Herbal treatment options for female fertility disorders: a systematic review of clinical trials

Herbal medicine has been used as tea, ointment, capsules, syrup, whole herbs, and tablets to treat fertility disorders. The herbs and their treatment use in different localities vary, and the effectiveness of herbal treatment for routine treatment of diseases is still a debated issue to date. This study is a 20-year review of the herbal medicines treatment options for female fertility disorders to provide an updated publication of herbal treatments for female infertility and their associated outcomes, informing further research or translation.

PubMed, Google Scholar, Web of Science, Science Direct, and Cochrane databases were searched for clinical trials using Medical Subject Headings (MeSH) terms and related keywords, which retrieved 336 studies. All cross-sectional studies, reviews, and controlled trials utilizing phytotherapy on study participants without evidence of female infertility were excluded. Only 23 studies published in the English Language between January 2002 and August 2021 were included in the evidence synthesis after article screening.

Several herbal treatments in women cause a significant reduction in the symptoms of primary dysmenorrhea, PCOS, endometriosis, luteal phase defect, and vulvovaginal candidiasis, with substantial improvements in pregnancy and live birth rates. The herbal drugs identified from available studies were formulations – tablets or creams - with specified doses and administered orally or intravaginally.

Evidence exists that herbal treatments effectively treat female fertility disorders. However, they have not fully established the extent of safety, side effects, and pharmacological mechanisms of the therapeutic effects attributed to these herbal treatments.