Shepherd's Purse (Capsella bursa-pastoris) and Heavy menstrual bleeding: evidence and sources

Capsella bursa-pastoris (L.) Medik. (shepherd's purse) is a medicinal plant recently introduced to European Pharmacopoeia. The main active compounds responsible for the activity profile of the raw material are flavonoids, phenolic acids, amino acids, phytosterols, vitamins and bioelements. This species is known for its properties supporting the functioning of the digestive system and antihemorrhagic properties in the ethnomedicine of Far Eastern countries. Modern research confirms these directions of activity. Additionally, the latest studies prove the anti-inflammatory, antioxidant, antibacterial, antifungal, acetylcholinesterase and anticancer properties and supportive action in the treatment of gynecological diseases. Shepherd's purse herb also has a strong position as an edible plant due to the growing interest in this plant as "healthy food". The protective, softening, antibacterial and antioxidant properties of sprout and herb extracts are useful in the production of modern cosmetics. Moreover, C. bursa-pastoris is valuable thanks to phytoremediation properties and the numerous practical uses in biotechnology for the creation of new resistant varieties of crop plants from the Brassicaceae family.

Objectives Heavy menstrual bleeding (HMB) is one of the leading causes of low quality of life and iron deficiency anemia in women. This study aimed to determine the effect of hydroalcoholic extracts of Capsella bursa-pastoris on HMB. Design This study is a triple-blinded, randomized clinical trial. Setting The study was conducted in gynecology clinics affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran. Subjects Our patients affected to a complaint of HMB. After obtaining a complete medical history of the women and filling out the demographic forms, the participants were assigned randomly into the experimental (n = 42) and control groups (n = 42). Intervention The eligible participants were given a pictorial blood loss assessment chart (PBLAC) to confirm HMB during the menstrual cycle. The experimental group received two capsules of mefenamic acid (500 mg) every 8 h and two Capsella bursa-pastoris capsules every 12 h. The intervention started from the first day of menstruation to the end of this period up to 7 days for two consecutive cycles. In the control group, the patients received mefenamic acid and placebo instead of Capsella bursa-pastoris capsules. Outcome measurements The PBLAC score and number of bleeding days, incidence of any possible problems, as well as participant satisfaction were measured. The data were analyzed using t-test, Chi-square, repeated-measures ANOVA, and ANCOVA tests in PASW Statistics ver. 18. Results After the intervention, there was observed significant decrease in the amount of menstrual bleeding in both groups. However, the mean decrease in the amount of bleeding was significantly more in the Capsella bursa-pastoris group (p Conclusion Compared with control group, hydroalcoholic extracts of Capsella bursa-pastoris capsule appeared to be effective in reducing menstrual bleeding in this study. Further research regarding the efficacy and safety of Capsella bursa-pastoris is required.

This study was aimed to investigate the antihemorrhoidal effects of ethanol (CBE) and water extracts (CBW) of Capsella bursa-pastoris, an edible plant and a precipitant (CBW-1) obtained from the CBW in croton oil (CO)-induced hemorrhoid model in rats. CBW-1 was contain three organic acids, citric acid (36.09%), malic acid (35.56%), and quinic acid (17.73%). Hemorrhoids were evaluated by histopathology of recto-anal tissues and biochemical parameters in plasma and recto-anal tissues of rats. CBW, CBE, and CBW-1 significantly reduced hemorrhagic necrotic enteritis induced by CO. CO also increased the cytokines and lipid peroxidation (LPO) in serum, and myeloperoxidase (MPO) activity and LPO in recto-anal tissues, and reduced the GSH, CAT, GPx, and SOD levels in serum and recto-anal tissues. However, CBE, CBW, and CBW-1 ameliorated the levels of the cytokines, LPO, MPO, and the antioxidants. Our results conclude that the curative effect of Capsella bursa-pastoris is closely related with its organic acids constituents, citric, malic, and quinic acids. PRACTICAL APPLICATIONS: The fresh leaves of Capsella bursa-pastoris are edible, eaten raw or cooked, and also used in salad. It has a widespread traditional usage in the treatment of the hemorrhoids in the Anatolia and in the Middle East Countries. According to our literature survey, any scientific evidence has not been found in the literature that C. bursa-pastoris could be used in the treatment of hemorrhoids. Therefore, in the current study, we aimed to investigate the antihemorrhoidal and antioxidant effects of ethanol and water extracts, and a precipitant (CBW-1) obtained from the CBW of C. bursa-pastoris in croton oil (CO)-induced hemorrhoid model in rats. The current results showed that its water extract and CBW-1 containing three organic acids, citric acid (36.09%), malic acid (35.56%), and quinic acid (17.73%) significantly reduced the hemorrhagic necrotic enteritis induced by CO ameliorating the levels of the cytokines, LPO, MPO, and the antioxidants. Our results conclude that the curative effect of C. bursa-pastoris is closely related with its organic acids constituents, citric, malic, and quinic acids.