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Vitex Extract

Also known as: Vitex agnus-castus L., Chasteberry, Chaste tree, Monk's pepper, Vitex agnus-castus

Overview

Vitex agnus-castus extract, derived from the chaste tree fruit, is a phytotherapeutic agent traditionally used for gynecological conditions such as premenstrual syndrome (PMS), cyclic mastalgia, and hyperprolactinemia. It contains bioactive compounds like flavonoids, iridoid glycosides, and diterpenoids. Primarily, it's used to alleviate PMS symptoms and related hormonal imbalances. Research on Vitex is moderately mature, featuring numerous randomized controlled trials (RCTs) and meta-analyses, though many studies have methodological limitations. The quality of evidence is mixed, with some high-quality trials but also a significant risk of bias and heterogeneity. Standardized extracts are preferred to ensure consistent dosing of active constituents like agnuside. It is available in various forms, including capsules, tablets, and liquid extracts.

Benefits

Vitex agnus-castus extract has shown benefits in several areas: - **Premenstrual Syndrome (PMS):** Meta-analyses of RCTs indicate a significant reduction in total PMS symptoms compared to placebo. One meta-analysis found a large pooled effect size (Hedges’ g = -1.21) indicating substantial symptom reduction, though with high heterogeneity and risk of bias. Another meta-analysis focusing on well-characterized extracts found that women taking Vitex were 2.57 times more likely to experience symptom remission compared to placebo. - **Cyclic Mastalgia:** Some evidence suggests efficacy in reducing cyclic breast pain, but data are less robust and fewer high-quality trials exist. - **Hyperprolactinemia:** Preliminary studies indicate Vitex may reduce elevated prolactin levels, potentially through dopaminergic mechanisms, but more clinical trials are needed to confirm this effect.

How it works

Vitex agnus-castus is believed to act primarily through dopaminergic pathways by binding to dopamine D2 receptors, inhibiting prolactin secretion from the pituitary gland. This reduction in prolactin may alleviate PMS symptoms and cyclic mastalgia. Animal studies suggest it may also modulate luteinizing hormone (LH) and testosterone levels, similar to dopamine agonists. The bioactive compounds are absorbed orally, with standardized extracts used to ensure consistent dosing. This modulation of hormonal pathways is central to its therapeutic effects.

Side effects

Vitex agnus-castus is generally well-tolerated in clinical trials. Common side effects include mild gastrointestinal discomfort, headache, and skin reactions, reported in less than 5% of users. Allergic reactions are rare. No serious adverse events have been consistently reported. Potential interactions exist with dopamine agonists or antagonists due to its dopaminergic activity; caution is advised for patients on such medications. It is contraindicated in pregnancy and breastfeeding due to a lack of safety data. Those with hormone-sensitive conditions should approach it cautiously. Limited data exist for use in men and children; it has primarily been studied in women of reproductive age.

Dosage

The typical minimum effective dose is around 20-40 mg of a standardized extract per day (e.g., Ze 440). The optimal dosage range is 20-40 mg daily of a standardized extract containing 0.5% agnuside or equivalent active constituents. There is no well-defined maximum safe dose, but doses above 40 mg/day have not shown additional benefit, and safety data are limited. It is usually taken once daily, often in the morning. Standardized extracts (e.g., Ze 440, BNO 1095) are preferred for consistency. It is best taken with food to improve gastrointestinal tolerance. No specific cofactors are required.

FAQs

How soon do benefits appear?

Symptom improvement typically occurs within 1-3 menstrual cycles of consistent use.

Is it safe long-term?

Long-term safety data are limited; however, short to medium-term use appears safe based on available research.

Can it be used with hormonal contraceptives?

Interaction data are limited; caution is advised when using Vitex with hormonal contraceptives due to potential hormonal effects.

Does it affect fertility?

There is no clear evidence of adverse effects on fertility; some data suggest potential hormonal modulation that could theoretically influence fertility.

Is it effective for all PMS symptoms?

Vitex is most effective for mood-related symptoms and breast tenderness associated with PMS.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/28237870/ – This systematic review and meta-analysis included 17 RCTs on Vitex for PMS, finding a large pooled effect size favoring Vitex but with high heterogeneity and risk of publication bias. The authors concluded that the evidence is promising but not definitive due to methodological limitations in the included studies.
https://pubmed.ncbi.nlm.nih.gov/31780016/ – This meta-analysis included 3 high-quality RCTs using standardized extracts of Vitex and found that women taking Vitex were 2.57 times more likely to experience symptom remission compared to placebo. The authors highlighted the need for more trials following CONSORT guidelines for herbal products to improve the quality of evidence.
https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-vitex-agnus-castus-l-fructus-revision-1_en.pdf – The European Medicines Agency assessment report reviewed pharmacological and toxicological data, including animal studies showing dopaminergic effects that reduce LH and testosterone. It supported the traditional use of Vitex for PMS and mastalgia, noting a good safety profile but emphasizing the need for standardized extracts and further clinical trials.
https://www.liebertpub.com/doi/abs/10.1089/jwh.2019.7770 – This study investigates the effectiveness of Vitex agnus-castus in treating PMS. The research highlights the potential of Vitex in alleviating PMS symptoms, contributing to its recognition as a valuable herbal remedy for women's health.
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1269781/full – This research explores the impact of Vitex agnus-castus on endocrine disorders. The study provides insights into the mechanisms through which Vitex influences hormonal balance, suggesting its potential therapeutic applications in managing endocrine-related conditions.