title: Ethnomedical research and review of Q'eqchi Maya women's reproductive health in the Lake Izabal region of Guatemala: Past, present and future prospects.
abstract: BACKGROUND
  In Central America, most Maya women use ethnomedicines for all aspects of their reproductive cycle including menstruation, pregnancy and menopause. However, very few of these plants have been documented, collected and tested in appropriate pharmacological assays to determine possible safety and efficacy. The aim of this work was to provide an overview of information on the ethnomedical uses, ethnopharmacology, chemistry and pharmacological research for medicinal plants used for women's reproductive health in Guatemala, with a special emphasis on the Q'eqchi Maya of the Lake Izabal region, to demonstrate therapeutic potential and support future research in the field.
  
  
  METHODS
  Reviews of the ethnobotanical, ethnomedical and ethnopharmacological literature were performed for 30 plants collected in the Lake Izabal region of Guatemala and used by the Q'eqchi Maya for treatment of reproductive health issues were performed up to and including July 2015 using multiple databases, library searches for abstracts, books, dissertations, and websites.
  
  
  CONCLUSIONS
  Review of the published research confirms that many of the plants used by Q'eqchi Maya women for the management of reproductive health issues have pharmacological activities, including analgesic, anti-inflammatory, estrogenic, progestagenic and/or serotonergic effects, that support the use of these plants and provide plausible mechanisms of action for their traditional uses. Furthermore, a new serotonin agonist, 9, 10-methylenedioxy-5, 6-Z-fadyenolide was isolated, thereby demonstrating an untapped potential for drug discovery. However, to date much of the pharmacological assays have been in vitro only, and few in vivo studies have been performed. Considering the large percentage of the Maya population in Guatemala that use traditional medicines, there remains a significant lack of pharmacological and toxicological data for these plants. Future research should focus on the safety and efficacy of medicinal plants using in vivo preclinical studies and clinical trials, as well as chemical analysis. Since medicinal plants from the Piperaceae are most commonly used as traditional medicines by the Q'eqchi Maya women, and new bioactive compounds have been identified from Piper species, investigations of commonly used plants from this family would be an appropriate place to start. Data generated from such studies would contribute to Guatemala's national effort to promote a complementary relationship between traditional Maya medicine and public health services.
authors.affiliation: Department of Medical Education, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Michel
authors.affiliation: School of Biological Chemistry, Faculty of Chemical Science and Pharmacy, Universidad de San Carlos, Guatemala City, Guatemala.
authors.forename: Armando
authors.initials: A
authors.lastname: Caceres
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 833 South Wood St., MC 877, Chicago, IL 60612, USA. Electronic address: mahady@uic.edu.
authors.forename: Gail B
authors.initials: GB
authors.lastname: Mahady
mesh_terms: D020834:Ethnopharmacology / Q000379:methods; D005260:Female; D006166:Guatemala; D006801:Humans; D010936:Plant Extracts / Q000627:therapeutic use*; D010946:Plants, Medicinal / Q000737:chemistry; D012098:Reproduction / Q000187:drug effects*; D060728:Reproductive Health; D016387:Women's Health
chemical_list: D010936:Plant Extracts
keywords: Cyclooxygenase; Dysmenorrhea; Estrogenic; Maya; Menopause; Pregnancy; Progestagenic; Serotonin