Background : Menopause is a physiological state that occurs in all women and refers to the halt of the reproductive phase. The cessation of the reproductive phase occurs through various stages and presents different symptoms such as hot flashes, night sweats, insomnia, anxiety, depression, and irritability. Such pre- and post-menopausal symptoms may affect the daily activities and production capacities of women, impacting the quality of life (QoL) of women. Hormone replacement therapy (HRT) is primarily used to manage menopausal symptoms. However, various side effects have been reported related to HRT. Therefore, women are choosing alternative medicine such as Ayurveda that can benefit them with less or no adverse effects. Shatavari (Asparagus racemosus) is known in Ayurveda as an effective medicinal plant source for various women’s health remedies since ancient times. This study aimed to evaluate the safety and efficacy of the Ayurvedic Shatavari formulation on menopausal symptoms compared to the placebo.
Methodology : This is a randomized, double-blinded, multicenter, placebo-controlled, clinical study. Altogether, 70 patients were randomized to two groups, i.e., the test group (active group) and the placebo group (microcrystalline cellulose), with 35 participants in each group.
Results : The study outcomes showed a positive and significant effect of the active test ingredient over the placebo in terms of reduction in hot flashes, night sweats, insomnia, anxiety, nervousness, vaginal dryness, and loss of libido. The Utian QoL improved significantly in the test group compared to the placebo group. No significant adverse events were recorded in the test group, suggesting the safety of this formulation.
Conclusions : The test compound could be a safe alternative to modern drugs. The findings of this study support the traditional use of Shatavari. Further clinical and pharmacological studies with longer duration and larger and more diverse sample sizes are required to understand the generalized effect of Shatavari root extract in menopausal women.
Discussion : Most studies conducted so far are on postmenopausal women, whereas our study was conducted on both pre and postmenopausal women. Moreover, very few studies have shown the safety and efficacy of Shatavari alone on humans. The findings from this study support the positive effects of a novel Shatavari formulation taken for 60 days at a dose of 250 mg twice a day. This study also showed that the test product was safe and well-tolerated with no major adverse events in the participants with menopausal symptoms (hot flashes, anxiety, stress, sleep, etc.). Therefore, it could be a safe alternative to modern drugs. The efficacy of the test product was well demonstrated concerning a significant improvement in menopausal symptoms. It was found to be an effective therapy for psychological and somatic problems related to menopausal syndrome. The findings of our study supported the traditional use of Shatavari with modern scientific evidence. Further, clinical and pharmacological studies with longer durations and larger sample sizes are required to understand the mechanistic actions of this formulation in menopausal women.
Categories: Public Health, Integrative/Complementary Medicine, Obstetrics/Gynecology
Keywords: regensburg insomnia scale, utian quality of life, menopausal symptoms, shatavari, ayurveda, asparagus racemosus, menopause
Gudise V S, Dasari M P, Kuricheti S K (April 08, 2024) Efficacy and Safety of Shatavari Root Extract for the Management of Menopausal Symptoms: A Double-Blind, Multicenter, Randomized Controlled Trial. Cureus 16(4): e57879. DOI 10.7759/cureus.57879

Abstract: Shatavari (Asparagus racemosus) has been used for female health problems since ancient times and is useful for treating various female reproductive problems including menopausal problems, hormonal imbalance, lactation, menstrual issues, and others. Shatavarins, the primary phytoconstituents of Shatavari, have high molecular weights and may interact with hormone receptors. We have conducted a molecular docking analysis for different Shatavarins such as Shatavarin I, Shatavarin IV, Shatavarin VI, Shatavarin VII, Shatavarin VIII, Shatavarin IX, and Shatavarin X with different hormonal receptors such as estrogen alpha, beta, and gamma receptor, progesterone receptor, FSH, and LH receptors. The best docking conformations with the highest docking scores, specific interactions and bond formations, and the most important residues of the receptors were identified and reported. The study was successful in providing an initial comparative insight into the binding efficiencies of the Shatavarins for different female hormonal receptors.
Keywords: Shatavari, shatavarins, shatavarin I, shatavarin IV, hormonal receptor, ayurveda, alternative medicine
Molecular docking analysis of shatavarins with female hormonal receptors, Neelima Arora & Amit Kumar Banerjee, Bioinformation 20(7): 775-780 (2024)