Vitex agnus-castus, also known as the chaste tree, is a shrub whose berries, leaves, and seeds are used primarily for reproductive system conditions. Among women, Vitex agnus-castus is commonly utilized for premenstrual syndrome (PMS) symptoms, including painful breasts, menstrual disorders, fibrocystic breast disease, infertility, preventing miscarriage, and increasing breast milk production.
Men use the herb to help alleviate the symptoms of benign prostatic hyperplasia and to improve libido. It has non-reproductive system uses as well.
Vitex agnus-castus is a source of the flavone apigenin — and the apigenin flavone glucoside vitexin — which has antioxidant, anticancer, anti-inflammatory, antihyperalgesic, and neuroprotective effects.1-3 Another compound, casticin, has a significant ability to inhibit lipid peroxidation.4
In female rats with normal and induced aging, an extract of Vitex agnus-castus helped normalize aging-related effects that included follicle-stimulating-hormone (FSH) and luteinizing-hormone (LH) elevations as well as decreased estrogen and antioxidant enzyme levels.5
Chasteberry and Prolactin
Research in rat pituitary cells revealed an inhibitory effect for Vitex agnus-castus extract against excess secretion of prolactin — a hormone that enables milk production in women — suggesting its use as an alternative therapy for individuals with hyperprolactinemia (elevated blood levels of prolactin).6 High prolactin levels are associated with infertility, low libido, and bone loss in women and erectile dysfunction in men. In a randomized, double-blind, placebo-controlled trial involving women with a condition known as latent hyperprolactinemia, the administration of a 20-milligram capsule of chaste tree fruit for three months was associated with a reduction in prolactin release, normalization of shortened menstrual cycle luteal phase (which occurs following ovulation), and improvement in luteal phase progesterone synthesis.7 Women who received chasteberry also experienced an increase in beta-estradiol during this phase.
Investigation of the prolactin-suppressive mechanisms of Vitex agnus-castus has revealed compounds with an ability to bind to receptors for the neurotransmitter dopamine, which aids in the control of the brain’s pleasure and reward centers, among other functions.8 Pharmacologic research has confirmedthe dopaminergic effect of extracts of chasteberry and suggests actions via opioid receptors.9,10
Chasteberry and PMS
A trial that investigated the effects of daily chasteberry extract supplementation, during three menstrual cycles among 43 women with premenstrual syndrome, resulted in a significant reduction in symptoms that gradually returned after the supplement was discontinued.11 Another trial that compared the effects of chasteberry extract to a placebo, among 170 women with PMS, determined that improvement in irritability, mood alteration, anger, headache, breast fullness, and other premenstrual symptoms was greater among those who received the extract — and that the treatment was well tolerated.12 Ina trial involving Japanese women with PMS, daily administration of Vitex agnus-castus extract for three cycles revealed decreases in irritability, depressed mood, anger, headache, bloating, breast fullness, skin disorder, fatigue, drowsiness, and sleeplessness.13 The rate of response to the extract increased over time, with 91% of the participants showing a response at the third menstrual cycle. A double-blind, placebo-controlled trial that included 217 Chinese women with PMS also resulted in improvement in association with treatment with Vitex agnus-castus extract for up to three cycles.14
Yet another trial, which evaluated the effects Vitex agnus-castus administered for six days prior to the menses for six cycles among 128 women who suffered from PMS, resulted in significant improvement among those who received the herb in comparison with a placebo.15 The authors noted two important differences between their study and others: increased duration of treatment (six months instead of three) and cyclic use instead of daily usage (six days instead of 30 days).
A randomized, controlled trial that compared the effects of chasteberry to pyridoxine (vitamin B6), among women with premenstrual tension syndrome, found that chasteberry was associated with greater alleviation of typical complaints: breast tenderness, edema, inner tension, headache, constipation, and depression.16 In a trial that compared the effects of Vitex agnus-castus to fluoxetine (Prozac) in women with premenstrual dysphoric disorder (PMDD, a more severe form of premenstrual syndrome), a similar number of participants responded to both treatments; however, fluoxetine was more effective for psychological symptoms and chasteberry for physical symptoms.17
A systematic review of eight randomized trials that involved women with PMS or PMDD found positive effects for Vitex agnus-castus in all trials, as well as safety.18 Another review, which included 43 studies reported between 2009 and 2016, concluded that Vitex agnus-castus helped treat premenstrual syndrome, alleviated postmenstrual pain, and was beneficial for women experiencing infertility.19
Among women with cyclical mastalgia (breast pain), Vitex agnus-castus extract given daily for three menstrual cycles was associated with a greater reduction of pain intensity in comparison with a placebo.20 A review published in Evidence-Based Complementary and Alternative Medicine concluded that, “Data from randomized and non-randomized well-conducted studies provides convincing evidence to suggest that A. castus is safe, effective, and well tolerated in a majority of patients suffering from mastalgia.”21
Women who suffer from migraine headaches often experience worsening of the condition in the premenstrual phase. A study that included 100 women with migraines and PMS who were given Vitex agnus-castus daily for three months resulted in two-thirds of the participants reporting a dramatic reduction in PMS symptoms; 42% of the subjects experienced a reduction in frequency of monthly migraine attacks that was greater than 50%.22 Fifty-seven percent of the women had a reduction of over 50% in the number of monthly days with headache.
PCOS, Menopause, and Beyond
A review of preclinical and clinical studies that investigated the effects of alternative therapies for polycystic ovary syndrome (PCOS) and related decreased or absent menstruation, as well as elevated male hormone levels, revealed evidence for equivalent effects for Vitex agnus-castus and the drug bromocriptine.23
Difficulty in the ability to remember or concentrate is a common complaint among postmenopausal women. In a study involving female rats that had their ovaries removed to mimic human menopause, Vitex agnus-castus extract, as well as the hormone estradiol, improved learning and memory in comparison with a control group.24
“Fruits of Vitex agnus-castus have been used in the treatment of many female conditions”, wrote A. Rani and A. Sharma in a recent review. These conditions include: menstrual disorders such as amenorrhea and dysmenorrhea, premenstrual dysphoric disorder (PMDD), insufficiency of the corpus luteum, hyperprolactinemia, disrupted lactation, infertility, acne, menopause, cyclic breast pain, and cyclical mastalgia. Diarrhea, flatulence, and inflammatory conditions are also included.
“Vitex agnus-castus seems to hold great potential for an in-depth investigation for various biological activities,” the authors wrote.25
- He M et al. Fitoterapia. 2016 Dec;115:74-85.
- Chen S-N et al. Fitoterapia. 2011;82(4):528-533.
- Rafieian-Kopaei M et al. Electronic Physician. 2017;9(1):3685-3689.
- Hajdú Z et al. Phytother Res. 2007 Apr;21(4):391-4.
- Ahangarpour A et al. J Chin Med Assoc. 2016 Nov;79(11):589-596.
- Sliutz G et al. Horm Metab Res. 1993 May;25(5):253-5.
- Milewicz A et al. Arzneimittelforschung. 1993 Jul;43(7):752-6.
- Wuttke W et al. Phytomedicine. 2003 May;10(4):348-57.
- Meier B et al. Phytomedicine. 2000 Oct;7(5):373-81.
- Webster DE et al. J Ethnopharmacol. 2006 Jun 30;106(2):216-21.
- Berger D et al. Arch Gynecol Obstet. 2000 Nov;264(3):150-3.
- Schellenberg R et al. BMJ. 2001 Jan 20;322(7279):134-7.
- Momoeda M et al. Adv Ther. 2014 Mar;31(3):362-73.
- He Z et al. Maturitas. 2009 May 20;63(1):99-103.
- Zamani M et al. Acta Med Iran. 2012;50(2):101-6.
- Lauritzen C et al. Phytomedicine. 1997 Sep;4(3):183-9.
- Atmaca M et al. Hum Psychopharmacol. 2003 Apr;18(3):191-5.
- Cerqueira RO et al. Arch Womens Ment Health. 2017 Dec;20(6):713-719.
- Rafieian-Kopaei M et al. Electron Physician. 2017 Jan 25;9(1):3685-3689.
- Halaska M et al. Breast. 1999 Aug;8(4):175-81.
- Carmichael AR et al. Evid Based Complement Alternat Med. 2008 Sep;5(3):247-50.
- Ambrosini A et al. Acta Neurol Belg. 2013 Mar;113(1):25-9.
- Arentz S et al. BMC Complement Altern Med. 2014 Dec 18;14:511.
- Allahtavakoli M et al. Basic Clin Neurosci. 2015 Jul;6(3):185-92.
- Rani A et al. Pharmacogn Rev. 2013 Jul;7(14):188-98.