Agnus castus

Vitex Agnus Castus
Common names: Chaste tree, Monk’s pepper
Parts used and where grown
Agnus castus grows in Mediterranean countries and central Asia. The dried fruit,
which has a pepper-like aroma and flavour, is used in herbal medicine
Agnus castus has been used in connection with the following conditions (refer to
the individual health concern for complete information):
Health Concerns
Premenstrual syndrome
Female infertility
Fibrocystic breast disease
Acne (associated with menstrual cycle)
Hemorrhagic (heavy menstruation)
Pregnacy and postpartum support
Science Ratings
Reliable and relatively consistent scientific data showing a substantial
health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health
benefit or minimal health benefit.
For a herb, supported by traditional use but minimal or no scientific
evidence. For a supplement, little scientific support and/or minimal health benefit.
Historical or traditional use (may or may not be supported by scientific studies)
Hippocrates, Dioscorides, and Theophrastus mention the use of agnus castus for
a wide variety of conditions, including haemorrhage following childbirth and
assisting with the “passing of afterbirth.” Decoctions of the fruit and plant were
also used in sitz baths for diseases of the uterus. In addition, agnus castus was
believed to suppress libido and inspire chastity, which explains one of its common
names, chaste tree.
Active constituents
Agnus castus contains a few different constituents, including flavonoids, iridoid
glycosides, and terpenoids. The whole fruit extract, rather than one of its
individual constituents, appears to be necessary for the medicinal activity of
agnus castus.1 Agnus castus does not contain hormones. The benefits of agnus
castus stem from its actions upon the pituitary gland—specifically on the
production of a hormone called luteinising hormone (LH). This indirectly increases
progesterone production and helps regulate the menstrual cycle. Agnus castus
also keeps prolactin secretion in check.2 3 The ability to decrease mildly elevated
prolactin levels may benefit some infertile women as well as some women with
breast tenderness associated with premenstrual syndrome (PMS).
A controlled clinical trial found that women taking 20 mg per day of a
concentrated agnus castus extract for three menstrual cycles had a significant
reduction in symptoms of PMS, including irritability, mood swings, headache, and
breast tenderness.4 Another double-blind trial found that women taking agnus
castus had slightly greater relief from symptoms of PMS, including breast
tenderness, cramping, and headaches, than those taking vitamin B6.5 These trials
support the findings of preliminary agnus castus trials for women with PMS.6 7
Agnus castus (32.4 mg per day), in combination with some homoeopathic
remedies, has also been found in a double-blind trial to successfully treat breast
tenderness (also called mastalgia).8
A review of other trials and case reports suggests there is at least preliminary
support that agnus castus should be considered for women with irregular periods,
infertility, and mildly elevated prolactin levels.9 Double-blind trials have confirmed
the effectiveness of agnus castus at lowering mildly elevated prolactin levels in
women.10 According to one small trial, acne associated with PMS, may also be
reduced using agnus castus.11
How much is usually taken?
The German Commission E monograph recommends a daily intake—30–40 mg of
the dried herb—in capsules or in liquid preparations.12 Agnus castus is typically
taken once in the morning with liquid for a few months consecutively.
With its emphasis on long-term balancing of a woman’s hormonal system, agnus
castus is not a fast-acting herb and is unlikely to give immediate relief to the
discomfort associated with PMS. For premenstrual syndrome, frequent or heavy
periods, agnus castus can be used continuously for four to six months. Infertile
women with amenorrhoea (lack of menstruation) can remain on agnus castus for
12 to 18 months, unless pregnancy occurs during treatment.
Are there any side effects or interactions?
Side effects may include minor stomach upset and a mild skin rash with itching.
Agnus castus is not recommended for use during pregnancy and should not be
used concurrently with hormone therapy (e.g., oestrogen, progesterone).
At the time of writing, there were no well-known drug interactions with agnus
1. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission
E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative
Medicine Communications, 1998, 108.
2. Sliutz G, Speiser P, Schultz AM, et al. Agnus castus extracts inhibit prolactin
secretion of rat pituitary cells. Horm Metab Res 1993;25:253–5.
3. Böhnert KJ. The use of Vitex agnus castus for hyperprolactinemia. Quart Rev
Nat Med 1997;Spring:19–21.
4. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus
fruit extract: prospective, randomized, placebo controlled study. BMJ
5. Lauritzen C, Reuter HD, Repges R, et al. Treatment of premenstrual tension
syndrome with Vitex agnus-castus. Controlled, double-blind study versus
pyridoxine. Phytomed 1997;4:183–9.
6. Dittmar FW, Böhnert KJ, Peeters M, et al. Premenstrual syndrome: Treatment
with a phytopharmaceutical. Therapiwoche Gynäkol 1992;5:60–8.
7. Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a
phytopharmaceutical formulation containing Vitex agnus castus. J Women Health
Gender-Based Med 2000;9:315–20.
8. Halaska M, Beles P, Gorkow C, Sieder C. Treatment of cyclical mastalgia with a
solution containing Vitex agnus extract: results of a placebo-controlled doubleblind study. The Breast 1999;8:175–81.
9. Bone K. Vitex agnus-castus: Scientific studies and clinical applications. Eur J
Herbal Med 1994;1:12–5.
10. Milewicz A, Gejdel E, Sworen H, et al. Vitex agnus castus extract for the
treatment of menstrual irregularities due to latent hyperprolactinemia. Arzneim
Forsch 1993;43:752–6 [in German].
11. Amann W. Improvement of acne vulgaris following therapy with Agnus castus
(Agnolyt). Ther Ggw 1967;106:124–6 [in German].
12. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission
E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative
Medicine Communications, 1998, 108.