Vitex agnus castus, also called chasteberry, is one of the most popular botanicals in Europe for treating menstrual disorders and has been recognized as gentle and effective for 2,500 years. Numerous clinical studies document its benefit.
Many menstrual problems can be traced to deficient progesterone production during the second half of the menstrual cycle, also called the luteal phase. Insufficient progesterone during this phase of the menstrual cycle results in estrogen dominance, leading to a shortening of that part of the cycle, commonly referred to as luteal phase defect. A shortened luteal phase with too much estrogen and not enough progesterone causes all kinds of problems for women: heavy periods, scanty periods, too frequent periods, or no periods at all. Another pituitary hormone, prolactin, may also be elevated during this time, resulting in breast tenderness and pain, a classic symptom of PMS.
How does vitex help?
First of all, what does it not do? Vitex does not act as a phytoestrogen (plant estrogen), a term commonly associated with balancing the female reproductive system. Vitex works through another important chemical pathway, the hypothalamus-pituitary axis, to balance female hormones. Vitex increases luteinizing hormone production while inhibiting the release of follicle stimulating hormone, leading to an indirect increase in progesterone and a normalization of prolactin levels. The combination of actions produced by vitex seems to restore the estrogen/progesterone balance.
Vitex and PMS
Clinical studies using vitex extract show a reduction in headaches, breast tenderness, bloating, fatigue, cravings for sweets, and also feelings of anxiety, irritability, depression and mood swings, after only one month. Vitex tincture, at an average daily dose of 42 drops, was prescribed for 2447 women who had a variety of menstrual disorders, including PMS. Although this was an uncontrolled study, both patients and physicians reported that vitex significantly improved symptoms. At the end of the study 31% of patients had complete relief of symptoms, and 55% reported significant improvement. “The doctors and patients were satisfied with the treatment in over 90% of cases, i.e., symptoms either disappeared altogether or were significantly improved. The good acceptability of the preparation is also shown by the long duration of the treatment, with a mean of 5 months, and up to 9 years in some cases…The tolerance is exceptional: only 2.3% of patients experienced unwanted effects with the treatment…”
In another uncontrolled observational study 1,542 women were given 42 drops of vitex tincture (Agnolyt) each day. Among the patients, 33% had complete relief of symptoms while 57% reported improvement. Again, their doctors rated vitex tincture as very good, good, or satisfactory in 93% of the cases.
Women with PMS may want to use vitex either alone or preferably as part of a comprehensive herbal formula. Clinical studies using vitex show a reduction in headaches, breast tenderness, bloating, fatigue, cravings for sweets, and also feelings of anxiety, irritability, depression and mood swings, often after only one month.
Other uses
Low levels of progesterone are believed to contribute significantly to menopausal symptoms. The ability of vitex to increase the secretion of luteinizing hormone which raises progesterone levels is the likely mode of action. Physicians in Europe commonly recommend vitex for the treatment of hot flashes.
Vitex is used as a way to prevent repeat uterine fibroids, and is probably the most effective herb in the treatment of menorrhagia. However, it needs to be used for several months before its effects are noticed.
Vitex is often used to help infertility caused by a luteal phase defect (a shortening of the post-ovulatory part of the menstrual cycle): women taking vitex for three months appear to have more success at becoming pregnant.
The herb vitex can help the body establish a proper balance between estrogen and progesterone by encouraging the production of progesterone. If taken regularly for several months, it helps to restore hormonal balance and alleviate PMS symptoms.
In one study of 100 nursing mothers, vitex was shown to significantly improve milk flow and milk-release when compared to placebo. Vitex is traditionally taken the first day after birth and continued for ten days. Vitex is only recommended if there are any problems with milk production.
Herbalists have used vitex with much success in treating teenage acne. Well-known herbalist and author, Christopher Hobbs, finds vitex very useful for treating teenage acne, preferably accompanied by changes in eating habits. “I have worked with some teenagers who had chronic acne for several years who were not willing to change their diet in any way. They felt attached to soft drinks, french fries, pizza and hamburgers, and no amount of logical discussion could change their minds. If vitex can help in these cases, it seems likely to help in other cases where dietary improvements are possible, and in my experience it can help dramatically. I have given it to both young men and women with equal effectiveness. The remedy often takes from one to two months before it becomes fully active.”
Dosage and safety
Recommended Dosage: Different forms and concentrations make general dosage recommendations difficult. It is recommended that you follow the label instructions or your doctor’s advise. 40 drops (2ml) of vitex extract or 120 drops (6ml) tincture taken daily can be used for up to eighteen months continuously, unless pregnancy occurs (at which point vitex use should be discontinued). Two tablets (250mg each) of an dry extract is also a common recommendation.
The safety of vitex is exceptional – in one study, vitex was given up to 9 years in some cases, with very few side-effects. It is usually recommended by that Vitex be taken as a single daily dose first thing in the morning. It may interfere with the effectiveness of birth control medications. It is important to note that Vitex is not a fast acting medication and needs to be taken consistently for some time. The average length of treatment is six months.
References
- Loch, E. Bohnert K.J. Peeters M, et al. “The treatment of menstrual disorders with Vitex agnus-castus tincture.” Der Frauenarzt. 1991. 32(8): pp.867-70.
- Dittmar, F., Bohnert, K.J., Peeters M. et al. “Premenstrual syndrome: treatment with a phytopharmaceutical.” Therapiewoche Gynakol. 1992. 5(1): pp.60-8.
- Lauritzen, C.H. et al. “Treatment of premenstrual tension syndrome with Vitex agnus castus: controlled, double-blind study versus pyridoxine.” Phytomed. 1997. 4: pp.183-9.
- Mohr, H. “Clinical investigations of means to increase lactation.” Dtsche. Med. Wschr. 1954. 79 (41): pp.1513-1516.
- Hobbs, Christopher. Vitex: the women’s herb. 2nd ed. 1996. Botanica Press.
Vitex can help with the following
Hyperprolactinemia
Chaste berry extracts inhibit prolactin secretion of rat pituitary cells. [Horm Metab Res 25: p.253, 1993] A randomized placebo-controlled, double-blind, study of 52 women with elevated prolactin production, using a daily dose of one capsule (20 mg) of a chaste berry preparation, found after 3 months of therapy that prolactin release was reduced and estrogen (17 beta-estradiol) production increased. Side effects were not seen. [Arzneimittelforschung 43: p.752, 1993]
In another study, 13 women with high prolactin levels and irregular cycles were given a vitex compound. Their prolactin levels fell, and a normal menstrual cycles returned to all of the women. [Zbl Gynakologie, 1959, 18: pp.701-9]
Low Progesterone or Estrogen Dominance
Vitex increases luteinizing hormone production while inhibiting the release of follicle stimulating hormone, leading to an indirect increase in progesterone and a normalization of prolactin levels. If taken regularly for several months, it helps to restore hormonal balance and alleviate PMS symptoms.
Adolescent Acne
Vitex has been found to be very useful for treating teenage acne, preferably accompanied by changes in eating habits.
Fibroids
Vitex is used as a way to prevent repeat uterine fibroids.
Menorrhagia (Heavy Periods)
Vitex is probably one of the most effective herbs in the treatment of menorrhagia. However, it needs to be used for several months before its effects are noticed.
Motherhood Issues
In one study of 100 nursing mothers, vitex was shown to significantly improve milk flow and milk-release when compared to placebo. Vitex is traditionally taken the first day after birth and continued for ten days. Vitex is only recommended if there are any problems with milk production.
Endometriosis
Vitex (as a hormone normalizer) may be considered the most appropriate of the herbal remedies for the underlying processes involved in endometriosis.
Some report that the benefits of Vitex are short lived. A short period of use may produce short-term benefits, but long-term use may actually make symptoms associatted with estrogen dominance worse.
Menopausal Status / Issues
Low levels of progesterone are believed to contribute significantly to menopausal symptoms. The ability of vitex to increase the secretion of luteinizing hormone which raises progesterone levels is the likely mode of action. Physicians in Europe commonly recommend vitex for the treatment of hot flashes.
Metrorrhagia
Vitex acts on the pituitary gland in the brain to adjust levels of LH (luteinizing hormone) and FSH (follicle stimulating hormone). Vitex indirectly promotes progesterone in cases of excess estrogen. Overall, it helps to restore normal rhythm to the reproductive hormones.
Amenorrhea
In this study, a chasteberry preparation was used in a study of 3,162 women to assess the effectiveness of vitex for corpus luteum insufficiency. 77.4% had menstrual cycle disturbances of various types and the others suffered from a range of gynecological problems which included symptoms of corpus luteum insufficiency. The average length of treatment was 5 months. Hormone cytology and symptoms were used to assess the treatment.
The women reported the treatment as completely effective (33%), significant improvement (55%), and no change (7%). Their doctors reported very good results in 68% of cases, adequate in 22%, and no change in 7%. [Tjherapiewoche, 1993, 43(48): pp.2577-80]
In another study, 20 women with secondary amenorrhea took a chasteberry extract for 6 months. Lab testing was done to measure progesterone, FSH, and LH, and pap smears were done at the beginning of the study, at 3 months, and at 6 months. At the end of the study, the researchers were able to evaluate 15 of the women. Ten out of the 15 women had a return of their menstrual cycles. Testing showed that values for progesterone and LH increased, and FSH values either did not change or decreased slightly. [Gynakol Praxis, 1990, 14(3): pp.489-95]
In a third study, 18 women with abnormally low progesterone levels were given vitex daily. After 3 months of treatment, 13 showed increases in progesterone and 2 became pregnant. [Zeitscchrift Fur Allgemein, 1987, 63: pp.932-3]
Female Infertility
Vitex is often used to help infertility caused by a luteal phase defect (a shortening of the post-ovulatory part of the menstrual cycle): women taking vitex for three months appear to have more success at becoming pregnant.
Fibrocystic Breasts
Since many women with fibrocystic breasts and cyclical breast tenderness also suffer from premenstrual syndrome (PMS), there is often an overlap in herbal recommendations for these two conditions despite a lack of research dealing directly with fibrocystic breasts.
Vitex has been shown to help reestablish normal balance of estrogen and progesterone during a woman’s menstrual cycle. This is important because some women may suffer from PMS and other menstrual irregularities due to underproduction of the hormone progesterone during the second half of their cycle. Vitex stimulates the pituitary gland to produce more luteinizing hormone, and this leads to a greater production of progesterone. Studies have shown that using vitex once in the morning over a period of several months will help normalize hormone balance and alleviate symptoms of PMS.
Doctors who use herbal medicine will typically suggest 40 drops of a liquid, concentrated vitex extract or one capsule of the equivalent dried, powdered extract to be taken once per day in the morning with some liquid. Vitex should be taken for at least four cycles to determine efficacy.
Premenstrual Syndrome / PMDD
Clinical studies using vitex extract show a reduction in headaches, breast tenderness, bloating, fatigue, cravings for sweets, and also feelings of anxiety, irritability, depression and mood swings, after only one month. Whether this would be effective for the more severe symptoms of PMDD is not known.
Possible Pregnancy-Related Issues
Vitex should not be used by pregnant women.
Key
| May do some good |
| Likely to help |
| Highly recommended |
| Avoid absolutely |
Glossary
Vitex
Vitex agnus castus. Common name: chaste tree berry.
Estrogen
One of the female sex hormones produced by the ovaries.
Pituitary
The pituitary gland is small and bean-shaped, located below the brain in the skull base very near the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Prolactin
An anterior pituitary peptide hormone that initiates and maintains lactation.
Premenstrual Syndrome
PMS consists of various physical and/or emotional symptoms that occur in the second half of the menstrual cycle, after ovulation. The symptoms begin about midcycle, are generally the most intense during the last seven days before menstruation and include: acne; backache; bloating; fatigue; headache; sore breasts; changes in sexual desire; depression; difficulty concentrating; difficulty handling stress; irritability; tearfulness.
Luteinizing Hormone
Anterior pituitary hormone stimulating estrogen production by the ovary; promoting formation of progesterone by the corpus luteum in women and stimulating testosterone release in men.
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
Tincture
An alcohol or water-alcohol solution, usually referring to a preparation from herbal materials.
Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Uterine Fibroids
Fibroids are the most frequently seen tumors of the female reproductive system. Also known as uterine myomas, leiomyomas, or fibromas, they are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. In more than 99% of cases they are benign (non-cancerous). They may range in size from the size of a pea to the size of a softball or small grapefruit. Some women never have symptoms, the most common of which are: heavy or prolonged menstrual periods; abnormal bleeding between menstrual periods; pelvic pain; frequent urination; low back pain; pain during intercourse; a firm mass, often located near the middle of the pelvis, which can be felt by a physician.
Menorrhagia
Abnormally heavy menstrual period.
Placebo
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.
Acne
A chronic skin disorder due to inflammation of hair follicles and sebaceous glands (secretion glands in the skin).
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Milligram
(mg): 1/1,000 of a gram by weight.
Pyridoxine
(Vitamin B-6): A B-complex vitamin that plays a role as a coenzyme in the breakdown and utilization of carbohydrates, fats and proteins. It facilitates the release of glycogen for energy from the liver and muscles. It also participates in the utilization of energy in the brain and nervous tissue and is essential for the regulation of the central nervous system.
Lactation
Production of milk; period after giving birth during which milk is secreted in the breasts.