Vitex

Vitex has been shown to help re-establish normal balance of estrogen and progesterone during the menstrual cycle. Vitex also blocks prolactin secretion in women with excessive levels of this hormone; excessive levels of prolactin can lead to breast tenderness and failure to ovulate. A double-blind trial has confirmed that vitex reduces mildly elevated levels of prolactin before a woman’s period.¹ Studies have shown that using vitex once in the morning over a period of several months helps normalize hormone balance and thus alleviate the symptoms of PMS.² Preliminary and double-blind research has found that vitex relieves PMS symptoms. The amount in most of these trials was 20 mg per day of a concentrated vitex extract for three menstrual cycles experience a significant reduction in symptoms of PMS.^{3, 4, 5}

Vitex has been shown to be as effective as 200 mg vitamin B6 in a double-blind trial of women with PMS.⁶Two surveys examined 1,542 women with PMS who had taken a German liquid extract of vitex for their PMS symptoms for as long as 16 years.⁷ With an average intake of 42 drops per day, 92% of the women surveyed reported the effectiveness of vitex as “very good,”“good,” or “satisfactory.”

Some healthcare practitioners recommend 40 drops of a liquid, concentrated vitex extract or one capsule of the equivalent dried, powdered extract once per day in the morning with some liquid. Vitex should be taken for at least four cycles to determine efficacy.

Vitex is occasionally used as an herbal treatment for infertility—particularly in cases with established luteal phase defect (shortened second half of the menstrual cycle) and high levels of the hormone, prolactin. In one trial, 48 women (ages 23 to 39) who were diagnosed with infertility took vitex once daily for three months.⁸ Seven women became pregnant during the trial, and 25 women experienced normalized progesterone levels—which may increase the chances for pregnancy. In another double-blind trial, significantly more infertile women became pregnant after taking a product whose main ingredient is vitex (the other ingredients were homeopathic preparations) than did those who took a placebo.⁹ The amount used in this trial was 30 drops of fluid extract twice a day, for a total of 1.8 ml per day. This specific preparation is not available in the United States. Some doctors recommend taking 40 drops of a liquid extract of vitex each morning with water. Approximately 35–40 mg of encapsulated powdered vitex (one capsule taken in the morning) provides a similar amount. Vitex should be discontinued once a woman becomes pregnant.

Since many women with FBD and cyclical breast tenderness also suffer from PMS, there is often an overlap in herbal recommendations for these two conditions despite a lack of research dealing directly with FBD.

In one double-blind trial, a liquid preparation containing 32.4 mg of vitex and homeopathic ingredients was found to successfully reduce breast tenderness associated with the menstrual cycle (e.g. cyclic mastalgia).¹⁰ Vitex is thought to reduce breast tenderness at menses because of its ability to reduce elevated levels of the hormone, prolactin.¹¹

Doctors typically suggest 40 drops of a liquid, concentrated vitex extract or 35–40 mg of the equivalent dried, powdered extract to be taken once per day in the morning with some liquid. Vitex should be taken for at least three menstrual cycles to determine efficacy.

Some older, preliminary German research suggests that vitex might contribute to clearing of premenstrual acne, possibly by regulating hormonal influences on acne.¹² Women in these studies used 40 drops of a concentrated liquid product once daily.¹³

In herbal medicine, vitex (Vitex agnus-castus; chaste tree) is sometimes used to treat female infertility and amenorrhea.¹⁴ Elevation of prolactin can be a cause of amenorrhea, and vitex has been shown in animals to reduce elevated prolactin levels.¹⁵ In a controlled trial, prolactin production was normalized in women with high prolactin levels after three months of treatment with vitex.¹⁶ Vitex has also been found to raise levels of luteinizing hormone and subsequent progesterone levels in women with luteal phase defect—a condition that can also lead to menstrual cycle abnormalities, including amenorrhea.¹⁷ To date, only one small preliminary trial has studied the effects of vitex on amenorrhea. This study found that ten of fifteen women with amenorrhea began having a normal period after taking 40 drops of a liquid vitex preparation once daily for six months.¹⁸ Further research is needed to determine what role vitex may play in the management of amenorrhea.

Clinical reports from Germany have suggested that vitex may help relieve different menstrual abnormalities associated with premenstrual syndrome, including dysmenorrhea.¹⁹ These studies used 40 drops of a liquid preparation that delivers the equivalent of 40 mg of the dried berries of the plant.

Vitex is recommended either alone or in combination with other herbs, such as dandelion root, prickly ash, and motherwort, by some doctors to treat the symptoms of endometriosis.^{20, 21} Although vitex affects hormones that in turn affect the severity of endometriosis,²² and it may be effective for premenstrual syndrome,²³ no research has tested the effect of vitex supplementation on women with endometriosis. Similarly, no other botanical medicines have been scientifically researched for treating this disease.

Among women taking vitex, menorrhagia has reportedly improved after taking the herb for several months.²⁴ With its emphasis on long-term balancing of a woman’s hormonal system, vitex is not a fast-acting herb. For frequent or heavy periods, vitex can be used continuously for six to nine months. Forty drops of the concentrated liquid herbal extract of vitex can be added to a glass of water and drunk in the morning. Vitex is also available in powdered form in tablets and capsules. Thirty-five to forty milligrams may be taken in the morning.

Numerous herbs, known as galactagogues, are used in traditional herbal medicine systems around the world to promote production of breast milk.²⁵ These are known as galactagogues. Vitex is one of the best recognized herbs in Europe for promoting lactation. An older German clinical trial found that 15 drops of a vitex tincture three times per day could increase the amount of milk produced by mothers with or without pregnancy complications, as compared with mothers given vitamin B1 or nothing.²⁶ However, vitex should not be taken during pregnancy.