In early times, Hippocrates discussed use of chasteberry (Vitex agnus-castus, chaste tree, agnus castus, hemp tree, and monk’s pepper) as a medicinal agent. The dried ripe fruit is used medicinally. The chemical constituents consist of iridoids (aucubin and agnuside), flavonoids (isovitexin, kaempferol, and quercetagetin), volatile oil (cineol, pinene, limonene, caryophyllene, and cardinene), and fatty acids, including linoleic acid. In addition, the leaves and flowers contain progesterone, hydroxyprogesterone, testosterone, and epitestosterone.

The effects of chast eberry, which appear dose dependent, may be caused by its indirect effects upon various hormones. Lower doses (approximately 120 mg/day) are thought to diminish follicle-stimulating hormone release and increase luteinizing hormone release, leading to decreased estrogen levels and increased progesterone and prolactin levels. Higher doses (approximately 480 mg/day) result in decreased prolactin release. Chasteberry may also have antibacterial and antifungal effects.

Chasteberry has been used orally for menstrual irregularities, including dysmenorrhea, secondary amenorrhea, metrorrhagia, oligomenorrhea, and polymenorrhea. It has also been used for symptoms of menopause, PMS, acne, female infertility, fibrocystic breasts, benign prostatic hyperplasia, impotence, decreased libido, nervousness, dementia, rheumatic conditions, colds, and dyspepsia; preventing miscarriage in patients with progesterone insufficiency; reducing sexual desire; controlling postpartum bleeding; aiding in expulsion of placental material; and increasing lactation. Chasteberry products are available alone and in combination form. Some examples are Vitex, Wild Yam & Chaste Tree, Menopause, Phytoestrogen, and Phytoprogest.

Although chasteberry possibly is effective in treating symptoms of PMS and in treating menstrual disorders, there is insufficient evidence available to determine its effectiveness in treating symptoms of menopause.

The adverse effects associated with the use of chasteberry include gastrointestinal upset, headache, nausea, itching, urticaria, rash, acne, and intramenstrual bleeding. Some patients have experienced alopecia, fatigue, agitation, tachycardia, and dry mouth. Side effects are rare, occurring in 2% to 5% of patients. Chasteberry may interfere with the action of dopamine antagonists, as it has dopaminergic effects. It may interfere with the efficacy of oral contraceptives and hormone replacement therapy (HRT) because of its hormone-regulating activity. There are no known herbal or dietary supplement interactions.

Women with hormone-sensitive cancers or conditions should avoid the use of this herb.

Dosing recommendations vary by manufacturer. The pharmacist should recommend that the patient follow the dosing recommendations on the package label and not exceed the recommended dose.

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1. CHASTE TREE Botanical name: Vitex agnus-castus Synonyms: Vitex, Chasteberry, Monk’s pepper Family: Verbenaceae Part used: Fruit MAJOR CHEMICAL CONSTITUENTS The principal constituents are two labdane diterpenoids, including rotundifuran, vitexilactone, as well as vitexilactam A; flavonoids, including casticin, penduletin, chrysosplenol, isoorientin, and isovitexin; iridoids, including aucubin and agnuside; fatty oils, including caprinic acid, palmitic acid, and stearic acid...
2. WILD YAM Botanical name: Dioscorea villosa Family name: Dioscoreacaea Synonyms: Colic root, rheumatism root Part used: Root and rhizome MAJOR CHEMICAL CONSTITUENTS Glycoside and steroidal saponins, including diosgenin and dioscin, alkaloids, tannins, phytosterols, and starch PRINCIPAL USES • Spasmolytic in the treatment of uterine cramping, dysmenorrhea, and chronic pelvic pain • Spasmolytic in cases of urinary tract...