Vitex (Vitex agnus-castus) is a common shrub in the Mediterranean region which occupies rough ground around roads and gullies, recognisable by its strong scent, leaf stem carrying several leaflets resembling hemp, and spikes of lavender coloured flowers. Dioscorides mentions that it was used to encourage chastity, and we still know it as chaste-tree or monk’s pepper because it can be used by both men and women to suppress libido.¹

In small quantities, vitex is used to treat disorders of the menstrual cycle. Dioscorides tells us that it will expel the menstrual flow, but to be precise, it regulates the cycle and so encourages ovulation in cases of amenorrhea, as well as being able to treat the opposite condition of oligomenorrhea (menorrhagia).

Vitex has this complex effect due the activity of plant diterpenes on dopaminergic, oestrogen and opioid receptors in the hypothalamus and pituitary. Excess prolactin (hyperprolactinemia) is responsible for the suppression of key hormones (FSH, LH,  progesterone) which regulate the menstrual cycle, and dopamine inhibits prolactin. The effect is to normalise oestrogen and progesterone.²

There have been a number of clinical trials that have shown vitex to be comparable to the drug bromocriptine (dopamine agonist) in reducing latent prolactinemia. They also show it to be superior to placebo, as well as vitamin B6 and magnesium in treating PMS. One trial found it equivalent to fluoxetine (SSRI) in the more serious premenstrual dysphoric disorder.^3,4

In the case of menopause, a recent clinical trial of 52 women taking vitex for eight weeks found significant improvement in anxiety, vasomotor symptoms and total dysfunction according to the Greene Questionnaire (1975 Scotland). Scores for depression and sexual dysfunction were no better.⁵ The herb we most use is, however, black cohosh.

Interestingly, vitex also appears to regulate the pancreas. In the mouse model, vitex has a protective effect on the pancreas, reducing serum glucose and increasing insulin. This would make vitex useful for the treatment of polycystic ovarian syndrome (PCOS), which is associated with insulin resistance and obesity; however, we think of peony and liquorice instead for reducing the excess androgens.⁶ Nevertheless, vitex is useful for treating hormonal acne.

To normalise the menstrual cycle, vitex is used in small quantities. The dose is 2 ml /day of the tincture (berries), or it can also be taken as an infusion of the berries twice per day, either way it takes time to have an effect.

As a low potency homeopathic remedy, we use vitex (Agnus castus) to treat the loss of nervous and sexual energy. Boericke says that Agnus-castus can treat impotence in men, as well as amenorrhoea, leukorrhea and sterility in women. The patient is absent-minded, forgetful and full of forebodings.⁷

A version of this Article appears in the 2021 eBook edition of Wholefoods And Common medicinal Herbs.

Disclaimer: this article is intended for the purpose of general education only, and is not a substitute for a diagnosis, treatment advice, or a prescription given in a consultation with a qualified physician.

References:

1.         Dioscorides P. De Materia Medica. South Africa: Ibidis; 2000.

2.         Heskes AM, Sundram TCM, Boughton BA, et al. Biosynthesis of bioactive diterpenoids in the medicinal plant Vitex agnus-castus. Plant J 2018;93:943–58.

3.         van Die MD, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med 2013;79:562–75.

4.         Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001;322:134–7.

5.         Naseri R, Farnia V, Yazdchi K, Alikhani M, Basanj B, Salemi S. Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study. Korean J Fam Med 2019;40:362–7.

6.         Ahangarpour A, Oroojan AA, Khorsandi L, Najimi SA. Pancreatic protective and hypoglycemic effects of Vitex agnus-castus L. fruit hydroalcoholic extract in D-galactose-induced aging mouse model. Res Pharm Sci 2017;12:137–43.

7.         Boericke W. Pocket Manual Of Homoeopathic Materia Medica, c. 1927. Delhi: Indian Books & Periodical Publishers; 2007.