Chaste tree is a small shrub native to Greece and Italy and naturalized to warm climates in the United States. Its peppery fruit has been used medicinally for at least two thousand years. It is mentioned by the Greek physician, Dioscorides, as a beverage taken to lower libido (Schulz et al., 1998). According to the Greek historian, Pliny (first century C.E.), chaste berry strewn on the beds of soldiers' wives was a testimony of the wives' faithfulness while their husbands were at battle (Hobbs, 1996). Despite historical and folk use, there is no scientific evidence to suggest that chaste berry actually reduces libido.
Chaste berry has historically been used to treat hangovers, flatulence, fevers, and constipation (Hobbs, 1996). It was also recognized to bring on menstruation and to relieve uterine cramps (Mills, 1985). American Eclectic physicians of the nineteenth century recommended chaste berry not only as an emmenagogue but also to stimulate lactation (Felter and Lloyd, 1985). Today, chaste berry is used primarily for conditions of the female reproductive system that may stem from latent hyperprolactinemia or corpus luteum insufficiency (luteal phase defect).
In latent hyperprolactinemia, excessive secretion of prolactin may cause breast swelling and breast pain (Schneider and Bohnet, 1981). Studies have determined that chaste berry may help to correct prolactin levels through effects on dopamine receptors (Jarry et al., 1991; Jarry et al., 1994). Chaste berry also affects beneficially 'luteal phase defect,' a condition marked by short menstrual cycles, thought to be caused by insufficient progesterone secretion consequent to deficits in the corpus luteum (Mühlenstedt et al., 1978). Drugs that lower prolactin secretion have been shown to prolong the luteal phase of the menstrual cycle, as chaste berry has also been shown to do (Schulz et al., 1998; Milewicz et al., 1993).
Both hyperprolactinemia and luteal phase defect have been pointed to as causal to premenstrual syndrome (PMS) and cyclic mastalgia. In clinical trials, chaste berry was shown to relieve both PMS, and, especially, breast swelling and pain (Wuttke et al., 1995). Compared to vitamin B6, chaste berry was superior in reducing mastalgia, premenstrual fluid retention, headache, and fatigue (Lauritzen et al., 1997).
From 1943 to 1997, approximately 32 clinical studies were conducted on a proprietary chaste berry product (Angolyt®, Madaus, Germany). Seven studies evaluated its effectiveness in treating PMS, four on mastitis and fibrocystic disease, three on menopausal symptons, three on increasing lactation, four on hyperprolactinemia, seven on uterine bleeding diorders, three on acne, and four on miscellaneous menstrual irregularities (Hobbs and Blumenthal, 1999). Commercial chaste berry is administered in capsules and extract forms standardized to the iridoid constituent content, agnuside. Agnuside reduces pain in laboratory mice (Okuyama et al., 1998).
Description
Chaste tree fruit is the ripe, dried fruits of Vitex agnus castus L. [Fam. Verbenaceae], as well as their preparations in effective dosage.
Chemistry and Pharmacology
Constituents include the flavonoids casticin, penduletin, and chrysophanol D; alkaloids (viticin); iridoids acucbin and agnuside, volatile oil (0.5%), and essential oil containing a-pinene and b-pinene (Leung and Foster, 1996; Newall et al., 1996). Vitexin and isovitexin are the primary water-soluble flavones (Hobbs and Blumenthal, 1999).
According to the Commission E, there is evidence that aqueous-alcoholic extracts of chaste tree fruit inhibit secretion of prolactin in vitro. In human pharmacology there are no data about the lowering of prolactin levels. There is no knowledge regarding pharmacokinetics and systematic toxicological studies have not been conducted.
Uses
The Commission E approved the use of chaste tree fruit for irregularities of the menstrual cycle, premenstrual complaints, and mastodynia. The herb has been studied for use in cases of insufficient lactation (Bruckner, 1989).
Note: If tension, swelling of the breasts, and disturbances of menstruation occur, a physician should be consulted.
Contraindications
None known.
Side Effects
Occasional itching, urticarial exanthemas.
Use During Pregnancy and Lactation
Not recommended.
Interactions with Other Drugs
In animal experiments, there is evidence of a dopaminergic effect; therefore, ingestion of dopamine-receptor antagonists may weaken the effect.
Dosage and Administration
Unless otherwise prescribed: 30-40 mg (0.03-0.04 g) per day of crushed fruit for aqueous-alcoholic extracts in dry or fluid form.
Bruckner, C. 1989. In mitteleuropa genutzte heilpflanzen mit milchsekretionsfoerdernder wirkung (galactagoga). Gleditschia 17:189-201.
Felter, H.W. and J.U. Lloyd. 1985. King's American Dispensatory, Vols. 12. Portland, OR: Eclectic Medical Publications [reprint of 1898 original].
Hobbs, C. 1996. Vitex, The Women's Herb. Santa Cruz: Botanica Press.
Hobbs, C. and M. Blumenthal. 1999. Vitex agnus-castus: A Literature Review. HerbalGram 47 (in press).
Jarry, H., S. Leonhardt, C. Gorkow, W. Wuttke. 1994. 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 102(6):448454.
Jarry, H. et al. 1991. Agnus castus as a dopaminergic active constituent in Mastodynon®N. Z Phytother 12:77-82.
Lauritzen, C. et al. 1997. Treatment of premenstrual tension syndrome with vitex agnus castus. Controlled, double-blind study versus pyridoxine. Phytomedicine 4:183-189.
Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc.
Milewicz, A. et al. 1993. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimforsch 43(7):752-756.
Mills, S.Y. 1985. The Dictionary of Modern Herbalism. Wellingborough: Thorsons.
Mühlenstedt, D., H.G. Bohnet, J.P. Hanker, H.P. Schneider. 1978. Short luteal phase and prolactin. Int J Fertil 23(3):213-218.
Newall, C.A., L.A. Anderson, J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press.
Okuyama E., S. Fujimori, M.Yamazaki et al. 1998. Pharmacologically active components of viticis fructus (Vitex rotundifolia). II. The components having analgesic effects. Chem Pharm Bull 46(4):655-662.
Schulz, V., R. Hänsel, V.E. Tyler. 1998. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. New York: Springer.
Wuttke, W., Gorkow, J. Jarry. 1995. Dopaminergic compounds in Vitex agnus castus. In: Loew D. and N. Rietbrock. (eds.). Phytopharmaka in Forschung and klinischer Anwendung. Darmstadt: Steinkopff Verlag. 81-91.
Additional Resources
Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing.
Halaska, M. et al. 1998. [Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo] [In Czech]. Ceska Gynekol 63(5):388-392.
Leow, D. and N. Rietbrock. (eds.). 1995. Phytopharmaka in forschung und klinischer Anwendung Steinkopff Verlag, Darmstadt.
McGuffin, M., C. Hobbs, R. Upton, A. Goldberg. 1997. American Herbal Product Association's Botanical Safety Handbook. Boca Raton: CRC Press.
Turner, S. and S. Mills. 1993. A double blind clinical trial on a herbal remedy for premenstrual syndrome; a case study. Complementary Therapies in Medicine (1):73-77.
This material was adapted from The Complete German Commission E Monographs—Therapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.
1) The Overview section is new information.
2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.
3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:
Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
Infusion: 2 g in 150 ml of water
Fluidextract 1:1 (g/ml): 2 ml
Tincture 1:5 (g/ml): 10 ml
4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.
This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.
Excerpt from Herbal Medicine: Expanded Commission E Monographs Copyright 2000 American Botanical Council Published by Integrative Medicine Communications Available from the American Botanical Council.
This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.