African Journal of
Plant Science

  • Abbreviation: Afr. J. Plant Sci.
  • Language: English
  • ISSN: 1996-0824
  • DOI: 10.5897/AJPS
  • Start Year: 2007
  • Published Articles: 761

Review

Vital role of herbal medicines in women’s health: A perspective review

R. Ramasubramania Raja
  • R. Ramasubramania Raja
  • Department of Pharmacognosy, Narayana Pharmacy College, Nellore, Andhrapradesh, India.
  • Google Scholar


  •  Received: 15 May 2015
  •  Accepted: 29 June 2015
  •  Published: 30 August 2015

 ABSTRACT

This is a perspective review of medicinal plants useful traditionally for women's healthcare in countries like India. Medicinal plants have a significant role in women's healthcare in many rural areas. Plants with therapeutic efficacious observations have historically been used as a starting point in the development of new drugs, and modern pharmaceuticals have been derived from them. A review about the therapeutic effectiveness, safety and best use of herbals in day to day practice to get rid of many diseases adds value to making use of herbals in this context. Kitchen remedies are the easy access for women for their cost effective health care. Many of the dietary health practices by women reflect their health consciousness. Herbal remedies include medicinal herbs and ayurveda herbal remedies for common disorders among women such as urinary tract infection, pubertal changes, post-menopausal syndrome, hot flushes, menopause, poly cystic ovarian syndrome, bacterial vaginosis, yeast infections, infertility, delayed labor, low breast milk production, abortion and other female disorders.
 
Key words: Medicinal plants, menopausal syndrome, herbal remedies, infertility. 


 INTRODUCTION

Women play an important role in the society as well as in the total life scenario on earth. Despite obvious differences between women and men biologically, psychologically, and socially, the act of differentiating women's health from that of men arose in Western medicine only in the last two decades of the twentieth century. Only health care providers who are specialized in areas related to reproduction were expected to be knowledgeable about issues particular to women. Women from rural sector or modern society rely on herbals for their health care and beauty care (Beal, 1998). Herbal remedies for women include medicinal herbs and Ayurveda herbal remedies for problems like urinary tract infection, pubertal changes, post-menopausal syndrome, hot flushes, menopause, poly cystic ovarian syndrome, bacterial vaginosis, yeast infections, infertility, delayed labor, low breast milk production, abortion and other female disorders. Women have handed down information from mother to daughter on how herbs can remedy some of the common maladies of life. Women, like the moon, change in cycles.

Through menarche (the first menses), menstrual cycles (Bourdy and Walter, 1992), pregnancy, nursing, and menopause, herbs have been a common denominator for the wise woman and those she comforts. Medicinal plants are sometimes referred to as being phytoestrogenic or phytoprogesteronic. This is because some plants have molecular structures similar to the hormones estrogen (phytoestrogenic) and progesterone (phytoprogesteronic). They can occupy the receptor sites in the body that would normally be taken up by these hormones. Herbs are beautiful allies for women to use throughout their lives. Medicinal plants, because of their high values and least side effects, are used by women around the globe.  The practice is increasing and seems quite encouraging, as it reverts back to the olden days where herbs and its usage found interesting episodes.

The cost and availability of herbs and their utilization resources transferred from one generation to another keep the information alive and useful to all. Since women play a multirole and face a variety of problems, special health care is needed. Medical care is becoming costly and much painful; its affordability is no within the reach of the poor. So there is a great demand for usage of medicinal among women in both rural and urban sectors. They are nourishing, comforting, and have stood the test of time for millions of women over thousands of years (Overk et al., 2008).


 WOMEN HEALTH CARE

World scenario (World Health Organization, 2008)

Around the globe, women at all ages suffer from variety of diseases and health issues. Stress and poor health care, malnutrition and many aspects worsen their health. Medicinal plants have role in taking care of such issues. In order to understand the modern definition of women's health, it is important to understand women's health care viewed by the medical and medical research establishments. Traditionally, the health of women has been seen as synonymous with maternal or reproductive health. Clearly, the Western medical profession's view of women's health as maternal was concordant with societal mores that valued women mainly for their ability to bear children. Childbirth and sexually transmitted diseases, and cervical cancer have been the most important health issues for women in all ages and places.

 

Indian context (Subramanian et al., 2006)

Due to the unpleasant risks and side effects of long-term pharmaceutical treatment for women's health conditions, specifically menstruation and menopause, women's healthcare and the search for alternative treatment options have become an important focus of global scientific research. Women are getting more stress, and lack of self-care and poor nourishment lead to anemia and other malnutrition symptoms. Women’s ability to tolerate suffering and their reluctance to be examined by male personnel are additional constraints in their getting adequate health care in the Indian scenario. Pollution and industrial wastes badly reflect on metabolism and lead to health problems in women. In addition, the smoke from household biomass has serious impact, such as eye problems, respiratory problems, chronic bronchitis and lung cancer among women, as the exposure time is more in our social setup. It may lead to anemia in those women susceptible to carbon monoxide toxicity. Mortality, smoking, chewing tobacco and alcohol use were four separate binary outcomes in the analysis in Indian scenario.

Smoking, drinking alcohol, and chewing tobacco also show graded associations with socioeconomic status within indigenous groups. Socioeconomic status difference substantially accounts for the health inequalities between indigenous and non-indigenous groups in India. However, a strong socioeconomic gradient in health is also evident within indigenous populations, reiterating the overall importance of socioeconomic status for reducing population-level health disparities, regard-less of indignity.

 

Women healthcare in India

Women’s health can be seriously affected by many factors such as stress, emotional, physical and so on problems. The major problems are menstrual irregularities, mental health, and malnutrition status like anaemia. The effective intake of herbals may lead to better results in this regard. Women from occupational sector suffer from stress, reluctance about their food habits, more prone to ill effects in their health. As women shoulder all responsibilities in their homes and society, adequate care must be provided to handle their problems (Sethuraman et al., 2006).

The practice of traditional medicine is widespread in China, India, Japan, Pakistan, Sri Lanka and Thailand. In China, about 40% of the total medicinal consumption is attributed to traditional tribal medicines. In Japan, herbal medicinal preparations are more in demand than mainstream pharmaceutical products (Lim, 1993).

The modern field of women's health includes the study of illnesses and conditions that are unique to women, more common or serious in women, have distinct causes or manifestations in women, or have different outcomes or treatments in women. Since the 1980s, research on gender differences in health and disease has had important implications for the treatment and prevention of a variety of common serious illnesses, including heart disease, stroke, lung cancer, depression, colon cancer, and dementia. Research in all these areas is ongoing. A greater understanding of the factors influencing women's health from a biological perspective has been paralleled by a greater understanding   of  the  psychosocial   and societal factors that affect women's health status. Differences in employment patterns also result in fewer women being medically insured than men, strongly affecting access to health care and health status.

The field of women's health seeks to promote an understanding of the biological and psychosocial factor affecting women's health, and to integrate this understanding into public health initiatives, including training of health care providers. Recognition by the medical research establishment of the need to study health and disease in women as well as men has been essential to this new paradigm. Despite the strong influence of biological factors, psychosocial issues still remain the single most important determinant of health status for many women.

The importance of herbals in traditional healthcare practices, providing clues to new areas of research and in biodiversity conservation is now well recognized. However, information on the uses of plants for medicine is lacking in many interior areas. Developmental activities and changing socio-economic conditions have implication on traditional knowledge. 


 ROLE OF HERBALS IN WOMEN’S HEALTH CARE

Among the women population, a large percentage suffer from anemia and related issues.  Women have unique health concerns, and Botanic Choice has natural solutions. Nature's medicine chest provides the support you need for strong bones, bladder health, hormone balance and heart health.

 

Gastro-intestinal ailments

Although women may experience heartburn, they generally have less damage in their esophagus than men. Because women are more sensitive to irritants, they may experience heartburn more strongly than men. The common gastric disorders of women are: nausea, gastritis, gallstones, irritable bowel syndrome (IBS), and colonic disorders.

 

Gynaecological problems (Pinn, 2001)

Gynaecological problems are abnormal uterine bleeding and endometrial ablation. Endometrial ablation is a form of minimally invasive procedure in the treatment of heavy menstrual bleeding. Endometriosis is a gynaecological problem. It is affects women usually between the ages of 30 - 45 years old. Many problems produce endometriosis such as heavy and sometimes irregular periods and also gynaecological problems.

Uterine fibroids are muscle swellings that are found in the womb. Fibroids are very common in women. They are  commonly found in women between the ages of 35 - 45 years old.

Osteoporosis is the commonest long term complication of the menopause. Severe cases of osteoporosis can result in spinal problems and a decrease in height or in hip fractures with minimal trauma. The instance of coronary heart disease and strokes is much lower in women before the menopause age. Wild yam root (Dioscorea villosa) is a member of the Dioscoreaceae family.

Wild yam improves liver and kidney function and can lessen dysmenorrhea and ovarian pain. It is anti-inflammatory, antispasmodic, diuretic, and nutritive, and a cholagogue (improves liver function). Wild yam contains diosgenin, which is a precursor to progesterone and was once used to make birth control pills. Today, wild yam, valued as an herb, is useful for dysmenorrhea, infertility, menopause, menstrual cramps, ovarian pain, and threatened miscarriage. Soy products, which are eaten widely in the Far East, are hypothesized to play a role in this region’s: lower rates of cancers and heart disease and menopausal symptoms. Soy products such as beans, tempeh, tofu, soy milk, and miso contain isoflavones, an antioxidant which can reduce hot flashes and help inhibit tumor growth and cancer.

Plants, namely Tinospora cordifolia, whose leaves are used as health tonic; Delonix regia, whose flowers are used for treating dysmenorrhoea; Buteamonosperma whose bark are used for menorrhagia and leucorrhoea are found similar to those published in the literature (Vidyasagar and Prashantkumar, 2007). Further scientific assessment of these medicines on phytochemistry, biological activity and clinical studies is however greatly needed.  Most commonly useful herbs are: Andrographis paniculata Nees, Abrus precatorius L., Butea monosperma Roxb., Caesalpinia bonducella L. , Catharanthus roseus L., Celosia argentia L., Crotalaria prostrate Rottl., Lawsonia innermis L., Maytenus senegalensis Lam.,  Mimosudica L., Striga densiflora Benth.,  Tinospora cordifolia Willd and  Tridax procumbens

Menopause is the time of life when a women stops having periods (Brian, 2009). The periods stop because the ovaries stop producing the normal amounts of oestrogen and progesterone hormones. Hot flushes and night sweats are very common during menopause. Cinnamomum verum, Pueraria lobata, Ruta graveolens, Glycine max, Dioscora villosa, Cimicifuga racemosa, Vitex agnus, Angelica sinensis, Oenothera biennis, Ginkgo biloba, Trifolium pretense, Agrimonia pilosa hedeb, Ailanthus altissima (Mill) swingle are commonly employed in the treatment of gynaecological conditions.

Infertility or its concern worries a larger number of couples. It has been shown that if a couple is having regular unprotected sexual intercourse, then there is 80% chance of conception after 12 months and 90% chance of conception after 18 months.

There are three main causes of infertility. A woman needs to produce eggs regularly and at the right time of her menstrual cycle, the man needs to produce sperm of the right quality and quantity, and the two need to be able to meet and therefore the women’s fallopian tubes need to be open and undamaged. About 25% of infertility is due to lack of eggs; about 25% is due to a problem with the sperm, about 25% is due to tubal problems and for the balance 25%, the reason for infertility is not known.

Numerous studies have documented that health care consumers all over the world are spending money for alternative therapies and that billions of dollars are spent in the United States alone. Women use conventional health care services more frequently than men; thus, it is not surprising that women account for approximately two thirds of health care appointments for complementary and alternative therapies. The traditional conceptual frameworks of herbal medicine, homeopathy, acupuncture, and acupressure are presented, and common clinical applications to women's reproductive care are discussed.

Ethnobotanical data collection to select pharmacologically active species was carried out within a clearly defined therapeutic context: those plants used during the course of a woman's reproductive life. Various concepts, behaviours and practices relating to menstruation, pregnancy, birth and birth control were examined in detail from an ethno pharmacological point of view. A list of selected species of particular interest is proposed for further study.

Symptoms associated with menopause can greatly affect the quality of life for women. Botanical dietary supplements have been viewed by the public as safe and effective despite a lack of evidence. Taken together, these data indicate a need to reprioritize the order in which the bioassays are performed for maximal efficiency of programs involving bioassay-guided fractionation. In addition, there are possible explanations for the conflicts in the literature over the estrogenicity of Cimicifuga racemosa (Black cohosh).

Despite widespread use, there has been surprisingly little research on the outcomes or the potential risks of using herbal therapies during pregnancy. Similarly, phytoestrogens have become one of the fashionable areas of herbal treatment, although with remarkably little evidence of benefit. Studies have been carried out to assess their effectiveness in cardiovascular disease and osteoporosis but not their effect on irregularities of menstruation. Current herbal treatment in this area comes from traditional use, laboratory work; and a lack of adequate clinical trials make it impossible to suggest which remedies may be of benefit.

Estrogen replacement therapy is one of the most commonly prescribed medicines in the United States by traditional medical professionals (Russell, 2002). Over the past decade, the market for complementary/ alternative therapies for hormone replacement has dramatically increased. Women are seeking more "natural" alternatives to treat menopausal symptoms. Several popular herbal therapies for menopausal symptoms include phytoestrogens, black cohosh (Cimicifuga racemosa), dong quai (Angelica sinensis), chast tree (Vitex agnus-castus), and wild Mexican yam (Tiran, 2006).

Women approaching menopause frequently resort to complementary therapies and natural remedies, especially herbal medicines. Nurses working with mature women, both in communities and hospitals, debate about these remedies, yet are unable to answer women's questions, or know where to get information. However, with the increased use of complementary therapies generally, it is imperative that nurses recognize the parameters of their personal practice and appreciate the possible problems which may arise from ill-informed use of natural remedies, such as herb-drug interactions. This article provides an overview of herbal remedies popularly self-administered by women in their peri-menopausal period.

The effects and safety of several remedies are explored to facilitate nurses to offer accurate, comprehensive and evidence-based information to patients. The issue of integration of herbal medicine into mainstream management of menopausal symptoms is also debated as a means of providing optimum and safe care to women at this time.

 

General tonic

Medicinal plants used as general tonic include: Medicago sativa, Andrographis paniculata, Chicorium intybus,, Morinda citrifolia, Olea europea, Panax quinquefoilus, Zingiber officinale. Moderate malnutrition continues to affect 46% of children under five years of age and 47% of rural women in India. Women's lack of empowerment is believed to be an important factor in the persistent prevalence of malnutrition.

In India, women's empowerment often varies by community, with tribes sometimes being the most progressive. In addition to the known investments needed to reduce malnutrition, improving women's nutrition, promoting gender equality, empowering women, and ending violence against women could further reduce the prevalence of malnutrition in this segment of the Indian population (Uniyal et al.,   2006).

 

Headache

Plants useful in headache include (El-Mallakh et al., 1991b): Tumera diffuse, Ilex paraurensis. A number of clinical reports have revealed an association between the use of alcohol and drugs and the onset or exacerbation of headaches. The following characteristics were noted in the 236 respondents:  1) Over 89% reported having  experienced some type of headache; 2) headache-free individuals were significantly older than headache sufferers; 3) women were much more likely to have migraine headaches than men; 4) Onset of migraines occurred prior to onset of substance use, while onset of tension headaches occurred after onset of substance use. Although associational data must be interpreted with caution, an intriguing hypothesis compatible with the finding is that migraines may play a role in the genesis of substance use, while substance use may play a role in the genesis of tension headaches.

 

Fever, cough and cold

Medicinal plants are the inexpensive drugs for all categories of people in the world because of their less serious side effects compared to the synthetic ones. Plants useful in fever, cough and cold include Arnica Montana, Berberis vulgaris, Bupleurum falcatum, Eucalyptus globules, Hibiscus sabdariffa, Hyssopus officinalis, Datura stromonium, Althea officinalis, Urginia maritime, Rumex crispus, Eriodictyon californicum, Astragalus membarneceous, Trogonellafoenum- graecum, Tanacetum parthenium, Glycyrriza glabra, Verbascum densiflorum, Agastache rugosa gynae, and Baphicacanthus cusia (Nees) Bremek.

 

Cancer (Desai et al., 2008)

About one out of every 4-60 women will develop ovarian cancer in their lifetime. It has been noted that the more children a woman has, the lower her risk for ovarian cancer. Breast cancer is the most common form of cancer in women. It is the major cause of death from cancer for women aged between 30 and 60 years. Men can also suffer from breast cancer but compared with women it is a rare occurrence with an incidence rate of about 1% compared with the rate in women. Cervical cancer is one of the most common cancers affecting women. It occurs in the cervix which is the lower part of the womb protruding into the vagina. Cervical cancer is divided into two stages; early or pre-invasive stage, and the late or invasive stage. Women who have had several pregnancies or several sexual partners seem more at risk to cervical cancer. There are indications that cervical cancer may be caused by a virus, the wart virus.

 

Medicinal plants useful in cancer 

Medicinal plants useful in cancer include Momordica charantia, Tricosanthes kirilowii,Codonopsis pilosula,Vitis vinifera, Camelia sinensis, Lavendula angustifolia, Podophyllum peltatum, Viscus álbum; Pinus pinaster, Rosmarinus  officinalis, Ganoderma  lucidum,  Scutellaria species, Glycinemax, Thuja occidentalis, Withania somnifera, Allium sativum, Panax ginseng.

Since 1986, over 40,000 plant samples have been screened, but thus far only five chemicals showing significant activity against AIDS have been isolated. Three are currently in preclinical development. Before being considered for clinical trials in humans, these agents must show tolerable levels of toxicity in several animal models. For AIDS, three agents are presently in preclinical or early clinical development.


 OCCUPATIONAL HEALTH PROBLEMS OF WOMEN; HERBAL REMEDY

Occupational health problems occur due to work or because of the kind of work you do. These problems can include cuts, broken bones, sprains and strains, or amputations, repetitive motion disorders, hearing problems caused by exposure to noise, vision problems or even blindness, Illness caused by breathing, touching or ingesting unsafe substances, Illness caused by exposure to radiation, exposure to germs in healthcare settings. Good job safety and prevention practices can reduce your risk of these problems: try to stay fit, reduce stress, set up your work area properly, and use the right equipment and gear.

Only a small proportion of exposed workers develop occupational asthma (Kelly-Pieper, 2009). Workers most likely to develop the disease are those with a personal or family history of allergies or asthma and frequent exposure to highly sensitizing substances. But the disease also can develop in persons with no known allergies.

Occupational asthma may be suspected whenever a worker begins to develop respiratory symptoms. It may take several years to develop. A thorough physical examination and medical history for a worker with asthma symptoms should include a detailed listing of his or her work history and workplace conditions.

As women move beyond their traditional occupations, they meet new health hazards which may either replace or add to their existing occupational exposure. Women's labour force participation rates have increased steadily, and not only in the industrialized countries.

The dramatic economic successes of the newly industrialized states of Asia, for example, are substantially a reflection of increasing feminization of labor in this region. In these economies, female’s workforce participation rates increased far more rapidly than male from the 1960s, although their jobs were largely less-skilled and poorly paid. Women workers formed the largest pool of workers in export-oriented light industries, such as electronics and textiles, which underpinned economic expansion.

The major reason it is necessary to develop specific tools  for  research   into   women's   occupational   health  problems is that the labour force is still very much divided by sex, so women and men do very different work and are exposed to different risks. In order for men and women to be evenly distributed across the job market, about three quarters of women would have to change jobs. A recent study of workers in North Carolina, U.S.A. puts this figure at 76 per cent, even higher than that for racial segregation: 55%. Despite considerable progress in integrating women into the labour force, women are still found in jobs where employment conditions are relatively unfavourable. This sexual division of labor affects women’s health in at least six ways:

1) Women's jobs have specific characteristics (repetition, monotony, static effort, multiple simultaneous responsibilities) which may lead over time to changes in physical and mental health;

2) Spaces, equipment and schedules designed in relation to the average male body and lifestyle may cause problems for women;

3) Occupational segregation may result in health risks for women and men by causing task fragmentation, thereby increasing repetition and monotony;

4) Sex-based job assignment may be vaunted as protecting the health of both sexes and thus distract from more effective occupational health promotion practices;

5) Discrimination against women is stressful in and of itself and may affect mental health;

6) Part-time workers are excluded from many health-promoting benefits such as adequate sick leave and maternity leave.

Recent years have seen an increase in the number of women in the labor force, and public health practitioners, workers and scientists are starting to include women's concerns in their occupational health activities.


 COMMERCIAL IMPACT OF WOMEN’S HEALTH CARE PRODUCTS IN INDIAN ECONOMY

Health inequities, "the avoidable inequalities in health between groups of people within countries and between countries”, are shaped by the social and economic conditions of people's lives. In 2002 the World Health Organization (WHO) released the Madrid Statement, saying:  "to achieve the highest standard of health, health policies have to recognize that women and men, owing to their biological differences and their gender roles, have different needs, obstacles and opportunities."

Consistent with this, the government's approach to developing the National Women's Health Policy will be based on a principle of gender equity. To achieve gender equity in health, both women and men need health policies that target their specific or unique needs (Douglas, 2006).


 DISCUSSION

Medicinal plants are the inexpensive drugs for all categories of people in the world because of their less serious side effects compared to the synthetic ones. The effects on health of women's multiple roles are still poorly understood. Longitudinal studies could be valuable here too in disentangling the impact of different roles and responsibilities at different stages of the life-cycle. If much of the current literature on women and paid work, especially which concerned mental health, is ambiguous or contradictory, it frequently reflects inadequate research design and an unjustifiable level of generalization about women’s lives. Medicinal plants are sometimes referred to as being phytoestrogenic or phytoprogesteronic. This is because some plants have molecular structures similar to the hormones estrogen (phytoestrogenic) and progesterone (phytoprogesteronic). They can occupy the receptor sites in the body that would normally be taken up by these hormones. The occupational health of women in sex work varies with the meanings, customs and contexts of sex work in their local area.


 CONCLUSION

Medicinal plants are easily available and without any unwanted side and adverse effects. Comparing the herbal medicine and allopathic, the allopathic system of medicine cost is high and the adverse and side effect is more. It is not possible to take continuously allopathic medicine over a certain period of time to remedy diseases. Although, herbal medicines have positive results of 100% without side effects. Nowadays, we can see increase in the number of women in the labour force; public health practitioners, workers and scientists are starting to include women's concerns in their occupational health activities.  


 CONFLICT OF INTEREST

The authors have not declared any conflict of interest.



 REFERENCES

Beal MW (1998). Women's use of complementary and alternative therapies in reproductive health care. J. Nurse Midwifery, 43(3):224-234.
Crossref
 
Bourdy G, Walter A (1992). Maternity and medicinal plants in Vanuatu. I. The cycle of reproduction. J. Ethnopharmacol. 37(3):179-96.
Crossref
 
Brian JD, Frasor J, Lauren EB, Locklear TD, Perez A, Gomez- Laurito J, Mahady GB (2009). Estrogenic effects of herbal medicines from Costa Rica used for the management of menopausal symptoms Menopause. 16(4):748-755.
Crossref
 
Desai AG, Qazi GN, Ganju RK, El-Tamer M, Singh J, Saxena AK, Bedi YS, Taneja SC, Bhat HK (2008). Medicinal plants and cancer chemoprevention. Curr. Drug Metab.  9(7):581-591.
Crossref
 
Douglas WE (2006). How social marketing works in health care BMJ. 332(7551): 1207-1210.
Crossref
 
El-Mallakh RS, Kranzler HR, Kamanitz JR (1991b). Headaches and psychoactive substance use. Headache, 31:584-587.
Crossref
 
Lim Lin Lean (1993). "The Feminization of Labour in the Asia-Pacific Rim Countries: From Contributing to Economic Dynamism to Bearing the Brunt of Structural Adjustments", in Naohiro Ogawa, G.W. Jones and J.G. Williamson (eds), Human Resources in Development along the Asia-Pacific Rim (Singapore: Oxford University Press, 1993) Tables 6.2-6.3, pp. 177-181.
 
Kelly-Pieper K, Patil SP, Busse P, Yang N, Sampson H, Li XM, Wisnivesky JP, Kattan M (2009). Safety and tolerability of an antiasthma herbal Formula (ASHMI) in adult subjects with asthma: a randomized, double-blinded, placebo-controlled, dose-escalation phase I study. J. Altern. Complement Med. 15(7):735-43.
Crossref
 
Overk CR, Yao P, Chen S, Deng S, Imai A, Main M, Schinkovitz A, Farnsworth NR, Pauli GF, Bolton JL (2008). High-content screening and mechanism-based evaluation of estrogenic botanical extracts. Comb. Chem. High Throughput Screen.  11:283-293.
Crossref
 
Pinn G (2001). Herbs used in obstetrics and gynaecology. Aust. Fam. Physician, 30(4):351-354, 356.
 
Russell L, Hicks GS, Low AK, Shepherd JM, Brown CA (2002). Phytoestrogens: a viable option? Am. J. Med. Sci. 324(4):185-188.
Crossref
 
Sethuraman K, Lansdown R, Sullivan K (2006). Women's empowerment and domestic violence: the role of sociocultural determinants in maternal and child under nutrition in tribal and rural communities in South India. Food Nutr. Bull.  27:128-143. 
 
Subramanian SV, Davey Smith G, Subramanyam M (2006). Indigenous health and socioeconomic status in India. PLoS Med.  3(10):e421.
Crossref
 
Tiran D (2006). Integrated healthcare: herbal remedies for menopausal symptoms. Br. J. Nurs. 15(12):645-648.
Crossref
 
Uniyal SK, Singh KN, Jamwal P, Lal B (2006). Traditional use of medicinal plants among the tribal communities of Chhota Bhangal, Western Himalaya. J. Ethnobiol. Ethnomed.  2:14.
Crossref
 
Vidyasagar GM, Prashantkumar P (2007). Traditional herbal remedies for gynecological disorders in women of Bidar district, Karnataka, India. Fitoterapia.  78(1):48-51.
Crossref
 
World Health Organization (2008). Commission on the Social Determinant of Health, Key Concepts. Geneva: WHO - Ref 35.

 




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