March 22, 2017



Natural Standard Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Related Terms

  • Japanese herbs, Kampo, senkyu, shakuyaku, soujyutsu, takusha, toki, TSS, Tsumura TJ-23.


  • Toki-shakuyaku-san (Tsumura TJ-23) is a Chinese medicine which contains soujyutsu, shakuyaku, takusha, toki, and senkyu. It is traditionally used to treat dysmenorrhea, a disorder in women that involves painful menstrual periods. Smoking, depression and heavy menstrual flow can all be considered causes of dysmenorrhea. The condition can also be caused by underlying health issues.


  • Toki-shakuyaku-san has been shown to be more effective than placebo in treating women with dysmenorrhea. However, because this product is a supplement and not regulated by the FDA, the ingredients and effectiveness of different formulations may vary.

  • Other studies have suggested that toki-shakuyaku-san does have some effect on the ovulatory process by affecting steoidogenesis, mainly by the production of estradiol. There has been no clear mechanism of action identified for toki-shakuyaku-san. The product does not appear to suppress fertility or ovulation.


The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

  • Insufficient available evidence.

Author Information

  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).


Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Enomoto K, Higashida H, Maeno T. Effects of toki-shakuyaku-san (Tsumura TJ-23) on electrical activity in neuroblastoma cells and frog neuromuscular junctions. Neurosci Res. 1992 Oct;15(1-2):81-9. View Abstract

  2. French L, MD. Dysmenorrhea. Am Fam Physician. 2005 Jan 15;71(2):285-91. View Abstract

  3. Irahara M, Yasui T, Tezuka M, et al. Evidence that Toki-shakuyaku-san and its ingredients enhance the secretion of a cytokine-induced neutrophil chemoattractant (CINC/gro) in the ovulatory process. Methods Find Exp Clin Pharmacol. 2000 Dec;22(10):725-30. View Abstract

  4. Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com

  5. Proctor M, Farquhar C. Dysmenorrhoea. Clin Evid. 2002 Jun;(7):1639-53. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.


March 22, 2017