Nepal’s 395-Plant Pharmacopoeia for Women’s Reproductive Health, Mapped

In a sweeping systematic review that reads like a botanical map of Himalayan women’s health, researchers have catalogued 395 plant species drawn from 117 families and 298 genera that Nepalese communities have long used to treat gynecological disorders. The study, published in Plant Biosystems, applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to sift through decades of ethnobotanical literature spanning 1970 to May 2025. From an initial pool of 533 publications, 183 papers passed screening and formed the evidentiary backbone of the synthesis, assembled from databases including Google Scholar, PubMed, Scopus and ScienceDirect. The result is the most comprehensive consolidated picture yet of how Nepal’s diverse ethnic groups turn to the plant world when confronting menstrual disorders, fertility problems, pregnancy-related complaints, postpartum difficulties and other reproductive health concerns that remain shrouded in taboo and stigma.

The sheer taxonomic breadth documented in the review underscores how deeply plant-based medicine is woven into the everyday management of women’s reproductive health across Nepal’s ecological and cultural gradients. Fabaceae, the legume family, emerged as the single most represented family with 31 species, followed by Poaceae with 17, Asteraceae with 17 and Rosaceae with 15. This family-level pattern is biologically telling. Legumes are renowned for their rich secondary metabolism, producing alkaloids, saponins and flavonoids, many of which display pharmacological activity relevant to reproductive physiology. The prominence of the daisy family, Asteraceae, mirrors its reputation in ethnopharmacology as a reservoir of anti-inflammatory and antimicrobial compounds, while the grass and rose families bring their own suites of bioactive molecules. Such convergence between family-level chemistry and folk use patterns is precisely the kind of signal pharmacologists look for when prioritizing species for laboratory investigation.

The anatomy of the remedies is equally revealing. Roots dominated the catalogue, appearing in 131 remedies, closely trailed by leaves at 125, with fruits contributing 61 and seeds 60. Root-heavy usage is significant because roots frequently concentrate alkaloids and other defensive metabolites, making them pharmacologically potent but also raising questions about sustainable harvesting, since uprooting a plant ends its life. Herbs constituted nearly half of the species used, 47.34 percent, ahead of trees at 22.03 percent and shrubs at 18.23 percent, a distribution consistent with the accessibility of herbaceous flora in villages and their prominence in Himalayan traditional pharmacopoeias. Preparations follow the classic grammar of traditional medicine: juice was the leading mode of administration with 103 reports, followed by decoction at 82, paste at 65 and powder at 44. Each method carries pharmacological implications, as water-based decoctions and fresh juices extract water-soluble compounds, while pastes and powders can preserve and deliver less soluble constituents.

Among the hundreds of species, four names recur again and again in the literature: Asparagus racemosus, Astilbe rivularis, Bergenia ciliata and Achyranthes aspera. Each was repeatedly cited for a range of therapeutic applications, marking them as the most culturally salient plants in Nepal’s ethnogynecological corpus. Asparagus racemosus, better known as shatavari, is a cornerstone of Ayurvedic women’s health and has been examined in randomized, placebo-controlled trials for supporting postpartum lactation, giving it one of the stronger clinical dossiers among the highlighted species. Bergenia ciliata, a Himalayan rock-dwelling herb, has been the subject of comprehensive reviews covering its traditional uses, phytochemistry, pharmacology and safety profile, with documented antioxidant and anti-inflammatory properties. Astilbe rivularis has recently drawn laboratory attention for therapeutic potential in diabetic neuropathy models, while Achyranthes aspera has accumulated in vitro evidence of antimicrobial and anti-inflammatory activity, properties that plausibly underpin its folk deployment against reproductive tract complaints.

The context motivating this work is stark. Gynecological disorders exert profound social, mental, psychological and physical tolls, and in societies where menstruation, infertility and sexual health carry heavy stigma, many women either delay or forgo formal care altogether. The World Health Organization has long characterized reproductive health morbidities such as chronic pelvic pain as neglected, and gynecological disease in the developing world has been described in the medical literature as a silent pandemic. In Nepal, where a substantial share of the rural population relies on traditional medicine for primary healthcare, plant-based remedies are not a fringe alternative but often the first and only line of treatment available or deemed culturally acceptable. Surveys of pregnant Nepalese women have documented widespread herbal medicine use, frequently without disclosure to healthcare providers, a gap that carries real safety implications and makes rigorous documentation of what is being used, and how, a matter of clinical urgency.

Methodologically, the review distinguishes itself by consolidating decades of scattered, regionally fragmented ethnobotanical surveys into a single PRISMA-compliant synthesis. Individual field studies from districts as varied as Dolpa, Humla, Mustang, Manang, Makawanpur, Kaski, Parbat, Rolpa and the Terai plains have each captured local snapshots, but no unified baseline existed for women’s reproductive health specifically. By systematically extracting plant names, plant parts, preparation methods, life forms and therapeutic applications across 183 studies, the authors constructed a national-scale dataset amenable to quantitative summary. Such consolidation serves multiple purposes simultaneously. It preserves knowledge that anthropologists warn is disappearing as elder healers die and younger generations migrate to cities, it identifies cross-cultural patterns in plant selection that transcend ethnic boundaries, and it generates ranked shortlists of species whose repeated citation suggests genuine pharmacological promise rather than idiosyncratic local practice.

The review also situates Nepal within a global pattern. Meta-analyses from Southeast Asia, sub-Saharan Africa, Latin America and South Asia have all documented extensive ethnogynecological plant use, with common threads including uterotonic plants for labor induction, galactagogues for lactation and astringent species for menstrual regulation. Nepal’s contribution to this literature has, until now, been comparatively thin despite its extraordinary floristic diversity, which spans tropical lowlands to alpine Himalayan zones and includes portions of globally recognized biodiversity hotspots. Documenting 395 species used for reproductive health within a single country positions Nepal as one of the richest documented ethnogynecological landscapes anywhere, and simultaneously flags a conservation concern: several heavily used species, particularly those harvested for roots and rhizomes, face mounting pressure from habitat loss and commercial trade in medicinal and aromatic plants.

From a drug discovery standpoint, the review functions as a prioritized roadmap. Ethnobotany has historically accelerated the identification of bioactive compounds, and the authors explicitly frame their synthesis as a baseline for future pharmacological studies aimed at developing herbal drugs for women’s reproductive conditions. The next scientific steps are well established: phytochemical profiling of the most frequently cited species, in vitro bioassays targeting antimicrobial, anti-inflammatory, uterotonic and hormone-modulating endpoints, followed by safety and toxicity evaluation, which remains a critical blind spot given that remedies are routinely consumed during pregnancy and lactation, windows of heightened vulnerability. The evidence that species like shatavari can advance from folk remedy to randomized clinical trial demonstrates that this pipeline is viable, and the 395-species catalogue now offers researchers a data-driven starting point far more efficient than untargeted screening.

Beyond the laboratory, the study carries public health and policy weight. Understanding which plants pregnant women actually consume allows clinicians to counsel patients about potential herb-drug interactions and contraindications, addressing the documented under-disclosure of herbal use to obstetric providers. Conservation planners gain a species-level inventory to guide sustainable cultivation programs that could simultaneously protect wild populations and secure supply chains for rural healthcare. And for Nepal’s many ethnic communities, formal academic recognition of their botanical knowledge strengthens arguments for benefit-sharing under frameworks protecting traditional knowledge. As the authors note, this compilation provides the foundation upon which pharmacological validation, and ultimately improved, safer care for women whose reproductive health needs have too long been neglected, can be built. In charting the intersection of flora, culture and women’s health, the review transforms centuries of quiet, household-level healing practice into a scientific resource with genuinely global resonance.

Subject of Research: Traditional Nepalese medicinal plants used for women's reproductive health problems

Article Title: Traditional nepalese medicinal plants used for women's reproductive health problems: a systematic review

Article References: Bhatt, G., Ghimire, B., Tharu, K. P., Sharma, P., & Bhatt, K. (2026). Traditional nepalese medicinal plants used for women's reproductive health problems: a systematic review. Plant Biosystems, 160(5), Article 256. https://doi.org/10.1007/s44473-026-00247-w

Image Credits: AI Generated

DOI: 10.1007/s44473-026-00247-w

Keywords: medicinal plants, Nepal, women's health, gynecological disorders, ethnobotany, traditional medicine, PRISMA, herbal remedies, reproductive health, Asparagus racemosus, pharmacology, systematic review