The Tibetan uterotonic Zhi Byed 11: Mechanisms of action, efficacy, and historical use for postpartum hemorrhage

Rebecca Lynn Coelius, Amy Stenson, Jessica L. Morris, Mingji Cuomu, Carrie Tudor, Suellen Miller

Research output: Contribution to journalArticle

3 Scopus citations


Objective: To explore evidence for the traditional Tibetan medicine, Zhi Byed 11 (ZB11), for use as a uterotonic. Methods. The eleven ingredients in ZB11 were chemically analyzed by mass spectroscopy. A review was conducted of Western allopathic literature for scientific studies on ZB11's individual components. Literature from Tibetan and other traditional paradigms were reviewed. Results. Potential mechanisms of action for ZB11 as a uterotonic include laxative effects, a dose-dependant increase in smooth muscle tissue peristalsis that may also affect the uterus smooth muscle, and chemical components that are prostaglandin precursors and/or increase prostaglandin synthesis. A recent RCT demonstrated comparable efficacy to misoprostol in reducing severe postpartum hemorrhage (PPH) (>1000mL) and greater effect than placebo. Historical and anecdotal evidence for ZB11 and its ingredients for childbirth provide further support. Discussion. ZB11 and its ingredients are candidates for potentially effective uterotonics, especially in low-resource settings. Further research is warranted to understand the mechanisms of action and synergy between ingredients.

Original languageEnglish (US)
Article number794164
JournalEvidence-based Complementary and Alternative Medicine
Publication statusPublished - 2012
Externally publishedYes


ASJC Scopus subject areas

  • Complementary and alternative medicine

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