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Purpose . Primary dysmenorrhea (PD) is a common gynecological complaint among adolescent girls and women of reproductive age. This study aims to review the findings of published articles on the  in vitro  and  in vivo  efficacy of herbal medicines for PD.  Methods .  In vitro  and  in vivo  studies of herbal compounds, individual herbal extracts, or herbal formula decoctions published from their inception to April 2014 were included in this review.  Results . A total of 18 studies involving herbal medicines exhibited their inhibitory effect on PD. The majority of  in vitro  studies investigated the inhibition of uterine contractions.  In vivo  studies suggest that herbal medicines exert a peripheral analgesic effect and a possible anti-inflammatory activity via the inhibition of prostaglandin (PG) synthesis. The mechanisms of herbal medicines for PD are associated with PG level reduction, suppression of cyclooxygenase-2 expression, superoxide dismutase activation and malondialdehyde reduction, nitric oxide, inducible nitric oxide synthase, and nuclear factor-kappa B reduction, stimulation of somatostatin receptor, intracellular Ca 2+  reduction, and recovery of phospholipid metabolism.  Conclusions . Herbal medicines are thought to be promising sources for the development of effective therapeutic agents for PD. Further investigations on the appropriate herbal formula and their constituents are recommended.

A Review ofIn VitroandIn VivoStudies on the Efficacy of Herbal Medicines for Primary Dysmenorrhea