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Vitex (Chasteberry) and FertilityBy Nancy Dunne, ND, Naturopathic Physician Reprinted with kind permission of Dr. Dunne |
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Vitex agnus-castus (chaste tree berry) is a well-known herb that has been used for centuries in Europe for hormonal imbalances in women. It may be helpful for women with PCOS who do not have a normal menstrual cycle and thus don't ovulate or menstruate. A large percentage of these menstrual problems are related to insufficient progesterone during the luteal phase of the menstrual cycle, which is called a luteal phase defect or corpus luteum insufficiency. A corpus luteum insufficiency is defined as an abnormally low progesterone level 3 weeks after the onset of menstruation. Insufficient levels of progesterone may result in the formation of ovarian cysts. In addition, some PCOS women have too much prolactin, which can inhibit fertility. Vitex may help with both of these problems How does Vitex Work? Chaste tree berry acts on the hypothalamus and pituitary glands by increasing luteinizing hormone (LH) production and mildly inhibiting the release of follicle stimulating hormone (FSH). The result is a shift in the ratio of estrogen to progesterone, in favor of progesterone. The ability of chaste tree berry to raise progesterone levels in the body is an indirect effect, so the herb itself is not a hormone. Lack of menstruation (amenorrhea) that is caused by a lack of ovulation, and therefore a lack of progesterone production, should result in menses when progesterone is taken. Progesterone-induced menses indicates an intact reproductive system that just isn't going through its cycle. It suggests that the body is producing enough FSH to stimulate the ovaries, and that the ovaries can develop follicles. It also indicates that follicular production of estrogen is sufficient to cause the lining of the uterus (endometrium) to grow and that the sloughed endometrium is able to pass through the cervical opening and the vagina. Therefore it's possible that the problem is a dysfunction in the hypothalamus or pituitary glands. The ability of chaste tree to modulate the hypothalamus or pituitary then makes this herb a good candidate for treating amenorrhea (infertility). For a further discussion of this topic, we refer you to Dr. Tori Hudson's Women's Encyclopedia of Natural Medicine High levels of the hormone prolactin are commonly found with corpus luteum insufficiency. Vitex is useful for reducing high prolactin levels. It inhibits prolactin release by the pituitary gland, especially when you are under stress. The Evidence for Vitex Agnus Castus Here are some vitex studies relating to the use of the chasteberry: Vitex and Fertility. In this study, a chasteberry preparation was used in a study of 3,162 women to assess the effectiveness of vitex for corpus luteum insufficiency. 77.4% had menstrual cycle disturbances of various types and the others suffered from a range of gynecological problems which included symptoms of corpus luteum insufficiency. The average length of treatment was 5 months. Hormone cytology and symptoms were used to assess the treatment. The women reported the treatment as completely effective (33%), significant improvement (55%), and no change (7%). Their doctors reported very good results in 68% of cases, adequate in 22%, and no change in 7%. (1) In another study, 20 women with secondary amenorrhea took a chasteberry extract for 6 months. Lab testing was done to measure progesterone, FSH, and LH, and pap smears were done at the beginning of the study, at 3 months, and at 6 months. At the end of the study, the researchers were able to evaluate 15 of the women. Ten out of the 15 women had a return of their menstrual cycles. Testing showed that values for progesterone and LH increased, and FSH values either did not change or decreased slightly.(2) In a third study, 18 women with abnormally low progesterone levels were given vitex daily. After 3 months of treatment, 13 showed increases in progesterone and 2 became pregnant.(3) Vitex and hyperprolactinemia. In this study, 52 women with luteal phase defects due to latent hyperprolactinemia (high prolactin levels) were given either vitex or a placebo. Prolactin levels were normalized after 3 months in the treatment group and deficits in luteal progesterone production were eliminated. Two of the women became pregnant.(4) In another study, 13 women with high prolactin levels and irregular cycles were given a vitex compound. Their prolactin levels fell, and a normal menstrual cycles returned to all of the women.(5) Vitex and acne. In this study, a chasteberry preparation was used in women with menstrual cycle abnormalities. Acne was either eliminated or improved during treatment.(6) In another study, 117 women with four different types of acne were treated with a chasteberry preparation for 1-2 years. Improvement was seen after 6 weeks and by 3 months, about 70% were free of acne. Some treatment relapses were observed after 3-6 weeks.(7) Taking Vitex When using chaste tree berry, don’t expect immediate results. It may not have much effect until it is taken for at least 3-6 months. It’s not the same as taking progesterone. You don’t give it, stop it, and then expect a withdrawal bleed a few days later as you would if you were taking progesterone or synthetic progestins. Vitex Risks & Side Effects Vitex agnus castus is exceptionally safe. In one study, chaste tree berry was given up to 9 years with very few side effects. It's advisable to not take vitex if you are pregnant. Drug Interactions Interactions with hormone replacement therapy (potential/theoretical). Animal studies and human data have reported that chasteberry constituents have hormonal activity that may alter the effects of these medications and possibly the dose needed for treatment. conjugated estrogens, estradiol, estrone, esterified estrogens, estropipate, ethinyl estradiol, progesterone, medroxyprogesterone, hydroxyprogesterone, norethindrone. Interactions with oral contraceptives (potential/theoretical). Animal studies and human data have reported that chasteberry constituents have hormonal activity that may alter the effects of these medications and possibly the dose needed for treatment: norethindrone, ethynodiol diacetate, norgestrel, norgestimate, ethinyl estradiol, drospirenone, desogestrel, levonorgestrel . Interactions with dopamine agonists (potential/theoretical). An in-vitro study reported that chasteberry constituents had dopaminergic activity that may alter the effects of these medications and possibly the dose needed for treatment: selegeline, amantadine, carbidopa, levadopa, pramipexole, ropinirole, bromocriptine, pergolide. If you are taking any of these medication, it's a good idea to consult with your physician before taking vitex. How Much Should You Take? Every women is unique, so the amount and form of vitex you need won't be the same as for someone else. We recommend you seek guidance from a licensed naturopathic physician, who would have extensive knowledge of herbs and botanical medicines. Or, consult with Dr. Nancy Dunne, who is a naturopathic physician specializing in the treatment of PCOS. As a general guideline, your daily dose could be:
Chasteberry can be taken daily for up to 18 continuous months, unless pregnancy occurs. Vitex is usually taken in the morning as a single daily dose. Warning: The quality of botanical supplements varies widely. Don't buy any herbal or botanical product unless it has a "standardized" amount of the active component listed on the label. A "standardized" product has a consistent amount of active ingredients from one bottle to the next. If you buy a product that is not standardized, you have no clue as to what you are actually getting and are probably wasting your money. You can generally obtain the highest quality vitex products from a licensed naturopathic physician. If you wish to order a high-quality chasteberry product, call Dr. Nancy Dunne's clinic (Bitterroot Natural Medicine) at 406-728-8544. Footnotes (1) Loch, EG [Gynaecology in practice - A sure choice of therapy], Tjherapiewoche, 1993, 43(48):2577-80 (2) Loch, E, et al, [Diagnosis and treatment of dyshormonal menstrual periods in the general practice], Gynakol Praxis, 1990, 14(3):489-95 (3) Propping, D et al, [Treatment of corpus luteum insufficiency], Zeitscchrift Fur Allgemein, 1987, 63:932-3 (3) Milewicz A, et al, [Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinaemia. Results of a randomized placebo-controlled double-blind study], Arzniem-Forschung, 1993, 43(II-7):752-6 (4) Roeder, D, [Therapy of cyclical disorders with vitex agnus castus], Zeiterschrift fur Phytotherapie, 1994, 15(3):157-63 (5) Bleier, VW, Therapie von zyklus-und blutungsstrorungen und weiteren endokrin bedingten erkrankungen der frau mit pflanzlichen wirkstoffen, Zbl Gynakologie, 1959, 18:701-9 (6) Giss, G et al, Phytotherapeutische behandlung der akne,
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