Dysmenorrhea is one of the most usual causes of pelvic pain. It has negative effects on woman’s quality of life and sometimes leads to daily activity restriction. Primary dysmenorrhea is menstrual pain without pelvic pathology. Abnormal bleeding, noncyclic pain, alteration in pain severity and duration, and abnormal pelvic examination findings propose secondary dysmenorrhea and need more assessment. Treatment options for primary dysmenorrhea are consist of non-steroidal anti-inflammatory drugs and hormonal contraceptives. Due to side effects related to such treatments, women seek complementary and alternative medicines. The aim of this paper is to evaluate the reasons for using chlorella to improve the side effects of primary dysmenorrhea.

Keywords: Primary dysmenorrhea, Chlorella, Systemic symptoms, Inflammation

Chlorella is a kind of unicellular green algae including high concentration of protein, lipid, vitamins, antioxidants such as lutein, α and β-carotene, ascorbic acid, tocopherol and minerals [10-12]. Chlorella has the capacity to wipe off free radicals and has advantageous impacts on regulating the physiological functions of body in malignant diseases resulted from stress [13,14]. In addition, chlorella can ameliorate lipid profile and reduce lipid peroxidation [15,16]. It has been demonstrated that chlorella decreased pro-inflammatory mediators and cytokines while preventing vascular disorders related to chronic inflammation [17,18].

This review aims to provide the reasons for using chlorella to improve the side effects of dysmenorrhea. 

MECHANISMS OF ACTION

In the only clinical trial with the aim of evaluating the impacts of chlorella supplementation (1500 mg/day, for 8 weeks) on the systemic symptoms and serum concentrations of prostaglandins, inflammatory and oxidative biomarkers in women  (aged  18-35  years)   with   primary  dysmenorrhea, results of the intervention showed significant reduction in PGE2, PGF2α, hs-CRP and MDA, as well as systemic symptoms of dysmenorrhea (headache, fatigue, nausea, vomiting, and lack of energy) in chlorella supplemented group, compared to placebo group [19]. Hence, this study demonstrates that chlorella could decrease inflammation and lipid peroxidation. In agreement with the results of this study, it has been demonstrated that violaxanthin extracted from microalga chlorella ellipsoidea could suppress production of PGE2 and decreases COX-2 mRNA expression [20]. Chlorella vulgaris extract could inhibit pro-inflammatory mediators and prostaglandin E2 production [17]. It has been shown that COX-2 leads to the production of large concentrations of inflammatory mediators such as prostaglandins. PGE2 is a mediator with some apparently unrelated impacts that leads to swelling, pain, and stiffness. Thus, inhibition of PGE2 may consider as an advantageous approach for improving the treatment.

The results of different studies indicated that chlorella supplementation could decrease serum hs-CRP and MDA concentrations in non-alcoholic fatty liver patients [18,21]. The alcoholic extract of chlorella vulgaris reduced lipid peroxidation biomarkers in naphthalene exposed rats [22]. In another investigation, chlorella supplementation in hypercholestrolemic rats decreased inflammatory biomarkers and oxidative damage [23]. It was shown that in chlorella vulgaris fed mice the oxidant capacity ameliorated and plasma and liver concentration of MDA was reduced [24,25].

Chlorella contains a lot of amounts of carotenoids, chlorophyll, α-tocopherol, ascorbic acid and vitamin D; it has the complete vitamin B-complex, and is a rich source of antioxidant minerals which are important for the functions of biological systems within the body. Chlorella vulgaris has the capacity to decrease lipid peroxidation and can be due to the free radical scavenging effects of polyphenols and carotenoids available in this microalga. Carotenoids particularly α and β-carotene, clean radicals and cease the peroxidation process [26-28]. Vitamin E can hinder arachidonic acid oxidation and prostaglandins production. It has been reported that vitamin E decreased the severity and duration of primary dysmenorrhea [29,30].

CONCLUSION

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