Kampo medicine for women's health care “1st International Symposium on Kampo Medicine”

To the Editor, Japanese herbal medicine, known as Kampo, is a part of East Asian Chinese medicine. In the Huangdineijing (Yellow Emperer’s Canon of internal medicine), women’s health is thought to change every seven years, with a physical peak at 28 years old. Women are naturally conscious of physical and mental changes associated with their menstrual cycle, and often notice physical deterioration from around 40 years old. In this symposium, we would like to discuss how Kampo medicine contributes to women’s health care in Japan. The first presentation is “Analysis of Mesenteric Phlebosclerosis-Related Adverse Events Caused by Gardenia-containing Kampo Medicines Using the JADER Database.” Gardenia fruit is widely used in traditional medicine. Recent clinical reports have shown that longterm (≧5 years) administration of Gardenia fruit (called sanshishi in Japan) was associated with the incidence of mesenteric phlebosclerosis (MP). In this study, we assessed age (<50 years, 50–70 years and > 70 years groups) and gender differences among cases of MP caused by Gardenia-containing Kampo medicines to investigate the risk factors and the underlying mechanism to target the activation of sex hormone receptors. In all, 215 cases of MP caused by Gardenia-containing Kampo medicines were registered in the Japanese Adverse Drug Event Report database (JADER) from April 2004 to September 2021. We found statistically significant differences in MP cases by age and gender with a greater number in females over 50 years of age. We also analyzed whether geniposide, the major component of Gardenia, and its metabolized substance genipin, can directly activate estrogen receptors (ERα, ERβ) or androgen receptor (AR) by simulations of the performance of molecular docking using Molecular Operating Environment. The results showed that both geniposide and genipin have favorable binding ability with those sex hormone receptors, and that the binding energy with ERs is stronger than with AR. In conclusion, the results demonstrated the potential risks of MP being caused by Gardenia-containing Kampo medicines together with differences in aging and gender, and that sex hormone receptors were involved in the development of MP. The second presentation is “Kampo Medicines Treatment for Women.” Among patients who visit Kampo clinics, 70%–80% are women, which suggests that Kampo treatment is important to support women’s health and manage female health concerns. The Kampo medicine which is used today has evolved in its own unique way based on several classic texts of traditional Chinese medicine. Regarding women’s diseases, “Kinkiyoryaku”, which was written in China around 200 A.D., is the basis for the current treatment of women’s health problems in Japan. In this way, the importance of a medical approach to women-specific disorders has been recognized by Kampo medicine since ancient times. In this symposium, using case studies, the usefulness of Kampo treatment for treating various women’s health problems will be presented, such as menstruation disorders, infertility, habitual miscarriage, poor milk secretion, menopause syndrome and disorders which are common in females such as headaches, dizziness and fatigue. The third presentation is “Kampo Therapy for Pregnant Women.” From the viewpoint of oriental medicine, pregnant women give priority to feeding the fetus. To be short, yinketsu is a likely cause of feelings of heat, dizziness and anemia. Headache, cold sensitivity and edema are induced by each stagnation of ki, ketsu and sui by pregnancy. It is not rare for oriental medicine to show better effects on such symptoms than Western medicine. Kampo therapies are available for hyperemesis gravidarum, threatening premature abortion and delivery, pain and psychiatric symptoms of pregnancy. The fourth presentation is “Kampo Treatment for Female Patients with Cold Syndrome.” Patients are often encountered who complain of persistent and intolerable “coldness” (chilly sensation) in their bodies, fingertips and toes. This unusual feeling of coldness, which is more often observed in women than in men, is called “hi-e-sho” (cold syndrome) in Japanese. However, there is no definition of subjective coldness in Western medicine, and therefore it is not even recognized as a symptom or disease to be treated. The lack of an Received: 18 May 2022 Revised: 12 June 2022 Accepted: 15 June 2022