-------------------------------------------------------------------------------- What Is Chasteberry Used for Today? The modern use of chasteberry dates back to the 1950s, when the German pharmaceutical firm Madaus Company first produced a standardized extract. This herb has become a standard European treatment for cyclic breast tenderness, a condition related to PMS that is sometimes called cyclic mastitis, cyclic mastalgia, mastodynia, or fibrocystic breast disease. Chasteberry also appears to be useful for general PMS symptoms. Chasteberry is believed to work by suppressing the release of prolactin from the pituitary gland.1–4 Prolactin is a hormone that naturally rises during pregnancy to stimulate milk production. Inappropriately increased production of prolactin may be a factor in cyclic breast tenderness, as well as other symptoms of PMS. Elevated prolactin levels can also cause a woman's period to become irregular and even stop. For this reason, chasteberry is often tried for irregular or absent menstrual flow. However, we recommend that you do not attempt to self-treat significant menstrual irregularities without a full medical evaluation. There could be a serious medical condition causing the problem that you wouldn't want to miss. High prolactin levels can also cause infertility. For this reason, chasteberry is sometimes tried as a fertility drug;5 however, the two double-blind studies performed to evaluate this possible use failed to return statistically significant results.6,7 Finally, chasteberry is sometimes used for menopausal symptoms, but there is no evidence that it is effective. -------------------------------------------------------------------------------- What Is the Scientific Evidence for Chasteberry? There is a growing body of scientific research supporting the use of chasteberry. Cyclic Mastalgia A double-blind placebo-controlled trial of 97 women with symptoms of cyclic mastalgia found that treatment with chasteberry extract significantly reduced pain intensity by the end of one menstrual cycle.8 The reduction continued to increase throughout the second menstrual cycle, and at the end of both the first and second cycle, women in the treated group were doing better than those receiving placebo. However, something interesting happened in the third cycle. The benefits of chasteberry treatment reached a plateau, while the placebo group continued to improve. At the end of the third cycle, those receiving chasteberry were still doing better, but the difference was no longer statistically significant. Another double-blind trial of 104 women compared placebo against two forms of chasteberry (liquid and tablet) for at least three menstrual cycles.9 The results showed statistically significant and comparable improvements in the treated groups as compared to placebo. Benefits were also seen in a double-blind trial that enrolled 160 women with cyclic breast pain. The women were given either chasteberry, a drug related to progesterone, or placebo, and were followed for at least four menstrual cycles.10 Although there were many dropouts, the results again suggest that chasteberry is superior to placebo. Premenstrual Syndrome (PMS) A double-blind placebo-controlled study of 178 women found that treatment with chasteberry over three menstrual cycles significantly reduced PMS symptoms.11 The dose used was one tablet 3 times daily of a dry chasteberry extract. Women in the treatment group experienced significant improvements in symptoms, including irritability, depression, headache, and breast tenderness. Unfortunately, there is little corroborating evidence as yet for this one well-designed study. A previous double-blind trial compared chasteberry to vitamin B6 (pyridoxine) instead of a placebo.12 The two treatments proved equally effective. However, because vitamin B6 itself has not been shown effective for PMS, these results mean little.13 Two other studies are often cited in support of chasteberry as a treatment for PMS. These were rather informal reports of a total of about 3,000 women with PMS given chasteberry by their physicians.14,15 The physicians rated chasteberry as effective about 90% of the time, but in the absence of a control group, these reports are not very meaningful. Irregular Menstruation One double-blind trial followed 52 women with a form of irregular menstruation known as luteal phase defect.16 This condition is believed to be related to excessive prolactin release. After 3 months, the women who took chasteberry showed significant improvements. -------------------------------------------------------------------------------- Dosage The typical dose of dry chasteberry extract is 20 mg taken 1 to 3 times daily. Chasteberry is also sold as a liquid extract to be taken at a dosage of 40 drops each morning. However, extracts that require lower or higher dosing are also available. We recommend following the label instructions. -------------------------------------------------------------------------------- Safety Issues There haven't been any detailed studies of the safety of chasteberry. However, its widespread use in Germany has not led to any reports of significant adverse effects,17 other than a single case of excessive ovarian stimulation possibly caused by chasteberry.18 Because it lowers prolactin levels, chasteberry is not an appropriate treatment for pregnant or nursing women. Safety in young children or those with severe liver or kidney disease has not been established. There are no known drug interactions associated with chasteberry. However, it is quite conceivable that the herb could interfere with hormones or medications that affect the pituitary gland. -------------------------------------------------------------------------------- Interactions You Should Know About If you are taking hormones or drugs that affect the pituitary, such as bromocriptine, it is possible that chasteberry might interfere with their action. -------------------------------------------------------------------------------- References 1. Milewicz A, Gejdel E, Sworen H, et al. Vitex agnuscastus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study [translated from German]. Arzneimittelforschung. 1993;43:752–756. 2. Jarry H, Leonhardt S, Gorkow C, et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol. 1994;102:448–454. 3. Sliutz G, Speiser P, Schultz AM, et al. Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Horm Metab Res. 1993;25:253–255. 4. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer-Verlag; 1998:241–242. 5. Propping D, Katzorke T, Belkien L. Diagnosis and therapy of corpus luteum insufficiency in general practice [translated from German]. Therapiewoche. 1988;38:2992–3001. 6. Gerhard I, Patek A, Monga B, et al. MastodynonW for female infertility [in German; English abstract]. Forsch Komplementarmed. 1998;5:272–278. 7. Bergmann J, Luft B, Boehmann S, et al. The effectiveness of the complex agent, Phyto-HypophysonW L, in female sterility of hormonal origin [translated from German]. Forsch Komplementarmed Klass Naturheilkd. 2000;7:190–199. 8. Halaska M, Beles P, Gorkow C, et al. Treatment of cyclical mastalgia with a solution containing a Vitex agnus castus extract: results of a placebo-controlled double-blind study. Breast. 1999;8:175–181. 9. Wuttke W, Splitt G, Gorkow C, et al. Treatment of cyclical mastalgia: results of a randomised, placebo-controlled, double-blind study [translated from German]. Geburtsh Frauenheilk. 1997;57:569–574. 10. Kubista E, Muller G, Spona J. Treatment of mastopathy associated with cyclic mastodynia: clinical results and hormone profiles [translated from German]. Gynakol Rundsch. 1986;26:65–79. 11. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ. 2001;322:134–137. 12. Lauritzen C, Reuter HD, Repges R, et al. Treatment of premenstrual tension syndrome with Vitex agnus castus. Controlled, double-blind study versus pyridoxine. Phytomedicine. 1997;4:183–189. 13. Kleijnen J, Ter Riet G, Knipschild P. Vitamin B6 in the treatment of premenstrual syndrome--a review. Br J Obstet Gynaecol. 1990;97:847–852. 14. Dittmar FW, Bohnert KJ, Peeters M, et al. Premenstrual syndrome: treatment with a phytopharmaceutical [translated from German]. Therapie Woche Gynakol. 1992;5:60–68. 15. Peters-Welte C, Albrecht M. Menstrual abnormalities and PMS: Vitex agnus castus [translated from German]. Therapie Woche Gynakol. 1994;7:49–52. 16. Milewicz A, Gejdel E, Sworen H, et al. Vitex agnuscastus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study [translated from German]. Arzneimittelforschung. 1993;43:752–756. 17. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer-Verlag; 1998:243. 18. Cahill DJ, Fox R, Wardle PG, et al. Multiple follicular development associated with herbal medicine. Hum Reprod. 1994;9:1469–1470. |
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