A CRITICAL REVIEW ON THE CONTRACEPTIVE AND ABORTIFACIENT MEDICINAL HERB’S DESCRIBED IN BHAVAPRAKASHA NIGHANTU

A CRITICAL REVIEW ON THE CONTRACEPTIVE AND ABORTIFACIENT MEDICINAL HERB’S DESCRIBED IN BHAVAPRAKASHA NIGHANTU

R. Shalini

Green Gardens, Kanjirampara PO Thiruvananthapuram, Kerala, India.

ABSTRACT: Bhavaprakasha is Ayurveda's important nighantu (Lexicon) written in the sixteenth century AD. Many useful herbs are mentioned in Bhavaprakasha Nighantu that can be used daily. However, one common misconception is that all ayurvedic drugs are safe and devoid of any side effects since they are of herbal origin is not true. Ayurvedic herbs sometimes become harmful based on the condition of the patient. The present review reports cautions and contraindications in administering certain herbs mentioned in Bhavaprakasha Nighantu for pregnant ladies and those who wish to conceive. Out of total of twenty-three Vargas (Classified groups), six vargas that is Harithakyadi to Amradi Phala varga of Chunekar commentary of Bhavaprakasha Nighantu were reviewed. Hareethakyadi, Karpooradi, Guduchyadi, Pushpadi, Vadaadi, Amradi Phala, comprising two seventy-nine herbs were reviewed critically with regards to their already mentioned action on conceived women and who wish to conceive from Bhavaprakasha Nighantu under four headings (1) Garbhasravakara / Garbhapathakara herbs (Abortifacients) (2) Garbhanirodhakara (Contraceptive) (3) Garbhashaya sankocha kara (Oxytocics) (4) Avrishya (Anaphrodisiac). Also more than a hundred peer-reviewed journals were referred to determine their mode of action. Total fifty-eight herbs were found which was having adverse effect on pregnant women and those who wish to conceive. Hence a physician should be really cautious while prescribing these herbs to a infertile patient or a pregnant woman.

Keywords: Contraceptives, Anti fertility, Abortifacients, Drug safety, Ayurveda, Bhavaprakasha Nighantu, Chunekar commentary, Hareethakyadivarga

INTRODUCTION: Throughout history, women have tried to control or enhance their fertility using herbal remedies. Herbal contraceptives and abortifacients are those plants used for birth control or in the prevention of pregnancy and for premature expulsion of a foetus from the womb ¹.

Many plants have been reported to have sterilising, contraceptive, and abortifacient properties ¹. The fact that herbs have been used, since the beginning of time by women, to control their fertility, has been recently reiterated.

It is our traditional ethnopharmacological practice of inducing abortion making use of papaya (Carica papaya Linn.), pineapple (Ananas comosus (L) Merr) and custard apple (Anona squamosa L.), etc. Scientific research studies on these herbs proved that they have abortifacient and anti-fertility action ². Since, maternal mortality is the second most common cause of death among women and is as a result of unsafe induced abortions, there is a need Proper alignment, comprising contraception and safe abortion. Also, traditional knowledge of plant uses for medicinal purposes is transferred from one generation to another without written information on these uses. Hence when one dies, he dies with his/her rich knowledge of the medicinal plants and their uses. Documented traditional knowledge on medicinal plants used for contraception and abortion by Bhavaprakasha Nighantu is worthwhile in this regard to ensure the continuity of this knowledge and serve as baseline data for possible formulation of new drugs for fertility control.

Of all rights of women the greatest is to become a mother. Many herbs mentioned in Bhavaprakasha Nighantu have Garbhanirodhaka (Contraceptual) and Avrishya (Anaphrodisiac) action. Such herbs should never be prescribed to an infertile couple who wish to conceive. Also, Ayurveda has emphasized Garbhadharana Vidhi (Procedure to become pregnant) and Garbhini Paricharya (Care of pregnant women). Ayurvedic acharyas have mentioned food, medicine and activities to be followed by a pregnant woman. So, utmost care should be taken while prescribing herbs to a couple who wish to become parents or to a pregnant woman.

The most precaution to be taken by a physician while prescribing medicine to a pregnant woman is during the first trimester (First twelve weeks). Arthavajanaka (Emmenagogue herbs) and Garbhapaata / Garbhasravakara (Abortifacient herbs) should be avoided in the first trimester as it may lead to abortion. Arthavajanaka herbs are herbs that increases the flow of arthava (menstrual blood) also called as emmenagogue drugs in modern ³ it will lead to garbhasrava if used in the first trimester. Garbhasrava is expulsion of foetus before 3^rd month and Garbhapatha occurs after 4^th month Space between both Bhoja mentioned in Madhava Nidhana Madhukosha commentary ⁴.

Susrutha has mentioned Kshara and Garbhapaatakara herbs as the reason for Garbhasraava ⁵. Also, Acharyas have mentioned many Garbhashaya sankochaka (Oxytocics/ Ecbolics) herbs that should be avoided before the third stage of labour and will have an adverse effect on labour. Garbhashaya sankochaka herbs are those herbs that promote the contraction of uterus and promote the expulsion of foetus and placenta ³. In modern they are called as Ecbolic drugs or Oxytocics drugs. They are used to accelerate abortion in early pregnancy, to induce labour in late pregnancy, to minimise blood loss and to control postpartum haemorrhage in puerperium. The dangers are particularly noticed when the drug is administered late in pregnancy or during labour. Fetal complications due to this may befoetal distress, foetal hypoxia or even foetal death occurring due to uterine hyperstimulation ⁶.

So, these four categories of herbs are categorized as

(i) Garbhasravakara/ Garbhapathakara (Abortifacients) (ii) Garbhanirodhakara (Contraceptive herbs) (iii) Garbhashaya sankochakara (ecbolic) herbs (iv) Avrishya (Anaphrodisiac). Such herbs are taken fromsix Vargas (Classified groups) of Bhavaprakasha Nighantu from Hareethakyadi to Amradi Phala Varga, one of the commonly practiced and authenticated books written by Bhavamisra in the sixteenth century AD. It includes twenty-three chapters delineating about eight hundred herbs. This Nighantu incorporates drugs of plant, animal, and mineral origin and is considered the best Nighantu of modern times in the field of Ayurveda.

MATERIALS AND METHODS: Out of a total twenty-three Vargas, sixvargas from Hareethakyadi to Amradi Phalavarga were critically reviewed with regards to four actions like (1) Garbhapatha / Garbhasrava (Herbs promoting expulsion of foetus) (2) Garbhanirodha (Contraceptive) (3) Garbhashayasankochaka (Oxytocics) (4) Avrishya (Anaphrodisiac herbs). The data for the present article is mainly collected from Chunekar commentary of Bhavaprakasha Nighantu, Also other information provided in this review, was as a result of an extensive bibliographic investigation by analyzing classical textbooks, scientific journals, consulting worldwide accepted databases. The peer-reviewed papers were gathered from databases like SCOPUS, PUBMED, Google Scholar, INFLIBNET. All 58 plants were reviewed for their anti-fertility effects along with their possible mechanism of action, part used, family and animal used.

This review was concentrated to incorporate a list of various plants that have been mentioned for their use as anti-fertility agents in traditional medicines. It also contains plant extracts, which are already proved by various scientific papers.

More than 100 scientific peer reviewed articles were investigated for searching modern research studies of use of plants possessing anti-fertility activity. The various plants claimed and proved as anti-fertility, aborti-facient, contraceptive, spermicidal, were included.

RESULTS: Medicinal plants have been reported to possess anti-fertility effects by various mechanism of actions, one of the major action is their effect on sex hormones thereby suppressing fertility ⁸.

Moreover, plants with estrogenic property can directly influence pituitary action by modulation of luteinzing hormone (LH) and follicle stimulating hormone (FSH), decreasing their secretions and blocking ovulation⁹. The plants with anti-estrogenic activities intercept in the development of ovum and endometrium; on the other hand, plants have abortifacient effects ^{10, 11}.

The site of action of anti-fertility agents in females comprises the hypothalamus, the anterior pituitary, the ovary, the oviduct, the uterus, and the vagina. The mammalian uterus is the main site of anti-fertility effects ⁸.

In the present article, some Ayurvedic herbs grouped into four groups mentioned in six vargas of Bhavaprakasha Nighantu, and their mode of action in the reproductive system is mentioned. Following are the four categorized groups and herbs coming under them mentioned in six Vargas are given in Table 1-6, respectively. In Table 7, the total number of herbs in six vargas with four categorized actions are mentioned.

Hareethakyadi Varga:

TABLE 1: CLASSIFICATION OF HERBS IN HAREETHAKYADIVARGA HAVING CONTRACEPTIVE AND ABORTIFACIENT ACTION

# Abbreviations used: (1) Garbhapathakara/ Garbhasravakara (Abortifacients ) (2) Garbhanirodhakara (Contraceptives) (3) Garbhashayasankochakara (Ecbolics) (4) Avrishya (Anaphrodisiac herbs) $ B.P- BhavaprakashaNighantu, DGV- Dravyagunavijnanam, Cha.Sa.Su- CharakaSamhithaSuthraSthana, Su.Sa.Su- SusruthaSamhithaSuthraSthana, A.Sa.Su- Astanga SangrahaSuthra, A.Hr.Su- Astanga HridayamSuthra.

Karpooradi varga:

TABLE 2: CLASSIFICATION OF HERBS IN KARPOORADI VARGA HAVING CONTRACEPTIVE AND ABORTIFACIENT ACTION

#Abbreviations used: (1) Garbhapathakara/ Garbhasravakara (Abortifacients) (2) Garbhanirodhakara (Contraceptives) (3) Garbhashayasankochakara (Ecbolics) (4) Avrishya ( Anaphrodisiac herbs). $ B.P- BhavaprakashaNighantu

Guduchyadi varga:

TABLE 3: CLASSIFICATION OF HERBS IN GUDUCHYADI VARGA HAVING CONTRACEPTIVE AND ABORTIFACIENT ACTION

# Abbreviations used: (1) Garbhapathakara/ Garbhasravakara (Abortifacients) (2) Garbhanirodhakara (Contraceptives) (3) Garbhashayasankochakara (Ecbolics) (4) Avrishya (Anaphrodisiac herbs) $ B.P- BhavaprakashaNighatu, DGV- Dravyagunavijnanam, Ref- Reference.

Puspadi Varga:

TABLE 4: CLASSIFICATION OF HERBS IN PUSHPADIVARGA HAVING CONTRACEPTION AND ABORTI-FACIENT ACTION

# Abbreviations used: (1) Garbhapathakara/ Garbhasravakara (Abortifacients) (2) Garbhanirodhakara (Contraceptives) (3) Garbhashayasankochakara (Ecbolics) (4) Avrishya (Anaphrodisiac herbs)

Vadaathi Varga

TABLE 5: CLASSIFICATION OF HERBS IN VATAADI VARGA HAVING CONTRACEPTIVE AND ABORTIFACIENT ACTION

# Abbreviations used: (1) Garbhapathakara/ Garbhasravakara (Abortifacients) (2) Garbhanirodhakara (Contraceptives) (3) Garbhashayasankochakara (Ecbolics) (4) Avrishya (Anaphrodisiac herbs) $ B.P- BhavaprakashaNighantu.

Amradi Phala Varga:

TABLE 6: CLASSIFICATION OF HERBS IN AMRADI PHALAVARGA HAVING CONTRACEPTIVE AND ABORTIFACIENT ACTION

# Abbreviations used: (1) Garbhapathakara/ Garbhasravakara (Abortifacients) (2) Garbhanirodhakara (Contraceptives) (3) Garbhashayasankochakara (Ecbolics) (4) Avrishya (Anaphrodisiac herbs) $ B.P- BhavaprakashaNighantu, DGV- Dravyagunavijnanam.

TABLE 7: CLASSIFICATION OF ABOVE SAID ACTIONS OF HERBSIN EACH VARGAS

#(1) Garbhapathakara/ Garbhasravakara (Abortifacients) (2) Garbhanirodhakara (Contraceptives) (3) Garbhashayasankochaka (Ecbolics) (4) Avrishya ( Anaphrodisiac herbs.

DISCUSSION: Garbhasravakara/ Garbha-pathakara Herbs Bhavaprakasha has mentioned twenty Garbhapathakara herbs in the six groups excluding emmenagouge herbs. If we take into consideration emmenagouge herbs which also causes Garbhasrava, it will be more than this number. Garbhasrava occurring before the third month can occur due to non-congenial diet and mode of life; the foetus is not retained because up to this period, it is Asanjathasara (does not have proper development) and is in Amavastha¹². Arthavajanaka herbs explained in the first category taken by a pregnant woman causes garbhasrava if used in first trimester due to improper development of foetus and absence of placenta. Garbhapatha on the other hand, which occurs after fourth month can occur due to the use of Oxytocics herbs. Chunekar, commentator of Bhavaprakasha Nighantu has told many Garbhapathakara herbs. A pessary prepared from Beeja of chandana is mentioned to cause Garbhapatha ¹³.

Vasa (Adhatodavasica Nees.) has abortifacient action like Peganin from Peganumharmala. Vasa contains vasicine/peganin and vasicinone like in Peganumharmala L.. These quinazoline alkaloids (e.g. vasicine and vasicinone) are believed to be responsible for the abortifacient activity of Peganum harmala L. extracts. It has been reported that these chemicals have a uterine stimulatory effect, apparently through the release of prostaglandins ^{14, 15}.

Kadamba (Anthocephalus cadamba Miq.) is another herb having abortifacient action. It is found that methanolic extract of Kadamba stem bark showed abortifacient action. The mechanism of abortion could possibly be through the changes in the uterine milieu, altered hormone levels, luteolysis and partly estrogenecity ¹⁶.

Garbhanirodhaka Herbs: Second category is garbhanirodhaka herbs (Contraceptive herbs) that prevent Garbhadharana (conception). PV Sharma describes six herbs Gunja (Abrus precatorius Linn.), Pada (Cycleapeltata Hook.f & Thoms.), Pippali (Piper longum Linn.), Vidanga (Embelia ribes Burm. F.), Kampillaka (Mallotus Philip-pinensis Muell. Arg) and Japa (Hibiscus rosa-sinensis L.) as having Garbhanirodhaka action 3. Bhavaprakasha mentions burls of Burja (Betul-autilis) i.e. Burjagrandhi as having Garbha-nirodhaka action ¹⁷. Many other Garbhanirodhaka herbo- mineral combinations are mentioned in Yogaratnakara and Bhavaprakasha. Some of them are: The menstruating women who use equal quantity of powdered Pippali (Piper longum L.), Vidanga (Embeliaribes) and Tankana (Borax) mixed with milk should be consumed at the time of conception ¹⁸. Japakusuma (Flower of Hibiscusrosa sinensis) macerated with Aranala (rice washed water) added with one Mushti (40 gms) of old Guda (jaggery) consumed during menstrual period, such a women doesn’t become pregnant at all ¹⁹. Equal quantity of Talisa (Abieswebbiana) and Gairikachoorna (Red Chalk Powder) with cold water on fourth day of her menstrual cycle, the women will not conceive ²⁰. Thus total of twelve herbs having contraceptive action are mentioned. Some other herbs like Dronapushpi (Leucascephalotes (Roth.) Spreng.) and Apamarga (Achyranthesaspera Linn.) mentioned in BhavaprakashaNighantu have Garbhanirodhaka action. It is due to their anti-implantation activity. Avrishya herbs can also be used as Garbhanirodhaka herbs as most have reversible anti-fertility action.

The anti-implantation activity of Achyranthes aspera L. may be due to the estrogenic activity, causing the expulsion of ova from the tube, disrupting the luteotrophic activity of blastocyst. (Pincus, 1965, Anderson, 1972). For implantation, it is well known that exact estrogen and progesterone equilibrium is necessary and any disturbance in the level of these hormones causes infertility. The hormonal values of Achyrathesaspera Linn. disturbs hormonal milieu in the uterus and provokes the anti-fertility effect ²¹. Japa (HiniscusRosa-sinensis Linn.) also has similar estrogenic activity leading to anti-implantation ³⁶.

The loss of implantation at higher doses of prepared extract of Leucascephalotes may be due to antizygotic, blastocytotoxic or anti-implantation activity as described by Hafez (1970) ²².

NimbaThaila is another drug considered to be a strong spermicidal agent. Administration of neem oil to pregnant rats for 3 days showed significant anti-fertility activity. To elucidate a positive mechanism of action of neem oil, the following aspects cannot be ruled out: (i) Neem oil may kill the spermatozoa or ova in the female genital tract and hence a zygote is not formed, (ii) if a zygote is formed neem oil may be blastocidal and the dead blastocytes cannot implant in the uterus, and (iii) even if the blastocyst is formed normally, it may not be welcomed by the unprepared uterus since neem oil may denature the endometrial lining of the uterus. Although work is in progress to find out answers to the above options, it is expected that the major action of neem oil will be related to a non-hormonal mechanism. Since the post coital contraceptive effect of neem oil seems to be non-hormonal, neem oil would be expected to elicit less side effects than the steroidal contraceptives ²³.

Garbhashaya sankochaka Herbs: The third one is Garbhasankochakara or Ecbolic herbs, which increase the contraction of Garbhashaya ³. Total twenty Garbhashayasankochakara/ecbolics are mentioned in six vargas. They are of two types direct and indirect. Direct ecbolic work by three different mechanism of action. First one is stimulating the muscles of uterus like quinine (Cinchona officinalis Linn.). Dextrorotatory cinchona alkaloids i.e., cinchonine and quinidine had a greater action than the leavorotatory isomerides i.e., cinchonidine and quinine-in increasing the amplitude and rhythm of uterine contractions innon-pregnant guinea-pigs ²⁴.

Other herbs like Langali (Gloriosa superba L.) have similar oxytocic activity. Chunekar commentator of BhavaprakashaNighantu describes Kemuka (Costusspeciosus) is having more ecbolic action than Langali. Second is by stimulating the vessels causing vasoconstriction in Garbhashaya like Annamaya (Ergot) (Clavicepspurpuria). Karpasa (Gossypium herbaceum L.) also has action like ergot. Ergot alkaloids in obstetrics are administered at the third stage of lab or to prevent postpartum hemorrhage. They must be administered with great caution because of side effects e.g., blood pressure elevation and pain. Thus, the dose must be chosen with care because of the side effects. Ergot alkaloids used to be widely applied in obstetrics and yet, nowadays, only a few are still used. Ethylergonovine is used as a highly effective second-line uterotonic medication (unfortunately it is associated with severe vasoconstriction) ²⁵. Third group of direct ecbolic drugs stimulate the brain centre and induce oxytocic action like Kupilu. Abundant quantity of strychnine found in the seeds of StrychnosNux-Vomica (Loganiaceae) ²⁶. Under the effect of strychnine there is a reduction of the inhibitory post- synaptic potentials and a marked rise in the excitatory post- synaptic potentials of the motor neurones, caused by the cerebellum stimulation ²⁷. Second category is called indirect ecbolic herbs. They increase the blood flow in the organs of the pelvis and contract the uterus ³. These herbs are theekshna, ushna and bhedhana (Intence, Hot and Piercing) like Arka (Calotropis gigantea Linn.), Kumari (Aloe vera Linn.) etc. Hingu (Ferula asafoetida) though mentioned as a Garbhashaya sankochaka herb by Bhavaprakasha Chunekar commentary, in modern research study muscle relaxant action of Hingu was found (Mohammed Reza Khazdain et al., 2015) ²⁸. So taking into consideration these three properties Bhedhaneeyadashaimami herbs like Eranda (Ricinus communis L.), Trivrit (Operculina turpethum Linn.), Arka (Calotropis gigantea L.) etc mentioned in CharakaSamhithaSoothraSthana may be taken as indirect ecbolic ²⁹. More research works are yet to be done on these ten bhedhaneeyadashaimani herbs and other herbs having these qualities to find out their oxytocic activity.

Avrishya Herbs: The fourth category is Kamasadaka/ Shandyakara/ Pumsthwaghathi (Anaphrodisiac herbs), which decreases sexual power. Total twenty one herbs are mentioned as Anaphrodisiac. PV Sharma mentions that it is of two categories. (i) Shukranashaka: Some herbs decrease shukra (sperm) like Kshara ³. Kshara is Shukranashaka. It is told not give kshara to a women during Rithukaala (Ovulatory period).

So, it destroys both sperm and ovum.  Dhanyaka (Coriandrum sativum Linn.) is told as avrishya. It is Arthavanashaka (destroys ovum) and it is also Kamashakthinaashaka (destroys sexual power). Majority of avrishya herbs belong to first category. (ii) Shukravegashamaka: Some herbs depresses the nadi (nerves) of the penis like Suchi (Atropabelladona) and Karpoora (Cinnamomum camphora Linn.)  Chunekar commentator of BhavaprakashaNighantu mentions that Karpoora (Cinnamomum camphora Linn.) in small doses is vrishya and in large doses it is avrishya. This is due to the suppression of nadi of penis was observed that as concentration of the camphora solution increased, there was decrease in concentration, motility and viability of sperms ³⁰. A similar study, though in humans, by Jadhav, et al. also explained in their study how sperm motility and morphology reduced with increasing concentration of camphora ³¹. (iii) Sharangadhara mentions a third category of herbs with anaphrodisiac action: Shukrashoshana. Those herbs having opposite qualities of shukra will cause it’s deterioration like Hareethaki (Terminalia chebula Retz.) ³². Due to this reason, it is contraindicated in Krisha and durbala (debilitated and lean persons). This is due to reduction in plasma testosterone due to reduced male androgenesis, as testosterone is needed for the production of sperm ³³. Thulasi (Ocimum sanctum Linn.) and Japa (Hibiscus rosa-sinensis Linn.) also have similar anti-fertility and anti-spermatic action ^{34, 37}. Without a continuous androgen supply, sperm reproduction does not proceed optimally to completion ³⁵. Following is the list of plants reported to possess anti-fertility effects along with their botanical name and mechanism of actions.

CONCLUSION: Out of the total two seventy-nine herbs in six Vargas reviewed, fifty-eight were found to have abortifacient and contraceptive action. Emmenagogue abortifacients could not be included in the present review because of space constraints. Modern research studies from peer reviewed journals were taken for comparison with the actions of herbs mentioned in six vargas of Bhavaprakasha Nighantu. All these fifty-eight herbs should be avoided by couples who wish to become pregnant or by a pregnant woman. Many of these herbs are rare or controversial. So, research studies are not available on them. Efforts should be made to find their original identity, and more research studies are yet to be done on them to ascertain their safety and efficacy.

Regarding contraceptives, many of modern contraceptives have a lot of side effects, so we should make use of alternative safe and convenient contraceptives herbs mentioned in Bhavaprakasha Nighantu. New herbal contraceptives should be formulated and they should be brought to market.

ACKNOWLEDGEMENT: I would like thank my friend Dr. Kavitha K.S, Guest Lecture Govt Ayurveda College Thiruvananthapuram, Dr. Sara Monsy Oommen- Professor Govt Ayurveda College Thrippunithara and Dr. Ajayan Sadanandan Professor Ashtangam Ayurveda Vidyapeeth for their timely help in clearing my doubts. Last but not the least, I would like to thank my family for their support, without which I couldn’t complete this article.

CONFLICT OF INTEREST: Nil

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    How to cite this article:

    Shalini R: A critical review on the contraceptive and abortifacient medicinal herbs described in bhavaprakasha nighantu. Int J Pharm Sci & Res 2023; 14(5): 2164-72. doi: 10.13040/IJPSR.0975-8232.14(5).2164-72.

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