Vitex agnus-castus (chasteberry)
EMA-monograph herb with RCT signal for PMS symptoms and cyclic mastalgia.
Why
Vitex agnus-castus (chasteberry) holds an EMA HMPC monograph for premenstrual complaints. RCTs and meta-analyses report reductions in irritability, mood swings, anger, headache and breast fullness in premenstrual syndrome. Separate RCTs support effect on cyclic mastalgia. The Schellenberg BMJ 2001 trial remains the largest single PMS RCT, 52% symptom reduction on vitex vs 24% on placebo over 3 cycles.
How it works
Acts on dopamine D2 receptors in the anterior pituitary, reducing prolactin secretion, the prolactin-modulating effect underlies the cyclic mastalgia signal and likely contributes to PMS effects. Does not directly bind oestrogen or progesterone receptors at clinical doses.
Expected onset · Symptom reduction emerges over 2–3 menstrual cycles (8–12 weeks)
How to take
Dosage
Standardised extract: 20–40 mg/day (e.g. Ze 440, Femicur). Some trials use up to 240 mg/day of less concentrated extracts.
Timing
Once daily in the morning
On the label
Named standardised extracts (Ze 440, Femicur, Agnucaston, Premular) with stated milligrams. Generic chasteberry preparations vary widely.
Ideal for
Women with premenstrual syndrome (mood, irritability, breast tenderness, headache) or cyclic mastalgia.
Safety
Evidence
Schellenberg 2001 BMJ RCT (n=170): vitex 20 mg/day for 3 cycles produced ≥50% symptom improvement in 52% of women vs 24% on placebo. Verkaik 2017 systematic review (8 RCTs, n=1,427): vitex significantly reduced PMS symptoms vs placebo and was comparable to fluoxetine in head-to-head trials. EMA classifies the fruit extract as Well-Established Use for premenstrual complaints.
- EMA HMPC monograph, Vitex agnus-castus L., fructus (Well-Established Use + Traditional Use)
- Schellenberg et al., BMJ 2001, Vitex agnus-castus extract for premenstrual syndrome (RCT, n=170)
- Verkaik et al., Am J Obstet Gynecol 2017, Vitex agnus-castus for premenstrual syndrome: systematic review and meta-analysis
Where to get it
Shop Vitex agnus-castus (chasteberry) on AmazonSponsored · As an Amazon Associate, Healicus earns from qualifying purchases.