Peony

What Is Peony?

Peony is a common Chinese herbal medicine for treating hormone conditions in both men and women, as well as cardiovascular disease and muscle cramps. It’s named after the mythological physician of the gods, Paeos, who was said to cure Pluto and other Greek gods injured during the Trojan War.

There are 3 main forms of peony in herbal medicine, tree peony, red peony, and white peony. These differentiations have nothing to do with the color of the flower, but the color of the roots after preparation. White peony is the most common, made from the roots of the plant without the bark attached. It’s most commonly made from the species Paeonia lactiflora, but can be made from other species as well.

How Is Peony Used?

Peony is most commonly used for treating PMS symptoms, poly cystic ovarian syndrome (PCOS), muscle cramps, and epilepsy. It’s rarely used alone, as it’s thought to have stronger effects in combination with other herbs like licorice or black cohosh.

Traditional Uses

Peony is a common herb in the traditional Chinese herbal materia medica. It’s considered to be specific for the liver, providing a soothing effect on liver energy and improves overall function. It’s thought to nourish the blood, and is one of the great women’s tonics, especially in combination with licorice.

Compared to Angelica sinensis, Peony is used in much the same way, however, peony is used when the condition involved “heat”, while Angelica sinensis is used when the condition involves “cold”.

Botanical Information

Peony is the only member of the Paeoniaceae family. In the past it was included in the Ranunculaceae family instead along with over 2000 other species of plants. There are roughly 33 different species of peony worldwide.

Medicinally, there are 4 main species used;

• Paeonia suffruticosa (Tree peony)
• Paeonia lactiflora (Chinese peony)
• Paeonia veitchii (Chinese peony)
• Paeonia obovata (Chinese peony)

Phytochemistry

Peony’s signature compound is paeoniflorin, a monoterpene glycoside (pinane-type) that is both the chemical marker and the principal active of the root — the Chinese Pharmacopoeia sets a minimum of 1.6% paeoniflorin for white peony root (Radix Paeoniae Alba). It is the main driver of the herb’s smooth-muscle-relaxant, antispasmodic and anti-inflammatory effects, and underlies the classic paeoniflorin–glycyrrhizin synergy with licorice at the neuromuscular junction. Its isomer albiflorin accompanies it and is notably more abundant in white than in red peony root.

The other notable actives are phenolic. Paeonol † (an acetophenone) carries anti-inflammatory and analgesic activity but is comparatively minor in white peony root, being concentrated instead in tree peony bark (Moutan, P. suffruticosa) and red peony — so its presence and level help distinguish the peony forms. Astringent gallotannins, including pentagalloylglucose, make up much of the tannins fraction.

Constituent Summary

Figures are percent of dried root (w/w). † paeonol differentiates the peony forms: low in white peony root but a major marker of tree peony (Moutan) bark and red peony. Levels vary by species, processing (white vs. red) and grade.

Clinical Applications

Peony is useful as a smooth muscle relaxant due to its ability to interfere with acetylcholine in the neuromuscular junctions.

It’s also a fairly reliable aromatase inducer, useful for improving the production of estrogen from testosterone, and E1 and E2 to 2-hydroxy catechol estrogens.

Cautions & Safety

Caution advised in combination with blood thinners.

References

1. Bensky, D., Gamble, A., & Kaptchuk, T. J. (2004). Chinese herbal medicine: materia medica (Vol. 3, p. 1004). Seattle: Eastland Press.
2. Kimura, M., Kimura, I., Takahashi, K., Muroi, M., Yoshizaki, M., Kanaoka, M., & Kitagawa, I. (1984). Blocking effects of blended paeoniflorin or its related compounds with glycyrrhizin on neuromuscular junctions in frog and mouse. The Japanese Journal of Pharmacology, 36(3), 275-282.
3. Bone, K. (2003). A Clinical Guide to Blending Liquid Herbs E-Book: Herbal Formulations for the Individual Patient. Elsevier Health Sciences.
4. Takeuchi, T., Nishii, O., Okamura, T., & Yaginuma, T. (1991). Effect of paeoniflorin, glycyrrhizin and glycyrrhetic acid on ovarian androgen production. The American journal of Chinese medicine, 19(01), 73-78.
5. Grant, P., & Ramasamy, S. (2012). An update on plant derived anti-androgens. International journal of endocrinology and metabolism, 10(2), 497.
6. Tan, Y. Q., Chen, H. W., Li, J., & Wu, Q. J. (2020). Efficacy, Chemical Constituents, and Pharmacological Actions of Radix Paeoniae Rubra and Radix Paeoniae Alba. Frontiers in Pharmacology, 11, 1054.
7. Chinese Pharmacopoeia Commission. (2020). Pharmacopoeia of the People’s Republic of China, Vol. I: Paeoniae Radix Alba. China Medical Science Press.