Osteoporosis is characterized by skeletal degeneration with low bone mass and destruction of microarchitecture of bone tissue which is attributed to various factors including inflammation. Women are more likely to develop osteoporosis than men due to reduction in estrogen during menopause which leads to decline in bone-formation and increase in bone-resorption activity. Estrogen is able to suppress production of proinflammatory cytokines such as IL-1, IL-6, IL-7, and TNF- . This is why these cytokines are elevated in postmenopausal women. Studies have shown that estrogen reduction is able to stimulate focal inflammation in bone. Labisia pumila (LP) which is known to exert phytoestrogenic effect can be used as an alternative to ERT which can produce positive effects on bone without causing side effects. LP contains antioxidant as well as exerting anti-inflammatory effect which can act as free radical scavenger, thus inhibiting TNF-α production and COX-2 expression which leads to decline in RANKL expression, resulting in reduction in osteoclast activity which consequently reduces bone loss. Hence, it is the phytoestrogenic, anti-inflammatory, and antioxidative properties that make LP an effective agent against osteoporosis. 1. Introduction Plant has been one of the sources of medicine to treat various illnesses and diseases since ancient time. In the early 19th century, when chemical analysis first became available, scientists began to extract and modify the active ingredients from plants which later led to wide development of natural or traditional medicine that was mostly passed on orally from one generation to another. More than 35,000 plant species have been reported to be used in various human cultures around the world for their medical purposes [1]. Traditional medicine has been defined by the World Health Organization (WHO) as “health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination, to treat, diagnose and prevent illnesses or maintain well-being” [2]. Currently in Malaysia, over 2,000 species of lower plants with medicinal and therapeutic properties have been identified, and most of them have been used for many generations in various health care systems. About 17.1% of Malaysians used herbs to treat their health problems while 29.6% of them consumed herbs for their health maintenance [3]. The earliest report on medicinal plant research in Malaysia was carried out by Arthur in 1954 [4]. Subsequently, more
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