B25025 I By M. Faisal Hossain, BPharm, MPharm, PhD
A Legacy of Women’s Wellness
Vitex agnus-castus, commonly known as chasteberry, chaste tree, monk’s pepper, or gattilier, is native to the Mediterranean and Central Asia. Historically, it was valued for gynecological support, psychological disorders, hormone-related skin conditions, and even to promote chastity during medieval times—hence the name “chasteberry.”
Today, Vitex is promoted as a dietary supplement for premenstrual syndrome (PMS), breast tenderness, menstrual irregularities, infertility, and menopausal symptoms.
How Vitex Works: Hormonal Modulation
Hormonal Mechanism: How Vitex Works
Vitex’s primary mechanism involves dopaminergic activity at D2 receptors in the anterior pituitary. This activity reduces prolactin secretion, which, in turn, helps normalize the estrogen-progesterone ratio. Restored hormonal balance may alleviate PMS symptoms such as cyclical breast pain, irritability, and mood swings.
Clinical Research Findings
PMS Symptom Relief
A 2019 meta-analysis of double-blind, placebo-controlled trials evaluated standardized Vitex extracts (Ze 440 and BNO 1095) for premenstrual syndrome (PMS). Out of 21 clinical studies reviewed, only three high-quality trials (520 women) met strict CONSORT and PRISMA criteria.
Key Findings:
- Women taking Vitex were 2.57 times more likely to experience significant PMS symptom remission compared with placebo (95% CI: 1.52–4.35).
- Improvements included breast tenderness, mood swings, irritability, and overall PMS scores.
- The authors concluded that properly characterized Vitex extracts are clinically effective for PMS symptom reduction, although more rigorous trials are still needed.
Menstrual Irregularities & Pain
A 2024 single-center retrospective longitudinal cohort study evaluated Vitex agnus-castus (VAC) products (Cyclodynon® or Mastodynon®) in 1,700 women with menstrual cycle disorders, including abnormal uterine bleeding, dysmenorrhea, and breast tenderness. After three months of VAC treatment:
- Irregular cycles decreased from 9.1% to 0.1%.
- Breast tenderness (mastodynia/mastalgia) decreased from 39.9% to 0.8%.
- Menstrual pain improvement was reported by 85.2% of participants.
- Bleeding intensity and frequency improved in 83.4% and 79.2%, respectively.
- Quality of life (QoL) improved significantly across all domains, especially among women with dysmenorrhea.
Treatment was overall well tolerated with a favorable safety profile. While this study confirms earlier findings, it was observational and retrospective, so results should be interpreted with caution.
Luteal Phase Support, Fertility & Menopausal Symptoms
A randomized, double-blind, placebo-controlled clinical trial investigated a Vitex agnus-castus preparation (Strotan® capsules, 20 mg/day) in 52 women with luteal phase defects due to latent hyperprolactinemia. After three months of therapy:
- Prolactin secretion normalized (reduced post-TRH stimulation release).
- Luteal phase length and progesterone synthesis improved significantly.
- Two women conceived during treatment.
- No adverse effects were observed.
This study suggests that Vitex may benefit luteal phase progesterone production and fertility in women with mild hyperprolactinemia. However, NCCIH notes that overall evidence for Vitex in fertility or menopausal symptoms remains limited and preliminary, requiring more robust clinical trials.
Safety and Precautions
According to NCCIH and clinical studies:
- Generally safe short term (up to 3 months).
- Mild side effects: nausea, upset stomach, diarrhea, headache, or itching.
- Not recommended for:
- Women with hormone-sensitive cancers (breast, uterine, ovarian).
- Pregnant or breastfeeding women (safety not established).
- Consult a healthcare provider before use, especially when on hormone therapy, oral contraceptives, or dopamine medications.
Final Thoughts
Vitex berry remains one of the most popular herbal approaches for PMS symptom relief and menstrual cycle support. While preliminary clinical results are promising, NCCIH emphasizes that stronger evidence is needed, and safety considerations are crucial for women with hormone-sensitive conditions or during pregnancy. When used responsibly and under professional guidance, Vitex may serve as a gentle, supportive ally in women’s reproductive wellness.
References
- NCCIH: Chasteberry
- Jarry H, Wuttke W. Phytomedicine. 2013;20(8‑9):665‑669. doi:10.1055/s‑0032‑1327831
- Csupor D, et al. Complement Ther Med. 2019;47:102190. doi:10.1016/j.ctim.2019.08.024
- Höller M et al., Arch Gynecol Obstet. 2024;309(5):2089–2098. doi:10.1007/s00404-023-07363-4
- Milewicz A, et al. Arzneimittelforschung. 1993;43(7):752–756. PMID:8369008
- Aucoin M, et al. Aust J Herbal Med. 2021;33(4):163–166.
Acknowledgment:
This blog was prepared with assistance from ChatGPT by OpenAI. The featured image was also created with the help of AI tools.
Note:
This content is for informational purposes only and is not intended as medical advice. Always consult your healthcare provider before starting any supplement.
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