Mechanism of Action and Efficacy of Potential Botanical Drugs in Alternative Treatment for Uterin Fibroid


  • Tiara Sekar University of Lampung
  • Rodiani
  • DWi Aulia Ramdini



botany, uterine fibroid, leiomyoma, plant, medicinal plant


Uterine fibroids are benign gynecologic tumors that develop from the myometrium and become entangled in the majority of women. The available pharmacological treatments are useful for reducing the size of the fibroids and relieving the symptoms of uterine fibroids. However, these pharmacological agents are said to be unaffordable for most people and are also associated with considerable side effects. Therefore, botanical medicines stole the attention in the last decade because of their therapeutic effectiveness accompanied by affordable costs and comparable and stronger therapeutic efficacy, with fewer side effects. The aim of this review is to provide information regarding the mechanisms by which various botanical drugs possess uterine anti-fibroid activity. The source search method is carried out through several trusted websites such as Pubmed, Science Direct, and Google Scholar. Based on the literature that has been identified, five botanical drugs were found which will be discussed in this review. These botanical drugs will be explained their mechanism of action in carrying out uterine anti-fibroid activity which has the potential as an alternative treatment for uterine fibroids.


Hervé F, Katty A, Isabelle Q, dan Céline S. Impact of Uterine Fibroids on Quality of Life: a National Cross-Sectional Survey. Eur. J. Obstetrics Gynecol. Reproductive Biol. 2018;229:32–37. doi:10.1016/j.ejogrb.2018.07.032.

Stewart EA, Nicholson WK, Bradley L, dan Borah BJ. The Burden of Uterine Fibroids for African-American Women: Results of a National Survey. J. Womens Health (Larchmt). 2013;22: 807–816. doi:10.1089/jwh.2013.4334

Ciavattini A, Delli Carpini G, Clemente N, Moriconi L, Gentili C, dan Di Giuseppe J. Growth Trend of Small Uterine Fibroids and Human Chorionic Gonadotropin Serum Levels in Early Pregnancy: an Observational Study. Fertil Steril. 2016; 105:1255–1260. doi:10.1016/J.FERTNSTERT.2016.01.032

Liu, J. P., Yang, H., Xia, Y., and Cardini, F. Herbal Preparations for Uterine Fibroids. Cochrane Database Syst. Rev. 2013: CD005292. doi:10.1002/ 14651858.CD005292.pub3

Fu Y, Fan Y, Fan W, Lv Y, Ai L, dan Yu C. Efficacy and Safety of Traditional Chinese Herbal Formula Combined with Western Medicine for Uterine Fibroid: A Protocol for Systematic Review and Meta-Analysis. Med. Baltim. 2020;99:e22039. doi:10.1097/ MD.0000000000022039

Li H, Wu H, Zhang H, Li Y, Li S, Hou Q, et al. Identification of Curcumin-Inhibited Extracellular Matrix Receptors in Non-small Cell Lung Cancer A549 Cells by RNA Sequencing. Tumour Biol. 2017; 39: 1010428317705334. doi:10.1177/ 1010428317705334

Khan KN, Kitajima M, Hiraki K, Fujishita A, Nakashima M, Ishimaru T, et al. Cell Proliferation Effect of GnRH Agonist on Pathological Lesion of Women with Endometriosis, Adenomyosis and Uterine Myoma. Hum. Reprod. 2010;25:2878–2890. doi:10.1093/ humrep/deq240

Lethaby A, Puscasiu L, dan Vollenhoven B. Preoperative Medical Therapy before Surgery for Uterine Fibroids. Cochrane Database Syst. Rev. 2017;11: CD000547. doi:10.1002/14651858. CD000547.pub2

FDA. FDA Approves New Option to Treat Heavy Menstrual Bleeding Associated with Fibroids in Women FDA. U.S. Food Drug Adm. 2020. Diakses pada 1 Oktober 2022. Tersedia di:

Al-Hendy A, Venturella R, Arjona Ferreira JC, Li Y, Wagman RB, dan Lukes AS. Liberty Randomized Withdrawal Study: 2-year Efficacy and Safety of Relugolix Combination Therapy in Women with Heavy Menstrual Bleeding Associated with Uterine Fibroids. Fertil. Steril. 2021:116;e2. doi:10.1016/j. fertnstert.2021.07.014

Markham A dan Keam SJ. Camrelizumab: First Global Approval. Drugs. 2019;79:1355–1361. doi:10.1007/S40265-019-01105-010.1007/s40265-019-01167-0

Schlaff WD, Ackerman RT, Al-Hendy A, Archer DF, Barnhart KT, Bradley LD, et al. Elagolix for Heavy Menstrual Bleeding in Women with Uterine Fibroids. N. Engl. J. Med. 2020;382: 328–340. doi:10.1056/ NEJMOA1904351

Pazzaglia E, Praet J, Vandromme J, dan Rozenberg S. Medical or Surgical Management of Fibroids? an Internet Survey of Gynecologists’ Views. Maturitas.2017;95:6–10. doi:10.1016/j.maturitas.2016.10.012

Rozenberg S, Praet J, Pazzaglia E, Gilles C, Manigart Y, dan Vandromme J. The Use of Selective Progestin Receptor Modulators (SPRMs) and More Specifically Ulipristal Acetate in the Practice of Gynaecology. Aust. N. Z. J. Obstet. Gynaecol. 2017;57:393–399. doi:10.1111/ajo.12641

de Milliano I, Van Hattum D, Ket JCF, Huirne JAF, dan Hehenkamp WJK. Endometrial Changes during Ulipristal Acetate Use: A Systematic Review. Eur. J. Obstet. Gynecol. Reprod. Biol. 2017;214:56–64. doi:10.1016/j.ejogrb. 2017.04.042

Ekanem E dan Talaulikar V. Medical Therapy for Fibroids: What Next for Ulipristal Acetate? Adv. Ther. 2021;38: 137–148. doi:10.1007/S12325-020-01555- Z/TABLES/3

Parsanezhad ME, Azmoon M, Alborzi S, Rajaeefard A, Zarei A, Kazerooni T, et al. A Randomized, Controlled Clinical Trial Comparing the Effects of Aromatase Inhibitor (Letrozole) and Gonadotropin-Releasing Hormone Agonist (Triptorelin) on Uterine Leiomyoma Volume and Hormonal Status. Fertil. Steril. 2010; 93: 192–198. doi:10.1016/j.fertnstert.2008.09.064

Song H, Lu D, Navaratnam K, dan Shi G. Aromatase Inhibitors for Uterine Fibroids. Cochrane Database Syst. Rev. 2013. CD009505. doi:10.1002/14651858.CD009505.pub2 Study of Tumor-Shrinking Decoction (TSD) to Treat Symptomatic Uterine Fibroids. U.S. Natl. Libr. Med. 2020. Diakses pada 8 Oktober 2021. Tersedia di: https://

Cheng IC, Li RK, Leung GP, Li SL, Kong M, Lao LX., et al. Application of UPLC-MS/MS to Simultaneously Detect Four Bioactive Compounds in the Tumour-Shrinking Decoction (FM1523) for Uterine Fibroids Treatment. Phytochem Analysis. 2019;30:447–455. doi:10.1002/PCA.2827

Dhiman K. Ayurvedic Intervention in the Management of Uterine Fibroids: A Case Series. Ayu. 2019; 35: 303–308. doi:10.4103/0974-8520.153750

Eze-Steven P. Histopathological Investigations of Curcuma Longa (Turmeric) and Zingiber Officinale (Ginger) on Rats with Monosodium Glutamate-Induced Leiomyoma. J. Exp. Res. 2019; 7: 9–15

Mesquita FS, Dyer SN, Heinrich DA, Bulun SE, Marsh EE, dan Nowak RA. Reactive Oxygen Species Mediate Mitogenic Growth Factor Signaling Pathways in Human Leiomyoma Smooth Muscle Cells. Biol. Reprod. 2010;82;341–351. doi:10.1095/biolreprod.108.075887

Panahi Y, Sahebkar A, Amiri M, Davoudi SM, Beiraghdar F, Hoseininejad SL et al. Improvement of Sulphur Mustard-Induced Chronic Pruritus, Quality of Life and Antioxidant Status by Curcumin: Results of a Randomised, Double-Blind, Placebo-Controlled Trial. Br. J. Nutr. 2012;108:1272–1279. doi:10. 1017/S0007114511006544

Lin X, Bai D, Wei Z, Zhang Y, Huang Y, Deng H, et al. Curcumin Attenuates Oxidative Stress in RAW264.7 Cells by Increasing the Activity of Antioxidant Enzymes and Activating the Nrf2-Keap1 Pathway. PLoS One. 2019;14: e0216711. doi:10.1371/journal.pone.0216711

Sukonthanonta A. Curcumin in Reduction Size of Myoma Uteri. Thai J. Obstet. Gynaecol. 2015;23:165–171. doi:10.14456/tjog.2015.14

Ali AFM dan Ali L. Curcumin a new modality for treatment of uterine myoma. J. Am. Sci. 2013:1545–1003. Diakses pada 8 Oktober 2022. Tersedia di: http://www.jofamericanscience. orghttp//

Tsuiji K, Takeda T, Li B, Wakabayashi A, Kondo A, Kimura T, et al. Inhibitory Effect of Curcumin on Uterine Leiomyoma Cell Proliferation. Gynecol. Endocrinol.2011;27:512–517. doi:10.3109/09513590.2010.507287

Houston KD, Copland JA, Broaddus RR, Gottardis MM, Fischer SM, dan Walker CL. Inhibition of Proliferation and Estrogen Receptor Signaling by Peroxisome Proliferator-Activated Receptor Gamma Ligands in Uterine Leiomyoma. Cancer Res. 2003; 63: 1221–1227.

Malik M, Mendoza M, Payson M, dan Catherino WH. Curcumin, a Nutritional Supplement with Antineoplastic Activity, Enhances Leiomyoma Cell Apoptosis and Decreases Fibronectin Expression. Fertil. Steril. 2009;91: 2177–2184. doi:10.1016/j.fertnstert.2008.03.045

Yu CH, Zhao JS, Zhao H, Peng T, Shen DC, Xu QX, et al. Transcriptional Profiling of Uterine Leiomyoma Rats Treated by a Traditional Herb Pair, Curcumae Rhizoma and Sparganii Rhizoma. Braz J. Med. Biol. Res. 2019;52:e8132. doi:10.1590/1414-431x20198132

Hassan ZK dan Daghestani MH. Curcumin Effect on MMPs and TIMPs Genes in a Breast Cancer Cell Line. Asian pac. J. Cancer Prev. 2012;13: 3259–3264. doi:10.7314/APJCP.2012.13.7.3259

Supriono S, Pratomo B, dan Kriestian M. Effects of Curcumin against Matrix Metalloproteinase-2 (MMP-2) and Tissue Inhibitor Metalloproteinase- 2 (TIMP-2) Serum Level on Rat Model of Liver Fibrosis Resolution Process. Indones. J. Gastroenterol. Hepatol. Dig. Endosc. 2018;19:10–15. doi:10.24871/ 191201810-15

Roshdy E, Rajaratnam V, Maitra S, Sabry M, Allah AS, dan Al-Hendy A. Treatment of Symptomatic Uterine Fibroids with Green Tea Extract: A Pilot Randomized Controlled Clinical Study. Int. J. Womens. Health. 2013;5:477–486. doi:10.2147/IJWH.S41021

Wang L, Huang X, Jing H, Ma C, dan Wang H. Bilosomes as Effective Delivery Systems to Improve the Gastrointestinal Stability and Bioavailability of Epigallocatechin Gallate (EGCG). Food Res. Int. 2021; 149: 110631. doi:10.1016/j. foodres.2021.110631

Lorenz M, Paul F, Moobed M, Baumann G, Zimmermann BF, Stangl K, et al. The Activity of Catechol-O-Methyltransferase (COMT) Is Not Impaired by High Doses of Epigallocatechin-3-Gallate (EGCG) In Vivo. Eur. J. Pharmacol. 2014;740: 645–651. doi:10.1016/J.EJPHAR.2014.06.014

Zhang D, Rajaratnam V, Al-Hendy O, Halder S, dan Al-Hendy A. Green Tea Extract Inhibition of Human Leiomyoma Cell Proliferation Is Mediated via Catechol-O-Methyltransferase. Gynecol. Obstet. Invest. 2014;78:109–118. doi:10.1159/000363410

Zhang D, Al-Hendy M, Richard-Davis G, Montgomery-Rice V, Rajaratnam V, dan Al-Hendy A. Antiproliferative and Proapoptotic Effects of Epigallocatechin Gallate on Human Leiomyoma Cells. Fertil. Steril.2010; 94: 1887–1893. doi:10.1016/j.fertnstert.2009.08.065

Omar M, Laknaur A, Al-Hendy A, dan Yang Q. Myometrial Progesterone Hyper-Responsiveness Associated with Increased Risk of Human Uterine Fibroids. BMC Womens. Health.2019; 19(92). doi:10.1186/s12905- 019-0795-1

Westphal D, Kluck RM, dan Dewson G. Building Blocks of the Apoptotic Pore: How Bax and Bak Are Activated and Oligomerize during Apoptosis. Cell Death Differ. 2014;21: 196–205. doi:10.1038/cdd.2013.139

Mansilla SF, de la Vega MB, Calzetta NL, Siri SO, dan Gottifredi V. Cdk-independent and Pcna-dependent Functions of P21 in Dna Replication. Genes (Basel). 2020;11(593). doi:10.3390/genes11060593

Vishnubalaji R, Yue S, Alfayez M, Kassem M, Liu FF, Aldahmash A, et al. Bone Morphogenetic Protein 2 (BMP2) Induces Growth Suppression and Enhances Chemosensitivity of Human Colon Cancer Cells. Cancer Cell Int. 2016;16:77–12. doi:10.1186/S12935-016-0355-9

Ahmed RS, Liu G, Renzetti A, Farshi P, Yang H, Soave C, et al. Biological and Mechanistic Characterization of Novel Prodrugs of Green Tea Polyphenol Epigallocatechin Gallate Analogs in Human Leiomyoma Cell Lines. J. Cell. Biochem. 2016;117:2357–2369. doi:10.1002/jcb.25533

Lee TK, Lee DK, Kim DI, Lee YC, Chang YC, dan Kim CH. Inhibitory Effects of Scutellaria Barbata D. Don on Human Uterine Leiomyomal Smooth Muscle Cell Proliferation through Cell Cycle Analysis. Int. Immunopharmacol. 2004; 4: 447–454. doi:10.1016/J.INTIMP. 2003.12.012

Ramachandran S, Kwon KY, Shin SJ, Kwon SH, Cha SD, Bae I, et al. Cyclin-dependent Kinase Inhibitor p27Kip1 Controls Growth and Cell Cycle Progression in Human Uterine Leiomyoma. J. Korean Med. Sci. 2008;23: 667–673. doi:10.3346/JKMS.2008.23.4.667

Lee SM, Choi ES, Ha E, Ji KY, Shin SJ, dan Jung J. Gyejibongnyeong-hwan (Gui Zhi Fu Ling Wan) Ameliorates Human Uterine Myomas via Apoptosis. Front. Pharmacol. 2019;10(1105). doi:10.3389/ fphar.2019.01105

Benaglia, L., Cardellicchio, L., Filippi, F., Paffoni, A., Vercellini, P., Somigliana, E., et al. (2014). The Rapid Growth of Fibroids during Early Pregnancy. PLoS One 9, e85933. doi:10.1371/journal.pone.0085933

Lee MJ, Yun BS, Seong SJ, Kim ML, Jung YW, Kim MK, et al. Uterine Fibroid Shrinkage after Short-Term Use of Selective Progesterone Receptor Modulator or Gonadotropin-Releasing Hormone Agonist. Obstet. Gynecol. Sci. 2017;60:69–73. doi:10.5468/ogs.2017.60.1.69

Baird DD, Travlos G, Wilson R, Dunson DB, Hill MC, D’Aloisio AA, et al. Uterine Leiomyomata in Relation to Insulin-like Growth Factor-I, Insulin, and Diabetes. Epidemiology. 2019; 20: 604–610. doi:10.1097/EDE. 0b013e31819d8d3f

Sheng B, Song Y, Liu Y, Jiang C, dan Zhu X. Association between Vitamin D and Uterine Fibroids: A Study Protocol of an Open-Label, Randomised Controlled Trial. BMJ 2020;10: e038709. doi:10.1136/bmjopen- 2020-038709

Ando T, Kato H, Furui T, Morishige KI, Goshima S, dan Matsuo M. Uterine Smooth Muscle Tumours with Hyperintense Area on T1 Weighted Images: Differentiation between Leiomyosarcomas and Leiomyomas. Br. J. Radiol. 2018; 91: 20170767. doi:10.1259/bjr.20170767



How to Cite

Tiara Sekar, Rodiani, & DWi Aulia Ramdini. (2023). Mechanism of Action and Efficacy of Potential Botanical Drugs in Alternative Treatment for Uterin Fibroid. Medical Profession Journal of Lampung, 12(4), 628-639.




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