ABSTRACT
Background: The use of plant medications in Unani medicine has been suggested to alleviate pain and related symptoms associated with primary dysmenorrhea, thus enhancing the overall quality of life. The purpose of the current study was to evaluate and compare the efficacy of Zarawand Mudaharaj (Aristolochia rotunda L.) and Qust (Saussurea lappa C.B. Clarke) in treating primary dysmenorrhea. Methods: This single-blind, randomized comparative study was conducted on patients with primary dysmenorrhea aged 18-35 years. The study participants were randomly allocated into Group A and Group B. Group A received Zarawand Mudaharaj 2 g twice daily with 5 mL honey while Group B received Qust 1.5 g twice daily with 5 mL honey from the 1st to the 5th day of their menstrual cycles for three consecutive cycles. The primary outcome measures were changes in pain severity measured on a 10 cm Visual Analog Scale (VAS) and changes in Verbal Multidimensional Scoring System (VMSS) grades. The secondary outcome measures included changes in Health-Related Quality of Life (HRQoL) measured on short form health survey-12 (SF-12) and changes in the symptoms such as pain during menstruation, low-backache, nausea, vomiting, diarrhoea, giddiness, and headache. Results: Both groups showed a significant improvement in VMSS grade at all follow-ups compared to baseline (P < .0001). Group B showed better performance than Group A in changing the VMSS grade at the third cycle (P = .02) and the final follow-up (P = .002). Group B also had a more significant reduction in mean ± SD VAS score from baseline (6.43 ± 1.57) to the final follow-up (2.67 ± 1.69) (P < .0001) compared to Group A. Conclusion: The preliminary findings of the study support the use of Zarawand Mudaharaj and Qust in the treatment of primary dysmenorrhea, which is consistent with the traditional knowledge of Unani scholars.