Vitex Agnus Castus Extract (Chasteberry) Clinical Evidence
Schellenberg R, et al. Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome. 2012 Nov 15;19(14):1325-31.
What is the effective dose of Vitex agnus castus (VAC) for the treatment of PMS?
VAC has been shown to be an effective treatment for irregular periods, cyclical breast pain, and symptoms of PMS. However, the optimal dose has not been established.
Human clinical intervention trial.
Double-blind, placebo-controlled, parallel-group. Participants took 3 different doses of VAC or placebo for 3 menstrual cycles. Researchers used the visual analog scale to measure symptoms including irritability, mood swings, headaches, bloating, and breast fullness.
8, 20, or 30 mg, for 3 menstrual cycles.
162 women aged 18-45
Improvement of total symptom score in the 20 mg group was significantly higher than in the placebo or 8 mg group, but improvement in the 30 mg group was no higher than in the 20 mg group.
“This study demonstrated that the VAC extract Ze 440 was effective in relieving symptoms of PMS, when applied in a dose of 20 mg. Therefore for patients suffering from PMS, 20 mg Ze 440 should be the preferred daily dose.”
Complementary Therapies in Medicine
Cuspor D, et al. Vitex agnus-castus in premenstrual syndrome: a meta-analysis of double-blind randomised controlled trials. 2019 Dec;47:102190.
What is the consensus of clinical evidence for using Vitex agnus castus (VAC) to treat PMS?
VAC has been studied for the treatment of PMS, but the results of these studies have not been assessed in a meta-analysis to date.
Researchers evaluated 21 clinical trials of VAC and found only 3 were randomized, double-blind, placebo-controlled, and fulfilled all the requirements of the CONSORT recommendations for the study of herbal products. These 3 studies:
• Enrolled a total of 520 women
• Found VAC to be effective in the reduction of PMS symptoms
• Found women taking VAC were 2.57 times more likely than those in placebo groups to experience remission of symptoms
“Although several clinical trials have been carried out with VAC, the majority of the studies cannot be used as evidence for efficacy due to incomplete reporting, especially concerning the description of the used medication. Most trials following the CONSORT recommendations are needed to assess the efficacy of VAC extracts.”
Archives of Gynecology and Obstetrics
Berger D, et al. Efficacy of Vitex agnus castus L extract Ze in patients with pre-menstrual syndrome (PMS). 2000 Nov;264(3):150-53.
Is Vitex agnus castus (VAC) an effective treatment for PMS?
Vitex agnus castus, also known as chasteberry, got its common name because it was once thought to reduce sexual desire. This effect has been discredited, but it is likely that VAC does in fact have an effect on female hormones, specifically during the menstrual cycle, and that may help reduce symptoms of PMS.
Human clinical intervention.
Prospective, multicenter. Participants were followed for 8 menstrual cycles: 2 before treatment, 3 during treatment, and 3 after treatment. During the treatment period volunteers took VAC daily. Researchers used Moos’ Menstrual Distress Questionnaire (MMDQ) as the primary outcome measure and the visual analog scale (VAS, self-assessed) and a global impression scale (GI, self-assessed) as secondary outcomes.
20 mg, for 3 weeks
50 women with PMS, with an average age of 31.7 +/- 7.7 years. 43 completed the study.
At the end of the study, PMS symptoms were reduced by treatment. MMDQ scores fell significantly, by 42.5%. After treatment ended, symptoms gradually returned. However, even 3 cycles after cessation of treatment, a 20% difference persisted from baseline. At baseline, VAS scores were high in the late luteal phase and low in the follicular phase. VAS scores remained low during the follicular phase during treatment, but during the luteal phase they remained 21.7% lower 3 cycles after treatment. Prolactin levels remained within the physiological range throughout treatment.
Twenty of the 43 volunteers were considered responders, meaning they experienced at least a 50% reduction in symptoms. Thirty-eight participants rated global efficacy moderate to excellent; 5 found no efficacy.
The number of days with PMS symptoms fell from 7.5 to 6 per cycle. There were no differences between women who were taking oral contraceptives and those who were not.
Twenty volunteers reported side effects, but none were serious.
“In conclusion, patients with PMS can be treated successfully with Vitex agnus-castus extract Ze 440, as indicated by clear improvement in the main effect parameter during treatment and the gradual return after cessation of treatment. The main response to treatment seems related to symptomatic relief rather than to the duration of the syndrome.”
Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo-controlled study. 2001 Jan 20;3222(7279):134-37.
Is Vitex agnus castus (VAC) an effective and well tolerated treatment for PMS?
VAC is an herbal treatment for PMS that comes from the chaste tree, native to the Mediterranean region. Is it effective and safe?
Human clinical intervention
Randomized, double-blind, placebo-controlled, parallel group. Participants took VAC or placebo for 3 menstrual cycles. Researchers the following symptoms as primary outcomes: irritability, mood swings, anger, headache, and breast fullness. They used the following as secondary outcomes: impressions of severity of condition and improvement, risk and benefit, as well as the responder rate (number of volunteers who experienced at least a 50% reduction in symptoms). Seven participants (4 in the treatment group and 3 in the placebo group) reported mild side effects.
170 women with a mean age of 36 years
The primary outcome variables improved significantly more in the treatment group than in the control group. Impressions of severity, improvement, risk and benefit were also superior in the treatment group. The responder rate was 52% for treatment and 24% for placebo.
“Dry extract of agnus castus fruit is an effective and well tolerated treatment for the relief of symptoms of the premenstrual syndrome.”
Mechanism of Action
Breast pain is thought to be caused by excess prolactin in response to stress. Vitex may work by modulating this stress-induced secretion of prolactin via dopamine. Its flavonoids and endorphins may also bind to opioid receptors. Vitex significantly increases plasma levels of progesterone and total estrogen. At the same time, it also significantly reduces luteinizing and plasma prolactin hormones.