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Chasteberry PMS Question

October 5, 2012 Written by JP       [Font too small?]

In the course of my consulting work, many questions and answers emerge that I think would be of interest to readers of this site. Recently, a client inquired about an herbal extract commonly known as chasteberry or Vitex. Historically, Vitex agnus castus has been used to address irregular periods and symptoms associated with premenstrual syndrome (PMS). In modern times, concentrated and purified extracts of chasteberry have been subjected to some degree of scientific scrutiny. For the most part, the results of these controlled trials have been positive. However, it’s important to note that not all Vitex supplements are created equal. In fact, only a few products have actually undergone clinical testing and proven effective.

A little known fact about herbal supplements is that they’re usually far more complex than conventional medications. Most synthetic drugs consist of an isolated chemical or two. On the other hand, herbal extracts frequently possess hundreds or more naturally occurring components. Contained in fruits, leaves and roots are various substances ranging from nutrients and phytochemicals to prebiotic fibers. This inescapable fact not only differentiates herbal supplements from conventional medications, but also requires that we consider each supplement based on its own merits.

The names Ze 440 and BNO 1095 may sound like gibberish. But, in the world of Vitex research, these two extracts are widely known as the best studied chasteberry products currently available. Recent studies have determined that products containing BNO 1095 and Ze 440 are capable of reducing PMS symptoms including bloating, cramping, headache and irritability. In fact, dosages as low as 20 mg/day have been shown to safely manage PMS. Unfortunately, products containing both of these unique extracts are not easily accessible in many parts of the world. BNO 1095 is sold under several names in Asian and European countries: Agnucaston, Cyclodynon and Cyclopret. Ze 440 is primarily offered as Premular in Australia and South Africa. And, while one may be able to order these specific chasteberry remedies online or through holistic practitioners, you’re unlikely to find them on the shelves of local health food stores. The question of whether or not other Vitex products will produce similar results is largely a matter of anecdotal accounts and speculation.

Finally, even though chasteberry/Vitex has a good track record in terms of efficacy and safety, it should still be viewed as a natural “medicine”. Whenever possible, PMS, like many other health conditions, should preferentially be addressed through health promoting lifestyle changes. For instance, eating a whole food diet rich in B-vitamins and magnesium may dramatically lower the risk and severity of PMS. Dietary sources of Vitamins B1 (thiamine) and B2 (riboflavin) such as almonds, flax seeds, spinach, tuna and venison, may be especially protective for younger women at risk for menstrual discomfort. In addition, select alternative and complementary therapies, including acupuncture, may decrease and, occasionally, eliminate symptoms and some of the underlying causes of painful monthly cycles.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Click on the following links to learn more about the studies referenced in today’s column:

Study 1 - Dose-Dependent Efficacy of the Vitex Agnus Castus Extract Ze 440 (link)

Study 2 - Treatment for the Premenstrual Syndrome with Agnus Castus(link)

Study 3 - Efficacy of Vitex Agnus Castus L. Extract Ze 440 in Patients with (link)

Study 4 - Evaluating Therapeutic Effect in Symptoms of Moderate-to-Severe (link)

Study 5 - Treatment for Premenstrual Syndrome with Vitex Agnus Castus(link)

Study 6 – Importance of Acupuncture on Premenstrual Syndrome (link)

Study 7 – Dietary B Vitamin Intake and Incident Premenstrual Syndrome (link)

Dietary and Supplemental Magnesium May Reduce PMS Symptoms

Source: Iran J Nurs Midwifery Res. 2010 Dec;15(Suppl 1):401-5. (link)

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7 Comments & Updates to “Chasteberry PMS Question”

  1. liverock Says:

    Some men also say that Chasteberry helps them to stop hairloss. However, I personally think that men should beware of taking it.
    They didnt name it C-H-A-S-T-E berry unless they had a good reason!!

  2. JP Says:


    I’m with you on this one! I’ve yet to find any compelling evidence that shows that Vitex discourages hair loss or promotes hair growth.

    Be well!


  3. JP Says:

    Update 05/13/15:


    J Altern Complement Med. 2015 May 12.

    The Acute Effects of Yoga on Cognitive Measures for Women with Premenstrual Syndromes.

    OBJECTIVES: Recently, yoga classes specifically for women with premenstrual syndromes (PMS) have increased, but there is little research about the efficacy of these classes. The primary aims of this study were to evaluate the effect of yoga exercise on women with PMS and to evaluate the immediate change of attention performance after yoga classes.

    METHODS: This study examined the attention task results of women with PMS. Eleven women with PMS and 9 women without PMS were recruited. The PMS group took the tests before and immediately after the yoga class both in the luteal and follicular phase of one menstrual cycle, while the control group took the tests only twice: once in the luteal phase and once in the follicular phase. Both groups were required to finish resting electroencephalography (EEG) and cognitive task of the 2-back task with EEG recording.

    RESULTS: The alpha brain wave percentage was higher immediately after yoga exercise in the PMS group. This suggests that the participants felt more relaxed or were in a more peaceful mental condition after yoga exercise. In the 2-back task, the PMS group needed a longer reaction time to respond to the target stimulus in the luteal phase and performed better with higher accuracy and shorter reaction time after yoga exercise. The event-related potentials of the EEG recording displayed a significant variability at the P3 amplitude throughout the menstrual cycle in the PMS group, but the P3 amplitude was unchanged throughout the menstrual cycle in the control group.

    CONCLUSION: The results of this study suggest that women with PMS could attend short-term yoga exercise in the luteal phase to make themselves feel better and maintain a better attention level.

    Be well!


  4. JP Says:

    Update 05/13/15:


    Adv Ther. 2014 Mar;31(3):362-73.

    Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label study.

    INTRODUCTION: Herbal medicine containing Vitex agnus-castus (VAC) extract is widely used by women with premenstrual syndrome (PMS) in Europe, however, in Japan, clinical evidence remains to be determined. This study attempted to investigate the efficacy and safety profiles of VAC extract in Japanese patients with PMS.

    METHODS: A multi-center, prospective, open-label, single-arm, phase 3 study was performed in Japanese women with PMS and aged 18-44 years. The patients received Prefemin® (Max Zeller Söhne AG, Romanshorn, Switzerland), containing 20 mg of VAC extract, once daily for three menstrual cycles. The efficacy profile was examined based on the intensity of ten PMS symptoms-irritability, depressed mood, anger, headache, bloating, breast fullness, skin disorder, fatigue, drowsiness, and sleeplessness-recorded by patients via a visual analog scale (VAS). In addition, the responder rate was calculated based on the total VAS score defined by the sum of the VAS scores of the first six symptoms mentioned above. Furthermore, physician’s global assessment (PGA) scores were recorded. Adverse events including vital signs and laboratory test values were monitored as safety evaluation.

    RESULTS: Sixty-nine patients received Prefemin®. After the first menstrual cycle, a statistically significant decrease in total VAS score was observed (P<0.001), and the score continued to diminish for the following two cycles. Each of the ten symptom scores decreased significantly in this manner. In addition, the responder rate increased in a time-dependent manner; the rate at the third menstrual cycle was 91.0%, and almost all of the patients were without symptoms or exhibited only mild symptoms based on PGA. Eight patients exhibited non-serious adverse events, one of which was allergic dermatitis whose causal relationship with VAC was not ruled out.

    CONCLUSION: VAC extract improved PMS symptoms in Japanese patients, with no substantial adverse events. This is the first study to report the effect of VAC extract in Japanese patients.

    Be well!


  5. JP Says:

    Update 05/13/15:


    Acta Neurol Belg. 2013 Mar;113(1):25-9.

    Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observation.

    Premenstrual syndrome (PMS) affects most women during their reproductive life. Headache is regarded as a typical symptom of PMS and, close to menses, migrainous women could experience their worst migraine attacks. Vitex agnus-castus (VAC) is a phytopharmaceutical compound, considered worldwide to be a valid tool to treat PMS. Aim of this study is to explore if headache is ameliorate in migrainous women treated with VAC for PMS by an open-label clinical observation. Migrainous women with PMS were enrolled in the study and advised to assume a treatment with VAC (40 mg/day) for PMS for a 3-month period. Effects both on PMS and headache were assessed. Out of 107 women, 100 completed the 3-month treatment for PMS. Out of them, 66 women reported a dramatic reduction of PMS symptoms, 26 a mild reduction, and 8 no effect. Concerning migraine, 42 % of patients experienced a reduction higher than 50 % in frequency of monthly attacks, and 57 % of patients experienced a reduction higher than 50 % in monthly days with headache. No patients reported remarkable side effects. Pending a placebo-controlled trial to confirm our results, we observed that the use of VAC in migrainous women affected by PMS resulted to be safe and well tolerated, and may positively influence the frequency and duration of migraine attacks.

    Be well!


  6. JP Says:

    Updated 07/16/15:


    Chem Pharm Bull (Tokyo). 2014;62(4):379-85.

    Quality evaluation of medicinal products and health foods containing chaste berry (Vitex agnus-castus) in Japanese, European and American markets.

    The aim of present study was to evaluate the qualities of chaste berry (fruit of Vitex agnus-castus L.) preparations using HPLC fingerprint analysis. Seven medicinal products 1 from Japan and 6 from Europe, and 17 health foods, 6 from Japan and 11 from the United States were analyzed. HPLC profile and 26 authentic peaks were compared medicinal products and health foods. Whereas medicinal products had similar HPLC profiles, health foods had various profiles and each peak was also greatly different. The measured amounts of two markers in 5 traditional medicinal products, agnuside and casticin specified in the European Pharmacopoeia (EP), the U.S. Pharmacopoeia (USP) or the WHO monographs of chaste berry, were much lower than those in 2 medicinal products defined as “well-established use” by the European Medicines Agency. The amounts of two markers for 17 health foods differed in a great deal from 14-5054% and 3-1272%, respectively. Furthermore the amount ratios of two markers, agnuside/casticin, in about half of the health foods were remarkably larger than the standard crude drug and the ratios were closer to one of the related Chinese herbs, Vitex negundo L. It is concluded that a combination of HPLC fingerprints and the amount ratios of the marker compounds of chaste berry preparations serves as a useful tool to evaluate the qualities of these preparations.

    Be well!


  7. JP Says:

    Updated 07/16/15:


    J Res Med Sci. 2014 Jan;19(1):1-7.

    Effects of “vitex agnus castus” extract and magnesium supplementation, alone and in combination, on osteogenic and angiogenic factors and fracture healing in women with long bone fracture.

    BACKGROUND: The purpose of this study was to investigate the effects of the combination of vitex agnus castus extract, as a source of phytoestrogens, plus magnesium supplementation on osteogenic and angiogenic factors and callus formation in women with long bone fracture.

    MATERIAL AND METHODS: In a double-blind randomized placebo controlled trial, 64 women with long bone fracture, 20-45 years old, were randomly allocated to receive 1) one Agnugol tablet (4 mg dried fruit extract of vitex agnus castus) plus 250 mg magnesium oxide (VAC + Mg group (n = 10)), 2) one Agnugol tablet plus placebo (VAC group (n = 15)), 3) placebo plus 250 mg magnesium oxide (Mg group (n = 12)), or 4) placebo plus placebo (placebo group (n = 14)) per day for 8 weeks. At baseline and endpoint of the trial, serum alkaline phosphatase, osteocalcin, and vascular endothelial growth factor (VEGF) were measured together with radiological bone assessment.

    RESULTS: There were no significant differences in the characteristic aspects of concern between the four groups at baseline. Despite the increased level of alkaline phosphatase in the VAC group (188.33 ± 16.27 to 240.40 ± 21.49, P = 0.05), administration of VAC + Mg could not increase alkaline phosphatase activity. However, treatment with VAC + Mg significantly enhanced the osteocalcin level. The serum concentration of VEGF was increased in the VAC group (269.04 ± 116.63 to 640.03 ± 240.16, P < 0.05). Callus formation in the VAC + Mg group was higher than the other groups but the differences between the four groups were not significant (P = 0.39). No relevant side effect was observed in patients in each group.

    CONCLUSION: Our results suggest that administration of vitex agnus castus plus magnesium may promote fracture healing. However, more studies need to further explore the roles of vitex agnus castus in fracture repair processes.

    Be well!


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