An intrepid group of eight passionate herbalists had the ultimate Sri Lankan herbal medicine immersion experience in March 2018, where they witnessed traditional herbal medicine in action in the 21st century. The majority of the excursion was set in an enchanted sanctuary of exceptional beauty in Sri Lanka’s heartland. The tour included Ayurvedic healing practices taking place in a traditional working village, including soothing massages and oil applications, medicated steam baths, herbal saunas, medicine making classes with an acclaimed Ayurveda practitioner, a visit to the oldest planted tree in the world in the ancient city of Anuradhapura, a personal tour of a working Ayurveda hospital and manufacturing facility, but mostly just surrendering to Mother Nature herself. 
Keywords: Sri Lanka, traditional medicine, indigenous medicine, herbal medicine, Ayurveda, herb manufacturing.
 

Bacterial vaginosis (BV) and genitourinary disorders associated with vaginal dysbiosis are common in females of all ages. Bacterial vaginosis is characterised by a reduction of Lactobacillus-dominant vaginal flora and an overgrowth of facultative anaerobic bacteria. Recurrent infection of BV has a range of implications on the individual, such as psychosexual effects, fertility and pregnancy impacts, possible associations with pelvic inflammatory disease and increased risk of sexually transmitted infections (STI). Antimicrobial pharmaceutical treatment of BV eradicates the active infection but does not offer follow-up treatment to prevent an opportunistic environment for reinfection. In some cases, the treatment of BV predisposes an individual to recurrence as resistant organisms are favoured in an unstable econiche environment, and organisms of pathogenicity dominate in a dysbiotic trend. Effective treatment of recurrent BV may be more sustainable if the health of the vaginal micro-environment is rebalanced, whilst reducing risk factors. This may improve natural resistance to pathogenic organisms and break the cycle of this persistent condition.
The following case study is a 32-year-old woman with recurrent BV wanting to conceive. Modification of predisposing and maintaining factors, in association with targeted naturopathic interventions, which included vaginal pessary application, lifestyle modification and dietary change, influenced the vaginal pH and modified the ecology within the vaginal microbiome, providing effective, long-term relief when antimicrobial treatment alone was not able to prevent recurrent symptoms.
Keywords: Bacterial vaginosis, vaginal dysbiosis, Lactobacilli, metronidazole, probiotic therapy, lifestyle modification.
 

Recurrent pregnancy loss (RPL) occurs in 1% of couples and is defined as three consecutive failed pregnancies. While controversial, evidence exists that adequate levels of progesterone may be an important factor in pregnancy maintenance and that increasing levels of progesterone may increase the likelihood of success. Vitex agnus-castus (chaste tree) is a herbal medicine with evidence to support its use in a variety of hormonal conditions, including premenstrual disorder and cyclic mastalgia through modulation of reproductive hormones. This report details a case of RPL in which low progesterone levels were observed. One month of supplementation with Vitex was followed by successful pregnancy with normal levels of serum progesterone and a live birth at full term. A second successful pregnancy followed, also with Vitex supplementation. Although the exact role of Vitex in this case cannot be confirmed, it adds evidence to the hypothesis that this herb may be an effective intervention in cases of RPL, particularly those involving low progesterone, and that more research is warranted.
Keywords: Vitex agnus-castus, herbal medicine, progesterone, spontaneous abortion, recurrent pregnancy loss, luteal phase defect.

These abstracts are brief summaries of articles in recent issues of medical journals. Articles selected are of a general nature for the information of practitioners of naturopathy and herbal medicine. A dominant theme is often present throughout the journals, which will be reflected in the reviews.

These abstracts are brief summaries of articles which have appeared in recent issues of herbal medicine journals, some of which may be held in the NHAA library.

The AJHNM-based CPE questionnaire system is a voluntary system designed to assist members in the accumulation of NHAA CPE points. Questions are divided into the appropriate subject categories (herbal medicine and medical science) and each question refers to an article in this issue of the Australian Journal of Herbal and Naturopathic Medicine. Points accumulated through completion of these questions should be recorded in the NHAA CPE diary. Each completed question is worth one mark in the relevant category. Your completed CPE diary should be returned with your membership renewal at the end of the calendar year. For further information, please see the NHAA CPE Members’ Manual on the NHAA website www.nhaa.org.au.