Evaluation of the Efficacy of Medicinal Plants in Treating Bacterial Vaginosis: A Comprehensive Systematic Review of Interventional Studies

Background: Bacterial Vaginosis (BV) is the most prevalent cause of vaginal infection among women. This study aimed to summarize the evidence related to the effectiveness of medicinal plants as an alternative therapy for the management of BV. Materials and Methods: PubMed, Scopus, Cochrane Library, Web of Science, and Medline PubMed were systematically searched. Moreover, we searched Google Scholar to explore the possible effects of herbal treatments on BV in women of childbearing age up to 2022. All randomized clinical trials investigating the effects of medicinal plants as oral or vaginal monotherapy or in combination for BV treatment in women of childbearing age were included in this systematic review.Results: In total, 20 studies comprising 2685 participants were included in our review. The results show that combinations of herbal medicines such as Prangos ferulacea, Berberis vulgaris, Myrtus communis, and Quercus Brantii with metronidazole can have better results in the treatment of BV. Moreover, the main results show that some medicinal plant products alone such as Forzejehe (Tribulus terrestris + Myrtus communis + Foeniculum vulgare + Tamarindus indica), Zataria multiflora, and Calendula officinalis had therapeutic effects similar to metronidazole. Propolis and Brazilian pepper tree (Schinus) were effective in the treatment of BV, but they have less therapeutic effect than metronidazole. Conclusions: To reduce the complications caused by chemical treatments and also the resistance of patients to these treatments, it seems necessary to use supportive treatments along with chemical drugs after the necessary approvals have been obtained.