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Photo copyright Steven Foster

Vitex

Common names: Chaste tree, Monk’s pepper

Botanical name: Vitex agnus-castus

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):

Rating Health Concerns
3Stars Premenstrual syndrome
2Stars Female infertility
Fibrocystic breast disease
1Star Acne (associated with menstrual cycle)
Amenorrhea
Dysmenorrhea
Endometriosis
Menorrhagia (heavy menstruation)
Pregnancy and postpartum support
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

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.