Gynaecological problems are a category of diseases affecting female reproductive organs, such as the uterus, ovaries, fallopian tubes, and vagina. Some of the most common disorders affecting reproductive years include heavy menstrual bleeding, premenstrual syndrome, polycystic ovarian syndrome (PCOS), irregular menstrual periods, uterine fibroids, and endometriosis. Overall incidence rates are higher for menorrhagia (100.9 per 10 000 person-years), uterine fibroids (63.2 per 10 000 person-years), endometriosis (30.8 per 10 000 person-years), and polycystic ovary syndrome (25.3 per 10 000 person-years) (Stahlman et al., 2017).

In recent years, public attention to complementary and alternative medicine (CAM) has markedly increased. Along with clinical practice, a growing number of research reports on the use of such therapies have been noticed all over the world. In line with the overall growth of CAM use along with conventional therapies in different disorders, the use of herbal medicines and medicinal plants becomes also popular in gynaecological problems (Chukasemrat et al., 2021, Drozdoff et al., 2018). It seems that the lack of success in treating some gynaecological problems attracts the attention of both patients and scientists to medicinal plants (Grimm et al., 2021).

Fenugreek, with the scientific name of Trigonella foenum-graecum L. from the family Fabaceae (Leguminosae), is one of the important medicinal plants in gynaecological diseases (Singh et al., 2022b). Fenugreek seeds (FS) are also mentioned as a valuable medicinal material in some herbal pharmacopoeias, including British Pharmacopoeia (British Pharmacopoeia Committee, 2020) and Iranian Herbal Pharmacopoeia (Iranian Herbal Pharmacopoeia Committee, 2003).

Different traditional and folk medicines consider fenugreek as a useful medicinal plant in gynaecologist and obstetrics (Bahmani et al., 2016). The main medicinal part of the plant is the seed which contains diosgenin, a spirostan sapogenin. Diosgenin is widely studied regarding its biological activities in the female reproductive system due to its oestrogenic effects (Patel et al., 2018).

Considering the importance of fenugreek in women’s health, this review aims to provide a critical discussion regarding the current evidence on the pharmacological activities of fenugreek in gynaecological disorders.