Everything about Vitex

Common Name: Vitex, Chaste Tree, Monk’s Pepper

Scientific Name: Vitex Agnus‑Castus L.

History and Origin

Vitex or chaste tree or chasteberry (Vitex agnus‑castus) belongs to the family Verbenaceae, ⁽¹⁾ and according to the last studies, to the Lamiaceae family. ⁽²⁾

This plant is native to the arid and semi-arid Mediterranean regions and is widely cultivated in the warm temperate regions and subtropics. It generally grows in humid habitats like stream banks and valleys, littoral habitats, mostly on sandy soils, parched alluvial soils, and rocky areas near the sea, sometimes on limestone slopes, in sunny and hot places, and in ditches.

There are more than 250 species of Vitex genus in the world. They grow across the Mediterranean area, Southern Europe, West Asia, Crimea, Caucasia, Iran, North Africa, Central Asia to India, and in sheltered positions in the American State of New York. ⁽³⁾

Vitex Plant Structure

Vitex is a large shrub or a small deciduous tree with a height of up to 1.5 -2 m. ⁽¹⁾

The bark is white-felted. The opposite aromatic leaves are palmately compound with five to seven ⁽⁴⁾ finger-like leaflets. ⁽¹⁾Their color is gray-green, and the underside is lighter.

The fragrant flowers are in clusters, violet to blue to deep purple. ⁽¹⁾The fruits are small, gray-brown, hard ⁽⁴⁾, globular to oblong ⁽⁵⁾, and carry four seeds similar to black pepper.⁽¹⁾

Its ripe dried fruit and dried leaves have medicinal properties. ⁽⁵⁾

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Fig. 1 The photo of Vitex agnus‑castus Fig. 2 The photo of vitex flowers and leaves

Vitex Health Benefits

1. Regulating Blood Cholesterol Levels

In 2015, a study was carried out to review the possible effect of water and organic extracts of chasteberry (vitex) as an anti-hyperlipidemic agent in mice. The vitex fruits were dried, grounded into fine powders, and extracted with organic solvents and water. Forty-eight male mice were fed a high cholesterol diet for 28 days to construct hyperlipidemic models. Then, they evaluated the antihyperlipidemic activity of chasteberry extracts against hyperlipidemia induced in mice. They used Atorvastatin as a standard and measured total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels.

In comparison with normal mice, hyperlipidemic ones showed significantly higher lipid and liver enzymes profile outcome. After treatment with chasteberry extracts, TC, TG, LDL, and VLDL significantly decreased in hyperlipidemic mice. ⁽⁶⁾

2. Relieving Menopause Symptoms

A research was conducted to determine the effectiveness of Vitex, in comparison with placebo, in treating menopausal symptoms. They randomly divided the subjects into two groups of vitex and placebo (26 people in each group).

Before the intervention and 8 weeks after it, the researchers assessed menopausal symptoms by conducting a questionnaire. The symptoms were anxiety, depression, somatic complications, vasomotor, ⁽⁷⁾ which includes hot flashes and night sweats, ⁽⁸⁾ and sexual dysfunctions.

After the intervention, the mean scores for total menopausal disorders, anxiety, and vasomotor dysfunction were significantly lower in the vitex group than the placebo group. The mean scores of the variables of somatic complications, depression, and sexual dysfunction did not show significant differences between the groups. Based on these results, they concluded that administration of vitex agnus-castus as a phytoestrogenic medicine could reduce menopausal symptoms in women. ⁽⁷⁾

3. Improving Liver Function

Vitex agnus-castus (VAC) plant has been used for relieving the symptoms of menopause, but we do not have enough information about its actions on disturbances in lipid metabolism and nonalcoholic fat liver disease (NAFLD), frequently associated with menopause. In this study, OVX rats were used as animal models of estrogen deficiency (13 weeks after ovary removal, there is an increase in adiposity and NAFLD of ovariectomized (OVX) rats.)

The rats were treated with dried fruit extracts of vitex agnus-castus. The researchers found that the adiposity index was reduced, NAFLD was completely reversed, the activities of some antioxidant enzymes were restored, and the mitochondrial hydrogen peroxide production was significantly reduced in animals treated with the dried chasteberry extracts. ⁽⁹⁾

(Hydrogen peroxide (H₂O₂) is one of the main reactive oxygen species (ROS) formed by mitochondria. ⁽¹⁰⁾)

Therefore, we can conclude that the dried chasteberry extracts are effective in preventing NAFLD and oxidative stress. These two factors cause abnormal liver functions in the postmenopausal period. ⁽⁹⁾

4. Regulating Blood Glucose Levels

D-galactose (a reducing sugar) induces pancreatic disorder along with aging mouse model. Vitex agnus-castus (VAC) can potentially protect your pancreas. So, a study was conducted to evaluate the hypoglycemic and pancreas protective effects of hydroalcoholic extract of VAC desiccated fruits in D-galactose-induced aging female mice.

They divided 72 adult female mice into 6 groups: 1) control, 2) dried chasteberry hydroalcoholic extract, 3) D-galactose, 4) D-galactose + dried chasteberry hydroalcoholic extract, 5) aged, 6) aged + dried chasteberry hydroalcoholic extract.

The aged model was prepared by subcutaneous injection of D-galactose for 45 days and, dried chasteberry hydroalcoholic extract was gavaged twice a day in the last 7 days.

In comparison with the control group:

- Serum glucose levels decreased in the groups treated with dried chasteberry (groups 2, 4, and 6).

- Insulin level increased in group 2 and decreased in groups 4 and 6.

Administration of dried chasteberry hydroalcoholic extract improved insulin resistance in D-galactose and aging treated animals (groups 4, 6) and recovered the condition of their pancreases. According to the results, hydroalcoholic extract of VAC desiccated fruits has hypoglycemic and pancreatic protective effects in natural aged and aging model mice. ⁽¹¹⁾

5. Increasing Antioxidant Activity

In 2013, a study was designed to investigate the in vitro antioxidant and anticancer activities of organic extract and water (infusion and decoction) extract of vitex agnus-castus L. seeds.

The researchers assessed the antioxidant activities of the extracts by DPPH assay, their anticancer activities on MCF-7 breast cancer cells by determining cytotoxic, DNA damaging, and apoptotic activity ⁽¹²⁾ (programmed cell death for the specific elimination of unnecessary or unwanted cells from an organism.⁽¹³⁾)

Although V. agnus-castus L water extract (infusion and decoction) exhibited significant antioxidant activity, the results clearly indicated the antioxidant, cytotoxic, DNA damaging, and apoptotic activity of all extracts; the last three factors increased in a concentration-dependent manner. ⁽¹²⁾

6. Increasing Fertility

It seems that chasteberry affects prolactin and progesterone levels indirectly ⁽¹⁴⁾ and in a dose-dependent manner.⁽¹⁵⁾

Low doses of chasteberry (200 mg ⁽¹⁵⁾) decreases estrogen levels and increases progesterone and prolactin levels, possibly through inhibition of follicle-stimulating hormone (FSH) and stimulation of luteinizing hormone (LH). ⁽¹⁴⁾At high doses ⁽¹⁴⁾ (500 mg ⁽¹⁵⁾), it will lower prolactin levels and do not change FSH and LH. ⁽¹⁴⁾

Chasteberry has long been used for regulating menstrual cycles; it might be caused by its ability to regulate prolactin levels, stimulate corpus luteum development, and improve relative progesterone deficiency.

In an uncontrolled study on 34 women with hyperprolactinemia, the researchers observed that not only elevated prolactin levels in 80% of the subjects were reduced by daily use of chasteberry for 1 month, but also the symptoms of a variety of menstrual disorders were improved. These disorders include secondary amenorrhea, cystic hyperplasia of the endometrium, metrorrhagia, polymenorrhea, and oligomenorrhea.

Furthermore, in another uncontrolled study involving 45 infertile women with normal prolactin and low progesterone, 39 of them achieved pregnancy after they received chasteberry for three months.

In a second study on 31 women with infertility, 15 of these women were pregnant after 3 months on chasteberry.

Chasteberry is highly effective in restoring the menstrual cycle in a woman after years of taking oral contraceptive pills and improving low LH levels.

For infertility, you should use chasteberry for at least 3 to 6 months; ⁽¹⁶⁾don’t take it for longer than a year. You need to give your ovaries a rest and avoid overstimulating them. ⁽¹⁷⁾

The recommended daily dose of dried chasteberry needed to improve ovulatory factors affecting fertility is 500 to 1000 mg. It is best taken as a single dose in the morning.

You are recommended not to take chaste berry along with other progesterone drugs. ⁽¹⁶⁾

In a study on adult male mice, the researchers found that vitex agnus-castus extract consumption led to testicular tissue damage and low sperm count. Therefore, it may be concluded that continuous consumption of chasteberry may have a negative effect on male fertility.⁽¹⁸⁾

7. Relieving Premenstrual Syndrome (PMS) Symptoms

A study was conducted to compare the efficacy and tolerability of vitex agnus-castus fruit with a placebo for women with premenstrual syndrome.

The average age of the participants (170 women) was about 36, their average menstrual cycle and duration of menses were 28 and 4.5 days, respectively.

The researchers divided the women into two groups of active (86) and placebo (84) and gave them vitex agnus-castus extract or placebo once a day for three consecutive cycles.

Then, they measured changes in the main variables of irritability, mood alteration, anger, headache, breast fullness, and other menstrual symptoms like bloating by women's self-assessment from baseline to the end of third cycle.

Improvement in the main variables was greater in the active group compared with the placebo group. Seven women reported mild unfavorable events (four from the active group and three from placebo), but it did not make them discontinue the treatment.

Therefore, it can be concluded that the extract of vitex agnus-castus fruit is an effective and well-tolerated treatment for relieving PMS symptoms. ⁽¹⁹⁾ (Drug tolerance is a pharmacological concept describing subjects' reduced reaction to a drug following its repeated use.)

Don’t take chasteberry for more than four to six months for PMS; you should give your ovaries a rest and avoid overstimulating them. ⁽¹⁷⁾

8. Relieving Headache and Migraine

Headache seems to be a typical symptom of PMS. Worst migraine attacks may be observed among migrainous women close to menses.

Vitex agnus-castus (VAC) has been used for treating PMS in many parts of the world.

In 2013, a study was carried out to see if headaches are also ameliorate in migrainous women treated with VAC for PMS. The participants (migrainous women with PMS) were advised to have a treatment with VAC (40 mg/day) for PMS for a 3-month period. Then, the researchers evaluated the VAC effects on both PMS and headache.

Out of 107 participants, 100 completed the 3-month treatment for PMS. Out of them, 66 women reported that their PMS symptoms were significantly reduced; 26 reported a mild reduction, and 8 reported no effect.

Regarding migraine, 42 % of the participants experienced a reduction higher than 50 % in the frequency of monthly attacks, and 57 % of them experienced a reduction higher than 50 % in monthly days with headaches. None of them reported remarkable side effects.

The researchers found that the use of VAC in migrainous women affected by PMS seemed to be safe and well-tolerated and might have a good effect on the frequency and duration of migraine attacks. However, a placebo-controlled trial is needed to confirm the results. ⁽²⁰⁾

What Are Vitex Side Effects?

1. When Taken by Mouth

Vitex agnus-castus fruit extract is LIKELY SAFE for most people when taken appropriately for up to 3 months.

Some uncommon side effects are upset stomach, nausea, headaches, acne, trouble sleeping, weight gain, ⁽²¹⁾dizziness, tiredness, and dry mouth. ⁽²²⁾Furthermore, Some women notice a change in menstrual flow when they start taking vitex agnus-castus.

2. Pregnancy and Breast-Feeding

Consuming vitex agnus-castus is during pregnancy or breast-feeding is POSSIBLY UNSAFE. The concern is that it can interfere with hormones. So, stay on the safe side and don't use it if you are pregnant or breast-feeding.

3. Hormone-Sensitive Conditions such as Endometriosis, Uterine Fibroids, Breast Cancer, Uterus Cancer, or Ovarian Cancer

Vitex agnus-castus can have an effect on hormones and might affect estrogen levels. So, avoid using it if you have a hormone-sensitive condition. ⁽²¹⁾

Generally, concurrent use of chasteberry with hormone replacement therapy (HRT) is NOT recommended. ⁽²³⁾

4. In Vitro Fertilization (IVF)

Vitex agnus-castus can interfere with the effectiveness of in vitro fertilization. So, avoid using it if you are going through IVF treatment.

5. Parkinson's Disease

Some chemicals within vitex agnus-castus and some medications used for Parkinson's disease can affect the brain similarly. Therefore, vitex agnus-castus might affect therapy for Parkinson's disease.

6. Schizophrenia or Other Psychotic Disorders

Vitex agnus-castus seems to affect dopamine, a chemical in the brain decreased by some medications for mental disorders. Consequently, taking vitex agnus-castus might affect therapy for certain mental disorders. ⁽²¹⁾

7. Useful for Irregular Periods, but Caution Needed If You Have Polycystic Ovary Syndrome (PCOS)

Although vitex stimulates ovulation and can bring on a period within two to three months, it does not work for everyone.

If you have PCOS, vitex can make periods less regular by increasing luteinizing hormone (LH) levels; this hormone is already too high in most types of PCOS. It only works for the androgen excess caused by high prolactin. ⁽²⁴⁾

8. Allergy

If you have an allergy (or hypersensitivity) to any member of the Verbenaceae family or to any chasteberry component, avoid taking it.

Some mild skin reactions have been reported in clinical trials, including eczema, itching, rash, skin eruptions, urticaria (hives), and allergic exanthema (a skin rash accompanied by fever).

Generally, every person can have an allergy to certain herbs and spices. This sensitivity must be first diagnosed by the person and secondarily by the physician. However, these allergic reactions do not cause chronic or acute side effects; after identifying the allergenic plant and eliminating it from their diet, allergy-related complications will be gone away.

No company or product can be aware of the allergic reactions of different bodies in advance. The body's incompatibility with one or more specific herbs rarely occurs, but some consumers may encounter it anyway.

Nutritional Information

The nutrient composition of vitex agnus-castus includes protein, fiber, lipid, ash, carbohydrate, and moisture. ⁽²⁵⁾

Vitex Daily Dosage

- According to the German Commission E, a 2-gr dose of chasteberry is normal (whether powdered, crushed, or in a tea infusion.) ⁽²⁶⁾

- A 400-mg dose of powdered berries, taken twice a day, is also recommended for adults. ⁽²³⁾

Bioactive Compounds

According to a research, vitex fruit contains phytoestrogenic compounds. ⁽²⁵⁾ (Phytoestrogens are plant-derived compounds and have estrogenic and anti-estrogenic properties.)

Moreover, chaste berry contains a number of active constituents including flavonoids (casticin, kaempferol, orientin, quercetagetin, and isovitexin), iridoid glycosides (agnuside and aucubin), and essential oils (limonene, cineol, pinene, and sabinene). ⁽²²⁾

Best Time to Consume

1 -2 hours before or after meals.

- To lower Prolactin

First thing in the morning before breakfast

- To promote ovulation

Do take it in your follicular phase. Vitex works best when taken before ovulation and then continued until the first day of the period. Take a five-day break every month to prevent attenuation of the herb’s effect on the pituitary.

If you have regular periods: take a five-day break from the first day of your period.

If you don’t have regular periods: use it for 25 days. Then, take five days off. Then, 25 days on again.

- Don’t take vitex immediately (too soon) after stopping the birth control pill

When you first stop taking the pill, your ovaries and pituitary need some time to start to communicate with each other after years. Your body needs a gentle, slow start to that ovulation-communication. So, you are highly recommended not to confuse things with a strong pituitary herb. ⁽²⁴⁾

Possible Drug Interactions

1. Birth control pills (Contraceptive drugs)

Birth control pills contain hormones. On the other hand, vitex agnus-castus seems to change hormone levels in the body. Therefore, taking it along with birth control pills might decrease the effectiveness of the pills.

If you are taking birth control pills along with vitex agnus-castus, use an additional form of birth control too.

Some birth control pills are Triphasil (ethinyl estradiol and levonorgestrel), Ethinyl estradiol and norethindrone. ⁽²¹⁾

2. Estrogens or estrogen antagonists

Chasteberry contains estrogenic compounds. So, it may result in additive or opposing effects with estrogens or estrogen antagonists (e.g. tamoxifen). ⁽²³⁾

Some estrogen pills are conjugated estrogens (Premarin), Ethinylestradiol, and Estradiol.

3. Medications for mental conditions (Antipsychotic drugs)

Vitex agnus-castus seems to affect dopamine, a chemical in the brain decreased by medications for mental disorders. Taking vitex agnus-castus along with medications for mental conditions might decrease the effectiveness of some of these medications.

Some medications for mental conditions are chlorpromazine (Thorazine), clozapine (Clozaril), fluphenazine (Prolixin), haloperidol (Haldol), olanzapine (Zyprexa), perphenazine (Trilafon), prochlorperazine (Compazine), quetiapine (Seroquel), risperidone (Risperdal), thioridazine (Mellaril), and thiothixene (Navane).

4. Medications used for Parkinson's disease (Dopamine agonists)

Some chemicals within vitex agnus-castus and some medications used for Parkinson's disease can affect the brain similarly. So, Taking vitex agnus-castus with medications used for Parkinson's disease might increase the effects and side effects of some of these medications.

Some medications used for Parkinson's disease are bromocriptine (Parlodel), levodopa (Dopar, a component of Sinemet), pramipexole (Mirapex), and ropinirole (Requip).

5. Metoclopramide (Reglan)

Vitex agnus-castus and Metoclopramide (Reglan) both affect a certain brain chemical called dopamine. Therefore, taking vitex agnus-castus along with Metoclopramide might decrease its effectiveness. ⁽²¹⁾

Traditional Use

For more than 2500 years, the fruits have been used in ancient Egypt, Greece, Iran, and Rome for treating a variety of gynecologic problems. ⁽¹⁾

Over the past 50 years, Europeans have widely used chasteberry for treating some gynecologic conditions such as premenstrual syndrome (PMS), cyclical breast discomfort, menstrual cycle irregularities, and dysfunctional uterine bleeding. ⁽²²⁾

The fruits have been traditionally used to treat flatulence, diarrhea, menopause, acne, infertility, premenstrual dysphoric disorder, and other menstrual disorders (amenorrhea, dysmenorrhea). ⁽²⁾

Some other uses are suppressing appetite, inducing sleep, treating prostatitis, treating swollen testicles or ovaries, and relieving uterine pain. ⁽⁵⁾

Some Questions about Vitex

Does Vitex increase breast milk production?

We do not have enough evidence supporting chaste berry’s traditional use to enhance breast milk production. However, some evidence advocates that low doses might increase milk production in lactating women. ⁽²²⁾

Does Chasteberry increase progesterone?

Progesterone, a female sex hormone, is produced mainly in the ovaries following ovulation each month. It is a crucial part of the menstrual cycle and maintenance of pregnancy. ⁽²⁷⁾

Chasteberry seems to affect prolactin and progesterone levels indirectly and in a dose-dependent manner. At low doses (200 mg), it decreases estrogen levels and increases progesterone and prolactin levels, possibly through inhibition of follicle-stimulating hormone (FSH) and stimulation of luteinizing hormone (LH).

Does Vitex lower testosterone?

In spite of belonging to a group of male hormones (androgens), Testosterone is present in both males and females. ⁽²⁸⁾

Women's physical appearance and overall health can be affected by Testosterone imbalance. Symptoms of high testosterone are acne, excess hair on the face and body, irregular periods, mood changes, thinning hair, etc. Extremely high testosterone levels in women can cause obesity and infertility. ⁽²⁹⁾

According to a study done by Jolodar et al. and Nasri et al., Vitex fruit reduced the serum testosterone content in both female and male animals.

In another study carried out by Shahnazi et al., they found that a total fruit extract of Vitex had no impact on the serum free testosterone level in 70 women aged 18 - 45 years with PCOS.

This inconsistency might be due to the differences in human and animal samples. Furthermore, the studies of Shahnazi et al. lasted for three months. Since the effect of herbs increases over time, they recommended further long-term studies. ⁽³⁰⁾

Does Vitex increase dopamine?

Dopamine influences some brain functions affecting mood, sleep, memory, learning, concentration, and motor control.

So, dopamine balance is vital for both physical and mental wellbeing. Its deficiency may be related to certain medical conditions, including depression and Parkinson’s disease. ⁽³¹⁾

Vitex has been found to contain essential oil, flavonoids, iridoid glycosides, and dopaminergic compounds belonging to the diterpenes. ⁽³²⁾

Dopaminergic substances boost dopamine-related activity in the brain. ⁽³³⁾

Some medications, which help decrease or increase dopamine, may interact with Vitex agnus-castus. For more information, see the “Possible Drug Interactions” section.