Vitex agnus-castus and Premenstrual Syndrome

Deemed a curse to women, and having been a cause for fright in men, P.M.S. can be downright disruptive. Historical use of the herb Vitex agnus-castus, also known as Chaste tree, has been used for centuries for reducing the pain that is very often synonymous with premenstrual syndrome. The purpose of this research is to investigate whether and under which conditions the ingestion of vitex agnus-cactus would cause the reduction of premenstrual syndrome symptoms. Section one defines vitex agnus-cactus and premenstrual syndrome and looks at vitex agnus castus’ ability and/or inability to reduce premenstrual syndrome symptoms, and by what mechanism it may have the capacity to do so. In part one of the paper, I look at current peer reviewed articles, one by one, on the efficacy of vitex agnus-cactus, and the data is to be presented as it is written. Part two focuses in on analyzing what factors may contribute to the success or failure of the herb, variables such as the duration of use, dosage, and chosen administration tactic of the herb. The research methods are to be analyzed in part three, outlining whether the study was well designed, the statistic significance of the herb’s use, and the type of study enlisted. Finally, in section two, the prior information will be analyzed, and a conclusion summarizing the key points of the paper will ensue.

Premenstrual syndrome is thought to be a women’s issue, but popular culture wisecracks would have us believe otherwise. Men are affected by it, as a result of the behaviors and pain that can occur on their partners/daughters/mothers/sisters end. It could be argued, thus, that no other syndrome is as wide reaching as premenstrual syndrome. Premenstrual is important to investigate because of this very reason. It is prevalent, persistent, and a pain.

Section One

Vitex agnus-castus has been used traditionally as a tonic for the reproductive organs. It is implicated in having the effect of stimulating progesterone function, and in its abilities to normalize the activity of female sex hormones, thus being commonly used for premenstrual syndrome.[1] Premenstrual syndrome is defined as a disorder that affects fertile women during the one to two weeks before menstruation begins. Symptoms can include any or all of the following: abdominal bloating, acne, anxiety, backache, breast swelling and tenderness, cramps, depression, food cravings, fatigue, headaches, nervousness, water retention and dramatic mood swings.[2] One of the reasons for the many symptoms that can erupt from premenstrual syndrome is the fluctuating hormones, wherein there are inadequate levels of progesterone, and excessive levels of estrogen.[3] This is where it is thought by herbalists that vitex agnus- castus can make a difference: the suspected idea that vitex can increase progesterone levels. Estrogen is a hormone that is created by the follicle cells of the ovaries, while progesterone is produced by the glandular corpus luteum.[4] It has been speculated whether or not an excess or deficit of estrogen before menses can be responsible for PMS symptoms, and there is much controversial research regarding whether an increase in progesterone is all that is needed to improve premenstrual syndrome.[5][6]Furthermore, given that there is a large array of symptoms that can be experienced as a result of said hormonal changes before menses, it would be wise to infer that hormone changes are not the only cause of premenstrual tension. Food intake, genetic disposition, and environmental pollutants would also need to be investigated to gain a clearer picture in the true “cause” of premenstrual syndrome, (and the subsequent “imbalance” of hormones”). That being said, can vitex agnus-castus make a profound difference in minimizing or eliminating premenstrual syndrome symptoms, simply by supposedly raising progesterone levels?

Part One (A)

The hope that an herb may be as effective as therapy and/or an improved diet and lifestyle is a tempting one. This leads to the investigation of the reviewed articles on the efficacy of vitex agnus cactus, and the data that has been gathered. In study ‘A,’ treatment with vitex agnus-cactus was used in Chinese women with moderate to severe premenstrual syndrome.[7] It was a prospective randomized double-blind placebo-controlled study conducted over a three-cycle period (meaning that it was delivered for three menstrual cycles). Eligible patients were assigned into the placebo group and the herbal tablet administered group. Symptoms were documented with a daily rating scale with four symptom factors (negative affect, water retention, food cravings, and pain. All the four symptom factor scores were significantly reduced by the third treatment cycle. The efficacy of Vitex agnus castus was in decreasing the symptoms of negative affect and water retention more so than treating food cravings and pain, and it soared well and above the scores of the placebo group. The conclusion of study A was that Vitex agnus castus extract shows effective in treating moderate to severe PMS in Chinese women, especially in symptoms of negative affect and water retention.

Part Two (A)

This is not a short-term solution. The duration of use for this herb was for three cycles, which was also the time in which subjects received the most benefits. The dosage was not mentioned, however the chosen delivery method of vitex agnus-castus was through a tablet. There was a 60% decrease in PMS symptom scores, as recorded by the subjects. This is a significant decrease, however it may be weighed mostly on its recorded ability to decrease water retention and negative affect. Unfortunately, only four symptoms were written and recorded over the three cycle period, thus ignoring many other symptoms such as fatigue, blood loss, flow, breast swelling and headaches, to name a few.

Part Three (A)

The research methods enlisted a randomized double-blind placebo controlled study, which is the epitome of unbiased studies, bravo on this choice. The paper was written by the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital, and by the Chinese Academy of Medical Science, thus giving the paper backing from The number of subjects was relatively small, sixty-seven patients were enrolled, however it was not mentioned how may of this sample were administered Vitex agnus cactus, versus the placebo. The subjects were all Chinese women, and unfortunately no mention of age group was mentioned. This begs the question of whether vitex can be used on a diverse range of background cultures, or if it is exclusively effective for Chinese women, and whether or not it is more or less effective in the 12-20 range, or otherwise. The p value was <0.05, meaning that there is a 5% probability that the difference between the placebo group and the herb administered group is due to chance. This is a very excellent result. The study uses practical methods to consult their research. A questionnaire measuring the intensity of the four symptoms is a good tool, as pain, and its relief can only be measured truly by one’s own experiences. It may have been an even more successful experiment had Vitex agnus-cactus have been administered for more than three months, although that can only be speculated. More information on the women’s backgrounds would have been appreciated, including birth control use, hormonal replacement therapy use, and any medications that were already being used.

 

Part One (B)

In study ‘B,’ vitex-agnus cactus is administered to women that experience migraines, as part of premenstrual syndrome.[8] It was an open-label clinical observation study. 100 women completed the 3-month treatment for PMS. Effects on headaches were assessed, and 26 women received a mild reduction in symptoms, on 8 women it took no effect, and 66 women reported a dramatic reduction in headaches. Frequency of headaches were reported to decrease: 42% of patients experienced a 50% or more reduction in frequency of monthly attacks, and 57% of patients experienced a reduction higher than 50% in monthly days with a headache.

Part Two (B)

The duration of use for this herb was for three months. The dosage was 40mg per day, and the chosen delivery method of vitex agnus-cactus was through a tablet. It may have been a good idea to have different dosages administered to various women to test the effectiveness at higher and lesser levels. There was a significant decrease in migraine intensity, duration, and number of days headaches endured. This is a significant decrease, and cannot be ignored. Given that the focus was on the use of vitex-agnus cactus for migraines only, is useful as it individually assesses its success strictly on one symptom.

Part Three (B)

The research method used was an open-label clinical observation. This method has its flaws, as there is a bias on the patient and the scientists’ part. Perhaps the attention that the subjects received could have been helpful in reducing their pain, or the scientist’s observations may be biased, as influenced by wanting a positive report on the effectiveness of vitex-agnus cactus. The Headache Clinic wrote the report, and this gives a conscious bias to the scientists. The p value was not indicated, meaning that it would be difficult to assess the probability that the studies positive findings are due to chance. This takes away much of the faith in the study, as does failing to report a placebo controlled group.

Part One (C)

In study ‘C,’[9] the adverse effects of vitex agnus-castus were reviewed and explored. Herbalists, literature searches, and reference papers were identified to locate any adverse effects. The data from clinical trials indicates that the adverse events following vitex agnus-castus treatment are mild and reversible. The most frequent adverse events are nausea, headache, gastrointestinal disturbances, menstrual disorders, acne, and rash. No drug interactions were reported. Theoretically, it was added, vitex agnus-cactus may interfere with dopaminergic antagonists. All data available seems to indicate that vitex agnus-cactus is a safe herbal medicine, overall.

Part Two (C)

This study indicated no chosen administration of vitex agnus-cactus, nor did the dosage become indicated. The duration of use for vitex-agnus castus was not revealed, however this article indicated that they were in contact with those involved with prior exposure to vitex agnus-castus, and the scientists to determine side effects.

Part Three (C)

The research methods were thorough, having been in contact with twelve manufacturers of vitex, as well as searching records of the use of vitex with no language restrictions imposed. Even surveys, spontaneous reporting schemes, online literature papers and herbalist organizations were contacted. There is a problem with searching these places, and that is that there is a possibility that vitex agnus-castus was only tested for a shorter duration of time, and that there may have been conflicting reports between the “spontaneous reporting schemes,’ and what else the reporters consumed that may have caused the reaction. For this, it would be difficult to sort out. The number of subjects enlisted is also a mystery as many of documents and reports were enlisted in this review of vitex. Having added the many places where information was taken from for this review would have been appreciated and helpful to the viewer in determining any bias in choosing the studies. There is potential for bias, as the Department of Pharmacology of Natural Substances and General Physiology, out of the University of Rome, funded the article. This is essentially a research article, in which vitex agnus cactus has a systematic review of adverse events. The p values were irrelevant in this study, as the German Commission approved the use of vitex agnus-castus as legitimate.

Section Two

It would appear that vitex agnus-castus appears to cause the reduction of some premenstrual syndrome symptoms. Based on the research reported, vitex agnus-castus can be an effective remedy particularly for migraines, water retention, and negative affect (moodiness), as a result of premenstrual syndrome. This is not a remedy that will be appropriate to everyone, nor does it appear that it is a “one all” for curing P.M.S.. Instead, if used appropriately, it is a largely safe herb, with the chance of some minor side effects. It does take time for vitex agnus-castus to make a largely noticeable difference, as witnessed in the study of use on Chinese women, as well as the use in the study for migraines, both of which took approximately three months each. I would recommend this to a client in the event that their symptoms of premenstrual syndrome largely resembled migraines, water retention, and moodiness. It would have been useful had there been any recent articles over viewing whether or not there is an increase in progesterone upon taking this herb. Interestingly, I was unable to find any articles refuting vitex agnus-castus’ abilities to minimize PMS. Beyond this, further research is required to determine the most effective method of delivery (capsules, tincture), as well as an appropriate dosage to minimize the chances of having a negative reaction. Based on everything that was reviewed, vitex agnus-castus can be a long-term remedy to calm some of the most widely experienced premenstrual syndrome symptoms.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

http://www.ncbi.nlm.nih.gov/pubmed/22791378, Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observation. The Headache Clinic. Ambrosini A, Di Lorenzo C, Coppola G, Pierelli F.

http://www.ncbi.nlm.nih.gov/pubmed/20334585 , Treatment of moderate to severe premenstrual syndrome with Vitex agnus cactus in Chinese women. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People’s Republic of China. Ma L, Lin S, Chen R, Wang X.

 

Chapter 16: The reproductive system, page 561, 562 Essentials of Human Anatomy and Physiology Elaine. N. Marieb

 

http://www.ncbi.nlm.nih.gov/pubmed/15601382, No correlation of depression and anxiety to plasma estrogen and progesterone levels in patients with premenstrual dysphoric disorder. Department of Psychiatry, Chang Gung Memorial Hospital, Kee-Lung, Taiwan. Dec 2008, Hsaiao CC, Liu CY, Hsiao MC

 

http://www.ncbi.nlm.nih.gov/pubmed/7002278, Pre-mestrual tension and mood change, Blam AM, Goldstein SE, Chatterjee N, November 25 1980

Holistic Herbal, David Hoffmann, Harper Collins Publishers, 1990, page 191

 

Prescription for Nutritional Healing Third Edition, Phyllis A. Balch, CNC, James F. Balch, M.D. 2000, Penguin Putnam

 

 

http://www.ncbi.nlm.nih.gov/pubmed/15783241, Vitex agnus-castus: a systematic review of adverse events, Department of Pharmacology of Natural Substances and General Physiology, University of Rome, Daniele C, Thompson Coon J, Pittler MH, Ernst E.

 

[1] Holistic Herbal, David Hoffmann, Harper Collins Publishers, 1990, page 191

[2] Prescription for Nutritional Healing Third Edition, Phyllis A. Balch, CNC, James F. Balch, M.D. 2000, Penguin Putnam

[3] Prescription for Nutritional Healing Third Edition, Phyllis A. Balch, CNC, James F. Balch, M.D. 2000, Penguin Putnam

 

[4] Chapter 16: The reproductive system, page 561, 562 Essentials of Human Anatomy and Physiology Elaine. N. Marieb

[5] http://www.ncbi.nlm.nih.gov/pubmed/15601382, No correlation of depression and anxiety to plasma estrogen and progesterone levels in patients with premenstrual dysphoric disorder. Department of Psychiatry, Chang Gung Memorial Hospital, Kee-Lung, Taiwan. Dec 2008, Hsaiao CC, Liu CY, Hsiao MC

[6] http://www.ncbi.nlm.nih.gov/pubmed/7002278, Pre-mestrual tension and mood change, Blam AM, Goldstein SE, Chatterjee N, November 25 1980

[7] http://www.ncbi.nlm.nih.gov/pubmed/20334585 , Treatment of moderate to severe premenstrual syndrome with Vitex agnus cactus in Chinese women. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People’s Republic of China. Ma L, Lin S, Chen R, Wang X.

 

[8] http://www.ncbi.nlm.nih.gov/pubmed/22791378, Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observation. The Headache Clinic. Ambrosini A, Di Lorenzo C, Coppola G, Pierelli F.

[9] http://www.ncbi.nlm.nih.gov/pubmed/15783241, Vitex agnus-castus: a systematic review of adverse events, Department of Pharmacology of Natural Substances and General Physiology, University of Rome, Daniele C, Thompson Coon J, Pittler MH, Ernst E.