BACKGROUND: Constipation is a common chronic bowel disorder with an incidence of more than 50% in the elderly population. Complementary and alternative medicine is a cost-effective and satisfactory treatment for constipation used widely by the elderly. OBJECTIVE: This study evaluates the efficacy of an herbal formula made from Foeniculum vulgare Mill. and Rosa damascena for the treatment of constipation in an elderly population and consequent changes to their quality of life. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This double-blind randomized active controlled clinical trial, with parallel group allocation ratio of 1:1, was conducted in a referral clinic in Afzalipour Hospital, affiliated to Kerman University of Medical Sciences in Kerman, Southeastern Iran. Individuals over 60 years of age, diagnosed with functional constipation (based on the Rome IV criteria), were included in this study. Participants received a sachet of 10 g F. vulgare and R. damascena (herbal formula group) or polyethylene glycol 4000 (PEG 4000 group) with a glass of warm water two times a day for 4 weeks and were followed up for 4 additional weeks. MAIN OUTCOME MEASURES: Constipation severity, stool consistency, and the quality of life were used as the primary outcomes. Drug side effects were used as a secondary outcome. The outcomes were assessed using the Constipation Assessment Scale, the Bristol Stool Form Scale, and the Patient Assessment of Constipation Quality of Life questionnaire. RESULTS: A total of 25 participants in each group completed the four-week treatment cycle and the eight-week follow-up. At the end of the four-week treatment cycle, all clinical outcomes had significant improvements in both groups (P < 0.05). The analysis of constipation severity (P < 0.001), stool consistency (P < 0.001), and the quality of life (P < 0.001) showed significant improvements with fewer side effects (mild diarrhea) and a longer duration of symptom relief in the herbal formula group compared to the PEG 4000 group. CONCLUSION: Although both interventions significantly improved the treatment outcomes, constipation severity, stool consistency and the quality of life were improved more effectively by the herbal formula than by PEG 4000; however, the mechanism of action is not yet understood. TRIAL REGISTRATION This trial was registered in the Iranian Registry of Clinical Trials (IRCTID: IRCT20200108046056N1).
Aged ; Constipation/drug therapy* ; Double-Blind Method ; Foeniculum ; Humans ; Iran ; Middle Aged ; Quality of Life ; Rosa ; Treatment Outcome

This review paper evaluates use of Foeniculum vulgare extracts as a popular female plant in management of different ailments of women. Information in this paper was gathered from accessible sources (PubMed, Science Direct, Springer, Wiley, and Google), and traditional books (Persian or English modern traditional books), unpublished data (R&D reports, thesis and dissertation) by keywords based on the words F. vulgare or fennel and women. Efficacy of oral fennel oil in management of dysmenorrhea, premenstrual syndrome, amenorrhea, menopause, lactation, and polycystic ovary syndrome were confirmed according to results of clinical studies. Results of clinical efficacy of fennel oil on menstrual bleeding is complicated, but results of one meta-analysis study revealed that fennel oil significantly increased means of bleeding in the first menstrual periodic cycle (P = 0.001), while fennel oil had no significant effect on bleeding in the second menstrual cycle (P = 0.67). Topical and vaginal fennel extract (5%) exhibited good efficacy in treatment of sexual function, vaginal atrophy, and hirsutism. Fennel had no effect on bone density, or body mass index of menopause women. Results of clinical studies introduce fennel as a valuable medicinal plant in management of women's ailments, but understanding the mechanism of action could be the subject of future studies.
Amenorrhea ; Atrophy ; Body Mass Index ; Bone Density ; Dysmenorrhea ; Female ; Foeniculum ; Hemorrhage ; Hirsutism ; Humans ; Lactation ; Lethal Dose 50 ; Menopause ; Menstrual Cycle ; Phytoestrogens ; Plants ; Plants, Medicinal ; Polycystic Ovary Syndrome ; Premenstrual Syndrome ; Treatment Outcome ; Women's Health

OBJECTIVES: The aim of the present study is the systematic and critical investigation of the effectiveness of fennel on the climacteric symptoms among menopausal females. METHODS: A search of the trials studying the effect of fennel on menopausal females was conducted in 2017 using the MEDLINE and Scopus databases and the Cochrane Library with the following keywords: fennel, Foeniculum vulgare, and menopause. RESULTS: Fennel combined with officinalis is more effective in the attenuating of sleep disorders compared to Citalopram. The comparison of these two groups regarding the mean bone mineral density and bone mineral content (P = 0.14, P = 0.504); the total hip femoral (P = 0.42, P = 0.66); the trochanter (P = 0.075, P = 0.07); the intertrochanter (P = 0.84, P = 0.93); and the femoral neck (P = 0.43, P = 0.64) did not show any significant statistical differences; however, a statistically significant difference regarding the vasomotor symptoms (P < 0.01) was found. The other significant differences are related to the values of the total cholesterol (P = 0.103); low-density lipoprotein cholesterol, or LDL-C (P = 0.104); high-density lipoprotein cholesterol, or HDL-C (P = 0.266); triglyceride (P = 0.679); body weight (P = 0.212); body mass index (P = 0.041); waist and hip circumferences (P = 0.365); and fat distribution (P = 0.337) between the two groups. The standardized mean difference (SMD) values of sexual activity (SMD = 0.638; P < 0.001), and maturation value (SMD = 0.601; P = 0.003) are highly significant among the fennel-treated women compared with the placebo group. CONCLUSIONS: According to the findings of the present study, fennel is important in the relieving of vasomotor symptoms, vaginal itching, dryness, dyspareunia, sexual function, sexual satisfaction, and sleep distribution.
Body Mass Index ; Body Weight ; Bone Density ; Cholesterol ; Citalopram ; Climacteric ; Dyspareunia ; Female ; Femur ; Femur Neck ; Foeniculum ; Hip ; Humans ; Lipoproteins ; Menopause ; Orgasm ; Pruritus ; Sexual Behavior ; Sleep Wake Disorders ; Triglycerides

OBJECTIVES: The aim of the present systematic review and meta-analysis is the exploration of the potential evidence of the effectiveness of aromatherapy products on the sexual function of menopausal women. METHODS: From inception to December 2017, the search process was performed using the MEDLINE and Scopus databases and the Cochrane Library regarding the trials on the effectiveness of herbal-medicine aromatherapy on the sexual function of menopausal women. RESULTS: Three of the trials comprise suitable data for inclusion in the meta-analysis. According to the meta-analysis, it is possible to improve the standardized mean difference (SMD) of the sexual desire up to 0.56 in the aromatherapy group compared with the control group (SMD = 0.56; P < 0.001; heterogeneity; I² = 42%; P = 0.141). According to one of the trials, the serum-estrogen level of two different doses did not change in the neroli oil inhalation group compared with the almond-oil group. CONCLUSIONS: Both aromatherapy with neroli oil or lavender (monopreparation) and combined-oil aromatherapy with lavender, fennel, geranium, and rose significantly improved human sexual function; however, a significant change of the serum-estrogen level was not detected. The findings of the present review should be presented cautiously because of the corresponding limitations such as the lack of a standardized tool, the lack of intention-to-treat reporting, the low study amount, and the short-term follow-up.
Aromatherapy ; Female ; Foeniculum ; Follow-Up Studies ; Geranium ; Humans ; Inhalation ; Lavandula ; Menopause ; Population Characteristics ; Sexuality

OBJECTIVES: The present trial aimed to assess the effects of Fennel (Foeniculum vulgare Mill.) on lipid profiles. METHODS: In this double blind, randomized and placebo-controlled trial, sixty eligible postmenopausal women were randomly assigned into the fennel and placebo groups. Total blood cholesterol, cholesterol fractions, and triglycerides were tested at the baseline, and after three-month follow-up. RESULTS: There was no significant difference in triglyceride (P = 0.679), total cholesterol (P = 0.103), low-density lipoprotein cholesterol (LDL-C; P = 0.146) and high-density lipoprotein cholesterol (HDL-C; P = 0.266) levels between the two groups. In addition, in both groups, a paired t.test showed no significant difference in all mentioned parameters, except for HDL-C, indicating significant borderline improvement (P = 0.052) in the fennel group. CONCLUSIONS: The fennel group revealed a very slight positive change in LDL-C, triglyceride and HDL-C. Further studies with longer durations, higher doses, and larger sample sizes are recommended to validate the results.
Cholesterol ; Female ; Foeniculum ; Follow-Up Studies ; Humans ; Lipoproteins ; Postmenopause ; Sample Size ; Triglycerides

OBJECTIVES: Aim of present study was designed to investigate the soporific effect of fennel among menopausal women. METHODS: The present double-blinded and placebo-controlled trial examined the fennel effect on Pittsburgh Sleep Quality Index (PSQI). Total score and relevant 7 components, including sleep duration, sleep latency, use of sleeping medication, subjective sleep quality, sleep disturbances, daytime dysfunction and habitual sleep efficiency among 50 menopausal women compared to control group within a 12-week follow-up. RESULTS: The patients in both groups reported no certain side effects and all subjects completed the study. The mean actual sleep duration was 5 hours and 66 minutes. Intergroup comparison revealed no statistically significant differences in the mean total PSQI score (P = 0.439), subjective sleep quality (P = 0.826), habitual sleep efficiency (P = 0.127), sleep disturbances (P = 0.130), use of sleeping medication (P = 0.52) and daytime dysfunction (P = 0.439). A tendency toward significant between 2 groups was seen concerning the sleep duration (P = 0.059). Intergroup comparison showed significantly borderline levels (P = 0.059). CONCLUSIONS: The treatment of 12 weeks with fennel caused a slight effect that did not reach to significant. These findings should be considered cautiously because of small sample size, short-term follow-up and subjective measure of sleep quality.
Female ; Foeniculum ; Follow-Up Studies ; Humans ; Menopause ; Sample Size ; Sleep Wake Disorders

OBJECTIVES: The goal of this study is to assess the effect of fennel on bone density. METHODS: This was a double-blind, randomized, placebo-controlled trial, which studied sixty eligible postmenopausal women, who were randomly assigned to fennel and placebo groups. Then, the dual energy X-ray absorptiometry was utilized to measure bone mineral density (BMD) and bone mineral content (BMC) of the spine, femoral neck, intertrochanter, and trochanter at the baseline and after three-month follow-up. RESULTS: The mean BMD and BMC at lumbar spine (P = 0.14, P = 0.504), total hip femoral (P = 0.427, P = 0.471), trochanter (P = 0.075, P = 0.07), intertrochanter, (P = 0.864, P = 0.932) and femoral neck (P = 0.439, P = 0.641) was not significantly different between the fennel and placebo groups. CONCLUSIONS: The results of this study did not approve the effect of fennel on bone density in post-menopausal women. However, to gain deeper insights, further studies with longer durations and larger sample sizes are recommended.
Absorptiometry, Photon ; Bone Density* ; Female ; Femur ; Femur Neck ; Foeniculum* ; Follow-Up Studies ; Hip ; Humans ; Postmenopause ; Sample Size ; Spine

OBJECTIVES: The goal of this study was to evaluate the effect of fennel on body composition. METHODS: This study is a secondary analysis of a double-blind, randomized, placebo-controlled trial. Fifty-four out of 60 patients were able to successfully complete the original study. Seven out of 54 patients were excluded because they were not overweight and obese. Thus, 47 women were included in this secondary analysis. Of these 47 women, 22 were in the fennel group and 25 were in placebo group. Body weight, body mass index (BMI) as well as fat distribution was measured at the baseline and after a three-month follow-up. RESULTS: Comparison of fennel and placebo groups did not reveal any significant effect in terms of body weight, BMI, waist and hip circumferences and fat distribution. Also, the results of paired t-test did not variation of these parameters across groups before and after 12-week treatment. CONCLUSIONS: Menopausal women in fennel group experienced a slight increase in body weight and fat distribution, which was not significant. Further studies with larger sample sizes are recommended to validate the results of this study.
Body Composition* ; Body Fat Distribution ; Body Mass Index ; Body Weight ; Female ; Foeniculum* ; Follow-Up Studies ; Hip ; Humans ; Overweight ; Postmenopause ; Sample Size

OBJECTIVES: In this systematic review, the effectiveness of herbal medicines in improving depression and anxiety in menopausal women was assessed. METHODS: Three following databases were individually searched: MEDLINE (1966-March 2017), SCOPUS (1990-March 2017), and the Cochrane Library (Cochrane Central Register of Controlled Trials; 2017). RESULTS: A total of 9 trials were included in this systematic review. Overall, soy was found to have a beneficial effect. Also, fennel had a significant positive effect on menopausal women with depression and anxiety disorder, but not on healthy women. Red clover showed varying effects ranging from significant to non-significant on depression and anxiety. Moreover, kava was found to have a significant beneficial effect on depression and anxiety at dose of 200 mg/days. CONCLUSIONS: Our study demonstrated that herbal medicines could improve anxiety and depression in among menopausal women. However, the beneficial effect still remains indefinite due to the poor methodology.
Anxiety Disorders ; Anxiety* ; Depression* ; Female ; Foeniculum ; Humans ; Kava ; Menopause ; Phytoestrogens* ; Trifolium

A simple and rapid method based on proton nuclear magnetic resonance spectroscopy was developed for determination of trans-anethole content in fennel essential oil. Spectra of pure trans-anethole, of the pure essential oil of fennel, and of the pure oil of fennel with thymol internal standard were recorded. The signal of H-1/ was used for quantification of trans-anethole. This proton signal is well separated in the proton magnetic resonance spectrum of the compound. No reference compound is needed and cheap internal standard was used. The results obtained from spectroscopic analysis were compared with those obtained by gas chromatography. Additionally, the developed method was used for determination of the type of vegetable oil used as a carrier in commercial products, which cannot be quantified as such by gas chromatography. This study demonstrates the application of proton nuclear magnetic resonance spectroscopy as a quality control method for estimation of essential oil components.
Chromatography, Gas ; Foeniculum* ; Magnetic Resonance Spectroscopy* ; Protons ; Quality Control ; Spectrum Analysis* ; Thymol ; Vegetables