Pasqueflower has excellent traditional reference for use in reproductive health as well as for conditions of the nervous system (4) — likely the most favored uses among modern herbalists. 

Due to sustainability and safety issues (explained more thoroughly in our sustainability and safety sections), there is a strong case to consider using herbal analogues in place of pasqueflower.

Alternatives to pasqueflower

A list of herbs that may be considered have been included below.

Motherwort (Leonurus cardiaca) is an effective reproductive tonic due to its nourishing effects on the female reproductive system. It is specifically indicated where menstruation is delayed or suppressed as a result of emotional tension. Motherwort is also indicated for anxiety, panic and nervous tension (5).

Passionflower (Passiflora incarnata) is a powerful anxiolytic nervine herb. It can be used to help in cases of stress, tension and anxiety. Passionflower also has relaxant actions on the nervous system and can be beneficial for stress related palpitations, panic attacks and sleeplessness (6).

Raspberry leaf (Rubus idaeus) may be considered as an effective uterine tonic to help restore the balance and tone of the reproductive organs (7)

Shatavari (Asparagus racemosa) is an excellent nourishing tonic and one of the most important rejuvenative herbs for women. It has a particular affinity for the female reproductive system and can be used for menstrual pain and irregularity (8).

Using herbal medicines at home for acute or short-term illness can offer effective relief of symptoms. However, treatment of ongoing, serious or chronic health problems is best taken under consultation with a qualified medical herbalist to enable the safest and most effective healing. Medical herbalists are trained to understand the nuances of disease with a deep understanding of holistic health. A herbalist can offer treatment that is fine tuned and personalised to suit the specific circumstances and constitution of the patient. Use our find a herbalist resource to help find a practitioner.

Pasqueflower is considered to be cold and dry energetically. It has a specific affinity for the heart (physically, spiritually and emotionally) and reproductive system. It is particularly useful treating conditions in which the mind or mental states play a prominent role particularly for women with nervous tendencies (4).

In terms of the emotional indications for pasqueflower, it may be suitable for those who are melancholic with a negative or gloomy mentality (9). It may be a choice remedy for those with an overwhelmed depressive personality type (4), perhaps for those with a tendency to look on the darker side of life or who are lost in sadness (9).

It is also an excellent medicine for individuals who have a nervous or restless nature. In Henrietta’s Herbal, a pasqueflower patient is described as one who “weeps easily, and the mind is inclined to wander—to be unsettled” (9). Further comment suggests that the pasqueflower patient will have a “weak, soft, and open pulse, and the tissues have a tendency to dryness (except when the mucous tissues are discharging a thick, bland material), and, about the orbits the parts appear contracted, sunken, and dark in colour” (9). Pasqueflower’s therapeutic action is to calm and soothe the nervous system, offering some relief from mental strain (10).

Pasqueflower may also be given to promote sleep particularly where it is affected by nervous exhaustion or by nightmares and unpleasant dreams (9).

Pasqueflower is also sometimes used as a relaxant nervine to alleviate the nervous irritability that comes with weaning off from drugs, conventional sedatives or anxiety medications (2, 4, 10). For this application it may be combined with other nervine sedative herbs such as hops and valerian.

TCM perspective

It is the root of the pasqueflower plant (Pulsatilla chinensis), with its tufted white crown earning it the title of “white-headed gentleman” (bai tou weng), that is most commonly used for medicinal purposes in Traditional Chinese mMedicine (TCM). It is an essential herb in the Chinese pharmacopeia and belongs to the category of herbs that clear heat and relieve toxicity on account of its bitter and cold energetic properties. Specifically, these effects benefit the large intestine, liver and stomach systems and it is a leading TCM herb for treating “dysenteric disorder” (acute or chronic inflammation of the large intestine), particularly when there is blood in the stools. The stalk and leaf of this plant, known in TCM as bai tou weng jing and bai tou weng ye, have distinctly different properties to the root and are used to treat rheumatic joint pain and promote cardiovascular health.  

Pasqueflower was a highly esteemed medicine used by the eclectic physicians of the late 1800s and early 1900s in the United States who used it to treat numerous conditions — particularly those of the female reproductive system (11).

Some of the common indications for this herb as used by the Eclectics were for uterine disorders, menstrual pain, and amenorrhea (lack of menstruation). It was also used to relieve pain and congestion from middle-ear infections (11).

Other common indications were for nervous system disorders such as nervousness, anxiety and insomnia (11).

TCM perspective

Pasqueflower root has been used in traditional Chinese herbology for millennia as a chief herb for “li ji” (dysenteric disorders). It first appears in the earliest TCM materia medica, the Shen Nong Ben Cao Jing (the Classic of the Materia Medica), compiled towards the end of the Han dynasty (circa 206BCE–-220CE). Later classical texts also claimed pasqueflower root to be beneficial for the eyes (25). 

Bai Tou Weng Tang, the leading TCM prescription for pasqueflower root, belongs to the category of formulas that clear heat from the organs. It features in the Shang Han Lun (the Treatise on Cold Damage Diseases) – the first known classical text on Chinese herbal prescriptions also published in the late Han period —- where it is recommended for “terminal yin-stage dysenteric disorder”, a rather severe form of dysenteric disorder where the pathogen (damp-heat or toxicity) has entered the blood level causing bleeding.

Pasqueflower is considered to be a herb that should be used in small doses and with caution. This is due to its powerful and potentially toxic nature (3). However, pasqueflower has long been included in the work of herbal practitioners and continues to be widely used in modern herbal practice today. 

Mills and Bone discuss the issues of legislation around such herbs that have been listed with potential safety concerns by the European Commission Committee (12). In their book Principles and Practice of Phytotherapy they elucidate on this matter, highlighting the absence of any form of consultation with practitioner representatives in the decision process to categorise certain medicines as potentially ‘unsafe’. There are many herbs that contain negotiable levels of potentially toxic compounds if used incorrectly (12).

Whilst the question of definition in terms of true risk should not be ignored — it should be understood that the topic of safety for herbs such as pasqueflower is a matter of debate (12). As with any pharmacologically active medicine or drug, one should consider the applied context that is concurrent with safe herbal prescribing by professionals.

Reproductive system

Pasqueflower has a number of uses for conditions of the reproductive system. The British Herbal Pharmacopoeia reference the use of this plant for dysmenorrhea with scanty menses as well as for ovarian and ovulation pain (12, 13). 

Pasqueflower’s indication for painful or inflammatory conditions in the reproductive system is largely linked to its sedative (3) and antispasmodic actions (14). Its therapeutic actions are best applied where there is nervous tension causing or accompanying dysmenorrhea. Pasqueflower also exerts pronounced analgesic and antispasmodic action on the uterus (3).

It is a useful herb for painful conditions in both the female and male reproductive systems (13) due to these actions (14). Hoffman (14) suggests the use of pasqueflower for painful conditions of the testes and the British Herbal Medicine Association recommend it for epididymitis (inflammation of the epididymis, an anatomical feature at the back of the testicle) (13).

Nervous system

There are multiple indications for pasqueflower in relation to conditions of the nervous system. It is a gentle nervine medicine with antispasmodic actions, making it useful for conditions characterised by tension and spasmolysis (14). It also has analgesic and anti-inflammatory properties which lend themselves well in the treatment of headaches (9).

Nervous headaches are one such condition that is commonly referenced for pasqueflower as well as neuralgia (13, 14).  It may be used for headaches of multiple origin. These include; frontal headaches caused by nasal catarrh; nervous headaches caused by stress and tension and menstrual headaches including those related to menstrual irregularities (9).

Pasqueflower is indicated in emotional presentations such as hyperactivity, anxiety, panic, low mood and depression. It is often referenced for use for acute and intense episodes of anxiety, including for panic attacks where it can prove to be invaluable to have a bottle to hand (2). Pasqueflower may also be used where there is low mood, depression or melancholic tendencies (10).

It may also be a useful gently sedative nervine medicine to incorporate into a medicine for insomnia (13, 14). For this application it may be combined with other sedative herbs such as hops and valerian. 

A herbalist will usually only use sedatives intermittently or for short periods of time. For example they may be applied to support patients during acute phases of insomnia and anxiety. This is because sedatives work to treat the symptoms rather than the root cause. For ongoing insomnia or sleep problems it is best to consult with a qualified practitioner to identify and address the cause.

Herbalists often use pasqueflower alongside other nervines and nervous system trophorestoratives to assist in the treatment of chronic and recurring headaches, migraines and tension (12). Pasqueflower may pair well with passionflower, wood betony and lavender for nervous headaches. For severe headaches that last more than 72 hours, where vision or consciousness is affected or where they are accompanied by vomiting with less than four hours pain-free seek immediate medical attention (15).

Some other aromatic nervines to consider for stress, anxiety and for other emotional presentations would be lavender, lemon balm or chamomile with nervous trophorestoratives such as oat straw or ashwagandha. 

Eyes, ears and throat

Pasqueflower may be indicated for congestion or infection in the eyes, ears and throat. Its decongesting effects work by improving the tone of cranial vasculature allowing for improved blood movement. It also works by reducing inflammation (9, 16). 

It can be taken internally (not topically) for catarrhal conditions of the eyes, ears and nose (16). A herbalist may consider it as part of a formula to address more serious eye conditions such as glaucoma and cataracts as well as for nervous eye tics (taken internally) (16).

Pasqueflower is also indicated where there is catarrh and congestion in the upper respiratory system (16) with bright, yellow or green catarrh being one of its most typical indications (9).

Skin

Pasqueflower has been held in high esteem for use in skin conditions used both topically and internally. It is indicated for the treatment of skin infections, especially boils as it has potent antibacterial actions (13, 14). This may be applied through use of an infused cream or as a wash made using pasqueflower infusion of dried herbs.

What TCM practitioners say

TCM “dysenteric disorders” include both acute infections of the large intestine by bacteria, protozoans and other organisms as well as chronic inflammatory bowel diseases. Modern TCM treatment for these tends towards chronic conditions, acute flare-ups of chronic conditions or the sequealae of acute infections.

Many TCM herbs may be indicated in these instances, however, where pasqueflower root excels is in the treatment of dysenteric disorders deriving from damp-heat and toxicity in the intestines, in particular where the heat is greater than the dampness. In clinical practice, this means it is selected in cases of violent diarrhoea with more blood (heat) than pus (damp) and fever. Bai Tou Weng Tang (Pulsatilla Decoction) would be the formula of choice in such situations.

As the name suggests, bai tou weng is the chief herb in this formula where it is often prescribed in large doses of 12–-18g or even up to 30g. It is accompanied by huang lian (Coptis chinensis) and huang bai (Phellodendron spp), to reinforce the clearing of heat and dampness, and qin pi (Fraxinus excelsior|Ash bark) which acts as an astringent. The use of this classical formula has expanded over time and may also be applicable to appropriate cases (ie. those presenting with symptoms of damp-heat and toxicity) of gastroenteritis, ulcerative colitis, abnormal vaginal discharge, urinary tract infections and conjunctivitis.  

It is also used externally for scrofula (inflamed lymph nodes in the neck), hemorrhoids and itching vaginal discharge (for this purpose it is combined with ku shen (Sophora flavescens root) and used as a wash). 

The bitter and cold nature of this herb contraindicates its use for those with weak digestions (in particular, what is known as Spleen yang deficiency in TCM) and for extended periods of time. 

There is little available research on pasqueflower aside from a small number of in vitro studies that focus on extracts of pasqueflower and its bioactive compounds. Some of these studies have been included below to demonstrate the mechanism of action for some of its medicinal properties; however, there is a lack of available human studies.

Animal studies are not condoned by Herbal Reality, however for the purpose of including research from which some understanding of therapeutic actions can be confirmed, some animal studies have been included herein.

In vitro inhibition of cancer proliferation in signalling pathways using pasqueflower methanolic extracts

An in vitro study was conducted to examine the effects of methanolic extracts of pasque flower on HeLa cell proliferation (HeLa cells are an immortalised cell line used in scientific research) through the modulation of cancer-related signalling pathways. 

The study set out to access the cytotoxic activities in relation to specific bioactive compounds in pasqueflower leaf and root extracts. The results demonstrated that pasqueflower root extract inhibited 12 signalling pathways in cervical cancer cell lines. 

The extracts also encouraged apoptosis as well as deregulation of cellular proliferation, differentiation, and progression by altering important signalling molecules required for cell cycle progression. The study attributed the majority of pasqueflower’s cytotoxic actions to triterpenoid saponins accompanied by phenolic acids (17).

Antifungal activity of the rhizome extracts of pasqueflower vulgaris against Candida glabrata

This in vitro study set out to evaluate the antifungal, antimicrobial, antimalarial and cytotoxic activities of leaf and root extracts of pasqueflower. The study demonstrated effective anti-fungal activity against yeast Candida glabrata (18).

Mechanism underlying the effect of pasqueflower decoction in hepatocellular carcinoma treatment: a network pharmacology and in vitro analysis

A review was carried out to explore the mechanism of pasqueflower decoction on hepatocellular carcinoma (HCC) using a database search, network pharmacology and in vitro experiments. The study identified multiple studies that verify the active constituents of pasqueflower as well as relating potential target genes for HCC. Cell viability and cell cycle experiments verified that pasqueflower decoction inhibits cancer cell proliferation and kill HCC cells by inducing apoptosis. The study concludes that the results may provide a potential new therapeutic application of pasqueflower for the treatment of malignant tumors. Further research in the form of placebo controlled clinical studies are required in order to assess these effects in human subjects (19). 

These works afford us a deeper insight into the medicinal activities of this fascinating plant and show it has significant potential beyond many of its known traditional and modern uses.

The common name pasqueflower derives from the old French word for Easter ‘pasque’. The name relates to the flowering time of this plant at around Easter which is associated with the celebration of new life and reawakening as well as the resurrection of Christ in the Christian tradition.

Pasqueflower is more selective about its habitat than many other members of the buttercup family. It favours short-cropped grassland over chalk or limestone often in full sun.

It is native to the British Isles, Austria, Belarus, Belgium, Czech Republic, Denmark , France, Germany, Great Britain, Hungary, Northwest European Russia, Norway, Poland, Romania, Slovakia, South European Russia, Sweden, Switzerland andUkraine. It was previously found on magnesian limestone in Northern England (23).

Pasqueflower is endangered in many of its native regions across Europe. This is largely due to loss of habitat (1). It is also exceptionally difficult grow, particularly in larger crops. The combination of these issues has meant that this herb has become increasingly more difficult to source. It is vital that we seek the most sustainable options when sourcing our medicines especially in the case of threatened species such as pasqueflower. 

Many passionate gardeners, herbalists and those committed to experimenting with these harder to supply herbs, work to grow pasqueflower in smaller crop sizes for personal or small scale use. Where it is not possible to source sustainable, non- wild- harvested material it is important to consider alternative herbs (2).

The IUCN red list of threatened and at risk species classified pasqueflower as ‘near threatened’. It states that over the last 100 years, the plant has been severely affected by changes in habitat leading to a significant population decline. In the UK, pasture management has been identified as one of the significant causes. Active habitat recovery and conservation programs have positively supported the number of specimens over the past 50 years, although the number of subpopulations is still in decline. Part of the species distribution range is included in protected areas and recovery action plans at the species level are in place for the UK (1).

Cultivation of at risk medicinal plants often helps to take the pressure off of wild populations. However, is not yet understood how to successfully cultivate pasqueflower to meet the demands of the growing industry. It is extremely slow to germinate as well as having very specific soil requirements and it comes with a high risk of crop failure as pasqueflower does not overwinter well. It takes over a year to establish before it can be harvested and and it can take up to five years to reach its ultimate height (2). Smaller crops are easier to maintain and many herbalists successfully grow their own pasqueflower to meet the needs of their practice.

Habitat loss and over-harvesting from the wild are two of the biggest threats faced by medicinal plant species. There are an increasing number of well-known herbal medicines at risk of extinction. We must therefore ensure that we source our medicines with sustainability in mind. 

The herb supplement industry is growing at a rapid rate and until recent years a vast majority of medicinal plant produce in global trade was of unknown origin. There are some very real and urgent issues surrounding sustainability in the herb industry. These include environmental factors that affect the medicinal viability of herbs, the safety of the habitats that they are taken from, as well as the welfare of workers in the trade.

The botanical supply chain efforts for improved visibility (transparency and traceability) into verifiably sustainable production sites around the world is now certificated through the emergence of credible international voluntary sustainability standards (VSS). 

Read our article on Herbal quality & safety: What to know before you buy  and Sustainable sourcing of herbs to learn more about what to look for and questions to ask suppliers about sustainability.

Herbal Medicines are often extremely safe to take, however it is important to buy herbal medicines from a reputed supplier. Sometimes herbs bought from unreputable sources are contaminated, adulterated or substituted with incorrect plant matter.

Some important markers for quality to look for would be to look for certified organic labelling, ensuring that the correct scientific/botanical name is used and that suppliers can provide information about the source of ingredients used in the product.

A supplier should be able to tell you where the herbs have come from. There is more space for contamination and adulteration when the supply chain is unknown.

Pasqueflower has some very specific requirements in order to thrive. With care and attention, pasqueflower can be grown in smaller crops, in sheltered gardens, sloping or raised beds. They grow well in a rock bed, They will only thrive in well-drained, alkaline (chalk, lime or sand) soils with full to partial sun.

In more rain prone locations they are best situated on sloping beds, hillsides and in raised beds so their roots don’t sit in waterlogged soil over the winter months. 

Allow the plants to release their seeds before removing the old flower stalks to allow them to gently re-seed themselves. 

Young seedlings can be transplanted without too much difficulty. But established plants, with their long, deep tap roots may not transplant successfully (24).

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5. Motherwort. Herbal Reality. https://www.herbalreality.com/herb/motherwort/
6. Passionflower. Herbal Reality. https://www.herbalreality.com/herb/passionflower/
7. Rubus. Herbal Reality. https://www.herbalreality.com/herb/rubus/
8. Shatavari. Herbal Reality. https://www.herbalreality.com/herb/shatavari/
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13. British Herbal Medicine Association. Scientific Committee. A Guide to Traditional Herbal Medicines : A Sourcebook of Accepted Traditional Uses of Medicinal Plants within Europe. British Herbal Medicine Association; 2003.
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15. Headaches. nhs.uk. Published January 8, 2018. Accessed March 15, 2024. https://www.nhs.uk/conditions/headaches/#:~:text=See%20a%20GP%20if%3A
16. Menzies-Trull C. Herbal Medicine Keys to Physiomedicalism Including Pharmacopoeia. Newcastle, Staffs. Faculty Of Physiomedical Herbal Medicine; 2003.
17. Grażyna Łaska, Elwira Sieniawska, Maciejewska-Turska M, Łukasz Świątek, Pasco DS, Balachandran P. Pulsatilla vulgaris Inhibits Cancer Proliferation in Signaling Pathways of 12 Reporter Genes. International Journal of Molecular Sciences. 2023;24(2):1139-1139. doi:https://doi.org/10.3390/ijms24021139 Accessed March, 2024.
18. Łaska G, Sienkiewicz A. Antifungal activity of the rhizome extracts of Pulsatilla vulgaris against Candida glabrata. European Journal of Biological Research. 2019;9(2):93-103. Accessed March 9, 2024. http://www.journals.tmkarpinski.com/index.php/ejbr/article/view/152 Accessed March, 2024.
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