A preliminary validation of ethnomedicinal practices ensures that clinical trials are not wasted on plants that are used solely for cultural or religious reasons. The validation of the remedies was conducted with a non-experimental method 111819. This method consists of:

1. obtaining an accurate botanical identification,

2. determining whether the folk data can be understood in terms of bioscientific concepts and methods,

3. searching the chemical/pharmaceutical/pharmacological literature for the plant's known chemical constituents and to determine the known physiological effects of either the crude plant, related species, or isolated chemical compounds that the plant is known to contain. This information is used to assess whether the plant use is based on empirically verifiable principles or whether symbolic aspects of healing are of greater relevance. If ethnobotanical data, phytochemical and pharmacological information supports the folk use of a plant species it can be grouped into the validation level with the highest degree of confidence.

Four levels of validity were established 19:

1. If no information supports the use it indicates that the plant may be inactive; or no research has been done on the plant.

2. A plant (or closely related species of the same genus), which is used in geographically or temporally distinct areas in the treatment of similar illnesses, attains the lowest level of validity, if no further phytochemical or pharmacological information validates the popular use. Use in other areas increases the likelihood that the plant is active against the illness.

3. If in addition to the ethnobotanical data, phytochemical or pharmacological information also validates the use in Trinidad, the plant may exert a physiological action on the patient and is more likely to be effective than those at the lowest level of validity.

4. If ethnobotanical 20, phytochemical and pharmacological data supports the folk use of the plant, it is grouped in the highest level of validity and is most likely an effective remedy.

A comparable validation process was used to examine the plants used by traditional healers of ancient Persia to induce abortions 21. The authors evaluated the validity and the efficacy of the plants used by (1) comparing other reported uses of these plants in traditional medicine, (2) investigating the medical and pharmacological literature on the medicinal properties of the plant species used, and (3) investigating the reported cytotoxic effects of compounds prevalent in these plants.

Forty-two plants are used for reproductive problems of men and women. The term "man's waist pain" was not explained. The plants used for "man's disease" and "man's waist pain" were Catharanthus roseus, Urena sinuata and Clusea rosea. Parinari campestris and Richeria grandis are used for erectile dysfunction. Prostate problems are treated with Ageratum conyzoides, Scoparia dulcis, Cucurbita pepo, Cucurbita maxima, Gomphrena globosa and Justicia pectoralis.

Plants used for abortions are Aristolochia rugosa, Aristolochia trilobata, Ambrosia cumanenesis and Cocos nucifera.

Unspecified female complaints ae treated with Achyranthes indica, Artemisia absinthium, Brownea latifolia, Eleutherine bulbosa, Hibiscus rosa-sinensis, Eupatorium macrophyllum, Justicia secunda, Parthenium hysterophorus, Wedelia trilobata, Abelmoschus moschatus and Ageratum conyzoides. Desmodium canum is used for venereal diseases and Nopalea cochinellifera is used for menopause and hot flashes. The following plants are used for infertility and inflammations: Chamaesyce hirta, Cola nitida, Ruta graveolens, Commelina elegans, Ambrosia cumanenesis and Pilea microphylla.

The plants used for menstrual pain are: Aristolochia rugosa, Aristolochia trilobata

Ruta graveolens, Ambrosia cumanenesis, Capraria biflora, Cordia curassavica, Croton gossypifolius, Entada polystachya, Leonotis nepetaefolia and Eryngium foetidum. Plants used for childbirth, to shorten labour and remove the placenta are Mimosa pudica,

Ruta graveolens, Abelmoschus moschatus, Aristolochia rugosa, Aristolochia trilobata, Coleus aromaticus, Laportea aestuans, Vetiveria zizanioides, Abelmoschus moschatus and Eryngium foetidum. The ethnomedicinal plants used in Trinidad and Tobago for reproductive problems are summarised in Table 1. The validation of the plants is summarised in Table 2.

Abelmoschus moschatus plant is used for reproductive purposes in Fiji 22. Abelmoschus manihot is used for menorrhagia in Vanuatu 23. Myricetin, a naturally occurring flavonol with antioxidative and cytoprotective proterties is found in Abelmoschus moschatus Medic. This flavonol is used in the treatment of depression and anxiety in traditional Chinese medicine and has potential therapeutic benefit for cardiovascular diseases associated with diabetes mellitus 24.

The use of Achyranthes indica for venereal diseases in Trinidad has been previously recorded 11. In Nepal Achyranthes aspera is used to facilitate parturition 25. The benzene extract of the stem bark shows abortifacient activity in the rat 25. The ethanolic extract of A. aspera caused reproductive toxicity in male rats and the action may result from suppressing the synthesis of androgen 26. The methanolic leaf extract of Achyranthes aspera possesses significant (p < 0.05) abortifacient activity and increased pituitary and uterine wet weights in ovarectimized rats. The extract did not significantly influence serum concentration of the ovarian hormones and various lipids except lowering HDL at doses tested 26.

Ageratum conyzoides is used for venereal disease in El Salvador 20. Ageratum conyzoides plant extract inhibited uterine contractions induced by 5-hydroxytryptamine suggesting that the extract exhibited specific antiserotonergic activity on isolated uterus plant extract but had no effect on uterine contractions induced by acetylcholine 2829. The results support the popular use of the plant as a spasmolytic 2829.

The use of Ambrosia cumanenesis for women's problems has been previously recorded 11. Ambrosia elatior is used as a febrifuge in Tropical America 20. Dominican healers in New York City use Ambrosia peruviana for uterine fibroids 30. Synonyms of Ambrosia cumanenesis are A. californica; A. coronopifolia; A. psilostachya and Ambrosia rugelii; these synonyms are provided to guide future researchers to future research; very little is currently available. The sesquiterpene lactone cumanin from Ambrosia psilostachya, exerted a high in vivo anti-inflammatory response, which was equivalent to that of helenalin (ED₅₀ = 6.33 and 13.11 μmol/kg, respectively) 31.

Aristolochia species are used in Mexico, western Panama and Guatemala as analgesics, for stomach pain, female disorders, menstrual pain and as contraceptives 1120. At doses of 1000 μg/cm2, the chloroform extract of Aristolochia trilobata, induced oedema reductions ranging between 50 (bark) and 93% (leaves). The methanol extract produced oedema inhibition of 18% (A. trilobata leaves). The chloroform extract of the Aristolochia trilobata leaves showed an anti-inflammatory effect comparable to that of indomethacin 32.

Artemisia absinthium is used together with other plants as fertility regulators in western Panama and Paraguay and this use is ancient 3411. Artemisia absinthium is used by the Caribs in Guatemala for fever, vaginitis and stomach pains 11. Mugwort contains several pain relieving compounds including isothujone, linalool and cineole 35. These compounds may also relieve premenstrual syndrome. Aqueous extracts of Artemisia contain little thujone and are probably safe to use 35.

Chamaesyce prostrata was used in Barbados prior to 1834 for venereal complaints 11. The active component(s) in the water extract of Euphorbia hirta leaf have a similar diuretic spectrum to that of acetazolamide 35. Chamaesyce hirta aqueous extract showed central analgesic properties 36.

The antinociceptive action of 13,118-binaringenin (GB-1a), a biflavonoid isolated from Clusia columnaris was more potent than some well-known analgesic drugs used as references. Its mechanism of action seems unrelated to the opioid receptors 37. Compounds isolated from the trunk latex of Clusia grandiflora have potent antibacterial activity 38. A novel antitumoral compound was isolated from Clusia spp. resin 39.

Cocos nucifera shell produces a fluid when hot that is used ethnomedicinally in India 11. Cocos nucifera is used in complex plant combinations for venereal diseases in Cuba 40. The fiber husk is rich in catechins with anti-bacterial, anti-viral and anti-proliferative activity on leukaemic cells and normal blood lymphocytes 41.

In vitro crude extracts of kola nuts depress smooth muscle activity. The oestrous cycles of rats treated with hydro-alcohol extracts of Cola nitida, were blocked at the dioestrous II stage. Only 50% of the cycles of rats treated with Cola nitida were disrupted. The extract contains weak antioestrogen-like activity that provokes a blockage of female rat ovulation and oestrous cycle by acting on the hypophysis and/or hypothalamus secretion. This effect was mediated by oestrogen receptors 42.

Coleus aromaticus has been used historically for menorrhagia in Trinidad 11.Coleus barbatus is used to interrupt pregnancy in Brazil and is used as an emmenagogue in other countries 43. Coleus barbatus showed an anti-implantation effect in the preimplantation period in rats, but after embryo implantation the extract had little effect 43.

Commelina elliptica is used in a bath by the Alteños Indians in Bolivia to reduce high fevers. Commelina pallida and C. cayenensis are used as haemostatics, wound healing and ecbolics in Mexico 1120. Commelina communis has level 2 validity for diabetes 44. Commelina diffusa extract showed antibacterial and antifungal activity against Trichophyton spp., a common dermatophyte 45.

Cordia alba was used by the Aztecs as a diuretic. Cordia spinescens is used in Colombia to relieve postpartum pain 11.Cordia boissieri and C. collococca are used as emollient roots in the Antilles and Mexico 20. Cordia curassavica has antibacterial activity against bacteria known to cause gastrointestinal problems 46.

Croton nepetaefolius Baill., is used in Brazilian folk medicine as a sedative and antispasmodic agent. Croton draco, C.panamensis, and C.stipulaceus are used in Mexico for kidney ailments 20. Croton berlandieri bark decoction is used for syphilis in the Yucatan 20. The essential oil of C. nepetaefolius, administered orally, promotes a dose-dependent antinociceptive effect 1147. Active principles could include flavonoids and terpenoid compounds 47. At a dose of 20 mg/kg, intravenous bolus administration of the ethanolic extracts from Croton schiedeanus showed significant antihypertensive activity when assayed both in SHR and Wistar rats and in rat isolated aortic rings 48.

Cucurbita pepo is used for prostate disorders and urine intermittence in Palestine 11.

Desmodium gangeticum is used as an antipyretic in India 11. The water decoction of root and aerial parts of Desmodium gangeticum possesses anti-inflammatory and anti-nociceptive activity. These results support the traditional use of the water decoction of Desmodium gangeticum as an analgesic 49.

Eleutherine bulbosa is used in Columbia for menstrual cramps and in Haiti as an antifertility agent 1050. Eleutherine species are used in the Malay Peninsula, Bolivia and Peru for vaginal discharge, wounds, dysentery, diarrhoea and anaemia 11. Eleutherine bulbosa bulb extract showed antifertility and cicatrizant activity and was non-toxic 10.

Eryngium foetidum is used in the Caribbean and South America for the treatment of fevers and antiinflammatory disorders and for venereal diseases 1150. The topical antiinflammatory activity of the hexane extract and of stigmasterol was established and stigmasterol is not the only bioactive component 51.

Eupatorium species are used in South America as contraceptives, abortives and emmenagogues 52. Two species of Eupatorium were used in Trinidad for menstrual problems in 1893 11. Eupatorium macrophyllum has been used in Trinidad historically for amenorrhoea, dysmenorrhea, prolapse and womb problems in Trinidad 11. Chromolaena odorata (synonym Eupatorium odoratum) crude ethanol extract has antioxidant activity that protects fibroblasts and keratinocytes in vitro 53. The phenolic acids present and complex mixtures of lipophilic flavonoid aglycones protected cultured skin cells against oxidative damage 53.

The glycoside isorhamnetin 3-O-beta-robinobioside was found in Gomphrena boliviana. Upon inoculation of various doses of 5,6,7-trisubstituted flavones on two murine tumour lines, Sarcoma 180 and Ehrlich's carcinoma, a decrease of tumour growth was observed 54. Gomphrena globosa flowers contain betacyanins which have potential as as food colorants and antioxidants 55.

Hibiscus rosa-sinensis flower decoctions are used in India and Vanuatu as aphrodisiacs, for menorrhagia, uterine haemorrhage and for fertility control 11. Flower extracts produced an irregular estrous cycle in mice with prolonged oestrus and metoestrus and other indications of antiovulatory effects, androgenicity and estrogenic activity 5657585960. Hibiscus rosa sinensis possesseses anti-complementary, anti-diarrhetic and anti-phologistic activity. Hibiscus rosa sinensis flower showed anti-spermatogenic, androgenic, anti-tumour and anti-convulsant activities 5657585960.

Justicia pectoralis showed antinociceptive, bronchodilator and antiinflammatory effects 151161. These activities might be due to the coumarin in the plant 1115. One recent review showed that plant species rich in coumarin compounds have potential antineoplastic or cytotoxic activities that are correlated to their use as abortifacients 21.

The leaf and tem decoction of Leonotis nepetaefolia is used as an abortifacient and emmenagogue in the Caribbean 52.

Mimosa pudica is used in Nicaragua and Mexico for stomach aches, 'cleaning the womb', as a sedative, to stop menstruation and for gonorrhoea 11. The root is used as a temporary birth control in India 62. Mimosa pudica produced an antidepressant-like profile similar to two tricyclic antidepressants clomipramine and desipramine 63. Powdered roots were given to adult cycling female albino rats at dosages of 100 mg and 150 mg/kg body weight, administered intragastrically for 5 consecutive days. There was a significant reduction in the number of normal ova in the experimental rats in the study due to inhibition of steroidogenesis, thus producing an imbalance in oestrogen and/or progesterone levels. Alternatively, the powder may have acted on the hypothalamus and reduced the releasing hormones and/or changed the pituitary gonadotropin levels 62.

Nopalea cochinellifera is used for pain and inflammation in India 11. An oral glucose tolerance test showed that stems of Nopalea cochinellifera increases blood glucose levels in mice 64.

Parinari species are used for venereal diseases in some African countries 11. The methanolic extract of the stem bark of Parinari polyandra demonstrated anti-nociceptive and anti-inflammatory effects in mice and rats, justifying the local use of the plant 65.

Parthenium hysterophorus is used as a tonic, analgesic, antipyretic, antiperiodic, febrifuge and emmenagogue in Mauritius, Rodrigues, Mexico, Belize and India 1120. It is used for venereal diseases in Cuba 40. A depolarizing neuromuscular junctional blocking action of Parthenium hysterophorus leaf extracts was found in the rat 66.

Pilea microphylla is used ethnomedicinally in Asia and in Central America 1120. The entire plant is given to women in labour in Jamaica. Pilea microphylla was active against Staphyloccocus aureus 67.

Richeria grandis (syn. Guarania ramiflora) is used as an aphrodisiac in Trinidad. Roupala montana is also used in Trinidad and is a documented nervine 68.

Ruta graveolens and closely related species are used as emmenagogues, abortives, antispasmodics, sudorifics and anthelmintics in France, Spain, Brazil, Paraguay, New Mexico, Italy, Madeira and in other cultures and the antifertility uses were documented by Galen and Pliny the Elder 697011. Ruta species contain different alkaloids and furanocoumarins and may show toxic side effects when used as abortifacients 1169. Ruta graveolens has shown weak activity in vitro on excised uterine muscle 70. The antimicrobial activity of the plant is possibly due to the essential oils or flavonoids 71. Data collected in Uruguay from 1986 – 1999 of 86 cases of abortion involved 30 different plant species 72. Ruta chalepensis or Ruta graveolens were among the species most frequently used for abortions 72. Multiple organ system failure occurred in some patients who had ingested ruda (alone or in combination with parsley or fennel). Deaths occurred in 4 cases of ruda ingestion (2 cases of ruda alone, 2 cases of ruda with parsley and fennel) 72.

Scoparia dulcis is used in Nicaragua for belly pain and to 'clean the blood, kidney and system' 11. Antitumour-promoting compounds and antiviral agents were found in Scoparia dulcis 22. It also has antimicrobial and antifungal effects as well as antihyperlipidemic action in normal and experimental diabetic rats in addition to its antidiabetic activity 73.

Urena sinuata plant is used for reproductive purposes in the Pacific, Trinidad, China and India 1122. Its synonyms are Urena aculeata Mill., U. lobata ssp. sinuata (L.) Borss. Waalk., Urena morifolia DC., U. muricata DC., U. paradoxa Kunth and U. swartzi. The methanol extract of Urena lobata root exhibited broad spectrum antibacterial activity 74.

Vetiveria zizanioides is used in Pakistan as an emmenagogue and stimulant and is used by the Caribs in Guatemala for stomach pains 11.

Wedelia trilobata has been historically used for amenorrhea in Trinidad 11. Kaurenoic acid and luteolin in Wedelia paludosa showed antinociceptive action more potent than the standard analgesic drugs (acetyl salicylic acid, acetaminophen, dipyrone and indomethacin) 75. Wedelia paludosa and Wedelia trilobata contain the diterpene (kaurenoic acid), eudesmanolide lactones and luteolin (in leaves and stems) 1175. Kaurenoic acid has antibacterial, larvicidal and tripanocidal activity; it is also a potent stimulator of uterine contractions 75. Luteolin exerts antitumoural, mutagenic and antioxidant effects, has depressant action on smooth muscles and a stimulant action on isolated guinea pig heart 75.