Chasteberry
Place in Therapy
Place in Therapy
Chasteberry, or Vitex agnus castus is traditionally used for a number of different conditions such as mastalgia, menstrual abnormalities, breast pain, and impotence.1 Many studies have investigated its use in PMS and have found overall benefit in the reduction of many PMS symptoms.1 It is generally well tolerated with a small number of side effects. Its mechanism of action involves inhibiting prolactin secretion by binding competitively to dopamine receptors, without directly affecting leutinizing hormone or follicle stimulating hormone levels.2 It may also bind to opioid receptors, endorphins, as well as neuroactive flavonoids.3 Chasteberry is contraindicated in hormone sensitive cancers and theoretically it may also interact with oral contraceptives and hormonal medications, but one study suggests that there is no interaction with oral contraceptives.1,2 In animal studies it has been identified that chasteberry may interact with dopamine receptor antagonists and should be used with caution.4 Chasteberry should not be recommended in pregnant or lactating patients.1
Studies investigating the use of chasteberry generally had variances in dosing and study design, which makes dosage recommendation difficult. A common dose used in trials is 20 to 40mg of chasteberry extract per day, however the dose should be recommended with caution depending on the preparation as well as the symptoms that are being treated.1,2 Overall chasteberry would be a safe option to try for PMS, but due to lack of common outcome measures, clearly defined patient populations and transparency in reporting in many studies, chasteberry should not be actively recommended to patients for use in PMS.
References:
1. Natural Standard. Natural Standard Professional Monograph <Chasteberry>. 2013. http://www.naturalstandard.com.proxy.lib. uwaterloo.ca/databases/herb supplements/all/chasteberry.asp?. Last updated 07/07/13. Accessed 07/06/13.
2. Schellenberg, R, Zimmermann, C, Drewe, J, Hoexter, G, Zahner, C. Dose-dependent Efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome. Phytomedicine. 2012; 19:1325-1331. http://journals1.scholarsportal.info.proxy. lib.uwaterloo.ca/tmp/7063361011606461221.pdf. Accessed 07/07/13.
3. Whelan, AM, Jurgens, TM, Naylor, H. Herbs, Vitamins and Minerals in the Treatment of Premenstrual Syndrome: a Systematic Review. Can J Clin Pharmacol. 2009; 16(3). http://www.jptcp.com/. Accessed 07/07/13.
4. Zamani, M, Neghab, N, Torabianm S. Therapeutic Efffect of Vitex Agnus Castus in Patients with Premenstrual Syndrome. Acta Medica Iranica. 2012; 50(2): 101-106. http://journals.tums.ac.ir/upload_files/pdf/_/20208.pdf. Accessed 07/07/13.
Chasteberry, or Vitex agnus castus is traditionally used for a number of different conditions such as mastalgia, menstrual abnormalities, breast pain, and impotence.1 Many studies have investigated its use in PMS and have found overall benefit in the reduction of many PMS symptoms.1 It is generally well tolerated with a small number of side effects. Its mechanism of action involves inhibiting prolactin secretion by binding competitively to dopamine receptors, without directly affecting leutinizing hormone or follicle stimulating hormone levels.2 It may also bind to opioid receptors, endorphins, as well as neuroactive flavonoids.3 Chasteberry is contraindicated in hormone sensitive cancers and theoretically it may also interact with oral contraceptives and hormonal medications, but one study suggests that there is no interaction with oral contraceptives.1,2 In animal studies it has been identified that chasteberry may interact with dopamine receptor antagonists and should be used with caution.4 Chasteberry should not be recommended in pregnant or lactating patients.1
Studies investigating the use of chasteberry generally had variances in dosing and study design, which makes dosage recommendation difficult. A common dose used in trials is 20 to 40mg of chasteberry extract per day, however the dose should be recommended with caution depending on the preparation as well as the symptoms that are being treated.1,2 Overall chasteberry would be a safe option to try for PMS, but due to lack of common outcome measures, clearly defined patient populations and transparency in reporting in many studies, chasteberry should not be actively recommended to patients for use in PMS.
References:
1. Natural Standard. Natural Standard Professional Monograph <Chasteberry>. 2013. http://www.naturalstandard.com.proxy.lib. uwaterloo.ca/databases/herb supplements/all/chasteberry.asp?. Last updated 07/07/13. Accessed 07/06/13.
2. Schellenberg, R, Zimmermann, C, Drewe, J, Hoexter, G, Zahner, C. Dose-dependent Efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome. Phytomedicine. 2012; 19:1325-1331. http://journals1.scholarsportal.info.proxy. lib.uwaterloo.ca/tmp/7063361011606461221.pdf. Accessed 07/07/13.
3. Whelan, AM, Jurgens, TM, Naylor, H. Herbs, Vitamins and Minerals in the Treatment of Premenstrual Syndrome: a Systematic Review. Can J Clin Pharmacol. 2009; 16(3). http://www.jptcp.com/. Accessed 07/07/13.
4. Zamani, M, Neghab, N, Torabianm S. Therapeutic Efffect of Vitex Agnus Castus in Patients with Premenstrual Syndrome. Acta Medica Iranica. 2012; 50(2): 101-106. http://journals.tums.ac.ir/upload_files/pdf/_/20208.pdf. Accessed 07/07/13.