Despite having the common name chasteberry (deriving from the ancient belief it promotes chastity), Vitex agnus-castus is often used to promote female fertility and hormonal balance¹.

A well-established menstrual cycle herb

Vitex has German Commission E approval for menstrual cycle irregularities, premenstrual syndrome (PMS) and breast pain². Commission E was a government-appointed expert panel that reviewed the safety and efficacy of herbal medicines. More recent research supports their conclusions, including a retrospective cohort study of patients with menstrual cycle disorders³ and a narrative review of its use in gynaecology⁴.

How vitex works

Rather than acting as a hormone itself, vitex appears to work through the body’s signalling pathways. Its diterpenes inhibit the secretion of prolactin⁵, relieving PMS symptoms and benefitting fertility⁶. A 2023 review found that vitex improved symptoms in patients with mild hyperprolactinaemia⁷.

Vitex It normalises oestrogen, while increasing progesterone (important after ovulation to either prepare for ovulation or menstruation)⁸ and can restore balance after using the contraceptive pill⁹.

When to work with vitex

In practice, vitex is considered for a wide range of menstrual cycle-related concerns. These include irregular or absent periods, heavy or frequent bleeding, cyclical breast tenderness, PMS, luteal phase complaints, poor lactation and menopausal symptoms¹⁰. In one case, a 28-year-old woman taking vitex over three cycles noticed relief from PMS symptoms including anxiety, cravings, irritability and mood changes.

Vitex is usually taken as a tincture, an infusion of the berries or as dried herb, with a typical daily range of 3–6 g of dried berry¹⁰. Its effects tend to build gradually, which is why it is often taken consistently over several cycles rather than for a few days.

Safety and cautions

Vitex should be avoided alongside contraceptives, progestins, HRT or dopamine-receptor antagonists, and caution is advised in pregnancy¹¹. Care is also needed in women under 20, whose hormonal axis is easily disrupted, and in those with oestrogen- or progesterone-sensitive tumours. Possible side effects include digestive upset, nausea, skin reactions and headaches¹⁰.

It is recommended to take vitex under the guidance of a qualified herbalist, particularly if you take other medication or are trying to conceive.

References

1. Bokelmann JM. Medicinal herbs in primary care. Elsevier; 2022.
2. Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, et al., editors. The complete German Commission E monographs: therapeutic guide to herbal medicines. American Botanical Council; 1998.
3. Höller M, Steindl H, Abramov-Sommariva D, Kleemann J, Loleit A, Abels C, et al. Use of Vitex agnus-castus in patients with menstrual cycle disorders: a single-center retrospective longitudinal cohort study. Arch Gynecol Obstet. 2024;309(5):2089–98. doi:10.1007/s00404-023-07363-4
4. Mendes C, Fonseca AMD, Alves MS, Bayer LHCM, Veiga ECA, Sorpreso ICE, et al. Narrative review of Vitex agnus-castus in symptoms in gynecology. Rev Assoc Med Bras. 2022;68(5):716–9. doi:10.1590/1806-9282.20220174
5. Menzies-Trull C. Herbal medicine keys to physiomedicalism including pharmacopoeia. 3rd ed. Faculty of Physiomedical Herbal Medicine; 2022.
6. Lord R. Clinical herbalism: plant wisdom from east and west. Elsevier; 2022.
7. Puglia LT, Lowry J, Tamagno G. Vitex agnus castus effects on hyperprolactinaemia. Front Endocrinol. 2023;14:1269781. doi:10.3389/fendo.2023.1269781
8. Tierra M. The way of herbs. Gallery Books; 1998.
9. Hoffmann D. Medical herbalism. Healing Arts Press; 2003.
10. Thomsen M. The phytotherapy desk reference. 6th ed. Aeon Books; 2022.
11. Alfs M. 300 herbs: their indications and their contraindications. Aeon Books; 2022.

Header image: Vitex agnus-castus By Osnat Ravid Amir – Own work, CC BY-SA 4.0
Body image: Vitex agnus-castus By Cillas – Own work, CC BY-SA 4.0