Chaste tree: benefits, dosage, contraindications
Other name(s)
monk's pepper
Scientific name(s)
Vitex agnus-castus
Family or group:
Plants
Active ingredients:
Flavonoids
Tannins
Iridoids
Alkaloids
Indications
Scoring methodology
EFSA approval.
Premenstrual syndrome ✪✪✪✪✪
Several other randomized, placebo-controlled clinical trials using standardized extracts have confirmed that daily intake of Vitex agnus-castus for 3 menstrual cycles may reduce premenstrual syndrome symptoms. In three double-blind, placebo-controlled clinical trials conducted by different laboratories, extracts from Vitex agnus-castus berries reduced breast pain associated with premenstrual syndrome, or mastalgia. Furthermore, Commission E and the World Health Organization (WHO) recognize the use of Vitex agnus-castus to treat menstrual cycle irregularities. For treatment, its dried and crushed berries are used to produce standardized extracts standardized for either casticin or agnuside. Furthermore, a meta-analysis of the available clinical research, including 17 studies involving 2,401 patients, shows that taking Vitex agnus-castus is comparable to oral contraceptives, and slightly more effective than placebo or other natural supplements, in reducing premenstrual symptoms. Subgroup analysis indicates that efficacy is not affected by the dose or form used, although dried powdered chasteberries appear to be ineffective. The low quality of the studies evaluated and the high level of bias and heterogeneity limit the validity of these results.
Posologie
Oral: berries
20 - 40 mg
3 - months
Women
standardized extract, dry extract
Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome.
Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in China.
The Treatment of Premenstrual Syndrome With Preparations of Vitex Agnus Castus: A Systematic Review and Meta-Analysis
Treatment for premenstrual syndrome with agnus castus fruit extract: prospective, randomized, placebo-controlled study
Community herbal monograph on Vitex agnus-castus L., fructus
Antinociceptive effects, acute toxicity and chemical composition of Vitex agnus-castus essential oil.
Therapeutic effect of Vitex agnus-castus in patients with premenstrual syndrome.
Mastalgia ✪✪✪✪✪
Clinical research shows that taking chaste tree extract (Vitex agnus-castus) at a dose of 3.2 to 4.8 mg per day for 2 months reduces breast pain intensity by 67.5% and pain duration by 52.9% compared with baseline in healthy women suffering from cyclic mastalgia; compared with placebo, these changes are significant. Other preliminary clinical research shows that taking a chaste tree extract at a dose of 40 mg per day for 3 months is as effective in reducing mastalgia pain as flurbiprofen at a dose of 100 mg twice a day for 3 months.
Posologie
Oral: berries
3.2 - 40 mg
3 months
Women
standardized extract, dry extract
The Effectiveness of Herbal Medicines on Cyclic Mastalgia: A Systematic Review on Meta-analysis
Treatment of Cyclical Mastalgia With a Solution Containing a Vitex Agnus Castus Extract: Results of a Placebo-Controlled Double-Blind Study
Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trial.
Female fertility disorders ✪✪✪✪✪
German researchers concluded that Vitex agnus-castus (chaste tree) may help women with fertility problems attributable to secondary amenorrhea or luteal phase insufficiency (progesterone insufficiency). They recommended a treatment duration of 3 to 6 months. Because of their progesterone-like effect, Vitex extracts can be used for irregular menstrual cycles at all stages of life, including perimenopause. They may also be indicated to restore the estrogen-progesterone balance in the body during menopause. This hormonal action is due to its effect on the pituitary gland. A treatment of at least 2 cycles is required to regularize the menstrual cycle, and 3 to 7 months may be needed to expect a pregnancy in cases of infertility. Vitex-based products are often standardized to guarantee a certain content of active substances. Daily dosage varies depending on the product but should, according to the European Medicines Agency, correspond to the equivalent of 28 to 52 mg of dried berries. Because of its action on the hormonal system, its use could mask serious health problems such as pituitary cancer; Vitex should be used under a doctor's supervision.
Posologie
Oral: berries
28 - 52 mg
7 months
Women
standardized extract, dry extract
Medicinal Plants as Alternative Treatments for Female Sexual Dysfunction: Utopian Vision or Possible Treatment in Climacteric Women?
The 4-month effect of Vitex agnus-castus plant on sexual function of women of reproductive age: A clinical trial
Menstrual cycle disorders ✪✪✪✪✪
German researchers concluded that vitex (chaste tree) could help women with fertility problems attributable to secondary amenorrhea or luteal phase deficiency (progesterone insufficiency). They recommended a treatment lasting 3 to 6 months. Thanks to their progesterone-like effect, vitex berry extracts can be used in cases of an irregular menstrual cycle during all life stages, including perimenopause. This hormonal action is due to its effect on the pituitary gland. At least 2 cycles of treatment are required to regularize the menstrual cycle and 3 to 7 months to hope to achieve a pregnancy in cases of infertility.
Posologie
Oral: berries
28 - 52 mg
2 - months
Women
standardized extract, dry extract
Menopause ✪✪✪✪✪
Vitex appears promising for reducing menopausal discomforts, including skin laxity, when combined with other plants. Vitex berry extracts may be indicated to restore the estrogen-progesterone balance in the body during menopause. It has been studied in combination with Nigella (black seed) or St. John’s wort. Another clinical trial conducted in menopausal women shows that daily oral intake of one capsule of a combination of vitex 400 mg, evening primrose oil 500 mg, soy isoflavones 100 mg and black cohosh 520 mg, for 12 weeks, improves skin elasticity, skin smoothness and wrinkle density compared with placebo.
Posologie
Oral: berries
400 - 500 mg
3 - months
Women
standardized extract, dry extract
Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study
Effects of a Combination of Nigella Sativa and Vitex Agnus-Castus With Citalopram on Healthy Menopausal Women With Hot Flashes: Results From a Subpopulation Analysis
A Review of Effective Herbal Medicines in Controlling Menopausal Symptoms
Effects of a combination of botanical actives on skin health and antioxidant status in post-menopausal women: A randomized, double-blind, placebo-controlled clinical trial
Properties
Progestogenic action
The berries of Vitex contain diterpenoid compounds, iridoids (agnuside), flavonoids (casticin), alkaloids and steroids, as well as essential oils. The diterpenoid compounds act on the pituitary gland by stimulating dopamine-sensitive receptors (a chemical messenger present in the brain). This stimulation would reduce the secretion of a hormone, prolactin, by the pituitary and would increase the secretion of progesterone by the ovaries (corpus luteum), thereby regulating menstrual cycles. Insufficient secretion of progesterone ("corpus luteum insufficiency") can be a cause of female infertility, and Vitex has been studied for this indication. Low doses of Vitex extract of about 120 mg per day appear to increase prolactin release. Higher doses appear to suppress prolactin release. Vitex does not seem to affect testosterone. Preliminary research suggests that Vitex may have estrogenic and progestogenic activity. Linoleic acid, a constituent of Vitex, appears to have estrogenic effects. It seems to be selective for beta-estrogen receptors. The estrogen beta receptor predominates in the heart, the vascular system, the bones and the bladder, but not in the uterus. This suggests that Vitex does not exert estrogenic effects in the uterus.
Usages associés
Neurological
Vitex agnus-castus (chaste tree) appears to affect dopamine, and probably acetylcholine and opioid receptors (vitex may act as an agonist of μ-opioid receptors). nnVitex extracts contain multiple active constituents that appear to have agonist effects on pituitary dopamine (D2) receptors when used at higher doses.nnThis dopaminergic activity inhibits prolactin release.nnDopamine is the essential inhibitor of prolactin secretion and represents the main hypothalamic prolactin inhibitory factor (PIF). It circulates in the hypophyseal portal system before binding to D2-type dopaminergic receptors located on the lactotroph cells of the anterior pituitary, thus allowing inhibition of prolactin secretion both in vitro and in vivo. Although many findings indicate that dopamine physiologically serves as the PIF, it is not the only hypothalamic factor that inhibits prolactin secretion.nn
Usages associés
Safe dosage
Adults 18 years and older: 20 mg - 52 mg
The EMA recommends taking 20 mg of dry extract (corresponding to 180 mg of berries) per day for at least 3 months.
Interactions
Médicaments
Antipsychotic: moderate interaction
Theoretically, Vitex (chaste tree) could interfere with the action of dopamine antagonists such as antipsychotics because of Vitex's dopaminergic effects. Among these antipsychotic drugs are chlorpromazine (Thorazine), clozapine (Clozaril), fluphenazine (Prolixin), haloperidol (Haldol), olanzapine (Zyprexa), perphenazine (Trilafon), prochlorperazine (Compazine), quetiapine (Seroquel), risperidone (Risperdal), thioridazine (Mellaril), and thiothixene.
Oral contraceptives: moderate interaction
Theoretically, Vitex may interfere with the effectiveness of oral contraceptives because it appears to have hormone-modulating activity.
Dopamine agonists: moderate interaction
Theoretically, Vitex could potentiate the actions of dopaminergic agonists because of its dopaminergic effects. These drugs include bromocriptine (Parlodel), levodopa, pramipexole (Mirapex), ropinirole (Requip), and others.
Metoclopramide: moderate interaction
Metoclopramide is a dopamine antagonist. Because Vitex exerts dopaminergic activity, it is thought that it could interact with medications that antagonize dopamine receptors.
Estrogens: moderate interaction
Theoretically, Vitex may interfere with the effectiveness of hormone therapies because it appears to have hormone-modulating activity.
Precautions
Children up to 18 years: avoid
Use in children and adolescents under 18 years has not been established due to a lack of adequate data.
Hormone-sensitive disease: avoid
Because the chaste tree (Vitex) is believed to have a regulatory hormonal effect, its use should be avoided in cases of hormone-sensitive disease.
Schizophrenia: avoid
Since Vitex has dopaminergic activity, its use should be avoided in people with schizophrenia.
Contraindications
Pregnant women: contraindicated
The hormonal effects of Vitex could be harmful during pregnancy or breastfeeding.
Breastfeeding women: contraindicated
The hormonal effects of Vitex could be harmful during pregnancy or breastfeeding.
