Enter your email address
Submit
Write your message
Volume 14, Issue 1 (4-2024)
cmja 2024, 14(1): 21-28 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Beheshti Z, Bayat asghari A, Boshagh E, Aramoon A. Comparison of the effect viola odorata and evening primrose on the anxiety of menopausal women referring to health and treatment centers in Khomein city in 1402. cmja 2024; 14 (1) :21-28
URL: http://cmja.arakmu.ac.ir/article-1-972-en.html
URL: http://cmja.arakmu.ac.ir/article-1-972-en.html
1- Master of Nursing, the Instructor, Department of Nursing, Khomein Branch, Islamic Azad University, Khomein, Iran , Zeynabbeheshti7941@yahoo.com
2- PhD in Psychology, Health Assistant, Khomein Faculty of Medical Sciences, Khomein, Iran
3- The Instructor, Department of Nursing, Aligudarz, Branch, Islamic Azad University, Aligudarz, Iran
4- Master of Educational Sciences, Health Assistance, Khomein Faculty of Medical Sciences, Khomein, Iran
2- PhD in Psychology, Health Assistant, Khomein Faculty of Medical Sciences, Khomein, Iran
3- The Instructor, Department of Nursing, Aligudarz, Branch, Islamic Azad University, Aligudarz, Iran
4- Master of Educational Sciences, Health Assistance, Khomein Faculty of Medical Sciences, Khomein, Iran
Full-Text [PDF 683 kb]
(101 Downloads)
| Abstract (HTML) (177 Views)
Full-Text: (51 Views)
INTRODUCTION
Menopause is one of the critical stages of women's life that all women experience with age. Menopause is the permanent end of menstruation in women due to the cessation of ovarian follicular function, which leads to the termination of the reproductive period in women. Moreover, with the increase in life expectancy and the improvement of the quality of life and healthcare services, the population of elderly people is increasing. One of the complaints of women during menopause is anxiety and irritability. Considering the increasing rate of aging and the large population of menopausal women, and given the countless harms of hormone therapy and drug therapy, prevention and treatment of menopause complications using natural herbs is of particular importance. Among these natural compounds found in plants are phytoestrogens, with Oenothera biennis (evening primrose) and Viola odorata being notable examples of important plant phytoestrogens.
Considering the cheaper nature of medicinal plants and the tendency of menopausal women to consume these compounds, the present study was conducted with the aim of comparing the effects of these two medicinal plants on menopausal anxiety.
METHODS
The present clinical trial compared the effect of violet flower and evening primrose flower (independent variable) on the level of anxiety (dependent variable) in postmenopausal women. The samples were selected among postmenopausal women referring to the health and treatment centers of Khomein City in 2022-2023. A total of 135 women were chosen using the availability sampling method. A block randomization method with a block size of 6 was used to allocate the samples to three groups (n=45 each group).
Before starting the study, the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) was completed by the samples. Afterward, in the violet flower group, women consumed 5 ml of violet flower syrup twice a day (in the morning after waking up and at night before going to sleep) for one month. In the evening primrose flower, postmenopausal women received 1 g of moringa pearl twice a day (once in the morning and once at night) with a glass of water for one month. In the control group, 5 ml of lactose syrup was given for one month twice a day (in the morning after waking up and at night before going to bed). During the first 15 days, the researcher made sure the correct use of drugs by telephone follow-up and weekly review. The participants filled out the DASS-21 once more after the 30-day period of consumption. The data was analyzed in SPSS version 22 software.
RESULTS
The results of the post-hoc Tukey HSD test showed that the mean anxiety score was statistically significantly lower after consuming evening primrose flower (31.78±4.62) and violet flower (12.67±4.06) compared to the control group (4.85±41.29). Although both intervention groups showed improvement in anxiety, only the violet group demonstrated statistically significant advantages compared to the evening primrose group.
CONCLUSION
The results of this study indicated that both violet and evening primrose syrup could reduce anxiety in menopausal women. Furthermore, due to the greater effect of violet flower syrup in decreasing the anxiety of menopausal women, it is recommended that policymakers make appropriate plans for the employment of this method.
Ethical Considerations
Compliance with ethical guidelines
All ethical considerations were observed in this study. Informed consent was obtained from all participants and were assured of the confidentiality of their information. They were also informed of their voluntary nature of participation and the possibility of study withdrawal at any research stage. This study was approved by the Ethics Committee of Islamic Azad University, Aligoderz branch (IR.IAU.AGZ.REC.1401.002) and also registered in the Iranian Registry of Clinical Trials (IRCT202110501051142N9).
Funding
This article was the result of a research project with the number 162666975, which was financially supported by the Khomein Islamic Azad University.
Authors’ Contributions
All authors participated in the design, implementation, and writing of all parts of the research.
Conflict of Interest
The authors declare that there is no conflict of interest.
Acknowledgments
We hereby thank and appreciate all the participants in this research. We would like to express our gratitude and appreciation to the Research Vice-Chancellor of Islamic Azad University, Khomein branch, the officials and respected employees of health and treatment centers in Khomein City, and all the patients who helped us in conducting this research.
Menopause is one of the critical stages of women's life that all women experience with age. Menopause is the permanent end of menstruation in women due to the cessation of ovarian follicular function, which leads to the termination of the reproductive period in women. Moreover, with the increase in life expectancy and the improvement of the quality of life and healthcare services, the population of elderly people is increasing. One of the complaints of women during menopause is anxiety and irritability. Considering the increasing rate of aging and the large population of menopausal women, and given the countless harms of hormone therapy and drug therapy, prevention and treatment of menopause complications using natural herbs is of particular importance. Among these natural compounds found in plants are phytoestrogens, with Oenothera biennis (evening primrose) and Viola odorata being notable examples of important plant phytoestrogens.
Considering the cheaper nature of medicinal plants and the tendency of menopausal women to consume these compounds, the present study was conducted with the aim of comparing the effects of these two medicinal plants on menopausal anxiety.
METHODS
The present clinical trial compared the effect of violet flower and evening primrose flower (independent variable) on the level of anxiety (dependent variable) in postmenopausal women. The samples were selected among postmenopausal women referring to the health and treatment centers of Khomein City in 2022-2023. A total of 135 women were chosen using the availability sampling method. A block randomization method with a block size of 6 was used to allocate the samples to three groups (n=45 each group).
Before starting the study, the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) was completed by the samples. Afterward, in the violet flower group, women consumed 5 ml of violet flower syrup twice a day (in the morning after waking up and at night before going to sleep) for one month. In the evening primrose flower, postmenopausal women received 1 g of moringa pearl twice a day (once in the morning and once at night) with a glass of water for one month. In the control group, 5 ml of lactose syrup was given for one month twice a day (in the morning after waking up and at night before going to bed). During the first 15 days, the researcher made sure the correct use of drugs by telephone follow-up and weekly review. The participants filled out the DASS-21 once more after the 30-day period of consumption. The data was analyzed in SPSS version 22 software.
RESULTS
The results of the post-hoc Tukey HSD test showed that the mean anxiety score was statistically significantly lower after consuming evening primrose flower (31.78±4.62) and violet flower (12.67±4.06) compared to the control group (4.85±41.29). Although both intervention groups showed improvement in anxiety, only the violet group demonstrated statistically significant advantages compared to the evening primrose group.
CONCLUSION
The results of this study indicated that both violet and evening primrose syrup could reduce anxiety in menopausal women. Furthermore, due to the greater effect of violet flower syrup in decreasing the anxiety of menopausal women, it is recommended that policymakers make appropriate plans for the employment of this method.
Ethical Considerations
Compliance with ethical guidelines
All ethical considerations were observed in this study. Informed consent was obtained from all participants and were assured of the confidentiality of their information. They were also informed of their voluntary nature of participation and the possibility of study withdrawal at any research stage. This study was approved by the Ethics Committee of Islamic Azad University, Aligoderz branch (IR.IAU.AGZ.REC.1401.002) and also registered in the Iranian Registry of Clinical Trials (IRCT202110501051142N9).
Funding
This article was the result of a research project with the number 162666975, which was financially supported by the Khomein Islamic Azad University.
Authors’ Contributions
All authors participated in the design, implementation, and writing of all parts of the research.
Conflict of Interest
The authors declare that there is no conflict of interest.
Acknowledgments
We hereby thank and appreciate all the participants in this research. We would like to express our gratitude and appreciation to the Research Vice-Chancellor of Islamic Azad University, Khomein branch, the officials and respected employees of health and treatment centers in Khomein City, and all the patients who helped us in conducting this research.
Type of Study: Applicable |
Subject:
Medicinal Plants
References
1. Reisi M, Asadi L. The relationship between fetal environment and menopausal age: A narrative review study. .(Persian). The Iranian Journal of Obstetrics, Gynecology and Infertility. 2021;24(8):84-94. [doi:10.22038/ijogi.2021.19071]
2. Ancelin ML. Variations in reproductive events across life: a pooled analysis of data from 505 147 women across 10 countries: InterLACE Study Team (including ML Ancelin as co-author). Hum Reprod . 2019;34(5):881-93. [doi:10.1093/humrep/dez015]
3. Mousavi F, Mohammad-Alizadeh-Charandabi S, Mirgafourvand M, Bekhradi R. The effect of combined herbal capsules (Menohelp®) on early symptoms of menopause: a randomized double-blind placebo-controlled trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2023;26(3):66-77. [doi:10.22038/ijogi.2023.22601]
4. Tahmasebi G, Jannesari S, Namjooyan F, Nasiri M, Sadeghyan A. The effect of vaginal cream containing herbal extracts (Foeniculum vulgare, Salvia officinalis and Flaxseed) on the mental symptoms of vaginal atrophy in postmenopausal women: A randomized controlled clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2021;24(11):59-69. [doi:https://doi.org/10.22038/ijogi.2021.19540]
5. Dennerstein L, Dudley EC, Hopper JL, Guthrie JR, Burger HG. A prospective population-based study of menopausal symptoms. Obstet Gynecol. 2000;96(3):351-8. [doi:10.1016/S0029-7844(00)00930-3] [pmid:10960625]
6. Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci. 2015;17(3):327-35. [doi:10.31887/DCNS.2015.17.3/bbandelow] [pmid:26487813]
7. Levasseur M, St-Cyr Tribble D, Desrosiers J. Meaning of quality of life for older adults: importance of human functioning components. Arch Gerontol Geriatr. 2009;49(2):e91-e100. [doi:10.1016/j.archger.2008.08.013] [pmid:18977542]
8. Tangen T, Mykletun A. Depression and anxiety through the climacteric period: an epidemiological study (HUNT-II). J Psychosom Obstet Gynaecol. 2008;29(2):125-31. [doi:10.1080/01674820701733945] [pmid:18484441]
9. Rasooli F, Haj Amiry P, Mahmoudi M, Shohani M. Evaluation of the mental problems of menopausal women referred to the health care centers of Ilam University of Medical Sciences.(Persian). Hayat. 2004;10(1):5-14. [Link]
10. Rabiee M, Akbari H, Davati A, Moghadamnia M. Investigating the influence of mood-changes and effective elements of peri menopause on patients' companions referred to hospitals related to Shahed University. The Iranian Journal of Obstetrics, Gynecology and Infertility. (Persian).2012;15(15):8-15. [doi:10.22038/ijogi.2012.5680]
11. Shariat Moghani1 S, Simbar M, Rashidi Fakari2 F, Ghasemi V, Dolatian M, Golmakani N, et al. The Relationship Between Stress, Anxiety and Depression With Menopausal Women Experiences. Avicenna Journal of Nursing and Midwifery Care. 2018;26(5):333-40. [Link]
12. Kassim SH, Rajasagi NK, Zhao X, Chervenak R, Jennings SR. In Vivo Ablation of CD11c-Positive Dendritic Cells Increases Susceptibility to Herpes Simplex Virus Type 1 Infection and Diminishes NK and T-Cell Responses. Journal of Virology. 2006;80(8):3985-93. [doi:10.1128/JVI.80.8.3985-3993.2006]
13. Motaghi Dastenaei B, Safdari F, Jafarzadeh L, Raisi Dehkordi Z, Taghizadeh M, Nikzad M. The effect of Evening Primrose on hot flashes in menopausal women. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2017;20(10):62-8. [doi:10.22038/ijogi.2017.10157]
14. Archer DF, Seidman L, Constantine GD, Pickar JH, Olivier S. A double-blind, randomly assigned, placebo-controlled study of desvenlafaxine efficacy and safety for the treatment of vasomotor symptoms associated with menopause. American journal of obstetrics and gynecology. 2009;200(2):172.e1-10. [doi:10.1016/j.ajog.2008.09.877]
15. Habibi M, Hanasabzadeh M. The Effectiveness of Mindfulness Based Art Therapy on Depression, Anxiety, Stress and Quality of Life Among Postmenopausal Women.(Persian). Salmand: Iranian Journal of Ageing. 2014;9(1):22-31. [Link]
16. Yadegari Z, Akbari S, Sheikhan Z, Nasiri M, Akhlaghi F. The effect of consumption of the date fruit on the amount and duration of the postpartum bleeding. Iranian Journal of Obstetrics, Gynecology and Infertility. 2016;18:20-7. [doi:10.22038/ijogi.2016.6631]
17. Asgari K, Hashemi B. Comparing the Performance of Five Brain Systems and mood changes (Anxiety and Depression) with the Level of Estrogen in Postmenopausal and Premenopausal.(Persian). Armaghane Danesh. 2016;21(6):617-29. [Link]
18. Fattah A. Effect of Phytoestrogen on Depression and Anxiety in Menopausal Women: A Systematic Review. J Menopausal Med. 2017;23(3):160-5. [doi:10.6118/jmm.2017.23.3.160] [pmid: 29354615]
19. Montserrat-de la Paz S, Fernández-Arche MA, Ángel-Martín M, García-Giménez MD. Phytochemical characterization of potential nutraceutical ingredients from Evening Primrose oil (Oenothera biennis L.). Phytochemistry Letters. 2014;8:158-62. [doi:10.1016/j.phytol.2013.08.008]
20. Lotfi F, Karimi FZ, Mazloum SR, Yousefi M, Rakhshande H. The effect of viola odorata syrup on anxiety in postmenopausal women: A randomized clinical trial. (Persian) Hayat. 2021;27(1):45-58. [doi:10.5555/20210323209]
21. Feyzabadi Z, Jafari F, Kamali SH, Ashayeri H, Badiee Aval S, Esfahani MM, et al. Efficacy of Viola odorata in Treatment of Chronic Insomnia. Iran Red Crescent Med J. 2014;16(12):e17511. [doi:10.5812/ircmj.17511] [pmid: 25763239]
22. Hejazian MS, Ganjloo J, Ghorat F, Rastaghi S. Effect of Viola Odorata Nasal Drop on Sleep Quality of Older Adults. J Res Med Dent S. 2018;6:107-11. [doi:10.5455/jrmds.20186215]
23. Muhammad N, Saeed M, Khan H, Haq I. Evaluation of n-hexane extract of Viola betonicifolia for its neuropharmacological properties. J Nat Med. 2013;67(1):1-8. [doi:10.1007/s11418-012-0636-0]
24. Gautam S, Navneet, Kumar S. The Antibacterial and Phytochemical Aspects of Viola odorata Linn. Extracts Against Respiratory Tract Pathogens. Proceedings of the National Academy of Sciences. India - Section B: Biological Sciences. 2012;82:567-72. [doi:10.1007/s40011-012-0064-7]
25. Brown NM, Setchell KD. Animal models impacted by phytoestrogens in commercial chow: implications for pathways influenced by hormones. Lab Invest. 2001;81(5):735-47. [doi:10.1038/labinvest.3780282] [pmid:11351045]
26. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43. [doi:10.1016/0005-7967(94)00075-U] [pmid:7726811]
27. Sahebi A, Asghari M, Salari R, editors. Validation of Depression Anxiety and Stress Scale (DASS-21)for an Iranian Population. Journal of Iranian Psychologists.2005. [Link]
28. Keshavarz Z, Golezar S, Hajifoghaha M, Alizadeh S. The Effect of Phytoestrogens on Menopause Symptoms: A Systematic Review. Journal of Isfahan Medical School. 2018;36(477):446-59. [doi:10.22122/jims.v36i477.9503]
29. Thorup AC, Lambert MN, Kahr HS, Bjerre M, Jeppesen PB. Intake of novel red clover supplementation for 12 weeks improves bone status in healthy menopausal women. Evidence‐Based Complementary and Alternative Medicine. 2015;2015(1):689138. [doi:10.1155/2015/689138]
30. Levis S, Strickman-Stein N, Ganjei-Azar P, Xu P, Doerge DR, Krischer J. Soy isoflavones in the prevention of menopausal bone loss and menopausal symptoms: a randomized, double-blind trial. Archives of internal medicine. 2011;171(15):1363-9. [doi:10.1001/archinternmed.2011.330]
31. Forouzanmehr S, Zendehdel T, Mirmohammadali M, Faghihzadeh S. Valerian effect on anxiety in postmenopausal women. (Persian).The Iranian Journal of Obstetrics, Gynecology and Infertility. 2017;20(6):31-9. [doi:10.22038/ijogi.2017.9323]
32. Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Aghamiri V, Nazemiyeh H, Soltanpoor S. Efficacy of hop (Humuluslupulus L.) on early menopausal symptoms in perimenopausal women: A randomized double blind placebo-controlled trial. (Persian).Scientific Journal of Kurdistan University of Medical Sciences. 2014;19(3):12-22. [Link]
33. Pourabbas S, Kesmati M, Rasekh A. Study of the the anxiolytic effects of fennel and possible roles of both gabaergic system and estrogen receptors in these effects in adult female rat. (Persian).Physiology and Pharmacology. 2011;15(1):134-143. Link [Link]
34. Momeni H, Salehi A, Seragi A. Comparison of the effects of Vitagnos and vitamin E on anxiety in women with periodic chest pain: a randomized clinical trial. Knowledge and health in basic medical sciences.Danish and health magazine. 2014;9(2):1-8. [Link]
35. Wolman, I. Berek and Novak's Gynecology 15th Edition. J Obstet Gynecol India 64.2014: 150-51. doi: 10.1007/s13224-014-0538-z [doi:10.1007/s13224-014-0538-z]
36. Davis S, Murkies A, Wilcox G. Phytoeestrogens in clinical practice. Integrative Medicine. 1998:1:27-34.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Contact Information
Complementary Medicine Journal
Arak University of Medical Sciences, Sardasht, Arak, Iran.
Journal Tel: +98 86 34173524
Email: journalcmjaarakmu.ac.ir
