Effectiveness of Hijama Bila Shurt (dry cupping) and Hijama Bil Shurt (wet cupping) in management of gynecological disorders: A systematic narrative analysis

Abstract

The word Hijama is used in Unani system of medicine for cupping. It is the application of suction cups to the skin to draw out stagnant, congested blood and Vital Force, as well as other stagnant or morbid humors. These are increasingly and widely applied in managing gynecological disorders such as, dysmenorrhea, chronic pelvic pain, menorrhagia, polycystic ovarian disease, postpartum pain, and anxiety. The present systematic narrative review aims in evaluating clinical evidences on the effectiveness of Hijama Bila Shurt (dry cupping) and Hijama Bil Shurt (wet cupping) in gynecological diseases. A systematic search of electronic databases was conducted to identify relevant studies including randomized controlled trials, observational studies, pilot studies and preliminary studies through authoritative text books and peer reviewed scientific journals via PubMed, Google scholar, Scopus and Science Direct between 2012-2025. The search strategy combined terms such as "cupping," "Hijama," "dry cupping," "wet cupping," and "gynecological diseases". Inclusion criteria targeted clinical trials on gynecological conditions using cupping therapy with full-text availability. Studies were screened according to PRISMA using guidelines, and their quality was assessed using the Jadad scale. A total of 267 potentially relevant studies were found, although subsequently duplicates, irrelevant data, and insufficient data, were excluded. Finally, 42 studies were organized by condition, and narratively analyzed. Animal studies, editorials and non-gynecological conditions were excluded. This holistic approach advances gynecological diseases understanding, pioneering therapeutic alternatives in primary dysmenorrhea, PCOS, menorrhagia, postpartum pain, and anxiety, often outperforming standard treatments. However, it was noted that the evidence was limited by small sample sizes, lack of blinding, heterogeneous interventions and lack of standardized protocols. Further rigorously designed randomized controlled trials are essential to substantiate the safety and efficacy of cupping therapy in women's health and to validate the traditional concepts proposed by Unani scholars.