Benefits of Saffron (Crocus sativus) in the Management of Menstrual

Disorders: A Review

Debby Endayani Safitri

and Nur Setiawati Rahayu

Nutrition Study Program, Faculty of Health Sciences, University of Muhammadiyah Prof. DR. Hamka, Jakarta, Indonesia

Keywords: Crocus sativus, Menstrual Disorder, Saffron.

Abstract: Menstrual disorders are common problems which can occur in various symptoms, such as abnormal period,

heavy bleeding, menstrual pain, and psychological problem. It causes interference with women's daily

activity. Many studies used saffron as a treatment for menstrual disorders. Saffron has a beneficial effect on

the management of menstrual disorders. The benefit can be obtained through oral consumption or inhaling its

aroma. This is a literature review about the benefits of saffron and the possible mechanism in the management

of menstrual disorders. Result of this study confirmed that saffron can help relieve various symptoms of

menstrual disorders, especially premenstrual syndrome. Saffron was beneficial to reduce stress or depression

symptoms, it was also reducing pain more effectively than pain relievers and helped increase estrogen.

1 INTRODUCTION

Menstrual disorders are common problems which

cause interfere with women's daily activity. Most

teenagers and young adult women have experienced

these problems (Laksham et al., 2019; Rahayu &

Safitri, 2016). Its can occur in various symptoms,

such as abnormal period, heavy bleeding, menstrual

pain, and psychological problem. These symptoms

can cause a secondary problem, such as heavy

bleeding will lead to anemia. In comparison,

menstrual pain and the psychological problem will

decrease productivity. In the long term, menstrual

disorders can decrease the function of the

reproduction system.

Several factors have been found related to

menstrual disorders. Some micronutrients, such as

calcium, iron, thiamin, riboflavin, pyridoxine, and

vitamin A have benefits to prevent menstrual

disorders (Listiana et al., 2019; Rahayu & Safitri,

2016). Many studies used saffron as a treatment for

menstrual disorders. It has been found that saffron

reduced pain on women with dysmenorrhea (Azimi &

Abrishami, 2016). Saffron also has benefits in the

treatment of pre-menstrual syndrome (Agha-Hosseini

et al., 2008). Saffron is also known to have an anti-

inflammatory effect which can relieve menstrual

pain. It can also reduce the psychological effect due

to menstrual disorders, such as mood swings, stress,

or depression (Akhondzadeh et al., 2004).

This study used a literature review method.

Literature identification was done using the keywords

of “saffron” and “menstrual disorders” in PubMed,

Google Scholar, and Europe PMC databases with

open access. Articles were screened using inclusion

criteria of 1) in Bahasa/English, 2) the outcome was

symptoms of menstrual disorders. Studies which

were used animal as subject, were excluded. This

review is to provide comprehensive information

about the benefits of saffron in the management of

menstrual disorders.

2 CHEMICAL COMPOUNDS OF

SAFFRON

Saffron is high antioxidant herbs from Crocus sativus

plant. The mass of Crocus sativus flower mostly

consists of tepals (78.4%). Other parts are stamens,

stigmas, and styles, with 13.4%, 7.4%, and 0.7% of

the mass, respectively (Moratalla-López et al., 2019).

Most of saffron is produced in Iran, but it is also

produced in India, Greece, Morocco, Spain, Italy, and

Turkey. Commercial saffron is widely distributed as

dried red stigma, which is usually served brewed as a

tea. Saffron extract is also used as a dietary

supplement.

Saﬁtri, D. and Rahayu, N.

Beneﬁts of Saffron (Crocus sativus) in the Management of Menstrual Disorders: A Review.

DOI: 10.5220/0010758400003235

In Proceedings of the 3rd International Conference on Social Determinants of Health (ICSDH 2021), pages 48-52

ISBN: 978-989-758-542-5

Saffron contains macronutrients, fibers, minerals

(iron, magnesium, manganese), vitamins (thiamin,

riboflavin, pyridoxine, folate), and pigments

(Siddiqui et al., 2018; Wani et al., 2011). Saffron

nutritional value per 100 grams showed by Table 1.

Pigments identified are anthocyanin, carotenoid, and

zeaxantin (José Bagur et al., 2017). It also contains

beneficial bioactive compounds. The main bioactive

compounds identified are safranal, crocin, and

picrocrocin (Siddiqui et al., 2018). Crocin and

pirocrocin content of saffron are the highest among

other spices. Safranal is known to be responsible for

odor and aroma, while crocin is responsible for the

color, and picrocrocin for the bitter taste (Srivastava

et al., 2010). Phenolics and flavonoids are also known

to be present in saffron (Rahmani et al., 2017).

3 POSSIBLE MECHANISMS IN

MENSTRUAL DISORDER

TREATMENT

The menstrual disorder can variously present. The

most common type of menstrual disorder is pre-

menstrual syndrome (PMS). Other manifestations are

abnormal periods, dysmenorrhea, and heavy bleeding

(Rafique & Al-Sheikh, 2018). Several studies, as

shown in Table 2, have proven the benefits of Saffron

administration to reduce menstrual disorders.

In present studies, saffron was effective in

relieving pre-menstrual syndrome, dysmenorrhea,

and menstrual pain (Agha-Hosseini et al., 2008;

Fukui et al., 2011; Hausenblas et al., 2013). Saffron

can also lighten abnormal bleeding (Nahid et al.,

2009). Consuming saffron for 3-4 months can lower

depression and pre-menstrual syndrome severity. A

study conducted on women aged 20-45, who were

randomly assigned to consume 30 mg saffron per day

for two menstrual cycles, showed that it was effective

to relieve symptoms of PMS. This is indicated by

significant difference in the score of Total Daily

Premenstrual Symptoms and Hamilton Depression

Rating Scale (Agha-Hosseini et al., 2008).

Another study showed that consuming 500 mg of

mixture of saffron stigma extract and several other

herbs per day was showed a beneficial effect in

relieving pain in women with dysmenorrhea. The

effect is more significant from the effect of

mafenamic acid (Nahid et al., 2009).

Table 1: Nutrition Value of 100 g Saffron.

Nutrient Value % of RDA

Ener

310 Kcal 15.5

Carbohydrates 65.37 g 50

Protein 11.43 g 21

Total Fat 5.85

Dietar

Fibe

3.9

Folates 93 mcg 23

Pyridoxine 1.01 mg 77

Riboflavin 0.267 mg 20

Thiamin 0.115 m

Iron 11.1 m

139

Magnesiu

264 mg 66

Manganese 28.408 mg 1235

Beneﬁts of Saffron (Crocus sativus) in the Management of Menstrual Disorders: A Review

Table 2. Studies of Saffron and Menstrual Disorder.

No Autho

Metho

Subjects Results

1 Agha-Hosseini, 2008 Randomized and

double-blind

clinical trial

47 Subjects, women aged 20-45, were randomly assign

to consume 30mg saffron per day for two menstrual

cycles. Saffron was found to be effective to relieve

symptoms of PMS, indicated by significant

difference in the score of Total Daily Premenstrual

Symptoms and Hamilton Depression Rating Scale.

2 Fukui, 2011 Double blind 35 Aroma of saffron was relieving pre-menstrual

syndrome, dysmenorrhea, and another menstrual

disorder. Sniffing aroma of saffron for 20 minutes

was decreasing cortisol and estrogen level.

3. Nahid, 2009 Double blind RCT 180 Administration of 500 mg saffron, celery seed, and

anise significantly reduced pain than mefenamic

aci

, and control

rou

in the 2

and 3

erio

4. Parastoo, 2018 Double blind RCT 180 Administration of 30 mg saffron extract

significantly reduced pain than mefenamic acid, and

control group in the 2

and 3

period.

5. Beiranvand, 2015 Triple-Blind

Controlled RCT

78 Saffron was significantly associated with lower pre-

menstrual syndrome total score. But it has no

association with appetite, sedation, headache, and

euphoria.

6. Ai, et al. 2009 Controlled trial 45 Wistar-albino as subjects is divided into 3 groups

(15 each) and given orally normal saline, 20mg, dan

80mg/kg/day, respectively. After 30 days, serum

levels of FSH, LH, progesterone, and estrogen were

nificantl

increased.

Safranal is a compound that affects the odor and

aroma of saffron. Safranal has anxiolytic properties,

which is beneficial for the symptoms. Study

conducted on 35 women showed that sniffing the

aroma of saffron for 20 minutes can decrease cortisol

and increase estrogen (Fukui et al., 2011). Estrogen

works together with progesterone and prolactin to

regulate the menstrual cycle. A study, using 45

female rats, showed that serum levels of progesterone

and estrogen were significantly increased after

administration of 80mg/kg/day for 30 days (Ai et al.,

2009).

Saffron stigma contains thiamin, riboflavin,

pyridoxine, and folate. These vitamins are related to

the severity of the pre-menstrual syndrome and

abnormal periods (Listiana et al., 2019; Rahayu &

Safitri, 2016). Thiamin and riboflavin intake were

inversely associated with the severity of pre-

menstrual syndrome and the prevalence of abnormal

periods. Thiamin and riboflavin are an essential

component of energy metabolism. Thiamin was

known for improving blood circulation and reduced

skeletal muscle cramp. Thiamin was also

significantly decreasing depression, stress, and

anxiety. A controlled trial, conducted on dormitory

students aged 18-30, showed that administration of

100 mg B1 supplement for three months would

lowering the mean of physical and mental symptom

of Vitamin B1 group was significantly lower

(Abdollahifard et al., 2014). These are involved in

symptoms of pre-menstrual syndrome.

A meta-analysis study of 10 RCTs found that

pyridoxine relieved overall pre-menstrual and

depressive syndromes (Wyatt et al., 1999). Riboflavin

is needed to activate pyridoxine, which is correlated

to the level of the reproductive hormones. Low levels

of pyridoxine increase levels of prolactin and result in

higher severity of psychological symptoms due to

menstruation. Pyridoxine is a cofactor in the synthesis

of serotonin and dopamine. It is also involved in

gamma-aminobutyric acid (GABA) synthesis and

amino acid metabolism. Another meta-analysis also

explained that pyridoxine deficiency may results to

lower concentration of noradrenaline and serotonin

(Soheila et al., 2016).

The folate level was inversely associated with

homocysteine. Higher plasma homocysteine

concentrations were associated with lower estradiol

(a type of estrogen), higher follicle-stimulating

hormone, and lower luteal phase progesterone. As

these hormones regulate the menstrual cycle and

fertility, an imbalance will lead to sporadic

anovulation, which causes amenorrhea (Michels et

al., 2017). Besides folate, riboflavin and pyridoxine

ICSDH 2021 - International Conference on Social Determinants of Health

are also inversely related to homocysteine levels.

Beneficially, these vitamins are contained in saffron.

Saffron has an inflammatory effect that comes

from crocin, safranal, and anthocyanin content

(Rahmani et al., 2017). Inflammation is one problem

which associates with pre-menstrual syndrome. The

inflammation biomarker (hs-CRP) level was elevated

when pre-menstrual mood symptoms, abdominal

cramps, bloating, and breast pain were occurring

(Gold et al., 2016). Some studies suggest a beneficial

effect of anti-inflammatory agent administration for

treatment of menstrual disorder (Bofill Rodriguez et

al., 2019; Gold et al., 2016).

Saffron main bioactive has known to have an

antispasmodic effect. It prevents impulses from the

parasympathetic nervous system from causing

contractions, cramps, or spasms. Contraction and

cramp are often experienced as menstrual pain

occurs. Possible mechanisms explained including β2-

adrenoreceptors stimulation, histamine (H1) receptor

inhibition, and calcium channel blocking (Mokhtari-

zaer et al., 2015).

4 CONCLUSIONS

Saffron has a beneficial effect on the management of

menstrual disorders. The benefit can be obtained

through oral consumption or inhaling its aroma.

CONFLICT OF INTEREST

There is no conflict of interest.

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