Richard Mandelbaum RH(AHG)

2016

Vitex agnus-castus
Lamiaceae (previously Verbenaceae)

Chaste tree
Monk’s Pepper
Vitex

Part used: fruit

Native range: Mediterranean

Harvestable status / sustainability: easily cultivated elsewhere

Flavor: pungent, acrid, mildly bitter

Energetics: mildly warming, mildly drying

Actions: sex hormone modulator (normalizer), dopaminergic (dose-dependent), uterine

tonic, galactagogue (dose-dependent), diaphoretic, diuretic, carminative

Although sometimes described as phytoestrogenic, Vitex is more accurately viewed as a deep

pituitary amphoteric working through pituitary gland function (HPO or hypothalamus-
pituitary-ovarian axis). The herb is used most often for normalizing female reproductive
function but has some more narrow indications for men. Although primarily used to correct
relative progesterone deficiency / estrogen excess, Vitex when used appropriately is helpful
for relative estrogen deficiency / progesterone excess. As a deep endocrine normalizer
specific to sex hormone balance, chaste tree is also beneficial in normalizing hormones other
than estrogen and progesterone. The specific effects on hormone levels can be dose-
dependent: in higher doses Vitex is a dopamine agonist (dopaminergic) and prolactin
antagonist through its activation of pituitary receptors. Vitex is pungent and moving. In low
doses Vitex appears to have a prolactin agonist effect. In energetic terms chaste tree rectifies
Qi, has a downward action, and breaks up stagnant Liver Qi (Garran).
Richard Mandelbaum RH(AHG)
2016

Indications:
o Normalizes menstrual cycle, encourages ovulation and regular bleeding. Useful
in dysmenorrhea, amenorrhea, short / early cycle, and especially irregular
cycles.
o Enhances luteal phase function and is helpful for ovarian insufficiency.
o Useful in normalizing menstrual cycle after oral contraceptive use is
discontinued
o Used most often in cases of elevated estrogen (estradiol) and/or prolactin relative
to progesterone, i.e. luteal phase defects / corpus luteum insufficiency, but is a
modulator and can be helpful in the reverse as well.
PMS (except PMS-D): mood swings, anxiety, breast tenderness, swelling,
migraines, cramps
Hyperprolactinemia including prolactinoma; amenorrhea (high dose – see
below)
Endometriosis
Uterine fibroids
Fibrocystic breast disease
Polycystic ovarian disease
Vitex has been used to prevent miscarriage in women with a history of
miscarriage during the first trimester due to progesterone insufficiency or
inadequate endometrial response to pregnancy (most likely by improving
luteal function and therefore progesterone levels).
o Symptoms that worsen with menses or pre-menses, including herpes outbreaks,
acne, ulcers, migraines, etc.
o Perimenopausal complaints – hot flashes, night sweats, vaginal dryness,
anxiety/insomnia, low libido (see below) etc.
o Infertility related to hormonal imbalance (usually high dose is used)
o Can help to reverse insufficient or halted breast milk production (low dose used),
especially Liver Qi stagnation with anger, irritability, distention of the breasts or
mastitis. Tongue may have a thin coating and pulse is “string-like” or wiry.
(Garran)
• Safe and potentially useful in protocols for estrogen-sensitive cancers particularly in
pre-menopausal women
• Regulates libido and sexual function
o Low dose tends to reduce libido, higher dose to stimulate libido due to varying
impact on dopamine and prolactin levels. (Some of the impact on libido may
also be due to effects on testosterone.)
o Used traditionally for “sexual melancholia” in women
o Male sexual health: erectile dysfunction characterized by high prolactin, low
testosterone
• Hormone-related skin conditions (e.g. acne, herpes cold sores )
Richard Mandelbaum RH(AHG)
2016

Traditional uses:
• Documented usage dates back at least to ancient Greece, with primary uses including
promotion of lactation, inducement of menses, and reduction uterine inflammation.

Safety, Contraindications, Interactions and/or toxicity:

• AHPA Safety Class 1, Interaction Class A
• Usage is not recommended with concurrent usage of hormonal treatments such as oral
contraceptives or hormone replacement therapy.
• Care must be taken to use Vitex in the proper dose and when indicated due to
potentially significant hormonal impact.
• May cause occasional side effects including rash, headache, itching
• Not recommended for pre-pubescent children except under the guidance of a qualified
practitioner
• Although some authorities contraindicate Vitex during pregnancy, it has been used
safely during pregnancy as noted above; it should only be used under the guidance of a
qualified midwife or practitioner

Preparation:
Infusion
Tincture
Capsule

Dosage:
½ -1 tsp dried fruit to 8 oz water twice per day as infusion
Low dose: 5-10 gtt three times per day as tincture
High dose: 1-4 ml three times per day as tincture
500-1000 mg two to three times per day as capsule

Major plant constituents: Iridoid glycosides, flavonoids, essential oils

Additional notes:
• Usually needs to be used for approximately three menstrual cycles (three months) for
full effectiveness.
• In Germany Vitex is traditionally taken once per day in the a.m. Some herbalists
elsewhere now recommend a single dose in the morning but it is not established that
this is preferable or even traditional per se, and appears to be based on the major brand-
name proprietary formulation being sold in Germany at the time.
• Chaste tree is not interchangeable with the Vitex species used in traditional Chinese
medicine.
• It is not clear whether or not, or to what degree the dopaminergic activity of Vitex
might benefit dopamine-deficient neurological conditions such as Parkinson’s, M.S.,
epilepsy, etc.
Richard Mandelbaum RH(AHG)
2016

Sources:
AHPA Botanical Safety Handbook, 1st and 2nd Editions
Blumenthal, ABC Clinical Guide to Herbs
Bone and Mills, Principles and Practice of Phytotherapy
Brinker, Herb Contraindications and Drug Interactions
Gaby, A to Z Guide to Drug-Herb-Vitamin Interactions
Garran, Western Herbs According to Traditional Chinese Medicine
Hoffmann, Medical Herbalism
PDR for Herbal Medicines, Third Edition
Skenderi, Herbal Vade Mecum
Trickey, Women, Hormones, and the Menstrual Cycle
Winston and Kuhn, Herbal Therapy and Supplements
Yance, Herbal Medicine, Healing, and Cancer