Bussmann and Glenn Journal of Ethnobiology and Ethnomedicine 2010, 6:30 http://www.ethnobiomed.com/content/6/1/30 JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE RESEARCH Open Access Medicinal plants used in Northern Peru for reproductive problems and female health Rainer W Bussmann*, Ashley Glenn Abstract Infections of the reproductive tract, complications after childbirth, and reproductive problems continue to be a major health challenge worldwide. An impressive number of plant species is traditionally used to remedy such afflictions, and some have been investigated for their efficacy with positive results. A total of 105 plant species belonging to 91 genera and 62 families were documented and identified as herbal remedies for reproductive problems in Northern Peru. Most species used were Asteraceae (9.52%), followed by Lamiaceae and Fabaceae (8.57% and 6.67%). The most important families are clearly represented very similarly to their overall importance in the local pharmacopoeia. The majority of herbal preparations for reproductive afflictions were prepared from the leaves of plants (22.72%), the whole plant (21.97%), and stems (21.21%), while other plant parts were used less frequently. More than 60% of the cases fresh plant material was used to prepare remedies. Over 70% of the remedies were applied orally, while the remaining ones were applied topically. Many remedies were prepared as mixtures of multiple ingredients. Little scientific evidence exists to prove the efficacy of the species employed as reproductive disorder remedies in Northern Peru. Only 34% of the plants found or their congeners have been studied at all for their medicinal properties. The information gained on frequently used traditional remedies might give some leads for future targets for further analysis in order to develop new drugs. Background 71% of the population in Chile and 40% of the population According to 1999 WHO estimates reproductive pro- in Colombia have used TM. The WHO indicates that in blems, including, 340 million new cases of curable Sexu- many Asian countries TM is widely used, even though ally Transmitted Diseases (STIs; syphilis, gonorrhoea, Western medicine is often readily available, and in Japan, chlamydia and trichomoniasis) occur annually through- 60-70% of allopathic doctors prescribe TMs for their outtheworldinadultsaged15-49years.Indeveloping patients [2]. countries, STIs and their complications rank in the top Complementary Alternative Medicine (CAM) is gain- five disease categories for which adults seek health care. ing popularity in many developed countries. Forty-two Infection with STIs can lead to acute symptoms, chronic percent of the population in the US have used CAM at infection and serious delayed consequences such as infer- least once [3], and the use of at least one of 16 alternative tility, ectopic pregnancy, cervical cancer and the untimely therapies increased from 34% in 1990 to 42% in 1997 [4]. death of infants and adults [1]. The number of visits to providers of CAM now exceeds Traditional Medicine (TM) is used globally and is by far the number of visits to all primary care physicians rapidly growing in economic importance. In developing in the US [5,6]. The expenses for the use of TM and countries, TM is often the only accessible and affordable CAM are exponentially growing in many parts of the treatment available. The WHO reports that TM is the world. The 1997 out-of-pocket CAM expenditure was primary health care system for 80% of the population in estimated at US$ 2,7 billion in the USA, and the world developing countries. In Latin America, the WHO Regio- market for herbal medicines based on traditional knowl- nal Office for the Americas (AMRO/PAHO) reports that edge is now estimated at US$ 60 billion [7]. Northern Peru is believed to be the center of the Cen- * Correspondence: [email protected] tral Andean Health Axis [8], and traditional medicinal William L. Brown Center, Missouri Botanical Garden, P.O. Box 299, St. Louis, MO 63166-0299, USA practices in this region remain an important component © 2010 Bussmann and Glenn; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Bussmann and Glenn Journal of Ethnobiology and Ethnomedicine 2010, 6:30 Page 2 of 12 http://www.ethnobiomed.com/content/6/1/30 of everyday life [9-13]. TM is also gaining acceptance by conducted in Spanish by fluent speakers. Surveyors would national governments and health providers. Peru’s approach healers, collectors and market vendors and National Program in Complementary Medicine and the explain the premise for the study, including the goal of Pan American Health Organization recently compared conservation of medicinal plants in the area. Complementary Medicine to allopathic medicine in Vouchers of all specimens were deposited at the Her- clinics and hospitals operating within the Peruvian bario Truxillensis (HUT, Universidad Nacional de Tru- Social Security System. The results showed that the cost jillo), and Herbario Antenor Orrego (HAO, Universidad of using Traditional Medicine was less than the cost of Privada Antenor Orrego Trujillo). In order to recognize Western therapy. In addition, for each of the criteria Peru’s rights under the Convention on Biological Diversity, evaluated – clinical efficacy, user satisfaction, and future most notably with regard to the conservation of genetic risk reduction – Traditional Medicine ‘s efficacy was resources in the framework of a study treating medicinal higher than that of conventional treatments, including plants, the identification of the plant material was con- fewer side effects, higher perception of efficacy by both ducted entirely in Peru. No plant material collected either the patients and the clinics, and a 53-63% higher cost in this study in Northern Peru, or the previous study in efficiency of Traditional Medicine over that of conven- Southern Ecuador was exported in any form whatsoever. tional treatments for the selected conditions [14]. According to [6], the sustainable cultivation and harvest- Species identification and nomenclature ing of medicinal species is one of the most important The nomenclature of plant families, genera, and species challenges for the next few years. follows the Catalogue of the Flowering Plants and Gym- The present study attempts to give an overview on nosperms of Peru [15] and the Catalogue of Vascular medicinal plant species employed in Northern Peru in Plants of Ecuador [16]. The nomenclature was com- traditional remedies for reproductive problems and pared to the TROPICOS database. Species were identi- female health, and compare this use to the western fied using the available volumes of the Flora of Peru scientific evidence regarding their efficacy. [17], as well as [18-20], and the available volumes of the Flora of Ecuador [21]. Materials and Methods Plant Collections Results Plants for the present study were collected in the field, in A total of 105 plant species belonging to 91 genera and markets, and at the homes of traditional healers (curan- 62 families were documented and identified as herbal deros) in Northern Peru in 10 2-3 months long field visits remedies for reproductive problems in Northern Peru. between 2001 and 2009, as a larger scale project following Most species used were Asteraceae (9.52%), followed by initial collections in southern Ecuador (Figure 1). The Lamiaceae and Fabaceae (8.57% and 6.67%). Other same 116 informants (healers and market vendors) in the families were less important, and 44 contributed only Trujillo and Chiclayo area were repeatedly interviewed one species each to the pharmacopoeia (Table 1). The during this time, using structured questionnaires. The most important families are clearly represented very informants were always provided with fresh (non-dried) similarly to their overall importance in the local phar- plant material, either collected with them, by them, or macopoeia (Table 1) [9]. available at their market stands. The questionnaires did The majority of herbal preparations for reproductive not include any reference as to disease concepts, plant issues were prepared from the leaves of plants (22.72%), parts or preparations. In contrast, the participants were the whole plant (21.97%), and stems (21.21%), while asked simple questions along the lines “What is this plant other plant parts were used much less frequently (Table used for, which part, which quantity, how is it prepared, 2). This indicates that the local healers count on a very are any other plants added to the mixture.” All questions well developed knowledge about the properties of differ- were asked in the same order. All informants were of Mes- ent plant parts. In almost 62% of the cases fresh plant tizo origin, and spoke only Spanish as their native lan- material was used to prepare remedies, which differs lit- guage, and all interviews were conducted in Spanish. The tle from the average herbal preparation mode in North- study covered the four existing medicinal plant markets of ern Peru. Over 70% of the remedies were applied orally, the region, and included all vendors present. All interviews while the remaining ones were applied topically. Many were conducted with the same set of participants. remedies were prepared as mixtures of multiple ingredi- The specimens are registered under the collection series ents by boiling plant material either in water or in “RBU/PL,”“ISA,”“GER,”“JULS,”“EHCHL,”“VFCHL,” sugarcane spirit. “TRUBH,” and “TRUVANERICA,” depending on the year A complete overview of all plants encountered is given of fieldwork and collection location. Surveys were in Table 3. Bussmann and Glenn Journal of Ethnobiology and Ethnomedicine 2010, 6:30 Page 3 of 12 http://www.ethnobiomed.com/content/6/1/30 Figure 1 Location of the study area in Northern Peru. Discussion effects in Cordia sp., while [31-35] reported on anti-fer- Little scientific evidence exists to prove the efficacy of tility effects of Dioscorea sp.