Table 5. Characteristics of the research papers on the applications of ginger in female reproductive health.

Research studies
Reference	Subjects	Treatment	Study design	Sample size (n)	Adverse effects	Main results
Yilmaz et al., 2021 [46]	Female albino rats in estrous cycle	100 mg ginger powder, 200 mg ginger powder, or 2 cc distilled water (control group) was given to 3 subgroups. Ginger powder was mixed with 2 cc distilled water and administered by gavage. The control group also received 2 cc of distilled water by gavage	Experimental study	7	None	In the 5-day treatment group, antral follicle count and ovarian stromal VEGF were significantly high in the 100 mg ginger subgroup in comparison to the control group (p<0.05). In the 10-day treatment group, endometrial VEGF and ovarian stromal eNOS were significantly high in the 100 mg ginger subgroup in comparison to the control group (p<0.05). There was no statistically significant difference at 200 mg ginger dose both in 5-day and 10-day treatment groups
Usman et al., 2021 [47]	Female Balb/c mice aged 2-3 months	Group 1 as a control group) is given standard feed, and group 2 as ginger honey as much as 42 mg/20 g body weight is given by oral sonde and standard feed for 14 days	Experimental study	5	None	42 mg/20 g BW of ginger honey administration for 14 days increased 1.892 ng/dl of cortisol (p=0.165), increased 2.438 ng/dl of glutathione (p=0.002), and also increased 22.754 ng/ml estrogen levels in induced stress Balb/c female mice (p=0.001)
Atashpour et al., 2017 [48]	Adult female Wistar rats age 7-8 weeks	The control group (no intervention for 60 and 89 days), sham group (given distilled water and ethyl alcohol intraperitoneally daily for 60 and 89 days), and 7 experimental groups given estradiol valerate (PCOS inducing agent, intramuscular) alone and with 100 mg/kg clomiphene or different doses of ginger extract (175 and 350 mg/kg) orally daily for 60 and 89 days	Experimental study	7	None	PCOS-induced group LH and estrogen concentration increased while progesterone and FSH concentration decreased (p<0.05) compared to the control group. In clomiphene and ginger extract groups, there was an improvement in hormonal secretion (p<0.05). Clomiphene had a better effect on improving sexual hormones in PCOS than lower-dose ginger. Ginger extract at higher doses has better effects in improving PCOS
Bonab, 2020 [49]	Women aged 20-25 with PCOS	4 groups including control, Pilates exercise, combined (Exercise + Ginger supplement), and Ginger supplementation. The exercise intervention groups performed Pilates exercises for 12 weeks and the supplementation group consumed 1 g of ginger capsules three times per day	Quasi-experimental study with pre-test and post-test design	10	None	LH (p<0.05), testosterone (p<0.05), and insulin (p<0.05) levels decreased in the intervention groups compared to the control group. The FSH (p<0.05) and SHBG (p<0.05) indices in the intervention groups were higher than the control. The findings indicated the effects of treatments on the indices studied (p<0.05). While the combined treatment had the greatest effect, there were no significant differences between the exercise group and ginger supplementation group (p>0.05), except in the weight index the superiority was observed with the exercise group (p<0.05)
Rhode et al., 2007 [50]	SKOV3 ovarian cancer cells were obtained from the American Type Culture Collection. SKOV3, CaOV3, and ES-2 cells were originally harvested from patients with recurrent ovarian cancer	Activation of NF-κB and production of VEGF and IL-8 was determined in the presence or absence of ginger (75 µg/mL)	Experimental study	N/A	None	Ginger treatment of cultured ovarian cancer cells induced profound growth inhibition in all cell lines tested (p<0.05). We found that in vitro, 6-shogaol is the most active of the individual ginger components tested (p<0.05). Ginger treatment resulted in the inhibition of NF-kB activation as well as diminished secretion of VEGF and IL-8 (p<0.05)
Naveed et al., 2022 [51]	Females of reproductive age having dysmenorrhea for more than one year	Group 1 received 500 mg ginger 1 cup tea/day (200 mL). Group 2 received Vitamin E 100 IU 1 tablet/day. Group 3 control starch tablets 250 mg one tablet/day	Randomized controlled trial	30	None	There is a significant correlation in the results of the VAS scale throughout the study. The level of significance indicates that the VAS scale of pain showed various results in the pain levels of patients having ginger tea and vitamin E capsules for the pain management of menstruation of females. There is also a significance noticed in the placebo group (p<0.01 or p<0.05 throughout)
Harjai and Chand, 2018 [52]	Adolescent female nursing students	Experimental group 1 was given ginger two days before the onset of menses and continued through the first three days of menses. Experimental group 2 was given ginger only for the first three days of menses	Experimental study with pre-test and post-test design	30	None	Ginger application has a significant effect in reducing pain in both group 1 and group 2. Group 2 had an even more effective reduction in pain level than Group 1 (p<0.05)
Viljoen et al., 2014 [54]	Randomized controlled trials involving human participants and investigating ginger for the treatment of nausea and vomiting in pregnancy	Any form of orally administered ginger intervention (fresh root, dried root, powder, tablets, capsules, liquid extract, and tea) compared with an inert (placebo) or active ingredient	Meta-analysis	12	Allergic reaction, arrhythmia, dehydration, spontaneous abortion, belching, burning sensation, diarrhea, dry retching or vomiting, headaches, drowsiness, and heartburn	Ginger significantly improved the symptoms of nausea when compared to placebo (p=0.0002). Ginger did not significantly reduce the number of vomiting episodes compared to placebo, although there was a trend towards improvement (p=0.06). Subgroup analyses favor the lower daily dosage of <1500 mg ginger for nausea relief. Ginger did not pose a significant risk for spontaneous abortion compared to placebo (p=0.15), or to Vitamin B6 (p=0.19). Similarly, ginger did not pose a significant risk for the side effects of heartburn or drowsiness
Thomson et al., 2014 [55]	Placebo-controlled trials with a satisfactory score on the Cochrane Risk of Bias assessment tool	One study used 5 biscuits per day, each containing 500 mg of ginger, whereas the others used either capsules or syrup containing approximately 1 g of ginger daily	Meta-analysis	6	None	The use of ginger for at least 4 days is associated with a 5-fold likelihood of improvement in nausea and vomiting in early pregnancy (p<0.0001)