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© Steven Foster
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Botanical name: Vitex agnus-castus
Common names: Chaste tree, Monk’s pepper
Parts used and where grown
Vitex grows in Mediterranean countries and central Asia. The dried fruit, which has a
pepper-like aroma and flavor, is used in herbal medicine preparations.
Vitex has been used in
connection with the following conditions (refer to the individual
health concern for complete information):
Historical or traditional use (may
or may not be supported by scientific studies)
Hippocrates, Dioscorides, and Theophrastus mention the use of vitex for a wide variety of
conditions, including hemorrhage following childbirth and assisting with the “passing of
afterbirth.” Decoctions of the fruit and plant were also used in sitz baths for diseases
of the uterus. In addition, vitex was believed to suppress libido and inspire chastity, which
explains one of its common names, chaste tree.
Active constituents
Vitex contains several different constituents, including flavonoids, iridoid glycosides,
and terpenoids. The whole fruit extract, rather than one of its individual constituents,
appears to be necessary for the medicinal activity of vitex.1 Vitex does not
contain hormones. The benefits of vitex stem from its actions upon the pituitary
gland—specifically on the production of a hormone called luteinizing hormone (LH). This
indirectly increases progesterone production and helps
regulate the menstrual cycle. Vitex also keeps prolactin secretion in check.2
3 The ability to decrease mildly elevated prolactin levels may benefit some infertile women as well as some women with breast
tenderness associated with premenstrual syndrome (PMS).
A controlled clinical trial found that women taking 20 mg per day of a concentrated vitex
extract for three menstrual cycles had a significant reduction in symptoms of PMS, including
irritability, mood swings, headache, and breast tenderness.4 Another double-blind
trial found that women taking vitex had slightly greater relief from symptoms of PMS,
including breast tenderness, cramping, and headaches, than those taking vitamin B6.5 These trials support the findings of
preliminary vitex trials for women with PMS.6 7 Vitex (32.4 mg per day),
in combination with some homeopathic remedies, has also been found in a double-blind trial to
successfully treat breast tenderness (also called mastalgia).8
A review of other trials and case reports suggests there is at least preliminary support
that vitex should be considered for women with irregular periods, infertility, and mildly
elevated prolactin levels.9 Double-blind trials have confirmed the effectiveness of
vitex at lowering mildly elevated prolactin levels in women.10 According to one
small trial, acne associated with PMS, may also be
reduced using vitex.11
How much is usually taken?
The German Commission E monograph recommends a daily intake—30–40 mg of the
dried herb—in capsules or in liquid preparations.12 Vitex is typically taken
once in the morning with liquid for several months consecutively.
With its emphasis on long-term balancing of a woman’s hormonal system, vitex is not a
fast-acting herb and is unlikely to give immediate relief to the discomfort associated with
PMS. For premenstrual syndrome, frequent or heavy periods,
vitex can be used continuously for four to six months. Infertile women with amenorrhea (lack of menstruation) can remain on vitex for 12
to 18 months, unless pregnancy occurs during
treatment.
Are there any side effects or interactions?
Side effects may include minor stomach upset and a mild skin rash with itching. Vitex is
not recommended for use during pregnancy and should not
be used concurrently with hormone therapy (e.g., estrogen,
progesterone).
At the time of writing, there were no well-known drug interactions
with vitex.
References
1. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete
Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative
Medicine Communications, 1998, 108.
2. Sliutz G, Speiser P, Schultz AM, et al. Agnus castus extracts inhibit
prolactin secretion of rat pituitary cells. Horm Metab Res 1993;25:253–5.
3. Böhnert KJ. The use of Vitex agnus castus for
hyperprolactinemia. Quart Rev Nat Med 1997;Spring:19–21.
4. Schellenberg R. Treatment for the premenstrual syndrome with agnus
castus fruit extract: prospective, randomized, placebo controlled study. BMJ
2001;20:134–7.
5. Lauritzen C, Reuter HD, Repges R, et al. Treatment of premenstrual
tension syndrome with Vitex agnus-castus. Controlled, double-blind study versus
pyridoxine. Phytomed 1997;4:183–9.
6. Dittmar FW, Böhnert KJ, Peeters M, et al. Premenstrual syndrome:
Treatment with a phytopharmaceutical. Therapiwoche Gynäkol
1992;5:60–8.
7. Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a
phytopharmaceutical formulation containing Vitex agnus castus. J Women Health Gender-Based
Med 2000;9:315–20.
8. Halaska M, Beles P, Gorkow C, Sieder C. Treatment of cyclical
mastalgia with a solution containing Vitex agnus extract: results of a
placebo-controlled double-blind study. The Breast 1999;8:175–81.
9. Bone K. Vitex agnus-castus: Scientific studies and clinical
applications. Eur J Herbal Med 1994;1:12–5.
10. Milewicz A, Gejdel E, Sworen H, et al. Vitex agnus castus
extract for the treatment of menstrual irregularities due to latent hyperprolactinemia.
Arzneim Forsch 1993;43:752–6 [in German].
11. Amann W. Improvement of acne vulgaris following therapy with
Agnus castus (Agnolyt). Ther Ggw 1967;106:124–6 [in German].
12. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete
Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative
Medicine Communications, 1998, 108.
Copyright © 2004 Healthnotes, Inc. All rights reserved.
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The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in vitro),
clinical experience, or traditional usage as cited in each article. The results reported may
not necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over-the-counter medication is also available. Consult your doctor,
practitioner, and/or pharmacist for any health problem and before using any supplements or
before making any changes in prescribed medications. Information expires March 2005.
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