What Do We Know About Herbal Remedies and Menstrual Cramps? (Spoiler Alert: Not Much.)

herbalWhen I was entering adulthood and suffering from severe menstrual cramps, I suffered without relief for far too long. And I am certainly not alone in this experience. The most common gynecological disorder is dysmenorrhea — painful menstrual cramps — which strikes an estimated 90 percent of reproductive-age females. Furthermore, around 40 percent of American women use some form of complementary and alternative medicine, or CAM. “CAM” is a catchall for approaches to health care that fall outside of the mainstream. Given the popularity of CAM and the ubiquity of dysmenorrhea, it was no surprise that I experienced painful cramps, nor was it shocking that I tried a few herbal remedies, which are a type of CAM.

“Natural” doesn’t necessarily mean safe or effective, so be critical.

During my second year of college, at the age of 19, a friend recommended a couple of herbal remedies to add to my cramp-fighting arsenal. I tried them, but it was difficult to know if they really worked. My pain varied so wildly cycle to cycle that I had no way of knowing if I was just having a “good month” when I initially tried these products. Although I thought they worked at first, after I had accumulated more menstrual cycles under my belt, I started to wonder if my cramps were really any less painful. On average, I still seemed to be missing just as much school and work as before — but I wasn’t sure.

The problem was that I never collected any before-and-after data — I didn’t spend years ranking the severity and duration of my cramps, or keeping track of the hours spent in bed away from school, work, or other obligations. Furthermore, my initial sense of optimism could have colored my perceptions. Since we can be tricked by our own expectations and biases, it is important to have access to quality evidence — gathered in large, methodologically powerful studies.

Raspberry leaf tea was the first herbal remedy I tried. It tasted OK, and the ritualistic nature of drinking a hot beverage from a steaming mug was soothing. But is there any actual evidence that raspberry leaf can help relieve the pain of dysmenorrhea? Although it’s been used therapeutically since at least the 1500s, the only human studies I can find for any gynecological condition examine its use during pregnancy or labor — not for treating menstrual cramps. The only claims for raspberry leaf’s efficacy in treating cramps come from biased sources, like the manufacturers themselves. It seems the tea I drank during my late teen years had word of mouth and marketing going for it, but not much else. Continue reading

The History of the Birth Control Pill, Part 6: Los Campesinos

Welcome to the final installment of our series chronicling the history of the birth control pill. In earlier installments, we learned how chemists were able to extract a chemical from a wild yam called barbasco and convert it into progesterone, the active ingredient in the Pill.

In 1960, the FDA approved oral contraceptives for marketing. At this time, more than 2 million Americans were already using the Pill — and more than 100,000 Mexican campesinos (a Spanish word for peasants) were harvesting barbasco, the wild yam necessary for its production. By 1974, 125,000 Mexicans were collecting and selling barbasco. Every week, during the barbasco trade’s peak, an excess of 10 tons of the plant were removed from tropical Mexico.

Until the barbasco supply started to dwindle in the 1970s, Mexico enjoyed prominence as the world’s supplier of progesterone.

Though they were paid subsistence-level wages for their labors (half a peso per kilo of dried root), and the work itself was dangerous and backbreaking, they were putting Mexico on the map in the scientific community. After establishing a hormone synthesis industry in Mexico, the European stranglehold on hormones was loosened and the price of progesterone plummeted from $80 per gram to less than a dollar per gram. By 1954, Syntex, a Mexican laboratory, was the largest producer of steroids in the world, having usurped Europe’s monopoly.

Scientists depended on the campesinos’ knowledge of soil conditions and growth cycles, as well as their ability to differentiate between different species of yams. The campesinos relied on their knowledge of weather patterns, differences in root coloration, and size variations to determine when they could dig up roots with the highest concentrations of sapogenin, the chemical that was converted into progesterone in the laboratory. Over the decades, the campesinos slowly gained an education in organic chemistry. Continue reading

The History of the Birth Control Pill, Part 2: Barbasco and the Roots of Hormonal Contraception

Russell Marker. Image: Penn State University Archives

Russell Marker. Image: Penn State University Archives

Welcome to the second installment of our series chronicling the history of the birth control pill. Previously, we learned about the role a sex hormone called progesterone plays in inhibiting ovulation. Scientists had no easy way to isolate significant amounts of this chemical and wanted to find a quick and inexpensive method for synthesizing large quantities of progesterone.

Russell Marker was born to Maryland sharecroppers in 1903. Hoping to escape rural life, Marker was one of only two students in his junior-high class to attend high school. He graduated in three years and enrolled at the University of Maryland, where he earned bachelor’s and master’s degrees in chemistry. He needed one more class to receive his doctorate, but refused to take it, believing he had already mastered his chosen subject, organic chemistry. He was only interested in working in the lab and thought the required course would be a waste of his time. (The university did eventually award him an honorary doctorate in 1987.)

A wild-growing yam in Mexico provided chemicals that could be refined into progesterone, the active ingredient in the Pill.

At the time, the scientific community was abuzz with discoveries being made about hormones. They held tremendous potential for research, but scientists couldn’t figure out how to isolate large quantities of them for study. Up for a challenge, Marker set out to find a way to synthesize one hormone, called progesterone, in abundance. He hypothesized that plants from the genus Dioscorea, which includes yams and agaves, would be cheap sources of steroid hormones. Marker was specifically hoping to find plants rich in sapogenins, which are chemically similar to cholesterol. Continue reading

The History of the Birth Control Pill, Part 1: Hormones, Our “Chemical Messengers”

Welcome to the first installment of our series chronicling the history of the birth control pill, from our discovery of how hormones work, to the synthesis of these hormones from an inedible wild Mexican yam, to the creation of a pill that changed the world.

Underneath the surface of a large swath of Southern Mexico’s jungles lay the enormous roots of a wild yam, Dioscorea composita, known locally as barbasco. Mostly it was considered a nuisance, as it could get in the way of subsistence agriculture, but it did have its uses. Indigenous people used it as a fish poison, and traditional Mesoamerican healers used it to treat rheumatism, snakebites, muscular pain, and skin conditions. When the root was fermented in alcohol and put on aching joints, it was believed to work as a pain reliever.

The idea of a birth control pill was born in 1912 when Margaret Sanger dreamed of a “magic pill.”

Barbasco’s medicinal uses might not be surprising, given that scientists derived a chemical from the yam that led to the development of cortisone and oral contraceptives, both of which had sizable impacts on medicine and society. Oral contraceptives would not have been possible without a cheap and abundant source of progesterone, which was easily synthesized from the root after an American chemist, Russell Marker, discovered a process for converting a cholesterol found in barbasco’s roots to progesterone, a key ingredient in the Pill.

In the decades before this chemist’s excursion to Mexico, first-wave feminism was brewing in turn-of-the-century United States, and birth-control pioneer Margaret Sanger demanded access to contraception — in 1915, she invented the term “birth control,” and as early as 1912, the idea of a birth control pill had been envisioned — again, by Sanger, who wrote of her hope for a “magic pill.” A nurse, Sanger was spurred to action by the horror of watching women die prematurely after having too many children, while other women died from botched abortions. Continue reading