Herbs & Botanicals · Herbs · A tannin-rich European herb with almost no human research
Lady's mantle
Alchemilla vulgaris L. (aggregate; also A. xanthochlora Rothm.); aerial parts · also called Lady's mantle, Alchemillae herba, Frauenmantel
Lady's mantle is a meadow herb whose flowering tops are made into tea. It is traditionally used for mild diarrhea and for period and menopause complaints. It is rich in tannins. Almost no human research exists, so its benefits are unproven.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Lady's mantle
Lady's mantle is a traditional European tea herb for mild diarrhea and women's complaints. Almost no human research exists, so what it can do is unproven, and its safety is not well known.
What it is
Lady's mantle is the flowering above-ground part of Alchemilla vulgaris, a meadow plant in the rose family. The name covers a group of many very similar species (Alchemilla xanthochlora is a synonym in the ESCOP monograph). GBIF lists A. vulgaris and A. xanthochlora as accepted names.
The genus has about 1000 species, so products can differ in which one they contain. A common garden species, Alchemilla mollis, is a different plant studied separately.
Traditional and current uses
European folk medicine uses the tea for mild diarrhea and stomach complaints, painful and heavy periods, menopause complaints and vulvar itching. A German reference and ESCOP list it for mild, non-specific diarrhea.
It is also used on the skin and mouth. RxList rates the evidence as insufficient for every use.
What is in it and how it works
The herb is rich in ellagitannins, mainly agrimoniin, and contains flavonoids. Tannins are astringent, which is the usual explanation for its use in diarrhea and on the skin. This explanation has not been tested in people.
Lab and animal work reports antioxidant, anti-inflammatory and wound-healing activity, but the 2024 review says clinical studies are limited.
What the research shows
There is no human trial for diarrhea, period problems or menopause. The only randomized trial we found tested a glycerine spray against dexamethasone for sore throat after surgery in 94 people. It found no significant difference (57.8% vs 46.5%, P = 0.290) and had no placebo group.
A rat study of a PCOS-like condition found hormone markers moved toward normal with an extract. Rat results do not show the same in women. A skin-gel study showed faster cell scratch closure and better skin barrier readings.
At a glance
Traditional uses history, not proof
- European folk medicine: tea for mild diarrhea and stomach complaints (ESCOP monograph; German reference).
- Folk use for painful periods, heavy periods, menopause complaints and vulvar itching (2022 and 2024 reviews).
- Wounds and skin problems, and as a gargle (reviews and RxList).
Studied for research
- Mild diarrhea and gut complaints, insufficient (reference listing, no trial)
- Painful or heavy periods, insufficient (no human trial)
- Menopause complaints and vulvar itching, insufficient (no human trial)
- Hormone balance, very low (one rat study)
- Sore throat after surgery, very low (one trial against a drug, no placebo)
- Skin and wound care, very low (lab and a skin-barrier test)
Main compounds
- Agrimoniin, the main ellagitannin (tannins about 6-8% in one reference)
- Pedunculagin, another ellagitannin
- Flavonoids (about 2%), phenolic acids
Common forms
- Dried aerial parts as a tea
- Tincture or liquid extract
- Glycerine spray (the form tested after surgery)
- Topical gels and rinses
Research links: ESCOP lady's mantle monograph summary · Review of the genus Alchemilla (J Ethnopharmacol, 2024) · Lady's mantle spray vs dexamethasone, sore throat trial (2021) · Research Library · Genes & Biomarkers Library
The plant and its history
- Accepted scientific name
- Alchemilla vulgaris L. (aggregate); also Alchemilla xanthochlora Rothm.
- Naming authority
- L.
- Synonyms
- Alchemilla xanthochlora Rothm. (synonym per ESCOP; accepted in GBIF); Alchemilla vulgaris agg.; Alchemilla vulgaris sensu lato
- Common names
- Lady's mantle (en); Frauenmantel (de); Alquimila (es); Alchemillae herba (la)
- Botanical family
- Rosaceae
- Classification
- Plantae > Tracheophyta > Magnoliopsida > Rosales > Rosaceae > Alchemilla > Alchemilla vulgaris
- Native range
- Europe (not checked in a source)
- Habitat
- Meadows (general knowledge; not checked in a source)
- What the plant looks like
- Harvest and processing
- The medicinal drug is the flowering aerial parts (ESCOP definition).
- Look-alikes and adulterants
- Name: Alchemilla mollis (garden lady's mantle); Note: A commonly sold garden species; some products may use it. A. mollis is studied separately in the lab.; Name: Other Alchemilla microspecies; Note: The genus has about 1000 species and over 300 in Europe, so which species is in a product can differ.
Traditional use and history history, not clinical proof
| Tradition or era | Documented use | Source |
|---|---|---|
| European folk medicine | Tea for diarrhea, stomach complaints, painful and heavy periods, menopause complaints, vulvar itching and wound care. | p37981119 |
| German Commission E (1986, per search snippet) | Listed for non-specific diarrhea; positive monograph per a secondary reference. NOT verified from the original. | s-altmeyers-alchemillae |
| ESCOP monograph (2013) | Non-specific diarrhoea and gastrointestinal complaints. | s-escop-ladys-mantle |
| EMA / HMPC | No EU herbal monograph found; not verified. | s-regulators-none |
Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.
What is inside, and how it may work
What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Agrimoniin PubChem 16129621 | Ellagitannin (hydrolysable tannin) | aerial parts Tannins overall 6-8%, up to 18% at most (secondary reference) | Named as the main tannin; astringent. Activity in people not shown. 1 11 | Laboratory research |
| Pedunculagin PubChem 442688 | Ellagitannin | aerial parts | Ellagitannin reported in Alchemilla species; its amount and effect in lady's mantle tea not read. 11 7 | Laboratory research |
| Flavonoids (for example quercetin derivatives) PubChem 5280343 | Flavonoid | aerial parts About 2% flavonoids (secondary reference) | Antioxidant in the lab. The quercetin CID is for the parent flavonol; the exact lady's mantle flavonoids are glycosides and were not identified here. 1 7 11 | Laboratory research |
| Phenolic acids, anthocyanins, coumarins, triterpenes | Mixed | aerial parts | Listed as constituents of Alchemilla species. 6 | Laboratory research |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Astringent binding of proteins | n/a | Tannins tighten tissues and bind proteins. This is the proposed basis for use in diarrhea and on skin; not tested in people. 1 3 | Pharmacological theory |
| Antioxidant and anti-inflammatory action | TNF-alpha (rat study) | Lab: antioxidant. Rat PCOS model: extract lowered TNF-alpha in aorta and ovary. 9 7 | Animal research |
| Skin fibroblast migration | n/a | Extracts sped up scratch closure in mouse fibroblast cells; human skin barrier test agreed in direction. 13 | Laboratory research |
Absorption, metabolism and elimination
- Absorption
- Not studied for lady's mantle. Large tannins are poorly absorbed in general (general knowledge, not verified here).
- Distribution
- Unknown.
- Metabolism
- Unknown.
- Elimination
- Unknown.
- Bioavailability
- No data.
Isolated compounds versus whole extracts
The herb's activity is usually attributed to the tannins and flavonoids acting together. No study compared isolated agrimoniin with the whole herb in people.
Nutritional composition
Lady's mantle is a tea or tincture herb, not a food source of vitamins or minerals. Its tannins can reduce iron absorption (see safety).
4 very low certainty4 not enough evidence
What is Lady's mantle good for?
The main proposed uses and how strong the human evidence is for each. "Very low" means lab, animal or one unclear study, and "insufficient" means no usable human evidence.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Mild diarrhea and gut complaints
Not enough evidenceLady's mantle tea is a traditional remedy for mild, non-specific diarrhea. A European herbal society lists it for this use. We found no human trial that tested it, so we cannot say it works.
4 studiesDried aerial parts as a tea are the traditional form; products and st…
Studies, doses and limits
What the trials found
No human trial of lady's mantle for diarrhea was found. The ESCOP public summary lists the use but gives no trial results, and its full monograph was not read. A pharmacognosy review notes traditional use for acute diarrhea. RxList rates the evidence insufficient.
Results
No human result exists.
Effect sizes as reported
None
Why this rating
Support is tradition and reference listings only. No trial, so no basis for a higher rating.
Form and dose studied
Dried aerial parts as a tea are the traditional form; products and strengths vary and nothing here compares them.
Who was studied
Adults with mild loose stools: not tested.
Limits
A listing in a monograph is not the same as proof from a trial. Diarrhea that is severe, bloody or lasts more than a few days needs medical care.
Why researchers looked
The herb is rich in tannins, which tighten (astringe) tissues. That is the usual explanation for its use in loose stools.
Traditional use
Used in European folk medicine for diarrhea and stomach complaints. Listed in a German Commission E monograph (per a secondary reference) and in the ESCOP monograph for non-specific diarrhoea and gastrointestinal complaints.
Proposed mechanism Pharmacological theory
The tannins are astringent. This is a proposed explanation, not something tested in people with diarrhea.
A proposed mechanism does not show that the effect happens in people.
See the safety section. The tannins can upset the stomach and can bind iron and some medicines. Safety in pregnancy is not established.
Painful, heavy or irregular periods
Not enough evidenceLady's mantle has long been used by women for painful and heavy periods. This is tradition. No human trial was found, so nobody can say whether it helps.
4 studiesTea is traditional. No products were compared.
Studies, doses and limits
What the trials found
No human trial for period complaints was found. A 2024 review of the whole genus lists dysmenorrhea among the folk uses and says clinical studies are limited. A 2022 review lists dysmenorrhea and menorrhagia as traditional uses.
Results
No human result exists.
Effect sizes as reported
None
Why this rating
No human data of any kind for this use.
Form and dose studied
Tea is traditional. No products were compared.
Who was studied
Women with period complaints: not tested.
Limits
Heavy or very painful periods can have causes that need a doctor. Do not treat heavy bleeding with a herb alone.
Why researchers looked
The name 'lady's mantle' and its Latin genus reflect a long history of use for women's complaints in Europe.
Traditional use
Folk medicine uses the herb for dysmenorrhea (painful periods) and, in one review, menorrhagia (heavy periods). The tea is the usual form.
Proposed mechanism Pharmacological theory
Not established. The tannins are astringent, which is the usual guess for use against heavy bleeding, but this has not been tested.
A proposed mechanism does not show that the effect happens in people.
See the safety section. The tannins can upset the stomach and can bind iron and some medicines. Safety in pregnancy is not established. Avoid in pregnancy unless a clinician agrees.
Menopausal complaints and vulvar itching
Not enough evidenceFolk medicine uses lady's mantle for menopause symptoms and itching of the vulva. No human trial supports this.
3 studiesNot compared.
Studies, doses and limits
What the trials found
No human trial was found. The 2024 review states clinical evidence is limited. RxList rates the evidence insufficient.
Results
No human result exists.
Effect sizes as reported
None
Why this rating
Tradition only.
Form and dose studied
Not compared.
Who was studied
Women in or after menopause: not tested.
Limits
Do not treat unexplained itching or bleeding after menopause as a herb matter. See a doctor.
Why researchers looked
Reviews list these as traditional women's uses.
Traditional use
Listed in a 2024 review as folk use for menopausal complaints and pruritus vulvae. RxList also lists menopause and skin uses.
Proposed mechanism Pharmacological theory
Not established. We found no evidence that lady's mantle acts like an estrogen in people.
A proposed mechanism does not show that the effect happens in people.
See the safety section. The tannins can upset the stomach and can bind iron and some medicines. Safety in pregnancy is not established.
Hormone balance (rat study only)
Very low certaintyIn a rat model of polycystic ovary syndrome, a lady's mantle extract moved hormone and inflammation markers back toward normal. This is animal research and does not show the same in women.
2 studiesExtract in rats; no tea or product in people.
Studies, doses and limits
What the trials found
No human study of hormone levels was found. The only experiment is a 35-day rat study (extract by mouth at 50 mg per 100 g body weight per day).
Results
Hormone imbalance, ovary changes and blood vessel dysfunction in PCOS rats returned to control values with the extract (abstract; no numbers read).
Effect sizes as reported
Not reported in the abstract
Why this rating
Single animal study, no human data. The abstract gives no numbers we could report.
Form and dose studied
Extract in rats; no tea or product in people.
Who was studied
Rats only.
Limits
Rat results often do not carry over to people. Claims that lady's mantle 'balances hormones' are not backed by human measurements.
Why researchers looked
Traditional use for gynecological complaints led researchers to test it in an animal model of PCOS.
Traditional use
Used traditionally for gynecological diseases.
Proposed mechanism Animal research
In PCOS rats, the extract was reported to lower TNF-alpha in aorta and ovary and to improve blood vessel function and hormone levels. Anti-inflammatory and blood-vessel-relaxing effects are the proposed route.
A proposed mechanism does not show that the effect happens in people.
Hormone-related effects in people are unknown, so people with hormone-sensitive conditions, or on hormone medicines, should ask a clinician first.
Sore throat after a breathing tube (spray)
Very low certaintyIn one randomized trial, a lady's mantle glycerine throat spray did about as well as an injected steroid for sore throat after surgery. There was no placebo group, so it cannot show the spray beats nothing.
1 studiesSingle pre-surgery spray of a branded A. vulgaris glycerine product. …
Studies, doses and limits
What the trials found
94 adults having chest surgery with a double-lumen tube were randomized to a branded Alchemilla vulgaris glycerine spray (with saline injection) or to IV dexamethasone (with saline spray). Sore throat at 24 hours: 57.8% (dexamethasone) vs 46.5% (spray), P = 0.290. No differences at 1, 6 or 24 h in sore throat or hoarseness.
Results
No significant difference between the spray and dexamethasone.
Effect sizes as reported
Difference not significant (P = 0.290)
Why this rating
One small trial, comparison with an active drug only, no placebo, branded product. A 'no difference' result does not prove the spray works.
Form and dose studied
Single pre-surgery spray of a branded A. vulgaris glycerine product. Not a tea.
Who was studied
Adults having thoracic surgery in Korea.
Limits
Cannot be applied to tea or other uses. No conflicts reported.
Why researchers looked
Anesthesiologists tested it because the herb is reported to calm inflammation.
Traditional use
Astringent and anti-inflammatory herb used traditionally as a gargle (RxList).
Proposed mechanism Pharmacological theory
Anti-inflammatory action suggested; not shown in this trial.
A proposed mechanism does not show that the effect happens in people.
No adverse events are discussed in the abstract.
Minor mouth ulcers
Not enough evidenceThe ESCOP summary mentions human data on minor mouth ulcers and good tolerability of a topical preparation. We could not read the trials.
1 studiesTopical preparation; details not known.
Studies, doses and limits
What the trials found
ESCOP's public summary says human data cover minor oral ulcers. No trial was identified or read. A 48-patient trial seen only on secondary websites was not cited.
Results
Not available.
Effect sizes as reported
None
Why this rating
The underlying trials are unread and unidentified.
Form and dose studied
Topical preparation; details not known.
Who was studied
Adults with minor mouth ulcers.
Limits
Unverified.
Why researchers looked
Astringent herbs are used on mouth and gum irritation.
Traditional use
Used as a gargle or mouth rinse in folk practice.
Proposed mechanism Pharmacological theory
Astringent tannins; not tested for this.
A proposed mechanism does not show that the effect happens in people.
ESCOP says a topical preparation was well tolerated.
Skin care and wound healing
Very low certaintyLab work and a skin-barrier test suggest lady's mantle extracts in gels can help skin repair. This is early and not shown to heal real wounds in patients.
4 studiesHydrogels with ethanol, propylene glycol or other extracts.
Studies, doses and limits
What the trials found
A Serbian study tested several extracts. In a cell scratch test all extracts and gels sped up closure, the ethanol extract most. In a skin test on human volunteers, barrier repair results agreed. A 2025 review says Alchemilla could be used in rashes, acne, stretch marks, eczema and psoriasis, but mostly on lab and cosmetic evidence.
Results
Faster scratch closure in cells and better skin barrier repair readings, as described in abstracts; numbers not read.
Effect sizes as reported
Not reported in the abstract
Why this rating
Mostly lab data. The human part measured skin barrier readings, not healing of wounds, and the number of volunteers was not in the abstract.
Form and dose studied
Hydrogels with ethanol, propylene glycol or other extracts.
Who was studied
Healthy human skin (barrier test).
Limits
Gel results depend on the vehicle. Not tea.
Why researchers looked
Folk use on wounds; researchers wanted to test whether the tradition has a basis.
Traditional use
Used on wounds and skin problems in European folk medicine.
Proposed mechanism Laboratory research
Phenolic compounds (tannins, flavonoids), antioxidant action and low gel pH are suggested to speed cell migration and skin barrier repair.
A proposed mechanism does not show that the effect happens in people.
ESCOP says a topical preparation was well tolerated; RxList says there is little information on skin safety.
Antioxidant and anti-inflammatory activity (lab and animal)
Very low certaintyLab and animal studies show antioxidant, anti-inflammatory and germ-fighting activity. This does not prove a health benefit in people.
3 studiesExtracts of several Alchemilla species.
Studies, doses and limits
What the trials found
Reviews report antioxidant, anti-inflammatory, antimicrobial, antiobesity, cardiovascular, anticancer and wound-healing effects from lab and animal studies. The 2024 review says clinical studies are limited. ESCOP reports lab astringent and antibacterial effects and animal blood-vessel-protective effects.
Results
Not applicable to people.
Effect sizes as reported
None
Why this rating
Lab and animal work cannot be read as benefit in people.
Form and dose studied
Extracts of several Alchemilla species.
Who was studied
Cells and animals.
Limits
Which species and which extract was used varies widely between studies.
Why researchers looked
Reviews summarise what the plant's tannins and flavonoids do in test tubes and animals.
Traditional use
Not applicable.
Proposed mechanism Laboratory research
Tannins, flavonoids and phenolic acids neutralise free radicals and reduce inflammation markers in lab models.
A proposed mechanism does not show that the effect happens in people.
Lab results say nothing about safe use.
Connections to the rest of health
How Lady's mantle connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Digestive Support | Traditional use | Not enough evidence | Mild diarrhea and gut complaints: Lady's mantle tea is a traditional remedy for mild, non-specific diarrhea. A European herbal society lists it for this use. We found no human trial that tested it, so we cannot say it works. | 3 1 12 7 |
| Gut Health | Traditional use | Not enough evidence | Mild diarrhea and gut complaints: Lady's mantle tea is a traditional remedy for mild, non-specific diarrhea. A European herbal society lists it for this use. We found no human trial that tested it, so we cannot say it works. | 3 1 12 7 |
| Womens Wellness | Traditional use | Not enough evidence | Painful, heavy or irregular periods: Lady's mantle has long been used by women for painful and heavy periods. This is tradition. No human trial was found, so nobody can say whether it helps. Menopausal complaints and vulvar itching: Folk medicine uses lady's mantle for menopause symptoms and itching of the vulva. No human trial supports this. | 6 7 12 1 |
| Menopause Support | Traditional use | Not enough evidence | Menopausal complaints and vulvar itching: Folk medicine uses lady's mantle for menopause symptoms and itching of the vulva. No human trial supports this. | 6 1 12 |
| Hormone Balance | Preliminary mechanism | Very low certainty | Hormone balance (rat study only): In a rat model of polycystic ovary syndrome, a lady's mantle extract moved hormone and inflammation markers back toward normal. This is animal research and does not show the same in women. | 9 6 |
| Womens Wellness | Preliminary mechanism | Very low certainty | Hormone balance (rat study only): In a rat model of polycystic ovary syndrome, a lady's mantle extract moved hormone and inflammation markers back toward normal. This is animal research and does not show the same in women. | 9 6 |
| Inflammation Balance | Very low certainty | Sore throat after a breathing tube (spray): In one randomized trial, a lady's mantle glycerine throat spray did about as well as an injected steroid for sore throat after surgery. There was no placebo group, so it cannot show the spray beats nothing. | 2 | |
| Healthy Skin | Not enough evidence | Minor mouth ulcers: The ESCOP summary mentions human data on minor mouth ulcers and good tolerability of a topical preparation. We could not read the trials. | 3 | |
| Healthy Skin | Preliminary mechanism | Very low certainty | Skin care and wound healing: Lab work and a skin-barrier test suggest lady's mantle extracts in gels can help skin repair. This is early and not shown to heal real wounds in patients. | 13 8 3 12 |
| Inflammation Balance | Preliminary mechanism | Very low certainty | Antioxidant and anti-inflammatory activity (lab and animal): Lab and animal studies show antioxidant, anti-inflammatory and germ-fighting activity. This does not prove a health benefit in people. | 6 7 3 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Reproductive system | Contraindication | Not enough evidence | Avoid in pregnancy and breastfeeding because reliable safety data is lacking. A safety relationship, not a benefit. Avoid in pregnancy and breastfeeding because reliable safety data are lacking. A safety relationship, not a benefit. Preparation or compound: Lady's mantle aerial parts |
12 |
| Liver | Adverse effect or risk | Not enough evidence | Disputed liver warning; no case reports found. Preparation or compound: Lady's mantle |
12 |
| Digestive System | Biological association | Not enough evidence | Studied for: Mild diarrhea and gut complaints Studied for: Minor mouth ulcers | 3 1 12 7 |
| Reproductive System | Biological association | Not enough evidence | Studied for: Painful, heavy or irregular periods Studied for: Menopausal complaints and vulvar itching | 6 7 12 1 9 |
| Endocrine System | Biological association | Very low certainty | Studied for: Hormone balance (rat study only) | 9 6 |
| Respiratory System | Biological association | Very low certainty | Studied for: Sore throat after a breathing tube (spray) | 2 |
| Integumentary System | Biological association | Very low certainty | Studied for: Skin care and wound healing | 13 8 3 12 |
| Immune System | Biological association | Very low certainty | Studied for: Antioxidant and anti-inflammatory activity (lab and animal) | 6 7 3 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Iron status (ferritin) | Drug or supplement interaction | Not enough evidence | Tannin-rich teas can lower iron absorption; indirect evidence from other herb teas. Preparation or compound: Tannins and polyphenols |
5 |
K. Biological pathways
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| TNF-alpha | Preliminary mechanism | Animal | Lower in aorta and ovary of PCOS rats given the extract. Animal data only. | 9 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Agrimoniin | Biological association | In vitro | Named as the main tannin; astringent. Activity in people not shown. Preparation or compound: aerial parts |
1 11 |
| Pedunculagin | Biological association | In vitro | Ellagitannin reported in Alchemilla species; its amount and effect in lady's mantle tea not read. Preparation or compound: aerial parts |
11 7 |
| Flavonoids (for example quercetin derivatives) | Biological association | In vitro | Antioxidant in the lab. The quercetin CID is for the parent flavonol; the exact lady's mantle flavonoids are glycosides and were not identified here. Preparation or compound: aerial parts |
1 7 11 |
| Phenolic acids, anthocyanins, coumarins, triterpenes | Biological association | In vitro | Listed as constituents of Alchemilla species. Preparation or compound: aerial parts |
6 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).
The evidence
The research centre for Lady's mantle. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We started from our existing lady's mantle summary, then read PubMed abstracts of every cited paper and public reference summaries. Items we only saw as summaries are labelled.
Study library: every study we checked 13
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Altmeyers Encyclopedia of Medicine 2026 Alchemillae herba Altmeyers Encyclopedia of Medicine · Source |
Authoritative guidance n/a |
n/a | n/a n/a n/a n/a · vs n/a |
Secondary reference. Tannins 6-8% (up to 18%), mainly hydrolysable ellagitannins with agrimoniin as the main one; flavonoids about 2%. Indication: mild non-specific diarrhea. Folk use of the tea for menstrual disorders and menopausal complaints, no clinical evidence given. Lists a positive German Commission E monograph. Side effects: allergic reactions rare. Contraindications: none known; infants and young children only after consulting a doctor. Interactions section empty. Pregnancy not addressed. Methods, limits and fundingOutcomes: What the source says Limitations: Secondary website, not an agency. Its Commission E status and figures were not checked against the original monograph. It also gives dose figures, which this page does not use. Read: summary-only |
| Chung 2021 Comparison of prophylactic effect of topical Alchemilla vulgaris in glycerine versus that of dexamethasone on postoperative sore throat after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled study Anesthesia and Pain Medicine (Seoul) · PMID 33866772 · DOI |
Controlled trial |
94 Adults having thoracic surgery with a double-lumen breathing tube, Korea |
Alchemilla vulgaris in glycerine oropharyngeal spray (Neo Mucosal Activator), 1 g mixed with 1 ml saline; the comparison group received dexamethasone 0.2 mg/kg IV aerial parts (product; part not stated in abstract) 1 g in 1 ml saline sprayed once before intubation single pre-intubation application; follow-up to 24 h · vs Dexamethasone IV plus saline spray (no placebo-only group) |
Sore throat at 24 h: 57.8% (dexamethasone group) vs 46.5% (Alchemilla group), P = 0.290. No significant differences at 1, 6 or 24 h in incidence or intensity of sore throat or hoarseness. No significant difference from dexamethasone (P = 0.290 at 24 h) Methods, limits and fundingOutcomes: Incidence of sore throat at 24 h (primary); sore throat and hoarseness at 1, 6, 24 h Limitations: No placebo-only group, so the trial cannot show the spray works better than nothing. Branded product spray, not tea. Abstract says 94 enrolled; group sizes given as 45 and 43. Abstract read only. Funding and conflicts: No conflict of interest reported Read: abstract |
| ESCOP 2013 Alchemillae herba (Lady's mantle) - monograph summary ESCOP · Source |
Authoritative guidance n/a |
n/a | n/a n/a n/a n/a · vs n/a |
Public summary page. Drug defined as flowering aerial parts of Alchemilla vulgaris L. (A. xanthochlora Rothm. as synonym). Indications: non-specific diarrhoea and gastrointestinal complaints. Tannins and flavonoids are the main constituents. Lab studies: antibacterial, astringent, antioxidant, anti-inflammatory, wound healing. Animal: angioprotective and wound-healing. Human data: minor oral ulcers. Preclinical: no mutagenicity concern. A topical preparation was well tolerated. Methods, limits and fundingOutcomes: What the source says Limitations: Only the free public summary was read. Contraindications, pregnancy, interactions and side-effect sections are in the paid full monograph and were NOT read. ESCOP is a scientific society, not a regulator. Read: summary-only |
| GBIF 2026 GBIF Backbone: Alchemilla vulgaris L. and Alchemilla xanthochlora Rothm. GBIF · Source |
Database check n/a |
n/a | n/a n/a n/a n/a · vs n/a |
GBIF key 7890713: Alchemilla vulgaris L., accepted species, family Rosaceae, order Rosales. A. xanthochlora Rothm. (key 3028198) is also listed as an accepted name in GBIF. NCBI Taxonomy id 49855 for Alchemilla vulgaris. Methods, limits and fundingOutcomes: What the source says Limitations: GBIF treats several segregate species as accepted; the traditional drug name covers an aggregate of many microspecies. Verified by API query on 2026-10-25. Read: api |
| Hurrell 1999 Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages British Journal of Nutrition · PMID 10999016 |
Controlled trial |
Adult volunteers; iron absorption from a bread meal measured with radio-iron | Herb teas (chamomile, vervain, lime flower, pennyroyal, peppermint), black tea, coffee, cocoa; NOT lady's mantle leaf/flower teas 20-400 mg total polyphenols per serving single test meals · vs Water control meal |
All polyphenol beverages reduced iron absorption in proportion to polyphenol content: 50-70% less at 20-50 mg polyphenols, 60-90% less at 100-400 mg. Herb teas: peppermint 84%, pennyroyal 73%, vervain 59%, lime flower 52%, chamomile 47% lower than water. Iron absorption reduced 47-94% depending on beverage Methods, limits and fundingOutcomes: Iron absorption Limitations: Lady's mantle was not tested. Used here only to show the general effect of polyphenol- and tannin-rich drinks. Abstract read only. Read: abstract |
| Jakimiuk 2024 A review of the traditional uses, phytochemistry, pharmacology, and clinical evidence for the use of the genus Alchemilla (Rosaceae) Journal of Ethnopharmacology · PMID 37981119 · DOI |
Systematic review human|animal|in-vitro |
Genus-wide literature review (searches 1960-2023) | Alchemilla species (lady's mantle), mainly aerial parts aerial parts n/a n/a · vs n/a |
Folk use for dysmenorrhea, pruritus vulvae and menopausal complaints. Main constituents: tannins, phenolic acids, flavonoids, anthocyanins, coumarins, triterpenes. Activities reported in lab and animal studies. Authors state clinical studies are limited and need to be done. Methods, limits and fundingOutcomes: Traditional uses, chemistry, lab and animal activity, clinical evidence Limitations: Narrative review of a whole genus (about 1000 species); not a systematic review of human trials. Abstract read only. Funding and conflicts: Authors declare no competing interests Read: abstract |
| Kanak 2022 Phenolic Composition and Antioxidant Activity of Alchemilla Species Plants (Basel) · PMID 36297733 · DOI |
Systematic review in-vitro |
Review of phenolic chemistry of Alchemilla species | Alchemilla species aerial parts mainly n/a n/a · vs n/a |
Species contain mainly flavonoids, tannins and phenolic acids with anti-inflammatory, antimicrobial and antioxidant activity in the lab. Traditional use for acute diarrhea, wounds, dysmenorrhea and menorrhagia. Methods, limits and fundingOutcomes: Phenolic composition and antioxidant activity Limitations: Narrative review; lab activity only. Abstract read only. Funding and conflicts: No conflict of interest Read: abstract |
| Kanak 2025 Harnessing the Power of Alchemilla: A Natural Solution for Skin Health and Dermatological Disorders Molecules · PMID 40333933 · DOI |
Systematic review in-vitro |
Review of Alchemilla in skin care (literature to Dec 2024) | Alchemilla species aerial parts mainly n/a n/a · vs n/a |
Authors say antioxidant, anti-inflammatory, astringent, antimicrobial, anti-elastase and tyrosinase-inhibiting properties suggest use in rashes, acne, stretch marks, eczema, psoriasis and wrinkles. Mostly lab and cosmetic evidence. Methods, limits and fundingOutcomes: Skin-related activity Limitations: Narrative review; abstract does not report clinical trial results. Abstract read only. Funding and conflicts: No conflicts of interest Read: abstract |
| Korun 2025 Beneficial Effects of Alchemilla vulgaris in DHEA-Induced Rat Model of Polycystic Ovary Syndrome Reproductive Sciences · PMID 40550985 · DOI |
Animal research animal |
Prepubertal female Wistar rats given DHEA for 35 days to model PCOS (three groups) | Alchemilla vulgaris extract by mouth not stated in abstract 50 mg per 100 g body weight per day 35 days · vs PCOS group without extract; healthy control |
Hormone imbalance, ovary changes and blood vessel dysfunction seen in PCOS rats returned to control levels with the extract; TNF-alpha in aorta and ovary was lower. Methods, limits and fundingOutcomes: Blood pressure, blood vessel function, ovary structure, hormone levels, TNF-alpha Limitations: Rat model only. Dose per body weight is far from any tea. Does not show an effect in women. Abstract read only. Funding and conflicts: No conflicts disclosed Read: abstract |
| Our own checks 2026 Regulator and database checks for lady's mantle Our own checks, 2026-10-25 · Source |
Database check n/a |
n/a | n/a n/a n/a n/a · vs n/a |
NCCIH Herbs at a Glance list (Acai to Yohimbe) has no lady's mantle entry. A web search of EMA pages found no EU herbal monograph for Alchemilla herba; EMA site search returned HTTP 401 and a guessed monograph URL returned 404, so absence is not proven. LiverTox and LactMed could not be reached (NCBI browser check), so no record was read. Memorial Sloan Kettering page gave 404 in earlier work. Methods, limits and fundingOutcomes: What the source says Limitations: Absence of a page we could find is not proof that none exists. Read: api |
| PubChem 2026 PubChem records: agrimoniin, pedunculagin, quercetin PubChem · Source |
Database check n/a |
n/a | n/a n/a n/a n/a · vs n/a |
Agrimoniin CID 16129621 (C82H54O52); pedunculagin CID 442688 (C34H24O22); quercetin CID 5280343 (C15H10O7). Verified by API. Methods, limits and fundingOutcomes: What the source says Limitations: Identity and formula only; plant content figures come from the Altmeyers summary. Read: api |
| RxList Alchemilla (Lady's Mantle) supplement monograph RxList · Source |
Authoritative guidance n/a |
n/a | n/a n/a n/a n/a · vs n/a |
Evidence rated insufficient for every use (stomach problems, mild diarrhea, diabetes, water retention, inflammation, spasms, gargle, heavy or painful periods, menopause, skin use). Rated possibly safe by mouth. Some German researchers warn of possible liver damage; other experts consider the concern exaggerated. Not enough reliable information in pregnancy or breastfeeding, so avoid. Moderate interaction listed: tannins may reduce absorption of oral medicines; take at least one hour after them. Little information on skin use. Methods, limits and fundingOutcomes: What the source says Limitations: Commercial reference (Natural Medicines-style content); date not shown. The liver statement gives no named cases. Read through a summary tool, not as a full page. Read: summary-only |
| Tasic-Kostov 2019 Towards a modern approach to traditional use: in vitro and in vivo evaluation of Alchemilla vulgaris L. gel wound healing potential Journal of Ethnopharmacology · PMID 30904703 · DOI |
Controlled trial in-vitro|human |
Cell dish (mouse fibroblast L929) plus a skin-barrier test on human skin with hydrogels | Alchemilla vulgaris extracts (several solvents) in hydrogels aerial parts (not stated in abstract) not stated in abstract not stated in abstract · vs Other gels / vehicles |
All extracts and gels sped up scratch closure in cells; ethanolic extract most; the propylene glycol extract gel was most favourable. The human-skin barrier test agreed in direction. Authors link effect to phenolic compounds and low gel pH. Methods, limits and fundingOutcomes: Cell migration in a scratch assay; skin barrier repair measured by skin instruments Limitations: Number of volunteers not given in the abstract. Measures skin barrier repair, not wound healing in patients. Abstract read only. Read: abstract |
What we do not know yet
- What the evidence supports: nothing about lady's mantle is above very low certainty. No placebo-controlled human trial was found for any use.
- What is uncertain: safety in pregnancy and breastfeeding, the liver warning, hormone effects in people, and iron and medicine interactions with this plant.
- What we could not read: the full ESCOP monograph, the mouth-ulcer trials, the original Commission E monograph, LiverTox, LactMed, and EMA pages.
How new research is added
New studies are found by a saved PubMed search and placed in a review queue. A person reads each one before it changes any evidence rating.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 5
- Overall: little safety data. No human safety trial of lady's mantle was found. A German reference lists no known contraindications and rare allergic reactions; RxList rates it possibly safe by mouth. These are short reference entries, not large safety studies. Authoritative guidance 1 12
- Tannins can upset the stomach and bind other things. The herb is rich in tannins (6-8% in one reference, as much as 18% at most). Tannins are astringent and can irritate the stomach or cause constipation in some people. One Swiss consumer source links mild stomach upset to tannins; we did not treat it as a clinical source. Pharmacological theory 1 12
- May reduce iron and some medicine absorption. RxList lists a moderate interaction: tannins may reduce how much of an oral medicine the body absorbs, and advises taking lady's mantle at least one hour after oral medicines. For iron, direct evidence is missing for this plant, but a human study found polyphenol-rich herb teas cut iron absorption from a meal by roughly half or more. People with low iron should not assume lady's mantle tea is different. Pharmacological theory 12 5
- Pregnancy and breastfeeding: avoid, data lacking. RxList says there is not enough reliable information and advises avoiding use. Lady's mantle has a long traditional use for women's complaints, but traditional use is not a safety record. We found no pregnancy study. Authoritative guidance 12 1
- Liver: a disputed warning, no cases found. RxList says some German researchers warn of possible liver damage while other experts consider the concern exaggerated. We found no case report. LiverTox could not be read. Authoritative guidance 12 10
Side effects 4
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Allergic reactions Source gives 'rare' without numbers. | rare (as stated by a German reference; no figure) | Not graded Not stated | Authoritative guidance 1 |
| Stomach upset or constipation from tannins Expected from the tannin content; not measured in a trial of this plant. | Not established | Mild (expected) Expected to settle when stopped | Pharmacological theory 1 12 |
| Lowered absorption of oral medicines and iron Iron figure comes from other herb teas, not lady's mantle. | Not established | Depends on the medicine Timing-related | Pharmacological theory 12 5 |
| Skin reactions with topical use ESCOP says a topical preparation was well tolerated; RxList says little information exists. | Not established | Unknown Unknown | Authoritative guidance 3 12 |
Liver
RxList states that some German researchers warn of possible liver damage, while other experts consider this concern exaggerated. No named case report, trial finding or LiverTox record was found. In the sore-throat trial the abstract does not report liver outcomes. Treat liver risk as unproven, not as ruled out. 12 10
How often. No frequency can be given. No case reports found.
Monitoring. No monitoring advice from any source we read. People with liver disease should ask their clinician before use.
This is a safety connection. It is not evidence that Lady's mantle supports liver health.
Medicines and supplements 4
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Oral medicines in general absorption | Tannins bind substances in the gut and may lower absorption. | Moderate per RxList; not tested with this herb. | Pharmacological theory Low certainty 12 | Ask a pharmacist about spacing it from your medicines. RxList suggests at least one hour after oral medicines. |
| Iron supplements and iron in food nutrient absorption | Polyphenols and tannins bind iron in the gut. | In a human study, polyphenol-containing herb teas reduced iron absorption from a bread meal by 47-84% depending on the tea. Lady's mantle was not tested. | Controlled trial Low certainty 5 | If you have low iron or take iron, ask your clinician. Do not drink the tea with iron-rich meals or iron tablets. |
| Hormone medicines (birth control, HRT, hormone-blocking drugs) hormonal | Traditional 'hormone' use and one rat study only; no human interaction data. | Unknown. | Animal research Not enough evidence 9 | No interaction is documented. Because the effect on hormones in people is unstudied, tell your prescriber if you use it. |
| Blood thinners, diabetes medicines, blood pressure medicines none documented | No source we read states an interaction. | Unknown. RxList lists traditional use for diabetes but no interaction. | Traditional use Not enough evidence 12 1 | Absence of a warning is not proof of safety. Ask a pharmacist. |
Who should check first 5
| Situation | Advice | Evidence |
|---|---|---|
| Pregnancy and breastfeeding | Avoid. Not enough reliable information (RxList). Traditional use for women's complaints does not show it is safe in pregnancy. | Authoritative guidance 12 |
| Infants and young children | A German reference says use only after consulting a doctor. | Authoritative guidance 1 |
| Known allergy to plants in the rose family or to lady's mantle | Avoid. Allergic reactions are described as rare. | Authoritative guidance 1 |
| Low iron or iron-deficiency anemia | Tannin-rich teas may reduce iron absorption; ask a clinician. Evidence is indirect. | Pharmacological theory 5 |
| Liver disease | Ask a clinician first because of a disputed liver warning. | Authoritative guidance 12 |
Overdose, product quality and regulators
Summary. No human toxicity data of note. ESCOP's public summary says preclinical testing showed no mutagenicity concern.
Animal. ESCOP summary: no mutagenicity concern in preclinical tests (details not read).
Human doses studied. Human studies are a single sore-throat spray trial and a skin-barrier test; neither reported toxicity in the abstract.
High dose or long term signals. Not studied. High tannin intake is expected to irritate the stomach.
Overdose response. No overdose reports found.
Genotoxicity. ESCOP summary reports no mutagenicity concern; full data not read.
Toxic plant parts. No toxic plant part is described in the sources we read. The aerial parts are the medicinal part.
No contamination or adulteration testing of lady's mantle products was found.
Species identity. The genus has about 1000 species and over 300 in Europe; the medicinal 'A. vulgaris agg.' covers many near-identical microspecies. Products may contain different ones, and A. mollis is a common garden plant. 6 4
When to get medical help
- Swelling of the face or throat, hives or trouble breathing after taking it (allergic reaction).
- Yellow skin or eyes, dark urine or severe upper-right belly pain (possible liver problem).
- Severe, bloody or lasting diarrhea, or heavy period bleeding. These need medical care; do not rely on a herb.
- Any bleeding or severe pain in pregnancy.
Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
What is lady's mantle?
Does lady's mantle help with diarrhea?
Does it help with painful or heavy periods?
Does it help with menopause symptoms?
Does lady's mantle balance hormones?
Can I use it in pregnancy or while breastfeeding?
Avoid it. RxList says there is not enough reliable information. Traditional use for women's complaints is not a safety record.
Do the tannins cause stomach upset?
Does it affect iron absorption?
Likely, though not tested for lady's mantle. A human study found polyphenol-rich herb teas cut iron absorption from a bread meal by 47-84%. Ask your clinician if your iron is low.
Does it interact with medicines?
RxList lists a moderate interaction: tannins may lower absorption of oral medicines, and it suggests taking lady's mantle at least one hour after them. No case reports were found. Ask a pharmacist about amounts and timing.
Is it bad for the liver?
Is it safe for children?
A German reference says infants and young children should use it only after consulting a doctor.
Explore by health goal
Womens WellnessInflammation BalanceHealthy SkinDigestive SupportGut HealthMenopause SupportHormone Balance
Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-25
- Last substantive update
- 2026-10-25
- How we research
- We started from our existing lady's mantle summary, then read PubMed abstracts of every cited paper and public reference summaries. Items we only saw as summaries are labelled.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No affiliate links are shown. If one is added later it will be labelled and kept apart from the evidence.
Sources 13
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Altmeyers Encyclopedia of Medicine. Alchemillae herba. Altmeyers Encyclopedia of Medicine. 2026. (summary-only)
- Chung CJ, Jeong SY, Jeong JH, et al.. Comparison of prophylactic effect of topical Alchemilla vulgaris in glycerine versus that of dexamethasone on postoperative sore throat after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled study. Anesthesia and Pain Medicine (Seoul). 2021. PMID 33866772. DOI 10.17085/apm.20082. (abstract)
- ESCOP. Alchemillae herba (Lady's mantle) - monograph summary. ESCOP. 2013. (summary-only)
- GBIF. GBIF Backbone: Alchemilla vulgaris L. and Alchemilla xanthochlora Rothm.. GBIF. 2026. (api)
- Hurrell RF, Reddy M, Cook JD. Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages. British Journal of Nutrition. 1999. PMID 10999016. (abstract)
- Jakimiuk K, Tomczyk M. A review of the traditional uses, phytochemistry, pharmacology, and clinical evidence for the use of the genus Alchemilla (Rosaceae). Journal of Ethnopharmacology. 2024. PMID 37981119. DOI 10.1016/j.jep.2023.117439. (abstract)
- Kanak S, Krzeminska B, Celinski R, et al.. Phenolic Composition and Antioxidant Activity of Alchemilla Species. Plants (Basel). 2022. PMID 36297733. DOI 10.3390/plants11202709. (abstract)
- Kanak S, Krzeminska B, Berecka-Rycerz A, et al.. Harnessing the Power of Alchemilla: A Natural Solution for Skin Health and Dermatological Disorders. Molecules. 2025. PMID 40333933. DOI 10.3390/molecules30081861. (abstract)
- Korun ZEU, Gocmez SS, Furat S, et al.. Beneficial Effects of Alchemilla vulgaris in DHEA-Induced Rat Model of Polycystic Ovary Syndrome. Reproductive Sciences. 2025. PMID 40550985. DOI 10.1007/s43032-025-01885-9. (abstract)
- Our own checks, 2026-10-25. Regulator and database checks for lady's mantle. Our own checks, 2026-10-25. 2026. (api)
- PubChem. PubChem records: agrimoniin, pedunculagin, quercetin. PubChem. 2026. (api)
- RxList. Alchemilla (Lady's Mantle) supplement monograph. RxList. . (summary-only)
- Tasic-Kostov M, Arsic I, Pavlovic D, et al.. Towards a modern approach to traditional use: in vitro and in vivo evaluation of Alchemilla vulgaris L. gel wound healing potential. Journal of Ethnopharmacology. 2019. PMID 30904703. DOI 10.1016/j.jep.2019.03.016. (abstract)