Background and Objective: Herbal products consumption is increased worldwide. This study was done to compare the effect of Evening Primrose, Vitex agnus and vitamin E on premenstrual syndrome. Methods: In this clinical trials study, 210 women with premenstrual syndrome were randomly divided eqaly into Evening Primrose (500 mg, 3 times per day), Vitex agnus (40 mg/day) and vitamin E (400 Iu/day) groups. The subjects were received the thraputic regiment for 2 months. Severity of premenstrual syndrome was recorded for each subject using DSR Dickerson questinare, perior and at the end of intervention. Results: After intervention, severity of premenstrual syndrome was reduced in Evening Primrose group (60.58±30.6 to 34.09±19.81), Vitex agnus (61.23±30.54 to 25.25±17.78) and the vitamin E group, (61.24±32.04 to 54.9±19.24). Severity of premenstrual syndrome were reduced in the Evening Primrose and Vitex agnus groups in compared to vitamin E group (P<0.05). Severity of premenstrual syndrome were reduced in Vitex agnus in comparision with Evening Primrose (P<0.05). Conclusion: Vitex agnus, Evening Primrose and vitamin E can reduce severity of premenstrual syndrome, but therapeutic effect of Vitex agnus is more than Evening Primrose and vitamin E.

Background and Objective: Conventional treatments for primary dysmenorrhea are often associated with adverse effects, including nausea, headache, and dizziness, and may be contraindicated in certain cases. In Iranian traditional medicine texts, fennel is recommended for pain relief and the induction of menstruation; it also exhibits antiemetic and antinauseant effects. Valerian is a traditional Indian medicinal plant that has been utilized as a sedative, antispasmodic, and hypnotic agent. The present study aimed to determine the effects of fennel and valerian herbal medicines on relieving primary dysmenorrhea-induced pain.
Methods: This clinical trial was conducted on 120 single girls with primary dysmenorrhea who referred to healthcare centers in Khomein, Iran, in 2019. The subjects were selected via a convenience sampling method and randomly allocated into the control, first intervention, and second intervention groups. The control group received mefenamic acid capsules (250 mg), the first intervention group received fennel capsules (30 mg of sweet fennel essential oil), and the second intervention group received valerian capsules (350 mg of plant root) over two consecutive menstrual cycles. Pain severity was measured using the visual analog scale (VAS) during two consecutive menstrual cycles prior to the intervention and two consecutive menstrual cycles following the initiation of the intervention (a total of four cycles).
Results: At the end of the study, the primary dysmenorrhea-induced pain severity significantly decreased in all three studied groups (P<0.05); however, this pain relief was significantly greater in the valerian-receiving group (the first intervention group) compared to the fennel-receiving (the second intervention group) and mefenamic acid-receiving (the control group) (P<0.05). The odds ratio (OR) of experiencing higher pain severity in the first and second intervention groups compared to the control group was determined to be 0.23 (95% CI: 0.07-0.72, P=0.013) and 0.51 (95% CI: 0.28-0.93, P=0.028), respectively.
Conclusion: Valerian and fennel herbal medicines can be utilized as effective alternatives with fewer adverse effects compared to mefenamic acid for relieving primary dysmenorrhea-induced pain.