Practice use of Unkeito (Wen-jing-tang), a herbal medicine, in the management of women's health: efficacy for ovulatory failure and chilly sensation

Kampo medicine (Chinese herbal medicine) has been reported to be effective in the treatment of pituitary-ovarian dysfunction in young women, the treatment of infertility in women during the reproductive age and the treatment of several undefined symptoms in peri- and postmenopausal women. It has been considered that both the diagnosis and treatment of ovulatory failure in adolescent girls or young women are necessary for the sake of future fertile capacity. However, treatment for the above patients is not easy as steroid hormones and strong stimulators of ovulation should not be recommended because of the several side effects it causes. Furthermore, young women, especially teenagers, seem to be reluctant to visit gynecology clinics. Recent publications such as the Women's Health Initiative (WHI), HERS study and its follow-up HERS II study, and European clinical research group published Million Women study resulted in a major shift in the recommendation on hormone replacement therapy to alternative medicine such as herbal medicine (Kampo medicine) in the treatment of peri- and postmenopausal women with several undefined symptoms and ovariectomy by the reason of substantial risks for cardiovascular disease and breast cancer during the treatment with popular hormone replacement therapy in United States and elsewhere. In modern Western medicine, it is not rare that hormone replacement therapy is used to treat all undefined symptoms, e.g. headache, hot flushes, dizziness, and chilly sensation. Kampo medicine first determines the condition underlying a given symptom in accordance with the Kampo theory.<BR>A number of herbal medicines have been used for many centuries in China and Japan for the treatment of menstrual disorders, infertility and undefined symptoms, e.g. hot flushes and chilly sensation. In general, the traditional Chinese herbal prescriptions are rather inexpensive and safe with little side effects, and have properties for normalizing biological balances.<BR>Unkeito is known to stimulate the synthesis and release of gonadotropins in the rat pituitary. On the other hand, Unkeito is also known to be effective in various menstrual disorders, abnormal uterine bleeding, and infertility by the appropriate regulation (stimulation or suppression) of pituitary-ovarian endocrine axis in humans. In the treatment of several types of ovulatory failure, recent dynamic studies have revealed the mechanism by which Unkeito regulates human's endocrine axis. Furthermore, some human studies revealed the mechanism by which Unkeito improves hot flushes and chilly sensation in the extremities through the regulation of the surface blood flow.<BR>In this paper, we critically review the clinical data available (to date) in order to assess the efficacy of Unkeito in inducing ovulation in several types of ovulatory failure and the efficacy for improving chilly sensation.