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Chasteberry (Vitex agnus-castus)

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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, agnus castus, agnus-castus, chaste berry, chaste tree, chaste tree berry, chastetree, gattilier (French), hemp tree, Keuschlammfruchte (German), kyskhedstrae (Danish), monk's pepper, Moenchspfeffer (German), petit poivre (French), Verbenaceae (family), vitex.

Background
  • The chaste tree is native to the Mediterranean and Central Asia. Its berries have long been used for a variety of abnormalities including "corpus luteum deficiency," mastalgia (breast pain), and menstrual abnormalities.
  • Chasteberry has been shown to inhibit prolactin secretion by competitively binding to dopamine receptors. Available evidence suggests that chasteberry may be an effective treatment option for hyperprolactinemic (elevated serum prolactin levels) conditions, and premenstrual syndrome (PMS). Chasteberry does not appear to affect levels of luteinizing hormone or follicle stimulating hormone.
  • Currently, clinical trials have found that treatment with chasteberry has been well tolerated with minimal side effects.
  • The dried fruit of chasteberry plants has been used for thousands of years as a means of treating various ailments, ranging from impotence to breast pain. It was popular in ancient Greece and Rome to help promote celibacy. More recently, chasteberry has gained recognition for its success in alleviating some signs and symptoms of hyperprolactinemia and premenstrual syndrome. It is thought to have a normalizing effect on the menstrual cycle and has been used successfully to treat both amenorrhea (absence of menstruation) and menorrhagia (heavy menstruation).

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 preliminary evidence is promising, additional study is warranted in this area.

B


Corpus luteum deficiency (CLD) is a term more commonly used in Europe than in the United States, and 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 implicated both in infertility and recurrent pregnancy loss. The use of chasteberry for this condition remains controversial.

C


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

C


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

C


There is limited controlled trial evidence suggesting possible benefits of chasteberry in the alleviation of symptoms of PMDD. Further evidence is necessary before a firm conclusion can be drawn.

C


Most studies evaluating chasteberry in PMS have been of poor study design, although one recent trial demonstrating benefit is of high quality. Further evidence is necessary 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), chastity, constipation, cystic endometrial hyperplasia (abnormal thickening of the inner lining of the uterus), libido, dementia, depression due to menopause, diarrhea, dysmenorrhea (painful periods), dyspepsia (upset stomach), endometriosis (growth of endometrial tissue outside the uterus), epilepsy, expulsion of the placenta, female infertility, fevers, fibrocystic breasts, flatulence (gas), fluid retention, follicular ovarian cysts, hangovers, hot flashes, hypogonadism (underactive sex organs), impotence, inflammation, lactation, menopause, menorrhagia (heavy menstruation), menstrual dermatoses, "menstrual neuroses," metrorrhagia (from functional causes, continuous or non-cyclical uterine bleeding), mouth ulcers, nervousness, oligomenorrhea (lengthened cycle), orofacial herpes simplex, overactive libido, polymenorrhea (shortened cycle), postpartum bleeding, premenstrual aphthous ulcerative stomatitis (mouth sores), prevention of miscarriage in patients with progesterone insufficiency, reducing sexual desire, rheumatic conditions, secondary amenorrhea, snake bite, upper respiratory tract infections, vaginal dryness.

Dosing

Adults (18 years and older):

  • Some experts recommend taking chasteberry on an empty stomach in the morning for maximal benefits. However, no studies have confirmed this finding. Various doses of chasteberry have been used in studies and practice. Traditional doses have ranged from 3.5-4.5 milligrams per day of dried extract to 600 milligrams three times per day of dried fruit. Other traditional dosing includes an aqueous alcoholic extract derived from 30-40 milligrams of dried fruit daily in 50-70% alcohol (v/v); 0.03-0.04 milliliters daily of fluid extract (1:1 gram per milliliter); 0.15-0.2 milliliter daily of tincture (1:5 gram per milliliter); 2.6-4.2 milligrams daily of a dried extract (9.5-11.5:1 w/w); or 0.5-1.0 grams of dried fruit taken three times daily.

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 individuals with a known allergy or hypersensitivity to members of the Vitex (Verbenaceae) family or any chasteberry components. Mild skin reactions have been reported in clinical trials including eczema, itching, rash, skin eruptions, urticaria (hives) and allergic exanthema.

Side Effects and Warnings

  • Chasteberry is likely safe when used orally in otherwise healthy adults using appropriate doses for the short-term alleviation of signs and symptoms associated with premenstrual syndrome (PMS) or hyperprolactinemia (elevated serum prolactin levels). Chasteberry appears to be generally well tolerated with few adverse events reported. In an observational trial of 551 patients, approximately 5% experienced side effects, which were primarily mild. However, there are no currently no available studies evaluating the long-term effects of chasteberry.
  • Rare occurrences of the following side effects have been reported: acne, alopecia (hair loss), eczema, itching, rash, skin eruptions, urticaria ("hives"), headache, vertigo, seizure, drowsiness, agitation, fatigue, sweating and dry mouth, depressed mood, increased intra-ocular pressure, tachycardia (fast heart rate), palpitations, circulatory disorders, pulmonary edema (lung swelling), diarrhea, nausea, gas/flatulence, heartburn, and vomiting, altered gonadotropin and ovarian hormone levels, hot flashes, mastalgia (breast pain), cycle changes, fibroid growth and weight gain, polyuria (frequent urination), menstrual bleeding, vaginitis (inflamed vagina), pelvic disease, and nosebleed.
  • Nevertheless, use cautiously in patients taking oral contraceptives or hormone replacement therapy.
  • Use cautiously in patients taking dopamine agonists or antagonists. Additionally, caution is advised in patients with Parkinson's disease and other illnesses of the central nervous systems as medications used for these conditions often affect dopamine and taking them with chasteberry may increase effects and side effects.
  • Avoid using in patients with hormone sensitive cancers or conditions, those who are pregnant or breastfeeding, and in women undergoing in vitro fertilization.

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 competitively binds to dopamine receptors and has been shown to affect prolactin secretion, possibly resulting in decreased breast milk production. However, some clinicians actually use low doses to stimulate milk production with some reported benefits.

Interactions

Interactions with Drugs

  • Chasteberry has been shown to bind to D-2 receptors and therefore may alter dopaminergic effects. Caution is advised in patients with Parkinson's disease and other illnesses of the central nervous systems as medications used for these conditions often affect dopamine and taking them with chasteberry may increase effects and side effects.
  • Chasteberry may increase plasma levels of estrogens and progesterone. Caution is advised in patients taking birth control pills or other agents that alter hormones, such as hormone replacement therapy.

Interactions with Herbs and Dietary Supplements

  • Chasteberry has been shown to bind to D-2 receptors and therefore may alter dopaminergic effects. Caution is advised in patients with Parkinson's disease and other illnesses of the central nervous systems as medications used for these conditions often affect dopamine and taking them with chasteberry may increase effects and side effects.
  • Chasteberry may increase plasma levels of estrogens and progesterone. Caution is advised in patients taking herbs or supplements that may also alter hormone levels due to possible adverse effects.

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. Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003;18(3):191-195.
  2. Berger D, Schaffner W, Schrader E, et al. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre- menstrual syndrome (PMS). Arch Gynecol Obstet 2000;264(3):150-153.
  3. Cahill DJ, Fox R, Wardle PG, et al. Multiple follicular development associated with herbal medicine. Hum Reprod 1994;9(8):1469-1470.
  4. Damayanti M, Susheela K, Sharma GJ. Effect of plant extracts and systemic fungicide on the pineapple fruit- rotting fungus, Ceratocystis paradoxa. Cytobios 1996;86(346):155-165.
  5. Gerhard I, Patek A, Monga B, et al. Mastodynon(R) bei weiblicher Sterilitat.Randomisierte,plazebokontrollierte klinische Doppelblindstudie . Forsch Komplementarmed 1998;5(6):272-278.
  6. Halaska M, Raus K, Beles P, et al. [Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo]. Ceska Gynekol 1998;63(5):388-392.
  7. Jarry H, Leonhardt S, Gorkow C, et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 1994;102(6):448-454.
  8. Jarry H, Spengler B, Porzel A, et al. Evidence for Estrogen Receptor beta-Selective Activity of Vitex agnus-castus and Isolated Flavones. Planta Med 2003;69(10):945-947.
  9. Kubista E, Muller G, Spona J. [Treatment of mastopathies with cyclic mastodynia. Clinical results and hormonal profiles]. Rev Fr Gynecol Obstet 1987;82(4):221-227.
  10. Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med 2000;9(3):315-320.
  11. Merz PG, Gorkow C, Schrodter A, et al. The effects of a special Agnus castus extract (BP1095E1) on prolactin secretion in healthy male subjects. Exp Clin Endocrinol Diabetes 1996;104(6):447-453.
  12. Milewicz A, Gejdel E, Sworen H, et al. [Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia: results of a randomized placebo- controlled double-blind study]. Arzneimittelforschung 1993;43(7):752-756.
  13. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001;322(7279):134-137.
  14. Sliutz G, Speiser P, Schultz AM, et al. Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Horm Metab Res 1993;25(5):253-255.
  15. Wuttke W, Jarry H, Christoffel V, et al. Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications. Phytomedicine 2003;10(4):348-357.

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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