[Lotus]

Paeonia lactiflora (White peony)
Paeonia lactiflora has been used for gynecological conditions by both Chinese and Western herbalists, and is used by Western herbalists for PCOS, hyperprolactinemia, endometriosis, ovarian failure and androgen excess. Paeonia has been shown to positively influence low progesterone, reduce elevated androgens (testosterone) and acts to modulate estrogen and prolactin.7 In vitro, the active constituent paeoniflorin has been shown to affect the ovarian follicle by its action on the aromatase enzyme.8 Aromatase is important for follicle maturation, ovulation and corpus luteum function, steroid hormone synthesis and the regulation of the conversion of androgens to estrogens. The biofeedback in the pituitary and hypothalamus rely on aromatase to regulate prolactin and GnRH. The daily dose for Paeonia is 4.5 to 9 mL of a 1:2 dried plant extract.9

The traditional Chinese/Kanpo formula known as Shakuyaku-Kanzo-To or TJ-68, which is a decoction of Glycyrrhiza glabra and Paeonia lactiflora, has been the subject of a number of clinical trials, all of which demonstrate activity in the hormonal regulation of androgens. In one trial involving eight women with hyperandrogenism and oligomenorrhea, the formula was given for 2 to 8 weeks. This combination regulated the LH to FSH ratio. Over this period of time, serum testosterone levels decreased to less than 50 ng/dL and this resulted in seven of the eight women ovulating regularly.10

Another trial involved 20 women diagnosed with PCOS. The formula was successful in lowering testosterone in 90% of the women, of which 25% went on to conceive.11 It is suggested that it acts directly on the ovary, increasing the activity of aromatase, which promotes the synthesis of estradiol from testosterone, thus lowering serum testosterone levels. It also seems to regulate the LH to FSH ratio.12



Effect of TCM herbal TJ-68 (shakuyaku-kanzo-to) on polycystic ovarian disease

JANUARY 28, 2014 BY SOUL CYSTERLEAVE A COMMENT

Effect of TJ-68 (shakuyaku-kanzo-to) on polycystic ovarian disease.

Takahashi K, Kitao M. Department of Obstetrics and Gynecology, Shimane Medical University, Izumo, Japan. Int J Fertil Menopausal Stud. 1994 Mar-Apr;39(2):69-76

OBJECTIVE–To investigate the effect of an herbal medicine, Shakuyaku-Kanzo-To (TJ-68), on endocrine variables in patients with polycystic ovarian disease (PCOD).

SETTING–Medical university hospital.

PATIENTS AND INTERVENTIONS–Thirty-four Japanese women with PCOD were treated daily with 7.5 g of TJ-68 for 24 weeks. Testosterone (T), free-testosterone (free-T), sex hormone binding globulin (SHBG), LH, FSH, estrone, 17 beta-estradiol, 3,4-dihydroxyphenylglycol (DOPEG), and 3, 4-dihydroxyphenylacetic acid (DOPAC) were examined.

RESULTS–No side effects were observed in any cases. At 4 weeks after initiation of treatment, serum T and free-T levels significantly decreased, while SHBG was not significantly elevated. Meanwhile, after 12 weeks of treatment, the mean serum T level of the patients who became pregnant decreased to 35% of that before the treatment, but levels did not change in the patients who failed to conceive. There was no significant difference in estrone/estradiol ratio before and after treatment, but the estradiol/testosterone ratio increased significantly after 4 weeks of treatment. The LH/FSH ratio after 24 weeks of treatment was significantly lower than that before treatment. DOPEG and the DOPEG/DOPAC ratio significantly decreased after 4 weeks of treatment.

CONCLUSIONS–It is suggested that TJ-68 acts directly on the ovary first, increasing the activity of aromatase, which promotes the synthesis of estradiol from testosterone, thus lowering serum T levels. Furthermore, the effect on catecholamines results in gradually improving the dissociate phenomenon of LH/FSH ratio. Therefore, TJ-68 is an effective herbal medicine for decreasing serum free-T levels and achieving pregnancy in patients with PCOD.