Objectives: To investigate the attitudes and symptoms associated with the menopausal transition in Guatemalan and Costa Rican women and the therapies used to treat these symptoms.Methods: As part of an NIH funded project, interviews of women, midwives, healers and medical personnel were performed.Plants used to treat menopause were collected in Guatemala and Costa Rica, extracted and tested.Results: Women living in Central America have a more positive attitude toward menopause that their U.S. counterparts.While women in Guatemala have slightly fewer symptoms, women in Costa Rica have menopausal symptoms similar to that observed in U.S. women.However, neither women from Guatemala nor Costa Rica use HRT extensively and use herbal products instead to treat the symptoms associated with menopause.Plant species used as symptomatic treatment were collected and tested for potential biological activities.Many of the herbal remedies were active in multiple bioassays, suggesting a pleotropic and plausible mechanism of action for the treatment of anxiety, depression, vasomotor symptoms associated with the menopausal transition.Conclusions: Women in Central American countries have similar symptoms during menopause as their U.S, counterparts but have a more positive outlook on the transition, as it marks an end to the reproductive years and allows for more sexual freedom.These women however, do not use HRT to any great extent, but opt for more natural therapies such as herbal medicines and massage.Many of the herbal products used appear to have a plausible mechanism of action.

Infectious disease remains a significant cause of morbidity and mortality worldwide, accounting for approximately 50% of all deaths in tropical countries and as much as 20% of deaths in the Americas. Despite the significant progress made in microbiology and the control of microorganisms, sporadic incidents of epidemics due to drug-resistant microorganisms and previously unknown disease-causing microbes pose an enormous threat to global public health. For thousands of years botanicals (plant-based medicines) have played a significant role in the treatment of a wide range of medical conditions, including infectious diseases. Thousands of plant species have been tested against hundreds of bacterial strains in vitro, and many botanical extracts are active against a wide range of Gram-positive and Gramnegative bacteria. However, very few of these medicinal plant extracts have been tested in animal or human studies to determine safety and efficacy. This review focuses on the clinical evidence supporting the use of specific botanicals for the treatment/prevention of infectious diseases. The examples provided in this review such as cranberry, garlic, tea tree oil and green tea demonstrate that even commonly used botanicals may offer prospective new treatment of bacterial infections.

Many developing countries have restricted access and use of prescription drugs to treat common health conditions. In Guatemala, for example, it is estimated that between 65–80% of the people use traditional, complementary or alternative medicines as part of their primary health care. In terms of women's health, many of these plant-based medicines have little or no supporting in vitro, in vivo or clinical data. As part of an NIH funded grant AT002831–02, we have been collecting plants from Central America used to treat a wide range of women's health issues. To date, 63 plant species have been collected, extracted and assayed, with 23 plant species having biological activities corresponding to their traditional use. The plant extracts were active in COX-2 inhibitory, serotonin agonist, SERM, and anti-yeast assays. For example, a 95% ethanol extract of the fruit peel of Ananas comosus (L.) Merr., collected in Costa Rica was active in the serotonin receptor 1A (5HT-1A) binding assay, with an IC50 of 22.1µg/ml. A methanol extract of the dried powdered leaves of Citrus aurantium (Christm.) Swingle was active in the 5HT-1A binding assay (IC50 of 45.5µg/ml and inhibited the activity of COX-2 with an IC50 of 10.8µg/ml. A methanol extract of the rhizomes of Dioscorea bartlettii, collected in Guatemala were active in estrogen binding assays (α and β). The extract had an IC50 in ERα of 33.5µg/ml, and ERβ 30.1µg/ml. The results suggest a plausible mechanism of action for the treatment of common women's health conditions.

Modulators of the serotonin (5HT) 1a and 7 receptors have been implicated as part of the pathophysiology of the menopausal hot flash. Some botanical extracts used to treat menopausal symptoms, (i.e. black cohosh) appear to modulate serotonin as part of their overall mechanism of action. As part of NIH grant AT002381–02 we have been investigating medicinal plants from Guatemala used to treat menopause. The plants were collected, air-dried and voucher specimens deposited at the Herbarium of the School of Biology at the University of San Carlos. Dried plant material was extracted with 95% ethanol and the extracts were tested in a range of serotonin receptor binding assays (5-HT-1A, 2A, 5A, and 7). Five plants from the Piperaceae namely Piper aeruginosibaccum Trelease, P. auritum HBK, P. diandrum C. DC., P. hispidum Swingle, P. tuerckheimii C.DC, and one plant from the Menispermiaceae, Cissampelos tropaeolifolia DC. were of interest due to their strong inhibition of radiolabeled ligand binding to the 5-HT1A, 2A and 7 receptors (activity deemed as >50% binding at 50µg/ml of the extract) and their insignificant binding to the estrogen receptors. Cissampelos tropaeolifolia exhibited significant binding to the 5-HT1A receptor (88%) and the 5-HT7 serotonin receptor (94%), Piper tuerckheimii (90 and 72%, respectively) and P aeruginosibaccum (81 and 82%, respectively) were followed by P. hispidum (63 and 96%, respectively), P. auritum (66 and 83%, respectively) and P. diandrum (56 and 76%, respectively). One new compound, 4,6-dioxypiperolide isolated from P. hispidum, bound to the 5HT-7 receptor.