Review Article A ROLE FOR PHALERIA MACROCARPA (SCHEFF) BOERL. EXTRACTS IN THE MANAGEMENT OF WOMEN’S PATHOLOGICAL CONDITIONS: A RESEARCH REVIEW RAYMOND RUBIANTO TJANDRAWINATA 1* , HANNA CHRISTABEL ROULI 1 1 Dexa Laboratories of Biomolecular Sciences, Industri Selatan V Block PP no. 7, Kawasan Industri Jababeka II, Cikarang 17550, Indonesia Email: Raymond@dexa-medica.com Received: 02 Nov 2016 Revised and Accepted: 30 Jan 2017 ABSTRACT` Phaleria macrocarpa (Scheff) Boerl is a medicinal plant that originates from West Papua, Indonesia. The fruit of this plant is known to contain numerous different compounds that produce different bioactivities. Many of these bioactivities are related to women pathological conditions. The purpose of this review is to evaluate the effect of P. macrocarpa fruit extract in the management of these conditions. Different studies have proven that P. macrocarpa extract helps regulate hormone imbalance in women with problems relating to their menstruation cycle, especially during premenstrual syndrome. It helps alleviate symptoms of primary dysmenorrhea and endometriosis through its bioactivity as anti-inflammation, apoptosis inducer, anti-angiogenic and anti-oxidant agent. P. macrocarpa fruit extract also showed selective anti-proliferative, anti-inflammatory, and anti-angiogenic activity on breast and cervical cancer cells. It regulates cancer cell progression through numerous different pathways, making it highly favourable to be developed as a cancer treatment, whether as a single treatment or as an adjunct therapy. In conclusion, P. macrocarpa extract has great potential to be developed into treatments for women’s pathological conditions. However, further study, both preclinical and clinical studies are needed to ascertain its use in women to be effective and safe. Keywords: Phaleria macrocarpa, Premenstrual syndrome, Endometriosis, Breast cancer, Cervical cancer, Hormone imbalance © 2016 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) DOI: http://dx.doi.org/10.22159/ijpps.2017v9i3.16001 INTRODUCTION For many years plant extracts have been used for the management of women’s health conditions [1, 2]. However, scientific justifications which provide the bases for these therapeutic intents are virtualy absent. One serious problem with investigating the use of natural products for health benefits is the absence of acceptable clinical study data. Majority evidence is empirical or anecdotal involving the uncontrolled use of products of doubtful quality. Many of these traditional herbal medicines are active biologically and could be clinically beneficial. However, their real clinical effects are most likely to be dose dependent and due to the secondary metabolites contained within the product. It is likely that these active agents also cause unwanted toxicity. Without good clinical trial data and with no quality control of the product, it is unlikely that these agents would consistently provide therapeutic benefits. The Phaleria macrocarpa (Scheff) Boerl plant (known locally in Indonesia as mahkota dewa) is a plant which originates from the West Papua area in Indonesia and is empirically used as medicine. The ripe fruits of P. macrocarpa have red skin, with its fruit flesh, shells and seeds located inside the fruit. It has a smooth round surface, around 3- 5 cm in size. The fruit grows on the trunks and branches of the trees and suspended by short stalks. The stalk is attached to the stem and is fibrous and watery. It also has white flesh, [3]. The major ingredients of P. marcrocapa fruits are flavonoids, although alkaloids, saponins, tannins, and terpenoids are also found in the fruits in a much lower concentration. The n-hexane extract of P. macrocarpa fruit contains terpenoids, whereas the ethanol extract of P. macrocarpa fruit and seed contains alkaloids, flavonoids and triterpenoids. It has also been shown that the ethyl acetate extract of P. macrocarpa fruit contained flavonoids, triterpenoids and coumarin groups. Other isolated constituents of the fruit include Icariside C3, mangiferin and gallic acid [3]. Traditionally, the fruits of P. macrocarpa are frequently used as traditional medicine in conjunction with other ingredients. It is used empirically to treat a variety of chronic diseases such as diabetes mellitus, allergies, cancer, liver problem, heart disease, kidney failure, blood disease, hypertension and stroke [4, 5]. The fruits of P. macrocarpa are also known to have antimicrobial activities due to the presence of flavonoids [6]. An experiment which investigated the effects of P. macrocarpa fruit extract in diabetic animals exhibited an anti-diabetic property of the extract [7]. This is possibly due to the inhibitory activity on α-glucosidase [8]. In a separate study, it was previously reported that methanol extracts of P. macrocarpa caused anti-nephropathic action [9]. Many of these results suggest that the ingredients of P. macrocarpa may have properties to alleviate chronic diseases. In conjunction to these, other studies have show that P. macrocarpa fruit extracts and fractions may have pharmacological properties for women health conditions, such as premenstrual syndrome, endometriosis, breast as well as cervical cencer. Hence, this review is made based on different international publications on the effect of P. macrocarpa fruit extract on different women health conditions in the last 10 years**. Premenstrual syndrome (PMS) Since the dawn of time, history has noted that women tend to feel uncomfortable prior to the onset of menses. Unlike men, women of reproductive age have a cyclical hormonal pattern. This cyclical pattern may be associated with premenstrual syndrome (PMS) in some women. As the research of PMS continues, new evidence strongly lead to the involvement of endocrine system in the etiology. There are a number of theoretical rationales for cyclic hormonal changes causing premenstrual symptoms. PMS has been associated to include any of a number of different symptoms, both physical and emotional, which occur in a cyclic fashion just prior to the menstrual flow [10]. These symptoms should begin to lessen with the menstrual flow. Some women may get some symptoms and not others. Many patients have predominantly affective symptoms with very mild somatic symptoms, while other patients, particularly in an outpatient general gynecologic practice, may have somatic symptoms with few affective symptoms. It is not known whether these different groups have similar etiologies. However, it is entirely not clear at this moment that these cyclic changes actually cause PMS. Many women experience one or more symptoms such as depression, mood swings, sleeping disorders and pain. The imbalance of hormones which resulted in progesterone deficiency and estrogen dominance correlates with this symptom [11]. International Journal of Pharmacy and Pharmaceutical Sciences ISSN- 0975-1491 Vol 9, Issue 3, 2017