Repurposing of Bryophyllum pinnatum for dysmenorrhea treatment: a systematic scoping review and case series

Leonie Zurfluh; Marialuigia Giovannini Spinelli; Cornelia Betschart; Ana Paula Simões-Wüst

doi:10.3389/fphar.2023.1292919

Repurposing of Bryophyllum pinnatum for dysmenorrhea treatment: a systematic scoping review and case series

Front Pharmacol. 2023 Dec 1:14:1292919. doi: 10.3389/fphar.2023.1292919. eCollection 2023.

Authors

Leonie Zurfluh^#¹, Marialuigia Giovannini Spinelli^#^{2

3}, Cornelia Betschart⁴, Ana Paula Simões-Wüst^{1

2}

Affiliations

¹ Department of Obstetrics, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
² Klinik Arlesheim, Research Department, Arlesheim, Switzerland.
³ Praxis Geburt & Familie, Dr. med. Werner Stadlmayr GmbH, Aarau, Switzerland.
⁴ Department of Gynecology, University Hospital and University Zurich, Zurich, Switzerland.

^# Contributed equally.

Abstract

Dysmenorrhea affects women throughout their reproductive years but there has been a lack of effective and well-tolerated treatment options. Pain symptoms mainly result from inflammatory processes and increased contractile activity in the myometrium. The reported use of Bryophyllum pinnatum preparations against inflammation and pain in ethnomedicine as well as current pharmacological data on their inhibition of myometrial contractility led us to hypothesize that this medicinal plant might be a new treatment option for dysmenorrhea. In the first part of the present work, clinical, in vivo, and in vitro studies on the anti-nociceptive and anti-inflammatory, as well as on myometrium relaxing properties of B. pinnatum are reviewed. In the second part, cases of five women with dysmenorrhea who were tentatively treated with a B. pinnatum product are described. The review revealed thirty-three experimental in vivo and in vitro studies, but no clinical study, reporting anti-nociceptive and anti-inflammatory effects of B. pinnatum extracts and compounds in a wide range of conditions. Moreover, sixteen publications on smooth muscle contractility revealed relaxing effects. The latter consisted of clinical evidence, as well as of in vivo and in vitro data. The evidence reviewed therefore provided a rational basis for the use of B. pinnatum in the treatment of dysmenorrhea. We subsequently set out to tentatively treat patients with a well-tolerated B. pinnatum product that is registered (without indication) and commonly used in obstetrics and gynecology in Switzerland. All five treated patients reported a reduction in pain symptoms and 4 out of 5 indicated a reduced intake of painkillers during menstruation. Taken together, the reviewed information on the pharmacological properties and clinical evidence of B. pinnatum extracts and compounds as well as the outcomes of all five patients in the case series support our hypothesis in favor of B. pinnatum as a new, well-tolerated therapeutic approach for dysmenorrhea. Prospective clinical studies are urgently needed.

Keywords: Bryophyllum pinnatum; Kalanchoe pinnata; contractility; dysmenorrhea; inflammation; pain; smooth muscle.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This publication was supported partially by Weleda AG, the Johannes Kreyenbühl Foundation and the Dr. Hauschka Foundation. These funders, including the company Weleda AG, were not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.