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Chasteberry (Vitex agnus-castus)

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Also listed as: Vitex agnus-castus
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • Abraham's balm, Abrahams-strauch, Agneau chaste (French), Agni casti fructus (Latin), Agnocasto, agnoside, agnus castus, agnus-castus, apigenin, aucubin, castican, chaste berry, chaste tree, chaste tree berry, chastetree, cineole, gattilier (French), hemp tree, isovitexin, Keuschlammfruchte (German), kyskhedstrae (Danish), limonene, linolenic acid, monk's pepper, Moenchspfeffer (German), oleic acid, orientin, palmitic acid, petit poivre (French), sabinene, stearic acid, Verbenaceae (family), Vitex.

Background
  • The chaste tree grows in the Mediterranean and in Central Asia. Its berries have long been used for a variety of disorders.
  • Available evidence suggests chasteberry may be an effective treatment option for high prolactin levels and premenstrual syndrome (PMS). It has also been used in studies concerning corpus luteum deficiency / luteal phase deficiency, cyclical breast pain, female sexual dysfunction, fertility, irregular menstrual cycles, menopause, and premenstrual dysphoric disorder (PMDD). Further study is warranted.
  • Clinical trials have found that treatment with chasteberry has been well tolerated with minimal side effects.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Chasteberry may inhibit prolactin secretion, and thus has been suggested as a potential therapy in hyperprolactinemia, a condition characterized by elevated serum prolactin levels. Although early evidence is promising, additional study is needed in this area.

B


Chasteberry has been suggested as having a role in treating symptoms of PMS. Further evidence is needed before a firm conclusion can be made.

B


Corpus luteum deficiency (CLD) refers to irregular development of the corpus luteumfollowing ovulation, resulting in abnormal progesterone secretion and incomplete endometrial differentiation. The term luteal phase deficiency (LPD) has also been used in this setting and has been shown to be involved with both infertility and recurrent pregnancy loss. The use of chasteberry for this condition remains controversial.

C


Despite early promising results, it remains unclear if chasteberry is an effective treatment in the management of cyclic mastalgia (breast pain). Additional study is needed in this area.

C


The effectiveness of chasteberry for female sexual dysfunction has been studied, but further study is needed.

C


Chasteberry has been studied for its effects on infertility alone and as a combination product. However, it also has been suggested that chasteberry be avoided during pregnancy. Further study is needed before firm conclusions can be made.

C


It remains unclear if chasteberry is an effective therapy in the management of irregular menses (menstrual bleeding). Additional study is needed in this area.

C


Chasteberry, alone or in combination with other agents, has been suggested for the treatment of symptoms related to menopause. A combination product containing chasteberry showed a lack of significant effects in major symptoms. Further research may be needed in this area.

C


There is limited evidence suggesting possible benefits of chasteberry in the reduction of PMDD symptoms. Further research is needed before a firm conclusion can be drawn.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Acne, amenorrhea (absence of menstruation), antifungal, anti-inflammatory, anxiety, benign prostatic hypertrophy (BPH, enlarged prostate), canker sores (premenstrual, ulcerative), constipation, libido, dementia, diarrhea, dysmenorrhea (painful periods), dyspepsia (upset stomach), endometriosis (growth of endometrial tissue outside the uterus), epilepsy, fevers, fibrocystic breast disease, flatulence (gas), fluid retention, hangovers, herpes simplex (orofacial), hot flashes, hypogonadism (underactive sex organs), impotence, inflammation, insect repellant, lactation, menorrhagia (heavy menstruation), menstrual dermatoses (skin disorder during menstrual cycle), menstrual neuroses, metrorrhagia (from functional causes, continuous or non-cyclical uterine bleeding), nervousness, ovarian cysts (follicular), parasites, poisoning (ciguatera fish), postpartum bleeding, prevention of miscarriage in patients with progesterone insufficiency, rheumatic conditions, sexual vigor (decrease), snake bite, tumor (prolactinoma), ulcers (mouth), upper respiratory tract infections, uterine disorders (cystic endometrial hyperplasia, expulsion of the placenta), vaginal dryness.

Dosing

Adults (18 years and older):

  • Some experts recommend taking chasteberry on an empty stomach in the morning for the best benefits. However, no studies have confirmed this finding.
  • For corpus luteum deficiency / luteal phase deficiency, 30 drops of Mastodynon® has been used by mouth twice daily for three months. An average daily dose of 40 drops of Agnolyt® has been taken by mouth on an empty stomach for an average of 135 days. Additionally, 40 drops of a chasteberry extract has been taken by mouth daily for six months, and 15 drops has been taken by mouth three times daily for six weeks.
  • For cyclical breast pain, 1.8 milliliters (60 drops) of Mastodynon® chasteberry extract or one Mastodynon® tablet has been taken by mouth daily. 30 drops Vitex agnus castus extract solution (VACS) has been taken by mouth twice daily for four cycles.
  • For hyperprolactinemia, 20 milligrams of Strotan® capsules have been taken by mouth daily in women, or 40-160 milligrams of a chasteberry extract has been taken by mouth up to three times daily in men.
  • For irregular menstrual cycles, 15 drops of a chasteberry extract has been taken by mouth three times daily over several cycles.
  • For premenstrual dysphoric disorder (PMDD), chasteberry extract has been taken by mouth for two months (dosage unknown). 40mg of chasteberry has been taken by mouth daily for two months.
  • For premenstrual syndrome (PMS), 4-1,800 milligrams of chasteberry powder or ethanolic extract has been taken by mouth once to three times daily for up to three months or three menstrual cycles. 3.5-4.2 milligrams of Agnolyt® have been taken by mouth for up to four months. 40 milligrams of Femicur® has been taken by mouth daily (duration unknown); the suggested dosing for Femaprin®, the equivalent of Agnolyt® sold in the United States, is 30-40 milligrams daily. 40 drops of a chasteberry solution has been mixed in one glass of fruit juice and taken by mouth once daily before breakfast starting six days before menstruation and lasting until menstruation occurred for six consecutive cycles.

Children (younger than 18 years):

  • There is no proven safe or effective dose for chasteberry in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in people with a known allergy or sensitivity to chasteberry, its parts, or members of the Vitex (Verbenaceae) family. Mild skin reactions have been reported including eczema, itching, rash, skin eruptions, urticaria (hives) and allergic exanthema (rash occurring with a disease).

Side Effects and Warnings

  • Chasteberry is likely safe when used by mouth in otherwise healthy adults using appropriate doses for the short-term relief of signs and symptoms associated with premenstrual syndrome or high prolactin levels in the blood.
  • Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.
  • Chasteberry may also cause abscesses, acne, agitation, alopecia (loss of hair), breast pain (mastodynia, mastalgia), changes in hormones (gonadotropin), circulatory disorders, depressed mood, diarrhea, dizziness, dry mouth, eczema, fibroid growth, fluid in the lungs, gas, gastroenteritis (inflammation of intestinal tract), headache, heartburn, heart palpitations, heavy, irregular, or prolonged menstrual bleeding, hives, hot flashes, increased pressure in the eye, increased urination, inflammation, itching, menstrual cycle changes, multiple follicular development (number of follicles on ovaries), nausea, nosebleed, pelvic disease, rapid heart rate, rash, seizure, skin eruptions and redness, sweating, tonsillitis (inflammation of the tonsils), upset stomach, weight gain, vaginitis, vertigo, and vomiting.
  • Use cautiously in people taking antipsychotics, antiandrogens, bromocriptine, diuretics (agents that increase urine), dopamine agonists or antagonists, birth control, or hormone replacement therapy.
  • Use cautiously in women undergoing artificial fertilization.
  • Avoid in women whom are pregnant or breastfeeding.
  • Avoid using in people with hormone sensitive cancers or conditions.
  • Avoid in people with a known allergy or sensitivity to chasteberry, its parts, or members of the Vitex (Verbenaceae) family.

Pregnancy and Breastfeeding

  • Except under strict medical supervision, chasteberry should not be used in pregnancy due to potential uterine stimulatory properties. Some clinicians have used chasteberry in progesterone deficient women during their first trimester to prevent miscarriage, but it is not known if chasteberry is helpful or safe for this indication.
  • Chasteberry is not recommended in breastfeeding women due to a lack of available scientific evidence. Chasteberry may possibly decrease breast milk production. However, some clinicians actually use low doses to stimulate milk production with some reported benefits.

Interactions

Interactions with Drugs

  • Chasteberry may interact with antiandrogens, antibiotics, antidepressants, antipsychotics, birth control agents, bromocriptine, diuretics (increase urine production), dopamine agonists and antagonists, hormonal agents, hormone replacement therapy, and metoclopramide.

Interactions with Herbs and Dietary Supplements

  • Chasteberry may interact with antiandrogens, antibacterials, antidepressants, antipsychoitcs, birth control herbs and supplements, diuretics (increase urine production), dopamine agonists and antagonists, herbs and supplements for hormonal replacement therapy, and hormonal herbs and supplements.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Ciotta L, Pagano I, Stracquadanio M, et al. [Psychic aspects of the premenstrual dysphoric disorders. New therapeutic strategies: our experience with Vitex agnus castus]. Minerva Ginecol. 2011;63(3):237-245.
  2. Dante G and Facchinetti F. Herbal treatments for alleviating premenstrual symptoms: a systematic review. J Psychosom.Obstet.Gynaecol. 2011;32(1):42-51.
  3. Doll M. [The premenstrual syndrome: effectiveness of Vitex agnus castus]. Med.Monatsschr.Pharm. 2009;32(5):186-191.
  4. Freeman EW. Therapeutic management of premenstrual syndrome. Expert.Opin.Pharmacother. 2010;11(17):2879-2889.
  5. He Z, Chen R, Zhou Y, et al. Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in China. Maturitas 5-20-2009;63(1):99-103.
  6. Kumar-Roine S, Taiana Darius H, Matsui M, et al. A review of traditional remedies of ciguatera fish poisoning in the Pacific. Phytother.Res 2011;25(7):947-958.
  7. Laakmann E, Grajecki D, Doege K, et al. Efficacy of Cimicifuga racemosa, Hypericum perforatum and Agnus castus in the treatment of climacteric complaints: a systematic review. Gynecol.Endocrinol. 2012;28(9):703-709.
  8. Ma L, Lin S, Chen R, et al. Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Aust.N.Z.J Obstet.Gynaecol. 2010;50(2):189-193.
  9. Ma L, Lin S, Chen R, et al. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Gynecol.Endocrinol. 2010;26(8):612-616.
  10. Mazaro-Costa R, Andersen ML, Hachul H, et al. Medicinal plants as alternative treatments for female sexual dysfunction: utopian vision or possible treatment in climacteric women? J Sex Med. 2010;7(11):3695-3714.
  11. Pearlstein T. Psychotropic medications and other non-hormonal treatments for premenstrual disorders. Menopause.Int 2012;18(2):60-64.
  12. Semmler M, Abdel-Ghaffar F, Al-Rasheid K, et al. Nature helps: from research to products against blood-sucking arthropods. Parasitol.Res 2009;105(6):1483-1487.
  13. van Die MD, Bone KM, Burger HG, et al. Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis. J Altern.Complement Med. 2009;15(9):1045-1048.
  14. Whelan AM, Jurgens TM, and Naylor H. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. Can.J Clin Pharmacol. 2009;16(3):e407-e429.
  15. Zamani M, Neghab N, and Torabian S. Therapeutic effect of Vitex agnus castus in patients with premenstrual syndrome. Acta Med.Iran 2012;50(2):101-106.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.


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