Abstract
This study investigated the therapeutic potential of Codonopsis lanceolata peel extract (CPE) for premenstrual syndrome (PMS). The focus was on hormonal, immune, and microbial pathways. In vitro, CPE reduced nitric oxide production and suppressed IL-6 and TNF-α expression in LPS-stimulated macrophages. In pituitary GH3 cells stimulated with estradiol, CPE inhibited prolactin secretion. In a metoclopramide (MCP)-induced hyperprolactinemia mouse model, CPE decreased serum prolactin, PGE2, and inflammatory cytokines, while increasing PGE1 and FSH levels. Microbiome analysis showed that CPE enriched beneficial genera such as Lactobacillus and Bifidobacterium and reduced pro-inflammatory taxa including Oscillibacter and Desulfovibrionaceae. These microbial shifts were associated with improved inflammatory and hormonal markers. Overall, these findings suggest that CPE alleviates PMS symptoms by modulating endocrine function and regulating gut microbiota. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10068-025-02003-w.