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Amazing Uterine Antispasmodics: Cramp bark and Black haw

Botanical name: Viburnum opulus/Viburnum prunifolium

Vibirnum

Plant part(s) used: dried or fresh bark of roots, stems, or branchesActions
• uterine tonic
• uterine antispasmodic
• musculoskeletal antispasmodic

Viburnum is primarily women’s medicine with a specific affinity to the smooth muscle of uterus, but it also has some effect on the vascular system, the nervous system and the muscles of the limbs.

As the name, Cramp Bark suggests, Viburnum is used for cramping, which is a just a casual term for uterine contraction.  Uterine contraction/cramping during menstruation is common and for some women can be very disruptive to their lives.  Uterine contraction also occurs during pregnancy in the form of threatened miscarriage, pre-term labor and normal, healthy Braxton-Hicks contractions.  The uterus contracts strongly to accomplish birth and it continues to contract during the first few days postpartum as the uterus involutes (brings the organ back to a smaller, pre-pregnancy size and state).

The Viburnums are highly effective at sedating the uterus and relieving menstrual cramping. This is especially true for women whose menstrual cramps are extremely painful and debilitating. This herb is great for when the cramps are not just centered in the lower front pelvic area but radiate around the back and down the thighs and may even cause painful cramping in the bowel.

Historical Use
• used by eastern Native American tribes as an antispasmodic and for gynecologic problems and obstetric care
• first described in American botanical medicine in 1830 by a botanical physician who used it generally to relax cramps and spasms
• popular among Eclectic physicians and physiomedicalists for
relaxing cramps and spasms in asthma, hysteria, pains incidental to females, during pregnancy, and convulsions
stimulant tonic to the reproductive nerve centers, acting on the uterus to regulating its function Cramp bark was official in the USP from 1894 to 1916 and official in the NF from 1916 to 1960 for use as a sedative and antispasmodic. Black haw was cited in 1850 for its use in the treatment of uterine hemorrhage, and in 1859 for the treatment of threatened miscarriage. In 1866 it was described as a uterine sedative and anti-abortifacient, and in 1876, it was included in an allopathic medical report for the treatment of menorrhagia, metrorrhagia, and dysmenorrhea. It was listed as an official drug of the USP from 1882 to 1926 and cited in the NF from 1926 to 1960, and is considered a uterine spasmolytic and uterine anodyne. As of 1983 it was listed in the British Herbal Pharmacopoeia, and in the late 1990s uterine spasmolytic activity was confirmed in animal studies.
• nervous conditions of pregnant women
• threatened abortion
• uterine hemorrhage
• vomiting of pregnancy
• dysmenorrhea with cramp-like pains
• amenorrhea
• metrorrhagia
• after-pains
• spasmodic contraction of the bladder
• spasmodic stricture

Cramp bark was official in the USP from 1894 to 1916 and official in the NF from 1916 to 1960 for use as a sedative and antispasmodic.

Black haw was cited in 1850 for its use in the treatment of uterine hemorrhage, and in 1859 for the treatment of threatened miscarriage. In 1866 it was described as a uterine sedative and anti-abortifacient, and in 1876, it was included in an allopathic medical report for the treatment of menorrhagia, metrorrhagia, and dysmenorrhea. It was listed as an official drug of the USP from 1882 to 1926 and cited in the NF from 1926 to 1960, and is considered a uterine spasmolytic and uterine anodyne. As of 1983 it was listed in the British Herbal Pharmacopoeia, and in the late 1990s uterine spasmolytic activity was confirmed in animal studies.

Modern Clinical Indications
• after birth pains
• chronic pelvic pain
• dysfunctional uterine bleeding
• dysmenorrhea
• hypertension
• incoordinate uterine contractions
• irritable uterus and bladder
• muscle spasms
• neuralgic pain
• parturient/labor analgesia
• Partus preparator
• premature labor
• threatened abortion

Cramp bark, and its very similar sister herb, black haw, are among the most valued uterine anti- spasmodics, used widely by herbalists, midwives, and naturopathic physicians. Contemporary use of cramp bark includes treatment of cramps and spasms of most types, particularly involving the uterus and bladder (i.e., dysmenorrhea, threatened miscarriage, spasms accompanying UTI, irritable bladder, chronic pelvic pain, irritable uterus, “after pains”), for inflammation, neuralgia, as a mild sedative, a hypotensive, and occasionally in formulae for heart
palpitations, often combined with motherwort (Leonurus cardiaca) for this latter indication. Black haw and cramp bark extracts may also be used topically for the treatment of musculoskeletal pain. No clinical trials have been conducted on the use of either herb. Cramp bark has demonstrated smooth muscle relaxant activity, hypotensive effects, and cardiotonic effects. Both hypotensive and hypertensive effects have been reported from black haw studies.

Preparation and Dose
Tincture: 5-10 mL 3 times daily Decoction/infusion: 2.5-5g 3 times daily

Major Safety Information
Caution is advised in patients with kidney disease may be warranted due to oxalic acid content in black haw.
No similar cautions are listed for cramp bark. Due to the coumarin content of these herbs, a theoretical caution exists for using these herbs in combination with anticoagulant medications, or that these herbs may cause hemorrhagic problems. However, anticoagulant activity has not been demonstrated in vivo nor is there any evidence these herbs increase the risk of bleeding.

Use During Pregnancy and Lactation
Care should be taken with the use of all herbs during pregnancy and lactation, and especially during first trimester pregnancy. Reports from the Eclectic physicians suggest that this herb may have been used to prepare a woman for labor; however, its contemporary and widespread use is as an herb to relax the uterus in threatened miscarriage. There are no reported specific contraindications to the use of this herb in pregnancy or lactation.

Based on a review of the literature, no adverse effects are expected from use during pregnancy or lactation.

 

Sources:

Romm, Aviva Jill. Botanical Medicine for Women’s Health. St. Louis, MO: Elsevier, 2010.

Smith, Welby R. Trees and Shrubs of Minnesota: The Complete Guide to Species Identification. Minneapolis, MN: University of Minnesota, 2008.

Thayer, Samuel. The Forager’s Harvest: A Guide to Identifying, Harvesting, and Preparing Edible Wild Plants. Ogema, WI: Forager’s Harvest, 2006.

Trickey, Ruth. Women, Hormones and the Menstrual Cycle. 2nd ed. Crows Nest: Allen & Unwin, 2003.

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