hands.
Pieroni et al.,2004a
Citrus sinensis (L.)
Osbeck (Rutaceae) Fruits (peel) Decoction Oral Dysmenorrhea Fortini et al.,2016 Polymethoxy flavones
have anti.inflammatory
activity (Huang and Ho, 2010)
Not reported
Flowers Topical Vaginal
infections De Feo et al.,1992b No data found
Clinopodium vulgare
L. (Lamiaceae) Leaves, flowers Decoction Oral Emmenagogue Loi et al.,2002;Guarino
et al.,2008 No data found Not reported
Coffea arabica
L. (Rubiaceae) Seeds (not roasted) Decoction Oral Abortive Savo et al.,2011 No data found Not reported
Conium maculatum
L. (Apiaceae) Aerial parts Infusion Oral Abortive Bellia and Pieroni, 2015 No data found C. maculatum contains
very poisonous
piperidine alkaloids
(Vetter, 2004)
Corylus avellana
L. (Betulaceae) Leaves Decoction Topical To make the skin
“younger”and
to
give it colour
Cappelletti et al.,1981;
Pieroni et al.,2004a
Crataegus monogyna
Jacq. (Rosaceae) Flowers, leaves Decoction Not reported Dysmenorrhea Loi et al.,2004 Anti-infammatory and
antimicrobial properties
due to flavonoids
phenols and triterpenes
contents (Ahumada et al.,1997;
Güven et al.,2006;Tadić
et al.,2008)
Not reported
Boiled Topical Skin emollient Pieroni et al.,2004a
Infusion Oral Cystitis See above
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Uncini Manganelli
and Tomei, 1999
Tincture, decoction Oral To stop
menstruation Leporatti et al.,1985 No data found
Crocus sativus
L. (Iridaceae) Stigmas Decoction Oral Dysmenorrhea Antonone et al.,1988 Saffron is used for
promoting and regulating
menstrual periods and
for its ant-inflammatory
properties. Crocetin is
mainly responsible for
its pharmacological
activities (Bhargava, 2011)
Not reported
Cucurbita moschata
Duchesne
(Cucurbitaceae)
Fruits Raw Topical Dysmenorrhea Camangi and Tomei, 2003 No data found Not reported
Cyanus segetum Hill
(=Centaurea cyanus L.)
(Asteraceae)
Flowers Infusion Topical To give a special
gloss
and blue
nuance to
grey and white
hair
(avoiding the
yellowing
of hair)
Pieroni et al.,2004a
Cyclamen hederifolium
Aiton (Primulaceae) Bulbs Raw Oral Abortive,
dysmenorrhea Leporatti et al.,1985 Cyclamen extracts
has a higher saponin
content and show
anti-inflammatory and
antinociceptive activities
(Speroni et al.,2007)
Not reported
Cyclamen repandum Sm.
(Primulaceae) Bulbs Decoction Oral Abortive Loi et al.,2005 See above See above
Cydonia oblonga
Miller (Rosaceae) Seeds Raw Topical Mastitis Guarino et al.,2008 Phenolic compounds
and chlorogenic acid
show antimicrobial and
anti-inflammatory properties
(Al-Snafi, 2016)
Not reported
Cynodon dactylon (L.)
Pers. (Poaceae) Rhizome,
whole plant Decoction Oral Dysmenorrhea Fortini et al.,2016;
Idolo et al.,2010 Flavonoids and
glycosides show
anti.inflammatory properties
(Garg and Paliwal, 2011)
Not reported
Rhizome Cystitis Uncini Manganelli and
Tomei , 1999;Guarrera
et al.,2015;Motti
and Motti, 2017
Tannin, quinones and
phenols act as
antimicrobial agents
(Kaleeswaran et al.,2010)
Whole plant Amenorrhea De Feo and Senatore, 1993 No data found
Daucus carota L. subsp.
major (Lam.) Batt.
(Apiaceae)
Roots Raw Topical Rhagades De Feo et al.,1992b No data found Not reported
Dryopteris filix-mas (L.)
Schott (Dryopteridaceae) Leaves Decoction Oral Emmenagogue Bruni et al.,1997 No data found Not reported
Ecballium elaterium
(L.) (Cucurbitaceae) Whole plant Raw Topical Abortive Leto et al.,2013 No data found The juice can
cause serious
adverse
reactions and even
deaths
(Raikhlin-Eisenkraft
and Bentur, 2000;
Salhab, 2013)
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Equisetum arvense L.
(Equisetaceae) Aerial parts Decoction Topical Vaginal washing Cornara et al.,2014 Thymol, 1,8-cineole, Linalool
and β-Ionone shown
to possess antimicrobial
and antifungal effect
(Radulovićet al.,2006)
Not reported
Oral Cystitis Cornara et al.,2009
Fortini et al.,2016 See above
Galactagogue Coassini Lokar
and Poldini, 1988 No data found
Equisetum ramosissimum
Desf. (Equisetaceae) Aerial parts Decoction Oral Cystitis Cornara et al., 2009 Probably the
same as E. arvense
Not reported
Equisetum spp. (Equisetaceae) Aerial parts Decoction Oral Abortive Amico and Sorce, 1997 O data found Not reported
Equisetum telmateja
Ehrh. (Equisetaceae) Aerial parts Decoction Topical Vaginal washing Cornara et al.,2014 Probably the same
as E. arvense
Not reported
Oral Cystitis Leporatti et al.,1985;
Cornara
et al.,2009;
Fortini et al.,2016;
See above
Eryngium campestre
L. (Apiaceae) Roots Decoction Oral Emmenagogue Guarino et al.,2008 No data found Not reported
Infusion Galactofuge Ballero and Fresu, 1991 No data found
Euphorbia characias
L. (Euphorbiaceae) Leaves Raw Oral Abortive Guarrera et al.,2005b No data found The latex of
several members of
the Euphorbiaceae is
caustic and toxic
(Barbieri et al.,
1983)
Ficus carica L. (Moraceae) Fruits Decoction Oral Dysmenorrhea Fortini et al.,2016
Filipendula ulmaria (L.)
Maxim. (Rosaceae) Flowers Infusion Not reported Cellulite Dei Cas et al.,2015
Foeniculum vulgare
Miller (Apiaceae) Seeds, roots,
leaves, aerial
parts
Decoction, raw Oral Galactagogue Ferri, 1977;Uncini
Manganelli
et al.,2002; Camangi and
Tomei , 2003; Guarino et al.,
2008;
Maxia et al.,2008;Leto
et al.,2013; Menale and Muoio,
2014; Motti and Motti, 2017
Anethole has been
considered to be the
active oestrogenic agent.
Some other studies
have suggested that
the actual
pharmacologically
active agents are
polymers of anethole,
such as dianethole
and photoanethole
(Rather et al.,2016)
Not reported
Roots Decoction Oral Emmenagogue Forgione et al.,2008; Guarino
et al.,2008 No data found
Seeds Decoction Oral Dysmenorrhea Fortini et al.,2016 Essential oil
inhibits oxytocin and
prostaglandin (Badgujar
et al.,2014)The
effects of fennel essential
oil on the uterine
contractioninrats
have been reported
(Rather et al.,2016)
Fragaria vesca L. (Rosaceae) Roots Decoction Oral Emmenagogue Barone, 1963 No data found Not reported
Fumaria capreolata
L. (Papaveraceae) Aerial parts Infusion Oral Abortive Cornara et al.,2014 No data found Not reported
Galega officinalis L.
(Fabaceae) Seeds,
Aerial parts Infusion Oral Galactagogue No data found The risk of oral toxicity
of G. officinalis
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Uncini Manganelli et al.,2002;
Vitalini et al.,2015 administration to
mammals is not
negligible (Rasekh
et al.,2008).
Hedera helix L. (Araliaceae) Leaves Decoction Oral Abortive Corrain, 1989; Camangi
and Tomei, 2003 No data found Not reported
Dysmenorrhea Uncini Manganelli et al.,2002 The ivy shows
an anti-inflammatory
potential due to of
α-hederin (monodesmoside)
and hederasaponin-C
content (Gepdiremen
et al.,2005)
Fruits Raw Contraceptive Cornara et al.,2014 No data found
Leaves Infusion Topical To give a gloss or
colour to white
hair
Pieroni et al.,2004a
Cellulite Antonone et al.,1988;DeFeo
et al.,1992b;
Vitalini et al.,2015
Saponins improve
venous and lymphatic
drainage and reduce
edema, hederin, in
particular, has
anti-inflammatory effects
(Hexsel et al.,2005).
Helianthus
tuberosus
L. (Asteraceae)
Roots Cooked Oral Galactagogue Leporatti and Pavesi, 1990 No data found Not reported
Helleborus foetidus
L. (Ranunculaceae) Roots Raw Topical Peeled root
introduced in
the
vagina to
provoke
an
haemorrhage,
which leads to
abortion.
Scherrer et al.,2005 No data found Toxic features of
hellebores are
determined
by the aglycons of
cardiac steroids and
protoanemonin
(Maior
and Dobrotă,2013.).
Humulus lupulus L.
(Cannabaceae) Leaves Cooked Oral Dysmenorrhea Uncini Manganelli et al.,2002 The estrogenic activity
of hops is due to
prenylated flavonoids
(Chadwick et al.,2006;
Zanoli and Zavatti, 2008
Not reported
Hypericum perforatum
L. (Hypericaceae) Leaves Decoction Oral Dysmenorrhea Loi et al.,2004 No data found Individuals with
sensitivity towards
St John’swortmay
experience allergic
reactions. The use of
St John’swortisnot
advisedinknown
cases of
photosensitivity.
Concerns have been
raised over
interactions
between St John’s
wort
and certain
prescribed
medicines (including
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
oral
contraceptives
warfarin,
ciclosporin,
theophylline
etc.) (Barnes et al.,
2001)
Leaves flowers Infusion, decoction Oral Emmenagogue Leporatti et al.,1985;
Vitalini et al.,2015 No data found
Iris foetidissima L. (Iridaceae) Rhizome, flowers Decoction Oral Abortive Uncini Manganelli et al.,2002 No data found In the New Zealand
National Poison
Centre
I. foetidissima is
reported
as poisonous
(Arsene
and Draghia, 2014)
Jacobea
maritima (L.)
Pelser & Meijden
subsp. maritima (=Senecio
cineraria DC.) (Asteraceae
Flowers, leaves Decoction Oral Dysmenorrhea Uncini Manganelli et al.,2002 No data found Not reported
Juglans regia L.
(Juglandaceae) Leaves Decoction Oral Emmenagogue Bruni et al.,1997 No data found
Cystitis Coassini Lokar and Poldini, 1988 Leaf extracts of J. regia
show antimicrobial
activities (Panth et al.,2016)
Not reported
Topical Antiseptic of
genital
skin parts
Pieroni et al.,2004a See above
To colour the
hair (brown) Pieroni et al.,2004a
Juniperus sabina
L. (Cupressaceae) Fruits Infusion Oral Abortive Vitalini et al.,2015 No data found Not reported
Lactuca sativa L. (Asteraceae) Leaves Decoction Topical Vaginal diseases Menale et al.,2016 L. sativa shows
atibacterial properties due
to the presence of
phenolic compounds
(Edziri et al.,2011)
Not reported
Mastitis Motti and Motti, 2017 See above
Oral Galactagogue Passalacqua et al.,
2007;DeFeo
et al.,1992b
No data found
Lamium album L. (Lamiaceae) Aerial parts,
leaves, flowers Infusion Oral Dysmenorrhea Bellia and Pieroni, 2015;
Vitalini et al.,2015 No data found Not reported
Aerial parts Decoction Menorrhagia Guarino et al.,2008 No data found
Roots Decoction Against uterine
bleeding,
irregular
menses and
leukorrhea
Guarino et al.,2008 No data found
Lapsana communis
L. (Asteraceae) Whole plant Raw Topical Galactofuge Aleo et al.,2014 No data found Not reported
Leaves Raw Topical Galactagogue Aleo et al.,2014 No data found
Larix decidua Miller
(Pinaceae) Resin Raw Topical Resin (poultice
with lard) on
nipple
rhagades
Vitalin i et al.,2015 No data found Not reported
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Laurus nobilis L. (Lauraceae) Leaves Decoction,
infusion Oral Dysmenorrhea Passalacqua et al.,2007;
Menale and Muoio, 2014;
Fortini et al.,2016;Motti
and Motti, 2017
No data found Not reported
Galactagogue Passalacqua et al.,2007 No data found
Raw Topical Mastitis Uncini Manganelli et al.,2002 Linalool presents
a low antibacterial
activity (Millezi
et al.,2012)
Lavandula angustifolia
Miller (Lamiaceae) Flowers Macerate Topical Perfume Pieroni et al.,2004a
Lens culinaris Medik.
(Fabaceae) Seeds Cooked Oral Galactagogue Menale et al.,2016 No data found Not reported
Ligustrum vulgare L.
(Oleaceae) Flowers Infusion Topical Vaginal
irrigations Antonone et al.,1988 No data found Not reported
Lilium candidum L. (Liliaceae) Flowers, bulbs Raw Topical Mastitis Bruni et al.,1997 No data found Not reported
Linum bienne Miller
(Linaceae) Seeds Decoction Oral Galactagogue Uncini Manganelli et al.,2002 No data found Not reported
Linum usitatissimum L.
(Linaceae) Seeds Decoction Oral Against vaginal
candida Dei Cas et al.,2015 No data found Not reported
Galactagogue Uncini Manganelli et al.,2002 No data found
Not reported Re-balances the
menstrual
cycle
after childbirth
Loi et al.,2004 No data found
Infusion Not reported Mastitis Loi et al.,2004 No data found
Raw (Oil) Oral To facilitate the
parturition Vit alini et al.,2015 No data found
Lobularia maritima
(L.) Desv. (Brassicaceae) Aerial parts Decoction Oral Abortive Menale et al.,2016 No data found Not reported
Antifungal
against
sexual
diseases
Menale et al.,2016 No data found
Malus sylvestris (L.) Miller
(Rosaceae) Fruits Decoction Oral Dysmenorrhea Fortini et al.,2016 No data found Not reported
Malva arborea (L.) Webb &
Berthel. (=Lavatera
arborea L.) (Malvaceae)
Leaves Decoction Oral Cystitis Cornara et al.,2009 No data found Not reported
Malva neglecta Wallr.
(Malvaceae) Leaves and flowers Infusion Oral To facilitate
childbirth Dei Cas et al.,2015 No data found Not reported
To facilitate the
parturition Vit alini et al.,2013 No data found
Oral/Topical For vaginal
inflammations Vitalin i et al.,2015 No data found
Decoction Topical Mastitis and
breast
engorgement
Barone, 1963;
Dei Cas et al.,2015 No data found
Malva sylvestris L.
(Malvaceae) Flowers, leaves Decoction, infusion Oral Cystitis Uncini Manganelli and Tomei,
1999;
Cornara et al.,2009; Menale
and Muoio, 2014; Fortini
et al.,2016
Not reported
Leaves, roots Decoction Dysmenorrhea Loi et al.,2004; Passalacqua et al.,
2007;DiNovellaet al.,2013 Scopoletin, quercetin
and malvidin
3-glucoside show
anti-inflammatory properties
(Prudente et al.,2013)
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Leaves, flowers Boiled Topical, oral Mastitis Corrain, 1989; Bruni et al.,1997;
Passalacqua et al.,2007;
Montesano et al.,2012;
Dei Cas et al.,2015;
Fortini et al.,2016
A naphtaqiunone,
namely, malvone A,
could be responsible
for high antimicrobial
activity of this species
(Razavi et al.,2011)
Leaves, flowers Infusion Oral Rhagades De Feo et al.,1992b See above
Leaves, flowers Infusion Oral, topical To facilitate
childbirth Dei Cas et al.,2015;Vitalini
et al.,2015 No data found
Leaves, flowers Decoction, infusion Topical Vaginal
infections De Feo and Senatore, 1993;
Camangi
et al.,2003; Scherrer
et al.,2005
See above
Leaves Raw Topical To perfume facial
skin Pieroni et al.,2004a
Malva verticillata L.
(Malvaceae) Leaves flowers Infusion Oral For vaginal
and urogenital
tract
inflammations
Vitalin i et al.,2015 See M. sylvestris Not reported
Marrubium incanum Desr.
(Lamiaceae) Flowers Decoction Oral Galactagogue,
emmenagogue Leporatti et al.,1985 No data found Not reported
Marrubium vulgare L.
(Lamiaceae) Flowers Macerate Oral To regulate
menstrual
cycle
Passalacqua et al.,2007 No data found Not reported
Roots Decoction Dysmenorrhea Bruni et al.,1997 Marrubiin exerts
a marked antinociceptive
effect (De Jesus et al.,2000)
Not reported Emmenagogue Guarino et al.,2008 No data found
Leaves Decoction Topical Vaginal
infections Ballero and Fresu, 1993 Diterpenes, sterols,
phenylpropanoids and
flavonoids show
antimicrobial properties
(Morteza-Semnani
et al.,2008;
Boudjelal et al.,2012)
Matricaria chamomilla
L. (=Chamomilla recutita
(L.)
Rausch) (Asteraceae)
Flowers Decoction, infusion Oral Dysmenorrhea Coassini Lokar et al.,1983;
Corrain,
1989;Bruniet al.,1997;Amico
et al.,1997; Uncini Manganelli
et al.,2002;Guarreraet al.,
2005b;
Scherrer et al.,2005;Martelli
et al.,2015–2016; Vitalini et al.,
2015; Motti and Motti, 2017
Sesquiterpenes and
flavonoids has
anti-inflammatory, sedative
and antispasmodic effects
(Avallone et al.
2000;Švehlíková
and Repčák 2006)
Not reported
Mentha longifolia L.
(Lamiaceae) Leaves Infusion Oral Dysmenorrhea Vitalini et al.,2015 Phenolic acids
possess noteworthy
spasmodic effects
(Mikaili et al.,2013)
Not reported
Mentha spicata L. (Lamiaceae) Leaves Not reported Not reported Emmenagogue Guarino et al.,2008 No data found Not reported
Mentha spp. (Lamiaceae) leaves Decoction Oral Dysmenorrhea Menale et al.,2016 See M. longifolia Not reported
Mercurialis annua
L. (Euphorbiaceae) Whole plant Decoction Oral Galactofuge Ballero and Fresu, 1991;Guarino
et al.,2008;
Aleo et al.,2014
No data found Not reported
Muscari comosum (L.)
Miller(=Leopoldia
comosa L.)
(Asparagaceae)
Leaves Raw Topical Mastitis Leporatti and Pavesi, 1990 Antimicrobial and
anti-inflammatory properties
due to homoisoflavanone
rich fraction from the
crude extract of the
Not reported
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
bulbs (Mulholland
et al.,2013)
Myristica fragrans Houtt.
(Myristicaceae) Seeds Raw Oral Dysmenorrhea Bellia and Pieroni, 2015 No data found Not reported
Myrtus communis
L. (Myrtaceae) Fruits Macerate Oral Dysmenorrhea Savo et al.,2011 Myrtle berries
contain monoterpene
hydrocarbons and
oxygenated monoterpenes
(α-pinene, 1,8-cineole,
geranyl acetate, linalool)
and high concentrations
of flavonol glycosides,
flavonols and flavanol.
Myrtle shows
anti.inflammatory and
analgesic effects
(Alipour et al.,2014)
Not reported
Leaves Decoction, soaking Topical Vaginal
infections Chiovenda-Bensi, 1960;
Cornara et al.,2009 α-pinene, limonene,
eucalyptol, linalool and
terpineol seemed to
contribute to the
strong antimicrobial
activity of M.communis
(Appendino et al.,2006;
Akin et al.,2012).)
Narcissus tazetta
L. (Amaryllidaceae) Leaves Decoction Oral Emmenagogue Loi et al.,2002 No data found Not reported
Nepeta cataria L. (Lamiaceae) Flowers Not reported Not reported Emmenagogue Guarino et al.,2008 No data found Not reported
Leaves Infusion Oral Dysmenorrhea Vitalini et al.,2015 No data found
Nigella damascena
L. (Ranunculaceae) Seeds Raw Topical Galactagogue Ballero and Fresu, 1993;
Leto et al.,2013 No data found Not reported
Ocimum basilicum
L. (Lamiaceae) Leaves Raw Topical Perfume Pieroni et al.,2004a
Olea europaea L. (Oleaceae) Leaves Decoction Oral Abortive Savo et al.,2011 No data found Not reported
Fruits (Oil) Raw Topical Dysmenorrhea Cornara et al.,2009 No data found Not reported
Ononis spinosa L. (Fabaceae) Roots Decoction Oral Cystitis Bellia and Pieroni, 2015 No data found Not reported
Origanum majorana L.
(Lamiaceae) Leaves Infusion Oral Dysmenorrhea Coassini Lokar et al.,1983 No data found Not reported
Origanum vulgare L.
(Lamiaceae) Aerial parts Raw Topical Perfume Pieroni et al.,2004a No data found Not reported
Leaves Decoction Oral Dysmenorrhea De Feo et al.,1992b No data found
Whole plant Infusion Topical Cellulite De Feo et al.,1992b No data found
Papaver rhoeas L.
(Papaveraceae) Petals Raw Topical To dye lips and
cheeks Camangi and Tomei, 2003
Parietaria judaica L.
(=P. diffusa
Mert. et W.D.J. Koch)
(Urticaceae)
Aerial parts Decoction Oral Cystitis Amico and Sorce, 1997;
Uncini Manganelli
and Tomei, 1999;
Scherrer et al.,2005;
Cornara et al.,2009
No data found Not reported
Dysmenorrhea Fortini et al.,2016 No data found
Post-partum
depurative Pieroni et al.,2004b No data found
Leaves Raw Topical Rhagades Cornara et al.,2009 No data found
Parietaria lusitanica L.
(Urticaceae) Leaves Decoction Topical Mastitis Bruni et al.,1997 No data found Not reported
Parietaria officinalis L.
(Urticaceae) Aerial parts Decoction Oral Cystitis Cornara et al.,2014 No data found Not reported
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Dysmenorrhea Fortini et al.,2016 No data found
Petasites hybridus (L.) P.
Gaertn.,
B. Mey. & Scherb.
(Asteraceae)
Rhizoma, leaves Not reported Not reported Emmenagogue Guarino et al.,2008 No data found Not reported
Petroselinum crispum (Mill.)
A.
W. Hi l l . (=P. s a t i v u m
Hoffm.;
P. hortense
Hoffm.)(Apiaceae)
Leaves, aerial parts Decoction Oral Abortive Pagni and Corsi, 1979;
Uncini Manganelli and
Tomei , 1999; Uncini Manganelli
et al.,2002; Camangi and
Tomei , 2003;Pieroniet al.,
2004b; Scherrer et al.,2005;
Guarrera et al.,2005b;
Pieroni and Quave, 2005;
Forgione
et al.,2008;Mottiet al.,2009;
Savo et al.,2011;Montesano
et al.,2012;Tuttolomondo
et al.,2014a; Menale et al.,
2016;
The abortive
property could be due
to estrogenic and
utrerine tonic activity
(Farzaei et al.,2013).
Not reported
Seeds Corrain, 1989; Maccioni et al.,
2004;
Aerial parts Raw Topical Abortive
(crushed
aerial parts
inserted in
vagina)
Martelli et al.,2015–2016 See above
Decoction Oral Amenorrhea Leporatti et al.,1985;
Passalacqua et al.,2007;See above
Infusion, decoction Oral To regulate
menstrual
cycle
Guarino et al.,2008; Menale
et al.,2016 See above
Raw Topical Galactofuge Pagni and Corsi, 1979; Camangi
and
Tomei , 2003; Camangi et al.,
2003;
Passalacqua et al.,2007;
Guarino
et al.,2008;Aleoet al.,2014;
Aleo et al.,2014;
Vitalini et al.,2015
No data found
Raw Topical Mastitis Martelli et al.,2015–2016 The bioactive
flavonoid apigenin
has anti-inflammatory
property (Pápay et al.,
2012)
Decoction Topical To give the hair
a special gloss Pieroni et al.,2004a
Picea abies (L.) H.Karst.
(Pinaceae) Resin Raw Topical Antifecondative Coassini Lokar and Poldini, 1988 No data found Not reported
Pimpinella anisum L.
(Apiaceae) Seeds Infusion Oral Galactagogue Passalacqua et al.,
2007; Vitalini et al.,2015;No data found Not reported
Pinus pinaster Aiton
(Pinaceae) Leaves, buds Decoction Oral Cystitis Uncini Manganelli and Tomei,
1999 No data found Not reported
Pistacia lentiscus L.
(Anacardiaceae) Leaves Decoction Topical Breast
engorgement Barone, 1963 No data found Not reported
Polygonum hydropiper L.
(Polygonaceae) Not reported Infusion Oral Menorrhagia Guarino et al.,2008 No data found Not reported
Leaves Decoction Oral Galactagogue Di Novella et al.,2013 No data found Not reported
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Portulaca oleracea L.
(Portulacaceae)
Potentilla reptans L.
(Rosaceae) Roots Decoction Oral Emmenagogue Barone, 1963 No data found Not reported
Prunus avium L. (Rosaceae) Peduncles Decoction Oral Cellulite Savo et al.,2011 No data found Not reported
Prunus cerasus L. (Rosaceae) Fruits Raw Topical To refresh and
lighten
the colour
of the skin
Pieroni et al.,2004a
Prunus dulcis (Mill.) D.A.
Webb (Rosaceae) Seeds Raw Oral Galactagogue Bellia and Pieroni, 2015 No data found Not reported
Fruits Topical To treat “tired
skin”
Pieroni et al.,2004a
Prunus persica (L.) Batsch
(Rosaceae) Seeds Decoction Oral Dysmenorrhea Corrain, 1989 No data found Seeds can contain
cyanide-containing
compounds
(Ballhorn, 2011)
Leaves Decoction Topical Breast
engorgement Barone, 1963 No data found
Prunus spinosa L. (Rosaceae) Bark, roots Decoction Oral Menorrhagia Vitalini et al.,2015 No data found
Quercus cerris L. (Fagaceae) Seeds, leaves Decoction Oral Puerperal
swelling Fortini et al.,2016 No data found Not reported
Bark Vaginal
infections Antonone et al.,1988 No data found Not reported
Quercus pubescens Willd.
(Fagaceae) Seeds, leaves Decoction Oral Puerperal
swelling Fortini et al.,2016 No data found Not reported
Quercus robur L. (Fagaceae) Bark Decoction Oral Vaginal loss Antonone et al.,1988 No data found Not reported
Ranunculus ficaria L.
(Ranunculaceae) Leaves Infusion Topical Rhagades Ballero and Fresu, 1991 No data found This species can
induce
hepatotoxicity
(Yilmaz et al., 2015)
Raphanus raphanistrum L.
subsp. sativus
(L.) Schmalh. (=Raphanus
sativus
L.) (Brassicaceae)
Roots Raw Topical To remove spots
from the face
after
pregnancy
Loi et al.,2004 No data found Not reported
Ricinus communis L.
(Euphorbiaceae) Seeds Raw Topical Mastitis Corrain, 1989 The antimicrobial
activities of
R. communis is
demonstred
against dermatophytic
and pathogenic
bacterial strains
(Jena and Gupta,
2012; Naz and
Bano, 2012)
Not reported
for topical
administration
Robinia pseudacacia L.
(Fabaceae) Flowers Infusion Topical As hair dye Leporatti and Corradi, 2001
Rosa canina L. (Rosaceae) Flowers Raw Topical Rhagades Vitalini et al.,2015 No data found Not reported
Fruits Decoction Oral During childbirth
because
people believe
that this potion
makes the
delivery
easier.
Leporatti and Pavesi, 1990 No data found
Galls Not reported Not reported Guarino et al.,2008 No data found
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
As a uterine
contraction
carminative
Rosmarinus officinalis
L. (Lamiaceae) Leaves Decoction Oral Galactagogue Uncini Manganelli et al.,2002;
Camangi and Tomei, 2003;No data found Not reported
Abortive De Feo et al.,1992a
Infusion Topical To “clean”and
“smoothen”
facial skin
Pieroni et al.,2004a
Flowers Macerate Perfume Pieroni et al.,2004a
Rubus fruticosus L. (Rosaceae) Leaves Decoction Oral To regulate
menstrual
cycle
Antonone et al.,1988 No data found Not reported
Rubus idaeus L. (Rosaceae) Leaves Infusion Oral To facilitate the
parturition Vit alini et al.,2015 No data found Not reported
Decoction Topical Vaginal
infections Leporatti et al.,1985 Berries extract
expresses bactericidal
activity due to
flavonoids and
other phenolic
compounds (Rauha
et al.,2000;
Krauze-Baranowska
et al., 2014)
Not reported
Infusion Not reported Relaxing uterine
muscles Dei Cas et al.,2015 No data found
Rubus ulmifolius Schott
(Rosaceae) Leaves Compresses Not reported Dysmenorrhea Loi et al.,2004 Not found Not reported
Not reported To regulate
menstrual
cycle
Loi et al.,2004 Not found
Infusion Not reported Menopause
disorders Loi et al.,2004 Not found
Decoction Topical Vaginal
infections Leporatti et al.,1985 See R. idaeus
Rumex alpinus L.
(Polygonaceae) Leaves Raw Topical Dysmenorrhea Vitalini et al.,2015 No data found Not reported
Ruta chalepensis L. (Rutaceae) Leaves Decoction Oral Abortive Ballero and Fresu, 1991;
Martelli et al.,2015–2016 Rue can provoke
hyperemia in the
uterus and high
mobility (oxytocic
action) which may
cause abortion
(Asgarpanah and
Khoshkam, 2012).
Rue is possibly
the plant most
used by women
with abortive intent,
but it might cause
multiple organ
system
failure and death.
Because of its
effects, it should
not be used as a
medicinal herb or
as an abortifacient
(De Freitas et al.,
2005).
Raw Topical Menale et al.,2016
Decoction Oral Dysmenorrhea Maxia et al.,2008
Whole plant Vaginal
infections Barbagallo et al.,1979
Ruta graveolens L. (Rutaceae) Aerial parts,
leaves Decoction Oral Abortive Corrain, 1989; Camangi
and Tomei, 2003; Guarino See R. chalepensis See R. chalepensis
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
et al.,2008;Mottiet al.,2009;
Tuttolomondo et al.,2014b
Dysmenorrhea Guarino et al.,2008; Fortini
et al.,2016
Amenorrhoea Guarino et al.,2008
Salix fragilis L. (Salicaceae) Leaves Infusion Oral Anticonceptive Cornara et al.,2014 No data found Not reported
Salvia officinalis L.
(Lamiaceae) Leaves Infusion Oral Dysmenorrhea Dei Cas et al.,2015;
Vitalini et al.,2015 Flavonoids and
terpenes are the
compounds that
most likely contribute
to the anti-inflammatory
and antinociceptive
actions of the herb
(Ghorbani and
Esmaeilizadeh, 2017).
Not reported
Menopause
disorders Dei Cas et al.,2015;
Vitalini et al.,2015 No data found
Infusion, decoction Topical Vaginal
infections De Feo et al.,1992b;
Camangi et al.,2003 Sage shows
antimicrobial (Gram-
positive and negative)
and antifungal (including
Candida albicans)
(Bozin et al.,2007;
Khalil and Li, 2011)
Salvia sclarea L. (Lamiaceae) Flowers, leaves Decoction Oral Emmenagogue Leporatti et al.,1985 No data found Not reported
Salvia verbenaca L.
(Lamiaceae) Leaves Decoction Oral Emmenagogue Menale et al.,2016 No data found Not reported
Sambucus ebulus L.
(Adoxaceae) Leaves Decoction Topical Mastitis Barone, 1963 No data found The elderberry
leaves contain
cyanide inducing
glycosides and
should be treated
with high caution
(Shokrzadeh and
Saravi,
2010).
Sambucus nigra L.
(Adoxaceae) Fruits Decoction Oral Cystitis De Feo et al.,1992a No data found Not reported
Leaves Abortive Corrain, 1989 No data found See S. ebulus
Bark Emmenagogue Leporatti et al.,1985 No data found
Sanguisorba minor
Scop. (Rosaceae) Aerial parts Decoction Oral Emmenagogue Bruni et al.,1997 No data found Not reported
Santolina pinnata Viv.
(Asteraceae) Not reported Not reported Not reported Dysmenorrhea Corsi et al.,1981 No data found Not reported
Satureja montana L.
(Lamiaceae) Flowers Infusion Oral Dysmenorrhea Bellia and Pieroni, 2015 No data found Not reported
Scrophularia canina
L. (Scrophulariaceae) Leaves Raw Topical Rhagades Passalacqua et al.,2007 Glycoside esters,
iridoid glycosides and
triterpenoids are the
most common
compounds in the
Scrophularia genus.
Among them,
scropolioside like
iridoids have shown
potential for
anti-inflammatory and
wound healing activity
Not reported
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
(de Santos
Galíndez et al., 2002).
Secale cereale L. (Poaceae) Seeds Raw Topical Flour (poultice)
for vaginal
inflammation
Vitalin i et al.,2015 No data found Not reported
Flowers Oral Plants infected
by the ergot
ascomycete
Claviceps
purpurea used
to
collect fruiting
bodies,
the decoction
of
which is
abortive
Cornara et al.,2014 Ergot is the
alkaloid-containing
product of a fungus,
Claviceps purpurea that
can stimulate uterine
contractions and induces
spontaneous abortion
(De Costa, 2002)
Ergotism symptoms
in humans vary
greatly and are
generally classified
as convulsive,
gangrenous, or
gastrointestinal
(Belser-Ehrlich
et al.,2013)
Sempervivum tectorum
L. (Crassulaceae) Leaves Raw Topical Mastitis Fortini et al.,2016 The extract of S. tectorum
contains
several flavonoids
andiswidelyused
as an anti-inflammatory
agent (Kekesi et al.,2003)
Not reported
Rhagades De Feo et al.,1992b See above
Senecio vulgaris L.
(Asteraceae) Whole plant Not reported Not reported Uterine diseases Guarino et al.,2008 No data found Not reported
Tincture Oral Dysmenorrhea De Feo et al.,1992b No data found
Silybum marianum (L.)
Gaertn. (Asteraceae) Roots Decoction Oral Dysmenorrhea Bellia and Pieroni, 2015 No data found Not reported
Smilax aspera L.
(Smilacaceae) Roots Decoction Oral Emmenagogue Barone, 1963 No data found Not reported
Solanum lycopersicon L. (=
Lycopersicon
esculentum Miller)
Leaves Decoction Topical Rhagades De Feo et al.,1992b No data found Not reported
Solanum tuberosum L.
(Solanaceae) Tubers Raw Topical To whiten the
skin of the
hands
Pieroni et al.,2004a Not reported
Leaves Decoction Vaginal
infections De Feo et al.,1992b No data found
Solidago virgaurea L.
(Asteraceae) Flowers Decoction Oral Cystitis Coassini Lokar et al.,1983 Diterpenes show
moderate antibacterial
activity (Starks et al.,
2010;
Kołodziej et al.,2011)
Not reported
Spartium junceum L.
(Fabaceae) Flowers Raw Topical Galactagogue De Feo et al.,1992b No data found Not reported
Stellaria media
(L.) Willd.
(Caryophyllaceae)
Aerial parts (Juice) Raw Topical Galactofuge Guarino et al.,2008 No data found Not reported
Tanacetum parthenium
(L.) Sch. Bip. (Asteraceae) Whole plant Decoction Oral Against
menstrual
pains
Guarino et al.,2008 Terpenoids, especially
sesquiterpenes and
sesquiterpene lactones,
parthenolide, flavonoid
glycosides and pinenes
show multiple pharmacologic
properties (Abad et al.,1995;
Pareek et al.,2011)
Not reported
Aerial parts Cooked Uterine diseases Coassini Lokar et al.,1983 See above
Hum Ecol

Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Tanacetum vulgare L.
(Asteraceae) Aerial parts Infusion Oral Dysmenorrhea Bellia and Pieroni, 2015 See T. parthenium Not reported
Taxus baccata L. (Taxaceae) Branches Decoction Oral Abortive Bruni et al.,1997 No data found Taxines are the
active, poisonous
constituents and
have been implicated
in animal and human
poisonings (Wilson
et al.,2001).
Emmenagogue Bruni et al.,1997 No data found
Dysmenorrhea Bruni et al.,1997 No data found
Teucrium chamaedrys L.
(Lamiaceae) Aerial parts Infusion Oral Dysmenorrhea Bellia and Pieroni, 2015 No data found Not reported
Teucrium montanum L.
(Lamiaceae) Leaves Not reported Not reported Menstrual cycle
disorders Fossati et al.,1999 No data found Not reported
Teucrium polium L.
(Lamiaceae) Leaves Decoction Oral Menopause
disorders Bruni et al.,1997 No data found Not reported
Tilia cordata Miller
(Malvaceae) Flowers Infusion Topical Vaginal
infections Camangi et al.,2003 No data found Not reported
Tilia platyphyllos Scop.
(Malvaceae) Flowers Decoction Oral Cystitis Fortini et al., 2016 No data found Not reported
Tribulus terrestris L.
(Zygophyllaceae) Aerial parts Decoction Oral Galactagogue Bruni et al.,1997 No data found Not reported
Trifolium pratense L.
(Fabaceae) Leaves Decoction Oral Emmenagogue Leporatti et al.,1985 No data found Not reported
Triticum aestivum L. (Poaceae) Fruits Pasta Oral Galactagogue Guarrera et al.,2005a No data found Not reported
Ulmus minor Miller (=Ulmus
campestris
Auct. non L.) (Ulmaceae)
Leaves Not reported Not reported Galactagogue Fossati et al.,1999 No data found Not reported
Bark Decoction Topical Vaginal
infections Leporatti et al.,1985 U. campestris
extract shows, analgesic
and anti-inflammatory
and antipyretic effects.
Flavonoids, tannins and
phenols are probably
responsible for
observed activities
(Boudaoud-Ouahmed et al.,
2015).
Not reported
Leaves Decoction Topical Breast
engorgement Barone, 1963 No data found
Urtica dioica L. (Urticaceae) Roots Decoction Topical Abortive bath Cornara et al.,2014 No data found Not reported
Aerial parts Oral Cystitis Coassini Lokar et al.,1983;
Coassini Lokar and
Poldini, 1988
Wat er ext r act
shows antimicrobial
properties (Gülçin
et al.,2004)
Emmenagogue Chimenti Signorini
and Fumagalli, 1983 No data found
Boiled Dysmenorrhea Ranfa et al.,2013 The analgesic activities of
nettle being related
to its antioxidant
activity (Gülçin
et al.,2004).
Raw Menorrhagia Coassini Lokar et al.,1983 No data found
Whole plant Decoction Vaginal
infections Barbagallo et al.,1979 Wa ter ex t rac t s how s
antimicrobial properties
(Gülçin et al.,2004)
Urtica spp. (Urticaceae) Aerial parts Infusion Oral Galactagogue Bianchi and Gallifuoco, 2004 No data found Not reported
Hum Ecol

been widely documented that M. chamomilla is effective at
relieving dysmenorrhoea symptoms (Jahanian et al. 1999;
Jenabi and Ebrahimzadeh 2009;Modaresset al. 2011).
Adiantum capillus-veneris contains a number of com-
pounds belonging mainly to the classes of triterpenoids, fla-
vonoids, phenyl propanoids, phenolics, coumarins, and phy-
tosterols, and its organic extracts exhibit anti-inflammatory
and analgesic properties, and thus the plant is frequently used
to treat inflammatory diseases (Ibraheim et al. 2011; Haider
et al. 2011; Yuan et al. 2013;Rastogiet al. 2018).
Achillea millefolium is rich in bioactive compounds such as
flavonoids and caffeic acid derivatives (Glasl et al. 2002;
Benedek et al. 2007) that contribute to a wide range of medic-
inal properties. This species produces an antispasmodic effect
(Chandler et al. 1982) mediated through calcium channel
blockade (Yaeesh et al. 2006). The antiphlogistic properties
of yarrow are mediated by sesquiterpenes (Kastner et al.
1993).
Laurus nobilis leaves contain several classes of secondary
metabolites such as sesquiterpenes, lactones, alkaloids and
glycosylated flavonoids (Dall’Acqua et al. 2006). The essen-
tial oil derived from laurel exhibits significant analgesic and
anti-inflammatory properties (Patrakar et al. 2012).
Several plants are used to regulate the menstrual cycle.The
most commonly reported are marigold (Calendula officinalis
L.),shepherd’s bag (Capsella bursa-pastoris L. Medicus),
horehound (Marrubium vulgare L.), parsley (Petroselinum
crispum), and stinging nettle (Urtica dioica L.).
Pharmacological studies have shown that Calendula
officinalis exhibits antibacterial, antiviral, anti-inflammatory,
and antioxidant properties (Basch et al. 2006;Muleyet al.
2009;Aroraet al. 2013) The main constituents of
C. officinalis include steroids, terpenoids, triterpenoids, flavo-
noids, phenolic acids, and carotenes (Loescher et al. 2014).
Faradiol, rutin, caffeic acid, and chlorogenic acid isolated
from C. officinalis exhibit biological activity (Masullo et al.
2015) but there is no clinical evidence of effects on the men-
strual cycle. Aerial parts of Capsella bursa-pastoris contain
flavonoids, polypeptides, choline, acetylcholine, histamine,
and tyramine (Kweon et al. 1996;Khare2008;Songet al.
2007), which, when used in traditional medicine for the treat-
ment of menstrual disorders, seem to be mediated through an
increased contraction of smooth muscles, thus showing a
uteromimitic effect (Miraldi et al. 2001; Al-Snafi 2015).
Marrubium vulgare is well known for its antimicrobial, im-
munomodulatory, analgesic, anti-hypertensive, antidiabetic,
and antioxidant properties, which have been related to the
presence of diterpenes, sterols, phenylpropanoids and flavo-
noids (Nawwar et al. 1989;Schlemperet al. 1996;Morteza-
Semnani et al. 2008; Boudjelal et al. 2012). Although the
plant is used in folk medicine to treat menstrual irregularities
(Lodhi et al. 2017), there is no clinical evidence on its effec-
tiveness in regulating menses. The healing properties and
Tab l e 1 (continued)
Species Part used Preparation Administration Uses References Phytochemical and
or clinical studies
Toxicity
Urtica urens L. (Urticaceae) Aerial parts Raw Topical Galactagogue Vitalini et al.,2015 No data found Not reported
Valeriana officinalis
L. (Caprifoliaceae) Roots Raw Topical In vagina as
abortifacient Di Novella et al.,2013 No data found Not reported
Vinca major L. (Apocynaceae) Leaves Raw Topical Galactofuge Leporatti and Pavesi,
1990;Letoet al.,2013 No data found Not reported
Vin c a m in o r L. (Apocynaceae) Whole plant, leaves Infusion, decoction Oral Galactofuge Ferri, 1977;
Antonone et al.,1988;
Vitalini et al.,2015
No data found Not reported
Viola odorata L. (Violaceae) Flowers Macerate Topical Facial skin toner
and perfume Pieroni et al.,2004a
Vitex agnus-castus L.
(Lamiaceae) Leaves, fruits Not reported Not reported Emmenagogue Guarino et al.,2008 No data found Not reported
Vitis vinifera L. (Vitaceae) Fruits (Wine) Raw Oral Galactagogue Pieroni et al.,2004b No data found Not reported
Zea mays L. (Poaceae) Stigmas Infusion, decoction Oral Cystitis De Feo et al., 1992;
Maccioni et al.,2004;
Dei Cas et al.,2015
Corn silks as
have shown
remarkable bioactivities
as effective diuretic
agent (Hasanudin
et al.,2012)
Not reported
Hum Ecol

medical uses of Petroselinum crispum are mostly related to a
wide range of active biomolecules present in the plant Agyare
et al. 2017. The properties of aerial parts of parsley are well
known as a uterine tonic, due to the presence of flavonoids
(apiin and apigenin) (Yoshikawa et al. 2000; Farzaei et al.
2013). Ethnomedicinal use of parsley to regulate menses
could be related to its anti-platelet, anti-coagulant, spasmolyt-
ic, analgesic, and oestrogenic properties (Farzaei et al. 2013;
Chauhan and Aishwarya 2018). The myristicin and apiole
contained in the plant increase the production of oestrogens,
which makes their use important in menopause. However,
large amounts can have a uterotonic effect and its use may
lead to miscarriage (Awe and Banjoko 2013). In traditional
therapy, Urtica dioica is reported for its anti-inflammatory
and antirheumatic effects, the analgesic activities of nettle be-
ing related to its antioxidant properties (Gülçin et al.,2004).
Grauso et al. (2019a), in a recent metabolomic study, identi-
fied several antioxidant metabolites in nettle based on a flavo-
noid and caffeoyl derivative chemical structure. However, no
scientific studies are available that demonstrate the effective-
ness of nettle in regulating the menstrual cycle. Flavonoids
along with terpenes are reported for Salvia officinalis leaves
(de Falco and Lanzotti 2018) as the compounds that most
likely contribute to the anti-inflammatory and antinociceptive
properties of the herb (Ghorbani and Esmaeilizadeh 2017).
Breast milk is considered the optimal food source for new-
borns through at least one year of age (Forinash et al. 2012),
while reduced breast milk production is reported as the most
frequent cause of breastfeeding failure (Sjölin et al. 1977).
Milk production can be increased in postpartum mothers by
the use of synthetic or natural products. Galactagogues are
substances or medicines either proven or believed to induce,
increase, or maintain human breast milk production. The
galactagogue effects of plants could be mediated by phytoes-
trogen action (Wilinska and Schleußner 2015). Among the
many galactagogue plants mentioned in this review, fennel
(Foeniculum vulgare Miller) and goat’srue(Galega
officinalis L.) are among the most cited. The widespread use
of fennel may be due to the presence of anethole, considered a
weakly oestrogen-like compound. It may increase breast milk
production or assist with the ‘let-down’reflex and promote
growth of breast tissue (Albert-Puleo 1980; Agarwal et al.
2008; Foong et al. 2015). Goat’sruehaslongbeenusedin
folk medicine to treat diabetes and as a galactagogue; it con-
tains galegin, a precursor to metformin. Several
phytoestrogens have been isolated from methanol extracts of
goat’s rue such as flavonol triglycosides, kaempferol, and
quercetin (Champavier et al. 2000; González-Andrés et al.
2004). According to Penagos Tabares et al. (2014), a daily
diet including goat’s rue is reported to increase milk yield in
Table 2 Percentage
frequency of use-reports
covering different use
categories
Menstrual cycle 34.8
Dysmenorrhea 52.1
Emmenagogue 28.6
To regulate menstrual cycle 10.1
Menorrhagia 5.9
Amenorrhea 3.4
Breastfeeding 21.5
Galactagogue 43.7
Mastitis 19.7
Galactafuge 18.3
Fissures 11.3
Breast engorgement 7.0
Cosmetic 9.6
Vaginal inflammations 8.4
Abortive 8.1
Cystitis 6.6
Pregnancy 6.3
To facilitate childbirth 50.0
Post-partum disorders 50.0
Menopause disorders 2.1
Contraceptive 1.3
Fig. 1 Number of use-reports for
each species
Hum Ecol

cows and sheep.No clinical trials are available to demonstrate
its galactagogue property in breastfeeding women. The
German Commission E refused approval of the use of this
species as a galactagogue because its effectiveness has not
been documented (Blumenthal et al. 1998).
The use of cabbage (Brassica oleracea L.) and lettuce
(Lactuca sativa L.) to treat mastitis is due to their anti-
inflammatory properties (Ahmad et al.,1992;Linet al. 2008;
Araruna and Carlos 2010; Rokayya et al. 2013;Mizgieret al.
2016). Scientific investigation of B. oleracea indicated 3-
methylsulfinylpropyl isothiocyanate, called iberin, as the active
ingredient of the plant and demonstrated its ability to target
TLRs, to disrupt TLR dimerization and to inhibit the inflamma-
tory responses (Shibata et al. 2014). From L. sativa two
triterpene lactones, 3,14-dihydroxy 11,13-dihydrocostunolide
and 8-tigloyl-15-deoxyl-actucin, were isolated, showing
lipoxygenase inhibition and significant in-vivo anti-inflamma-
tory activity on carrageenan-induced paw oedema (Araruna and
Carlos 2010).
Malva sylvestris L. and M. neglecta Wallr. are reported to
treat both mastitis and fissures; the properties of these species
are well-known as they are widely used in Mediterranean and
European traditional medicine to treat external and internal
inflammation, as well as wounds (Cutillo et al. 2006; Barros
et al. 2010;Gasparettoet al. 2012). Phytochemical screening
of M. sylvestris has led to the detection of scopoletin, querce-
tin, and malvidin 3-glucoside in the plant extract. The latter
compound was also able to inhibit ear oedema and leukocyte
migration. The former were able to prevent the formation of
oedema and cell infiltration, although less effectively than
hydroalcoholic extract and malvidin 3-glucoside (Prudente
et al.,2013). No data are available in the literature on the
phytochemicals responsible for the anti-inflammatory proper-
ties of M. neglecta.
Among the plants used for cosmetic purposes, the most
frequently cited are those for cellulite treatment. Cellulite, also
known as adiposis edematosa or dermopanniculosis
deformans, mainly affects postpubertal females and is charac-
terized by alterations to the skin surface, presenting as dim-
pled or puckered skin of the buttocks and posterior and lateral
thighs, and seems to be attributable to structural, inflammato-
ry, morphologic, and biochemical alterations in the subcuta-
neous tissue (Draelos 2005; Hexsel and Soirefmann 2011;
Friedman et al. 2017). One the most reported species for cel-
lulite treatment is common ivy (Hedera helix L.), whose
leaves are rich in flavonoids, such as rutinoside and rutoside,
and saponins, such as hederacoside, hederagenin, and hederin
(Grauso et al. 2019b). Saponins improve venous and lymphat-
ic drainage and reduce oedema; hederin, in particular, has
analgesic and anti-inflammatory effects (Hexsel et al. 2005).
Among the 197 plant species used, 17 contain toxic con-
stituents that may put women and their unborn children at
more or less serious risk. The majority of the toxic species
are customarily used for abortive purposes. C. maculatum
L., for example, contains very poisonous piperidine alkaloids
and is reported to be one of the most toxic species in the plant
kingdom (Vetter 2004). Helleborus species are considered to
be toxic, although poisonings are usually related to incorrect
dosage. Toxic features of hellebores are determined mostly by
the aglycons of cardiac steroids but protoanemonin - a γ–
lactone, is also a toxic compound (Corea et al. 2004; Maior
and Dobrotă2013). Euphorbia characias L. is administered
orally, but it is commonly recognized that the latex of several
members of the Euphorbiaceae family is caustic and toxic
(Barbieri et al. 1983). Rue (Ruta chalepensis L.;
R. graveolens L.) is the plant most widely used by women
to induce abortion (e.g., Ballero and Fresu 1991; Camangi
and Tomei 2003;Martelliet al.,2015–2016; Tuttolomondo
et al. 2014b), although it can cause multiple organ system
failure and death (De Freitas et al. 2005).
Conclusions
The studies we included in this systematic review demonstrate
the established tradition in Italy of using wild plants as addi-
tional or alternative treatments to conventional drugs in order
to cure various female disorders and diseases. The role of
ethnobotanical research is to avoid the loss of traditional
knowledge concerning medicinal plant lore and, at the same
time, provide the basis for developing new drugs from phyto-
chemical and biochemical research. This review has shown
that only by conducting studies on bioactivity and toxicolog-
ical properties of the plants used in folk phytotherapy will in-
depth understanding of their effectiveness, manner of use,
posology, and side effects be ultimately achieved.
Acknowledgements We would like to thank Mark Walters for fine-
tuning the original draft of the manuscript.
Funding This research did not receive any specific grant from funding
agencies in the public, commercial or not-for-profit sectors.
Compliance with Ethical Standards
Conflict of Interest The authors declare that they have no conflict of
interest.
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