VITEX
Common Names

Vitex, Chasteberry, Agnus Castus, Monk’s Pepper,
Chaste tree
Botanical Name
Vitex agnus-castus
Family
VERBENACEAE ~ Verbena Family

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What is it?

In herbal medicine we use the berries of Vitex; a small, long-lived shrub with densely packed branches that produce whorls of violet flowers followed by the fruits, which are then dried and used in medicine.


FLOWERS


BERRIES


DRIED

How has it been used?

Vitex has a rich and colourful history in herbal medicine and is no less a subject of interest and widespread use today.

Vitex was described over 2,500 years ago in Homer's epic, the Iliad, as a symbol of chastity that was capable of warding off evil and, being native to the Mediterranean region it would certainly have been used in Egyptian medicine, if only we had some written records from that time!

Nearly 2000 years ago, Dioscorides wrote in his Materia Medica that its use brings on menstruation, helps childbirth, increases milk production and that larger doses of it can bring on sleep.

The old names Monk’s Pepper and Chasteberry give an appreciation of at least part of how it was understood to work. The Monks of the middle ages would liberally use ground Vitex as a pepper on their food (it has a distinct but not unpleasant peppery taste) they were using it partly for the taste but mostly because if they took enough of it that it would decrease their sexual urges!

Vitex is nearly always used for women today though it can be very helpful to men with cystic acne or as a treatment for intractable insomnia. Numerous clinical studies (mostly in Germany) have shown that is has complex, notable and reproducible hormonal actions. When it is the right herb for the right woman, Vitex can be remarkable at helping with pre-menstrual tension, reducing the risk of miscarriage, improving fertility, improving the production of breast milk, helping with menopausal symptoms, helping with severe and cystic acne, helping withdraw from the contraceptive pill, reducing mid-cycle bleeding and helping to re-establish a healthy cycle in general.

Two esteemed herbal authors, David Hoffmann and Thomas Bartram, have described these actions in detail on Vitex and a large part of their work on this extraordinary herb is copied below.

David Hoffmann describes Vitex as a 'hormonal normaliser and uterine tonic' He says that 'Vitex has the effect of stimulating and normalising pituitary gland function, especially as it relates to relative progesterone levels. Vitex may be called an amphoteric remedy, as it can produce apparently opposite effects, though in truth it is simply normalising. For instance, Vitex has a reputation for being both an aphrodisiac and an anaphrodisiac!
The most important therapeutic application for Vitex comes from its ability to normalise the female sex hormones. It is thus indicated for dysmenorrhoea (painful periods) premenstrual syndrome and other disorders related to hormone function. It is especially beneficial during menopause. Similarly, it may help the body regain a natural balance after discontinuation of oral contraceptives.
Vitex not only eases symptoms of PMS, but also, over time, may actually cure the disorder. PMS has been linked to abnormally high levels of estrogen, and Vitex has proved especially helpful for cases in which symptoms tend to disappear when menstruation begins. Positive results may be perceived as early as the second menstrual cycle, but permanent improvement may take up to one year or longer.
Vitex is also effective for irregular menstruation, especially when related to endometriosis. In addition, because progesterone production declines at menopause. Vitex may reduce some of the undesirable symptoms associated with 'the change'.
Several studies show that Vitex can help control acne in teenagers, both young women and men. The herb is also useful for stabilising the menstrual cycle after withdrawal from progesterone containing birth control pills. It may help with fibroid cysts that occur in smooth muscle or in subserous areas, but is less likely to help with submucous cysts.
For women who are trying to get pregnant, Vitex may effectively regulate the ovulatory cycle. Clinical research shows that Vitex may start correcting imbalances about 10 days, but for full benefit, it should be taken for three cycles or longer'

Thomas Bartram describes Vitex (which he calls Agnus Castus) as 'acting on the anterior pituitary gland, reducing FSH (follicle-stimulating-hormone) and increasing LSH (luteum-stimulating-hormone).
Stimulates production of progesterone but reducing that of oestrogen.
Alternative to hormone replacement therapy (HRT)
"Has a corpus luteum hormone effect" - Rudolph Weiss.
Bartram suggests uses such as 'for symptoms caused by excess FSH and low progesterone output, used as substitution therapy for primary and secondary corpus luteum deficiency.
Pre-menstrual symptoms, especially nervous tension, irritability, mood-swings, depression, anxiety, crying, forgetfulness, insomnia.
Amenorrhoea (absent periods) by regulating hormones.
Pain in breasts. To promote breast milk in nursing mothers.
Acne vulgaris (to restore hormone balance).
Water retention (pre-menstrual) caused by oestrogen excess or progesterone deficiency.
"Regular bleeding between periods decreased following temporary increase" Dr W Amann
By opposing excess oestrogen it lessens the risk, however small, of endometrial carcinoma.
For symptoms of the menopause and of withdrawal on giving up the Pill'

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Science on Vitex

~ 93% of 1634 patients with PMS reported a decrease in, or cessation of, symptoms of PMS from using Vitex extracts over a period of three menstrual cycles (Loch EG, Selle H, Boblitz N: J Women's Health Gend Based Med 9(3):315-320,2000)

~ Observation by 153 gynaecologists of 551 patients with symptoms of cyclic disorders or PMS using Vitex over several menstrual cycles showed that over 80% were relieved of symptoms or stated that their condition had improved (Peters-Welte C, Albrecht M. TW Gynakol 1994;7(1):49-52)

~ Vitex extract improved PMS symptoms of irritability, mood alteration, anger, headache, breast fullness and bloating in a randomised, double-blind, placebo-controlled clinical trial (Schellenberg R: BMJ 322:134-137,2001)

~ A favourable action of milk production in nursing mothers was observed in an early controlled study using a low dose (40mg daily) of Vitex. Milk production was approximately three times higher in the group using Vitex compared to the control group after 20 days of treatment (Mohr W. Hippokrates 1957;28:586-591)

~ A controlled trial of 161 male and female patients with acne for at least 3 months using Vitex extract resulted in an improvement in 70% of cases. The mechanism for this action is not clear but is thought to be due to a mild anti-androgen effect (Giss G. Rothenburg W. Z Haut Geschlechtskr 1968;43(15):645-647)

~ Vitex has been particularly indicated for patients with a deficient corpus luteum function. In two studies women who had pathologically low levels of progesterone at day 20 of their cycle were shown to have normalised in 39 out of 45 cases after three months of treatment with a daily low dose of Vitex (36mg). 7 women became pregnant, 25 had normal progesterone levels at day 20 and another 7 women were tending back towards normal levels (Propping D, Karzorke T, Belkien L. Therapiewoche 1988;38(41):2992-3001)

~ The authors, titles and the 'where-and-when' published of well over 100 further studies and articles on Vitex are listed in a PDF found here

Safety of Vitex

Generally Vitex is a very safe herb but there are some precautions to its safe use. It may help women who get painful periods and symptoms of the premenstrual syndrome but it might make things worse for a woman who gets a painful period but does not get PMS.

Vitex is thought to be beneficial in low doses during breastfeeding and will likely aid milk production but, at least in theory, this might turn the other way with higher doses, so it may need to be used moderately at this time. Vitex is certainly considered safe in the early stages of pregnancy (myself and others believe it to help prevent miscarriage) but it is not usually advised to take it after the first trimester.

General safety note on herbs

Therapeutic substances, and this certainly all includes all medicinal herbs, can do good and, therefore, also have the potential to do harm. The maxim that 'the poison is in the dose' precisely describes how too much of anything can be bad for us and the ancient rule to 'firstly, do no harm is, to this day, held as the core directive by all practitioners of traditional herbal medicine. So, not only are we careful to do our best to use the right herbs but, equally, we take care to not give too much of them or use them overlong.

For some years now, against this old, proven and safe way of herbalism, there has been a rising tide of excessive caution and scare-mongering in many parts of the world. The same authorities and medical publications that no so long ago decried herbal medicines as ineffectual have now taken up a different kind of adversarial position. That they are dangerous substances that should not be taken for a long list of reasons and really should only be prescribed by Doctors, who of course have zero training in them.

Lists of '10 popular herbs and why you should avoid them' include things like Garlic and Ginger that might 'thin your blood'. It is absurd to the point of the ridiculous, but fear is a universal driver, and fear has also been long proven to be effective when used to manipulate and control others.

I realise that the reader who comes to a page like this is unlikely to be swayed by such misinformation, but I nevertheless want to remind you that the reason that herbs cannot be patented or owned by any individual or corporation is that they are the people's medicine. They belong to us all and it is my great hope that you will learn how to use them safely and wisely for yourself and the people you care for. Be safe but do not be afraid.

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Personal experiences

Vitex has been a tremendously important herb in my work from the very beginning. I could not imagine practicing herbal medicine without it and it has been a tremendous ally to a great many women in how well it has so often relieved or cured PMS, hormonal swings, painful periods, bad acne and infertility.

I see Vitex as being a herb that can bring balance to many women with many different kinds of hormonally related symptoms and, whilst there is no herb that is right for everyone, it almost always should be at least considered when a significant part of the problem is related to hormonal imbalance.

Having a profound respect for just how powerful this herb can affect change in a woman's hormones I have often used the ancient practice to listen to her body by giving a drop or two of Vitex on the tongue and feeling her pulse before, during and after (in effect you are listening to their 'heart') I would never pretend that this is a fail-safe method but there is a kind of body 'intelligence' that talks back to you when you do this with an empty mind and an open heart - the process is described in detail here

I do understand that not everyone is going to feel confident with listening to the pulse, in fact it really needs a lot of practice to learn and I am primarily putting this out there for students or practitioners of herbal medicine.

So, how else might we know if Vitex is the right herb? Sometimes you just have to try it and see but the perplexing aspect of this is that sometimes the problems can temporarily worsen in the first month of using it. Many women do feel a relief from it from their very first cycle, but it is also clear that for some women, when they first start using Vitex the next period is heavier than usual, or later than usual, or the PMS is different with some new symptoms or a different timing of the old ones. These are not to be taken as signs that it is the wrong herb and you really have to go through to the next cycle to see what happens because, in a great many cases, the next period and the time leading up to it can be much better, often marvellously so!

That said, there have also been times, not often but enough to see that this is a real potential, that there is a further worsening or disruption that occurs through the 2nd cycle as well. I will usually want to give Vitex for at least 3 cycles before feeling we can truly assess its benefits, but if it seems to be making things worse after 2 cycles, I think we have to stop and reconsider a plan B. In other words, I am unlikely to give it for a 3rd month if it has made things worse in the first two months.

Knowing if it is the right herb is only half the challenge, the next part is dosage!

Dosage is always one of the most critical factors to get right in herbal medicine and in the case of Vitex we have an excellent example of just how widely we have the potential to miss the mark!

Hoffmann, quoted extensively above, suggests that we can go up to very high doses of up to 2.5 mls three times a day (of a 1:5 tincture in 60% ethanol). This is much higher than most herbalists use in practice today and most practitioners would think that these amounts would be much too high for some women. Some, not all.

Bartram, also quoted in depth above, has a recommended dose of 20 drops of the tincture (approximately 1 ml) and even that may only be taken in the 2nd half of the cycle. These levels are more in keeping with how most modern herbalists would dose Vitex but, for some women, they could be too low to have a significant effect. Some, not all.

I hope you can already see that, between these two highly experienced practitioners, you have a range from 1 to nearly 8mls in a day, a huge difference.

The German Commission E, an internationally respected authority on herbal medicine, have recommended doses for Vitex that give the equivalent to just 30-40mg of the herb a day and it would appear that many commercial preparations use exactly these levels so presumably they have used the Commission as their guide when they have designed their products.

However, if we compare this to the dosages described above, 40mg of the herb would equate to only 4 or 5 drops of the herbal tincture, only a quarter of what would be most herbalist's starting point (which is commonly 20 drops a day)

Vitex is a powerful herb, it is understandable why commercial products would want to use a very low doses, however there may be many women who have been disappointed in its effects who simply haven't had enough of it to work. I say again, dosage is absolutely critical to the success of herbal medicine.

So, where is a person to start with dosage? I am sorry that I cannot give any advice to a person that I cannot meet in person, but I can tell you that, even when I do have a detailed work-up and do things like the pulse-analysis as mentioned above, it is still often a matter of try and see!

Holding firm to the first rule of 'do no harm' you have to be prepared to try a different range of doses to see how the person responds. What I can tell you is that the one feedback that I take as meaning we are using too little is that they don't notice anything! This is a potent herb that should make its presence felt.

As I said earlier, if we go through two cycles and things seem worse rather than better, then I would have to bring the 'experiment' to a close but, if they were not noticing anything obvious happening with their cycle etc. then I would take that as an indicator to try using a much higher dose than when we started. My typical starting dose is around 30 drops a day of the 1:5 tincture that we make in our clinic from organic Vitex berries, but I will go up to much higher doses than this if needed and, for at least some women, I might start at a much lower dose too. Like women, like hormones, like the cycles of life, it's complex.

Vitex is a herb that is sometimes used by itself but it also seems to combine particularly well with Raspberry leaf for heavy bleeds and spotting, with Cramp bark for painful or excessive periods and with Licorice root for premenstrual tension.

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Constitutional note

Much of the information here about the traditional uses of Vitex is consistent with the model of thinking whereby one may treat problem A with plant B. There is value in this approach, especially in how it helps us pass on useful knowledge to one another, but it falls short in one vital area; and that is that people are not all cut from the same cloth! Something that works brilliantly for one person does less for another -- why is this?

Part of the reason is that people vary in their constitutions as to whether they are either hotter or cooler and, at the same time, either dryer or damper. This useful and rather fascinating subject is introduced further here

Another big part of using the right herb when it is most needed comes from understanding the need to treat what is going wrong for the person that had led up to their getting a health condition. In this light, Vitex can particularly offer its benefits when an activation is needed in the 'cycle of healing', more about this here

Please understand that I cannot advise you, including on products or dosage, without seeing you in person in my clinic but for ideas on how you might find a good herbalist in your area read here

This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!

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© 2011 R.J.Whelan Ltd