Effect of vaginal suppository on bacterial vaginitis based on Persian medicine (Iranian traditional medicine): a randomised double blind clinical study.

J Obstet Gynaecol. 2018 Aug 7:1-5. doi: 10.1080/01443615.2018.1445706. [Epub ahead of print] Baery N1, Ghasemi Nejad A2, Amin M3, Mahroozade S4, Mokaberinejad R5, Bioos S6, Anushiravani M1, Aliasl J4,7, Karimi Darmiyan M8, Amin G9. Author information 1 a Department of Persian Medicine, School of Persian and Complementary Medicine , Mashhad University of Medical Sciences , Mashhad , Iran. 2 b Department of Obstetrics and Gynecology, Faculty of Medicine , Tehran University of Medical Sciences , Tehran , Iran. 3 c Pharmaceutical Sciences Research Center, Department of Drug and Food Control, Faculty of Pharmacy , Tehran University of Medical Science , Tehran , Iran. 4 d Research Institute for Islamic and Complementary Medicine, School of Iranian Traditional Medicine , Iran University of Medical Sciences , Tehran , Iran. 5 e Department of Traditional Medicine, School of Traditional Medicine , Shahid Beheshti University of Medical Sciences , Tehran , Iran. 6 f Faculty of Traditional Medicine , Tehran University of Medical Sciences , Tehran , Iran. 7 g Traditional Medicine Clinical Trial Research Center , Shahed University , Tehran , Iran. 8 h Department of Pharmaceutics, Faculty of Pharmacy , Tehran University of Medical Sciences , Tehran , Iran. 9 i Department of Traditional Pharmacy, Faculty of Traditional Medicine , Tehran University of Medical Sciences , Tehran , Iran. Abstract This trial was conducted on 127 women aged 18-50 years with bacterial vaginosis to compare the vaginal suppository of metronidazole with Forzejeh, a vaginal suppository of herbal Persian medicine combination of Tribulus terrestris, Myrtus commuis, Foeniculum vulgare and Tamarindus indica. The patients (63 in metronidazole group and 64 in Forzejeh group) received the medications for 1 week. Their symptoms including the amount and odour of discharge and cervical pain were assessed using a questionnaire. Cervical inflammation and Amsel criteria (pH of vaginal discharge, whiff test, presence of clue cells and Gram staining) were investigated at the beginning of the study and 14 days after treatment. The amount and odour of discharge, Amsel criteria, pelvic pain and cervical inflammation significantly decreased in Forzejeh and metronidazole groups (p = <.001). There was no statistically significant difference between the metronidazole and Fozejeh groups with respect to any of the clinical symptoms or the laboratory assessments. This study showed that Forzejeh, which is an herbal Persian medicine preparation, has a therapeutic effect the same as metronidazole in bacterial vaginosis. Impact statement What is already known on this subject? Bacterial vaginosis (BV) is a common problem in women. Common antibiotics for the treatment of BV include: metronidazole, tinidazole and clindamycin. Unfortunately, treatments often occur with a recurrence and failure. Therefore, alternative treatments are necessary. Many natural treatments are recommended for this condition in Persian Traditional Medicine sources. One of them is the vaginal suppository "Forzejeh" which is the combination of Tribulus terrestris, Myrtus commuis, Foeniculum vulgare and Tamarindus indica. These plants have antimicrobial activities. Forzejeh has been used for the treatment of BV in folk medicine for many years and has been formulated and standardised recently. What do the results of this study add? This study showed that the therapeutic effect of Forzejeh on bacterial vaginosis is similar to metronidazole. What are the implications of these findings for clinical practice and/or further research? A clinical study with a longer follow-up time is suggested for assessing the recurrence of BV after treatment with Forzejeh metronidazole. KEYWORDS: Bacterial vaginitis; Foeniculum vulgare; Myrtus commuis; Tamarindus indica; Tribulus terrestris