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European Journal of Applied Sciences – Vol. 10, No. 4

Publication Date: August 25, 2022

DOI:10.14738/aivp.104.12573. Revelo-Cáceres, D., Oliveras-López, M. J., & Serrana, H. L. D. L. (2022). Development of an Infusion for Dysmenorrhea Based on Fig

Leaves (Ficus Carica) and Mango. European Journal of Applied Sciences, 10(4). 51-61.

Services for Science and Education – United Kingdom

Development of an Infusion for Dysmenorrhea Based on Fig

Leaves (Ficus Carica) and Mango

Daniel Revelo-Cáceres

Universidad de Granada, Facultad de Farmacia, Granada-España

María Jesús Oliveras-López

Universidad Pablo de Olavide, Departamento de

Biología Molecular e Ingeniería Bioquímica, Sevilla-España

Herminia López-García de la Serrana

Universidad de Granada, Facultad de Farmacia, Granada-España

ABSTRACT

An infusion based on fig leaves and mango was developed. Its sensory acceptability

was evaluated as a possible alternative for the treatment of dysmenorrhea. Fig

leaves and mangoes were washed, cut, dehydrated and ground. The optimal time

for fig leaf dehydration was determined by means of a weight loss curve, producing

an outcome of 120 minutes at 45oC. Two formulations were made, the first

containing 1 g of dehydrated fig leaves and 0.6 g of dehydrated mango, and the

second containing 1 g of dehydrated fig leaves and 6 g of dehydrated mango.

Sensory analysis was performed according to taste, aroma, paired preference and

purchase intention ranking tests. Tasters preferred the formulation with the least

amount of dried mango. 93% of tasters indicated that they would buy this infusion

due to its possible functional properties against dysmenorrhea.

Keywords: Infusion, fig leaves, mango, dysmenorrhea, sensory analysis.

INTRODUCTION

Dysmenorrhea is the most common gynecological problem in women of all races and ages. It is

characterized by the presence of cramps during menstruation [1]. This discomfort mainly

presents itself in the lower abdomen, with the severity of this discomfort leading many women

to visit their gynecologist [2]. Pain usually emerges at the beginning of the menstrual flow,

generally lasts between 8 to 72 hours, and can cause lower back pain, headache, diarrhea,

fatigue, nausea and vomiting [3]. Dysmenorrhea usually begins in adolescence once the

ovulatory cycles are established and can last until the age of 40, with this condition sometimes

continuing during menopause. Dysmenorrhea causes work absenteeism, generating a high

economic cost. For this reason it is considered a health issue [4]. In addition, about 14% of

adolescent girls do not attend school due to painful contractions of the uterus [5]. This

gynecological condition produces mood swings and feelings of shame, causing serious

problems in women's social relationships [6]. There are several factors that increase the risk of

dysmenorrhea, including age (<30 years), early menarche (<12 years) and low body mass index

(<20) [7]. Similarly, heavy or irregular menstrual flow, depression, longer periods of menstrual

bleeding and family history are considered to predict higher risk of dysmenorrhea [8]. Several

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European Journal of Applied Sciences (EJAS) Vol. 10, Issue 4, August-2022

Services for Science and Education – United Kingdom

studies indicate that the presence of pain during menstruation is due to the excessive

production of prostaglandins, which increase intrauterine pressure, decrease uterine blood

flow and increase the sensitivity of the peripheral nerves leading to pelvic pain [9] [10].

Nonsteroidal anti-inflammatory drugs and oral contraceptive pills are the most recommended

treatments for women with dysmenorrhea [11]. Nonsteroidal anti-inflammatory drugs inhibit

the cyclooxygenase enzymes COX-1 and COX-2, which metabolize arachidonic acid to

prostaglandin. Ibuprofen, naproxen, diclofenac potassium and meclofenamate are the most

commonly used medications because they inhibit both COX-1 and COX-2. On the other hand,

there are medications such as celecoxib, rofecoxib and valdecoxib that are also used, although

they only inhibit COX-2. However, these medications can cause cardiac complications and so

their use is not recommended [12]. Headache, drowsiness, dizziness, nausea and indigestion

are other side effects of non-steroidal anti-inflammatory drugs [11]. Another drawback of

pharmacological treatment is that the intake of non-steroidal anti-inflammatory drugs or

contraceptive pills may be less appropriate there in some patients, such as adolescent girls.

Further, the cost of these drugs can be prohibitive, making them inaccessible to some [13]. For

these reasons, the use of non-pharmacological therapies, including yoga, acupuncture and

massages, has been encouraged. Despite this, there is insufficient evidence on the benefits of

these activities [14]. In another sense, the potential role of the inclusion or elimination in the

daily diet of certain foods and medicinal plants on dysmenorrhea in women has been studied.

In female students who consumed sodas with high sugar levels, a higher prevalence of

dysmenorrhea was found compared to women who rarely consumed these beverages [15]. The

opposite effect was observed in 22-year-old students with dysmenorrhea who were given 3g

of cinnamon for 72 hours. Following the intervention, pain decreased significantly from 5.7 to

3.6, demonstrating that cinnamon reduced the severity of menstrual pain safely and without

side effects [16]. Similarly, several studies have shown that certain plants such as chamomile

[17], ginger [18] and thyme [19] help to reduce pain from dysmenorrhea. Nonetheless, two

specific foods have aroused great interest due to their potential benefits in the treatment of

dysmenorrhea. These foods are fig leaf and mango.

The fig tree (Ficus carica) is one of the oldest cultivated plants in the Mediterranean [20]. Its

leaves have been used for several decades for the treatment of cardiovascular and respiratory

diseases, gastrointestinal problems and inflammatory disorders [21]. In previous research,

approximately 126 chemical compounds have been identified to be present in both fig leaves

and fruit [22]. These are divided into isoflavones, flavonoids, triterpenoids, lignans, alkaloids,

coumarins and sesquiterpenes [23]. Likewise, it has been shown that the phenolic content of

fig leaves is higher than the content found in red wine or tea [24]. Of further relevance, anti- inflammatory activity attributed to fig leaves is mainly due to the presence of two flavonoids

(apigenin and quercetin) [25]. In an in vivo study of individuals with lupus, apigenin was

observed to reduce the expression of COX-2 and the cellular inhibitor FLICE, causing malignant

cells to undergo apoptosis and, consequently, significantly reduce the inflammation caused by

this condition [26]. Similarly, apigenin has been shown to inhibit the production of

inflammation mediators in human lung epithelial cells [27]. The effect of apigenin has been

studied in female mice with induced endometriosis. This research concluded that this flavonoid

inhibited histopathological changes in the uterus and decreased the production of

inflammatory cytokines. For this reason, it was concluded that apigenin can be used as an agent

for the treatment of endometriosis [28]. In the ovaries of female mice, apigenin was found to

inhibit spontaneous cell metastasis, in this way, proving that this compound has anticancer

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Revelo-Cáceres, D., Oliveras-López, M. J., & Serrana, H. L. D. L. (2022). Development of an Infusion for Dysmenorrhea Based on Fig Leaves (Ficus

Carica) and Mango. European Journal of Applied Sciences, 10(4). 51-61.

URL: http://dx.doi.org/10.14738/aivp.104.12573

properties [29]. In the case of quercetin, this compound has been reported to decrease the

production of inflammation mediators and the production-activity of cyclooxygenase [30].

Quercetin has also been seen to induce apoptosis in leukemia cells, melanoma cells and ovarian

cancer cells, reducing pain symptoms in patients with these diseases [31] [32]. In people with

atopic dermatitis, quercetin has been shown to suppress inflammatory cytokines and pro- inflammatory factors. Given these findings, it has been argued that the use of this compound is

non-toxic and can be considered pharmacologically safe for humans [33].

Mango is one of the most consumed fruits worldwide because it has a good source of

carbohydrates, proteins, fats, fiber, vitamins, minerals and carotenoids [34]. This fruit has

antioxidant, anti-inflammatory, antitumor, antimicrobial, immunomodulatory, antiallergic,

antipyretic, antispasmodic and gastroprotective properties, which is why it has aroused great

interest in the scientific community [35]. All these properties are due to the presence of

mangifera, which is a C-glucosylxanthone (1,3,6,7-tetrahydroxyxanthone-C2-β-D-glucoside)

that is found in significant levels in the peel, stem, leaves, pulp, rind and seed [36]. The anti- inflammatory mechanism of action of mangiferin is related to the inhibition of factor NF-κB,

which plays an important role in inflammation, the response to stress, and the differentiation

and activation of immune cells. This factor is also involved in processes involving inflammatory

cytokines [37]. Likewise, mangiferin regulates the expression of COX-2 and prevents the

production of tumor necrosis factor alpha (TNF-α) and nitric oxide, which are closely related to

inflammatory processes [38]. In mice induced with neuroinflammation and visceral pain, oral

administration of mangiferin (10–100 mg / kg) was found to lead to significant anti- inflammatory activity [39]. Similarly, it was determined that mangiferin inhibited factor NF-κB

in mice with lung lesions, thereby preventing inflammatory signaling and the production of pro- inflammatory mediators [40]. On the other hand, it was found that mangiferin attenuated

inflammation in mice with colitis by inhibiting the production of nitric oxide, factor TNF-α and

factor NF-κB [41]. In recent years, the use of mangiferin in ovarian cancer has been studied. In

human ovarian cells, it has been uncovered that mangiferin inhibits the viability of cancer cells,

in addition to regulating the overexpression of the Notch3 gene, which may be related to

chemoresistance [42]. In human ovarian adenocarcinoma cells, mangiferin has been

established to inhibit tumor cell growth, suggesting that this compound can be used as a new

therapeutic agent in the treatment of ovarian cancer [43]. Likewise, in mice and in ovarian

adenocarcinoma cells, mangiferin was found to suppress the progression of ovarian cancer,

significantly reducing the volume and weight of tumors. This same study also found it to

regulate the expression of proteins associated with metastasis, namely, MMP2 and MMP9 [44].

The aim of the present research is to develop an infusion based on fig leaves and mango and

evaluate its sensory acceptability as a possible alternative for the treatment of dysmenorrhea.

MATERIALS AND METHODS

Plant material

The fig leaves and mangoes used in this experiment were purchased from a supermarket. Fig

leaves were classified according to size, appearance and the absence of defects. Fig leaves were

then washed and dried at room temperature. Mangoes were used in an optimal state of ripeness

and were also classified according to size, appearance and the absence of defects.