Scientific evaluation of medicinal plants used for the treatment of abnormal uterine bleeding by Avicenna.

PURPOSE: Abnormal uterine bleeding (AUB) is one of the prevalent gynecological disorders that cause considerable morbidity and management of that plays an important role in protecting women's health. This review focuses on medicinal plants mentioned by Avicenna, a great Iranian philosopher and physician (A.D. 980-1037), in his book Canon for treatment of AUB. METHODS: Medicinal plants mentioned in Canon for treatment of AUB were elicited and searched in electronic databases including PubMed, Scopus, Google Scholar and Cochrane library to find studies that confirmed their efficacy. Data were collected for the years 1980-2014. RESULTS: The findings included 23 plants belonging to 18 families. Scientific findings have revealed that these plants control AUB through four mechanisms of action including inhibition of inflammatory process, inhibition of prostaglandins production, antiproliferative activity on human cervical cancer cells (HeLa), and estrogenic activity. All of the plants exhibited anti-inflammatory activity in vitro and/or in vivo. Cuscuta chinensis and Portulaca oleracea exhibited estrogenic activity. Boswellia carteri, Lens culinaris, Myrtus communis, Polygonum aviculare, Pistacia lentiscus, and Punica granatum have revealed inhibitory activity on biosynthesis of prostaglandins. Some of the mentioned plants including: Ceratonia siliqua, Cuscuta chinensis, Cuscuta epithymum, Cydonia oblonga, Paeonia sp., Portulaca oleracea, Solanum nigrum, Rumex acetosa and Onopordum acanthium have shown antiproliferative activity on HeLa cells. CONCLUSION: Investigation of traditional Iranian medicine literatures can lead to the identification of effective natural medicines for the management of AUB; however, conclusive confirmation of the efficacy and safety of these treatments needs more evaluations.

An issue of blood: the healing of the woman with the haemorrhage (Mark 5.24B-34; Luke 8.42B-48; Matthew 9.19-22) in early medieval visual culture.

The textual and visual tradition of the story of the woman with the haemorrhage (Mark 5.24b-34parr), the so-called Haemorrhoissa, is related in a specific way to Christ's healing miracles but also to conceptions of female menstrual blood. We notice that with regard to the specific 'issue of blood' of the Haemorrhoissa, there is a visual lacuna in the specific iconography that developed around the story from early Christian times: in the transposition from text to image, there is no immediate depiction of her bleeding. However, the early medieval reception of the story also became an important catalyst for uterine taboos, menstruation and tits relation to magical healing, understood as a system of health practices. In this context, the dissemination of the motif in everyday material culture clearly points to a deep-rooted connection to uterine and menstrual issues. The paper considers both expressions and their-anthropologically framed-relation to this female 'issue of blood', which the Haemorrhoissa came to embody and epitomise literally, as well as figuratively.

[Religious (Halachic) infertility].

Reproductive concepts and practices among observant Orthodox Jews may Lead to Halachic subfertility in a significant portion of couples. According to Halachah [the Jewish code of law) sexual activity may not take place during the time a woman menstruates (Niddah) as well as for a full week thereafter (7 days of cleanliness). Coitus is allowed to resume after the woman has immersed herself in a ritual bath (mikvah). In the case of unexpected spotting or bleeding (Zavah), the woman should consult a rabbi and a doctor to determine the origin of the blood. Uterine bleeding entails that intercourse is forbidden for a minimum of 5 initial days plus 7 days thereafter. In practice, any minute bleeding or spotting, regardless of timing during the menstrual cycle, renders the woman ritually impure and invokes the stringencies of Niddah rulings. Even a physiologic occurrence such as midcycle ovulatory bleeding or spotting renders the woman Zavah and prohibits sexual intercourse at the optimal time for conception. The inability to conceive in this halachically mandated time period is not due to a biologic fault but rather to social, cultural and religious norms as defined by the rabbinate. Medically lengthening the pre-ovulatory phase is a common practice, as shortening the count of days of ritual impurity is often seen as nonnegotiable. Ethical issues concerning the role of the physician and the safety of such treatments are discussed.

Review of the confusion in current and historical terminology and definitions for disturbances of menstrual bleeding.

OBJECTIVE: There has been increasing recent recognition of the worldwide confusion in the terminology and definitions for abnormalities of menstrual and uterine bleeding. The present review was undertaken to objectively explore some of the origins and current uses of terms for symptoms, signs, and causes of abnormal uterine bleeding and to demonstrate the international lack of uniformity. DESIGN: A detailed, but not systematic, search of the huge current and historical literature across the range of menstrual terminology, definitions, and some causes, with an emphasis on "menorrhagia" and "dysfunctional uterine bleeding." SETTING: An international collaboration to study ways of reaching worldwide agreement on descriptive terms and definitions for abnormal bleeding. RESULT(S): A large number of synonyms and overlapping terms for heavy menstrual bleeding have been identified, as well as smaller numbers of terms for other symptoms and causes of abnormal uterine bleeding. The origins and meanings of several of these terms have been explored in detail and wide variations in meaning demonstrated. CONCLUSION(S): There is great confusion in the way these terminologies are used and there is an urgent need for international agreement on consistent use of terms and definitions for symptoms, signs, and causes of abnormal uterine bleeding.

What is the biblical attitude towards personal hygiene during vaginal bleeding?

OBJECTIVE: To analyze biblical passages associated with personal hygiene during vaginal bleeding. According to the Bible, a woman who is menstruating or who has pathological vaginal bleeding is unclean. Anybody who touches such a woman's bed or her personal things is also regarded as unclean and should therefore, wash carefully. Sexual relations are forbidden within 7 days from the beginning of menstruation and during pathological vaginal bleeding. Seven days after the cessation of vaginal bleeding, a woman is considered as clean, and therefore, sexual contacts are permitted. From a modern perspective sexual contacts during menses are associated with the development of chlamydial and gonococcal diseases, the risk of transmission of the human immunodeficiency virus infection, endometriosis and subsequent infertility. This report indicates that the roots of contemporary obstetric preventive medicine can be traced to Biblical times.

An autopsy: A historical vignette.

This paper recounts a case report from 1853 that describes the circumstances surrounding the death of a young woman, the request for and granting of permission for an autopsy, and exposition of how the autopsy findings were used from the point of view of education, quality control of practice, and vital statistics. There is, in addition, a description of the evolution of the use of the word autopsy.

Hemorragia uterina disfuncional: estudo clinico de 322 pacientes / Dysfunctional uterine hemorrhage: clinical study in 322 patients

No periodo de 1980 a 1987 foram estudadas na Clinica Ginecologica da Faculdade de Medicina da Universidade de Sao Paulo 322 pacientes portadoras de hemorragia uterina disfuncional com o objetivo de avaliar alguns dados epidemiologicos e os resultados de exames complementares. A idade das pacientes variou de 15 a 45 anos, media etaria de 29,8 anos. O padrao menstrual que predominou foi o hipermenorragico (115 pacientes - 35,7 por cento). A ligadura tubaria foi o antecedente pessoal predominante (90 pacientes - 27,9 por cento). Os sintomas e sinais associados foram: mastodinia, queda de cabelo, galactorreia, hirsutismo e acne. O valor medio das dosagens sanguineas de FSH, LH, prolactina, T3, T4, TSH e o perfil androgenico encontravam-se dentro dos parametros da normalidade. Os valores de progesterona foram compativeis com ciclos ovulatorios em 42,3 por cento das pacientes.

[Coagulation disorders in obstetric patients at gynaecological hospital of Leipzig University, 1961 through 1978 (author's transl)]. / Gerinnungsstörungen im geburtshilflichen Krankengut der Universitäts-Frauenklinik Leipzig von 1961 bis 1978.

Intrapartum coagulopathy was secured from 41 in 69,336 obstetric patients, between 1961 and 1978. Haemostatic disorders, such as v. Willebrand-Jürgens syndrome, idiopathic thrombocytopenia, plasmatic coagulation defects, and hyperfibrinolysis, had been recorded from ten patients even before parturition. The courses of pregnancy, childbirth, and puerperium of those patients are reported, with reference being made to the need for prepartum hospitalisation as well as for target-oriented substitutional therapy and non-invasive delivery control. - Acute intrapartum haemorrhagic syndrome occurred to 31 patients, among them 13 patients with loss coagulopathy. Prophylaxis and therapy of such coagulation disorders are discussed. The deaths of two mothers are analysed. Consumptive coagulopathy, triggered by typical gestational complications, was manifest in the other 18 patients. Prophylaxis and therapy of that severe obstetric coagulopathy are discussed.