Effects of combination therapy with Bunium persicum and Foeniculum vulgare extracts on patients with polycystic ovary syndrome


1 Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Department of Obstetrics and Gynecology, Reproductive Health Research Center, School of Medicine, Al-zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran

3 Department of Obstetrics and Gynecology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

4 Medical Plants Research Centre, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran


Background: Considering the side effects of common drugs used to treat polycystic ovary syndrome (PCOS), researchers have turned their attention to natural compounds, including medicinal plants. Foeniculum vulgare has estrogenic properties and has been traditionally used to treat gynecological disorders. Bunium persicum has medical aspects that have not yet been evaluated, so the aim of this study was to evaluate the effects of combination therapy with these extracts on clinical symptoms of women with PCOS.
Materials and Methods: In this double-blind clinical trial study, 70 women with PCOS referred to infertility clinics, were selected and randomly divided into two groups. The intervention group received B. persicum capsule 60 mg plus F. vulgare capsule 25 mg) twice daily for 4 months and the control groups received routine intervention. Before and after the intervention, levels of luteinizing hormone (LH), follicle-stimulating hormone, progesterone, prolactin, testosterone and dehydroepiandrosterone sulfate (DHEAS) levels, hirsutism score, and menstrual pattern were recorded and endometrial thickness and follicle count were determined by ultrasound. Data were analyzed by the SPSS21 software.
Results: Treatment with B. persicum and F. vulgare extracts significantly decreased LH and DHEAS levels, hirsutism score, and significantly increased menstrual duration compared to the control group. Before the intervention, 5.7% of the intervention and control groups had the normal menstrual pattern, while after the intervention 31.4% of the intervention group and 25.7% of the control group had the normal pattern.
Conclusion: Regarding the effect of these extracts combination and because they have no side-effects, which is a great advantage over chemical drugs, using of these plants recommend.


Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, et al. Polycystic ovary syndrome. Nat Rev Dis Primers 2016;2:16057.  Back to cited text no. 1
Lauritsen M, Bentzen J, Pinborg A, Loft A, Forman J, Thuesen L, et al. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone. Human Reprod 2014;29:791-801.  Back to cited text no. 2
Tehrani FR, Simbar M, Tohidi M, Hosseinpanah F, Azizi F. The prevalence of polycystic ovary syndrome in a community sample of Iranian population: Iranian PCOS prevalence study. Reprod Biol Endocrinol 2011;9:39.  Back to cited text no. 3
Archer JS, Chang RJ. Hirsutism and acne in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2004;18:737-54.  Back to cited text no. 4
Hart R. PCOS and infertility. Panminerva Med 2008;50:305-14.  Back to cited text no. 5
McCartney CR, Marshall JC. Clinical practice. Polycystic ovary syndrome. N Engl J Med 2016;375:54-64.  Back to cited text no. 6
Podfigurna-Stopa A, Luisi S, Regini C, Katulski K, Centini G, Meczekalski B, et al. Mood disorders and quality of life in polycystic ovary syndrome. Gynecol Endocrinol 2015;31:431-4.  Back to cited text no. 7
Pfeifer SM, Dayal M. Treatment of the adolescent patient with polycystic ovary syndrome. Obstet Gynecol Clin North Am 2003;30:337-52.  Back to cited text no. 8
Karampoor P, Azarnia M, Mirabolghasemi G, Alizadeh F. The effect of hydroalcoholic extract of fennel (Foeniculum vulgare) seed on serum levels of sexual hormones in female wistar rats with polycystic ovarian syndrome (PCOS). J Med Sci 2014;5:3.  Back to cited text no. 9
Pahlevani P, Mosavi S, Rastgoo Haghi A, Lahotian H, Esna Ashari F, Alizadeh Z. Study of the effects of stachys lvandulifolia alcoholic extract on histomorphometry of endometrium in polycystic ovarian syndrome rat model. Avic J Clin Med 2016;23:40-8.  Back to cited text no. 10
Askari K. Effect of hydroalcoholic extract of Vitex agnus-castus fruit on fertility and estrous cycle in letrozole-induced polycystic ovary (PCOS) in rat. Razi J Med Sci 2017;24:42-8.  Back to cited text no. 11
Oktay M, Gülçin İ, Küfrevioğlu Öİ. Determination of in vitro antioxidant activity of fennel (Foeniculum vulgare) seed extracts. LWT Food Sci Technol 2003;36:263-71.  Back to cited text no. 12
Moura LS, Carvalho RN Jr., Stefanini MB, Ming LC, Meireles MA. Supercritical fluid extraction from fennel (Foeniculum vulgare): Global yield, composition and kinetic data. J Supercrit Fluid 2005;35:212-9.  Back to cited text no. 13
Kooti W, Moradi MT, Ali-Akbari S, Sharafi-Ahvazi N, Asadi-Samani M, Ashtary-Larky D. Therapeutic and pharmacological potential of Foeniculum vulgare Mill: A review. J Herb Med Pharmacol 2014;4:212-44.  Back to cited text no. 14
Albert-Puleo M. Fennel and anise as estrogenic agents. J Ethnopharmacol 1980;2:337-44.  Back to cited text no. 15
Shah Z, Ali T, Shafi S. Phytopharmacological review of Bunium persicum (Boiss) B. fedtsch. J Drug Deliv Ther 2019;9:458-60.  Back to cited text no. 16
Hassan HA, Borzoo T, Majid A, Shahrzad D. Bunium persicum (Boiss) B. fedtsch: An overview on phytochemistry, therapeutic uses and its application in the food industry. J Appl Pharm Sci 2018;8:150-8.  Back to cited text no. 17
Mehrabadi MM, Zarshenas MM. A concise overview of phytochemistry, pharmacology and clinical aspects of Persian cumin Bunium persicum (Boiss.) B. fedtsch. Curr Drug Discov Technol 2021;18:485-91.  Back to cited text no. 18
Delaram M, Sadeghian Z. The comparison of Echinophora platyloba and fennel effects on the primary dysmenorrhea. Sci J Hamadan Univ Med Sci 2011;18:42-7.  Back to cited text no. 19
Rosenfield RL. Clinical practice. Hirsutism. N Engl J Med 2005;353:2578-88.  Back to cited text no. 20
Rosenfield RL. Etiology and Pathophysiology of Polycystic Ovary Syndrome in Adolescents. USA: UpToDate; 2019.  Back to cited text no. 21
Shirdel A, Bayrami A, Mahmoudi F. Effects of ethanolic extract of fennel on serum levels of sex hormones in polycystic female rats. In: 13th National Conference on Watershed Management Science and Engineering. Ardabil: University of Mohaghegh Ardabili; 2018.  Back to cited text no. 22
Sadr Fozalaee S, Farokhi F, Khaneshi F. The effect of metformin and aqueous extract Foeniculum vulgare (Fennel) on endometrialhistomorphometry and the level of steroid hormones in rats with polycystic ovary syndrome. Qom Univ Med Sci J 2015;8:12-9.  Back to cited text no. 23
Ghavi F, Shakeri F. Effects of fennel on serum hormone levels in students with polycystic ovary syndrome. Avic J Phytomed 2015;5:1-9.  Back to cited text no. 24
Fazeli R, Shiravi A. Effect of hydroalcoholic extract of Vitex agnus castus and Foeniculum vulgare on HPG axis and spermatogenesis of NMRI male rats. Anim Biol 2013;5:87-99.  Back to cited text no. 25
Parsaeyan N. The effect of Foeniculum vulgare (fennel) extract on lipid profile, lipid peroxidation and liver enzymes of diabetic rat. Iran J Diabetes Obes 2016;8:24-9.  Back to cited text no. 26
Thakur S, Bawara B, Dubey A, Nandini D, Chauhan NS, Saraf D. Effect of Carum carvi and Curcuma longa on hormonal and reproductive parameter of female rats. Int J Phytomed 2009;1:42-33.  Back to cited text no. 27
Kaki S, Moeini M, Hozhabri F, Nikousefat Z. The use of crushed caraway (Carum carvi) and black seed (Nigella sativa) additives on growth performance, antioxidant status, serum components and physiological responses of sanjabi lambs. Iran J Appl Anim Sci 2018;8:32-45.  Back to cited text no. 28
Kazemipoor M, Radzi CW, Hajifaraji M, Haerian BS, Mosaddegh MH, Cordell GA. Antiobesity effect of caraway extract on overweight and obese women: A randomized, triple-blind, placebo-controlled clinical trial. Evid Based Complement Alternat Med 2013;2013:2.  Back to cited text no. 29
Cho S, Choi Y, Park S, Park T. Carvacrol prevents diet-induced obesity by modulating gene expressions involved in adipogenesis and inflammation in mice fed with high-fat diet. J Nutr Biochem 2012;23:192-201.  Back to cited text no. 30
Shahat AA, Ahmed HH, Hammouda FM, Ghaleb H. Regulation of obesity and lipid disorders by Foeniculum vulgare extracts and Plantago ovata in high-fat diet-induced obese rats. Am J Food Tech 2012;7:622-32.  Back to cited text no. 31
Khazaei M, Montaseri A, Khazaei MR, Khanahmadi M. Study of Foeniculum vulgare effect on folliculogenesis in female mice. Int J Fertil Steril 2011;5:122-7.  Back to cited text no. 32
Akha O, Rabiei K, Kashi Z, Bahar A, Zaeif-Khorasani E, Kosaryan M, et al. The effect of fennel (Foeniculum vulgare) gel 3% in decreasing hair thickness in idiopathic mild to moderate hirsutism, A randomized placebo controlled clinical trial. Caspian J Intern Med 2014;5:26-33.  Back to cited text no. 33
Javidnia K, Dastgheib L, Mohammadi Samani S, Nasiri A. Antihirsutism activity of Fennel (fruits of Foeniculum vulgare) extract. A double-blind placebo controlled study. Phytomedicine 2003;10:455-8.  Back to cited text no. 34
Motavalli R, Mousazadeh T. Effect of fennel on reduction of symptoms associated with pain in primary dysmenorrhea. J Health Care 2019;21:26-33.  Back to cited text no. 35
Delaram M, Jafari F. The effect of fennel on the pre-menstrual syndrome. J Med Sci 2011;1:77-84.  Back to cited text no. 36