Vitex Guide

The Essential Guide to Vitex and the Chaste Tree

Dr. Jolene BrightenPublished: Last Reviewed: Sex Hormones

Odds are that if you’re struggling with symptoms of hormone imbalance, PMS, PCOS, infertility, endometriosis, irregular periods, missing periods or any other period problem, you’ve heard of vitex. Today, I’ll be talking more about the benefits and potential uses of vitex (also called chasteberry and chaste tree berry). Consider this your guide to understanding if this herb is right for you.

What is Vitex? 

Vitex is an herb in the verbena family that has been used in women’s medicine for thousands of years to balance hormones and enhance fertility. Even though it has a long history of traditional use, it has only recently been validated by science. Vitex goes by many names: chasteberry, chaste tree, Abraham’s balm, and monk's pepper.

The plant is found in Greece, Italy, and parts of the Middle East. We only use the fruit, which is why you’ll commonly hear it referred to as “chaste tree berry.” 

Vitex agnus-castus is an herb usually taken in capsule form for premenstrual tension syndrome (PMS), premenstrual dysphoric disorder (PMDD), irregular periods, painful periods, breast tenderness and symptoms of menopause. It is also a “go-to” herb for women struggling with breast tenderness, fibrocystic breasts (breasts that feel lumpy), and for enhancing fertility. 

How does vitex work?

It appears that vitex exhibits an effect on the pituitary gland to produce luteinizing hormone (LH), which is the hormone that triggers ovulation and the development of the corpus luteum. This, coupled with the fact that vitex can also increase progesterone and balance testosterone, makes vitex an ideal herb to help women with PCOS. 

Vitex also binds to dopamine receptors, which may lower prolactin. When prolactin is too high (in a woman who is not pregnant or has not just given birth), it can cause the ovaries to stop producing estrogen, which can lead to irregular periods, vaginal dryness, and low libido. Lowering prolactin may help alleviate symptoms of PMS. 

To be clear: Vitex does not contain any hormones. Rather, it stimulates certain systems in the body and can therefore help with naturally balancing hormones. 

For example, vitex has been shown to improve the reproductive systems of aging mice, leading researchers to conclude that it could be used to help women with sex hormone dysfunction and imbalance. 

What Are The Benefits of Vitex?

Vitex has myriad of uses in women’s health. It helps with mood swings, anger, irritability, headaches, breast tenderness, and bloating leading up to your period or that are related to hormones. 

Chasteberry may improve:

  • Symptoms of estrogen dominance
  • Frequent periods, luteal phase defect
  • Mood swings, anxiety, depression, irritability
  • Hot flashes, night sweats
  • Headaches, migraines
  • Breast tenderness, fibrocystic breasts
  • Painful periods, menstrual cramps 
  • PMS 
  • PMDD 
  • Fertility
  • Vaginal dryness 
  • Sleep disturbance

Vitex has also been shown to effectively lower prolactin, which can be elevated in several conditions, including hypothyroidism and prolactinoma. Elevated prolactin can result in amenorrhea (a missing period).

Hormonal Imbalance

Chasteberry is an incredible herb to help balance hormones and optimize estrogen and progesterone levels. In cases of relative estrogen dominance, when there’s not enough progesterone relative to the amount of estrogen present, Chasteberry can help raise progesterone. Progesterone naturally opposes estrogen and may help to minimize the negative effects it can have in your body.  

For women experiencing irregular or frequent periods, Vitex may help create predictable periods by improving progesterone levels. 

Vitex may modulate prolactin, a hormone that is responsible for the production of breast milk. Elevated prolactin can cause irregular or missing periods, PMS, and more. 

Premenstrual Syndrome (PMS) 

Clinically, I’ve seen women be able to resolve their breast tenderness, sleeplessness, and emotional concerns while using Vitex. It’s important to note that it will take the average woman about three months to notice its effect. 

A study of 1,634 women with various PMS symptoms showed that, over a three-cycle time period, symptoms (such as depression and cravings) were reduced or disappeared completely in 93% of subjects. That’s pretty incredible!

In a randomized, double blind, placebo-controlled study that followed women over 3 menstrual cycles it was found that Vitex was beneficial in alleviating bloating, headaches, breast tenderness, PMS food cravings, agitation, depression, and swollen breasts.

Vitex can help with:

  • Mood swings, anxiety, depression, irritability
  • Headaches, migraines
  • Breast tenderness, swelling, fibrocystic breasts
  • Painful periods, menstrual cramps
  • PMS food cravings
  • Sleep

When patients come into my office with symptoms like these, I start them on Balance—Women’s Hormone Support, a supplement containing Vitex, in addition to diet and lifestyle therapies to bring their hormones into balance. Vitex is great for supporting your body in balancing hormones naturally. 

Premenstrual Dysphoric Disorder (PMDD)

There have been studies showing that Vitex is effective in reducing the physical symptoms of premenstrual dysphoric disorder (PMDD).

Other studies have demonstrated Vitex as an effective treatment for PMS and PMDD with no adverse side effects.

Infertility in women

Vitex has been used for thousands of years as a natural fertility treatment in Greece, Italy, and many other regions of the world. Traditionally, women would take it as a tea, but more recently it’s more commonly taken in a capsule or as an extract, alongside other supportive herbs. 

Some women who struggle to get pregnant have what is called a luteal phase defect, a condition in which the second half of the menstrual cycle is too short. This can be related to abnormally high levels of prolactin and low levels of progesterone. Since vitex is effective at reducing prolactin in the body, and balancing estrogen and progesterone, it can support a regular cycle. 

Vitex has been shown to be effective in supporting optimal progesterone levels. Low progesterone has been associated with infertility and increased risk of miscarriage.

Vitex is considered safe to take when trying to conceive. While there is no evidence that it can cause harm during pregnancy, I have my patients taper off the herb once they have a positive pregnancy test. Currently, there is not enough data available to state that it is completely safe in pregnancy. For that reason, I use caution in my practice.

If you do become pregnant while using Vitex, please meet with a qualified health care provider who is trained in herbal medicine to help you taper off and decide if bioidentical progesterone therapy is necessary. A licensed naturopathic physician or functional medicine doctor who has experience with herbal medicines is most qualified in this area.

Fibrocystic Breast Disease

Because women with fibrocystic breast disease and breast tenderness also typically struggle with PMS, herbal treatments for these conditions are often similar. Vitex is thought to help reduce breast pain because of its effectiveness in reducing prolactin levels and increasing progesterone. 

Menopausal Symptoms

A study of 23 menopausal women indicated that vitex can be helpful in diminishing symptoms of menopause, such as night sweats, anxiety, and hot flashes. It has also been shown to be beneficial for women struggling with vaginal dryness and sleep disturbance. 

It’s important to note that most studies combine Vitex along with other herbs like Black Cohosh and St. John's Wort, so the effects of Vitex alone for menopause have not been well evaluated. It is common to combine herbs in naturopathic medical practice or when meeting with an herbalist.

You’ll find a combination of Vitex, Black Cohosh, and other nutrients to support optimal hormones in Balance—Women’s Hormone Support.

When it comes to hot flashes, studies have shown that Vitex is more effective than a placebo at reducing symptoms in about 4 weeks. 

Migraines

Many women experience hormonal headaches and migraines. They’re especially common around ovulation, as part of PMS, or when you begin your period. In fact, women who experience frequent migraines usually suffer their worst during PMS. Vitex may help reduce the severity and frequency of migraines.

As I explain in Beyond the Pill, women who experience migraines with an aura shouldn’t use hormonal birth control, like the pill, due to the increased risk of stroke. In addition, these synthetic hormones can make headaches and migraines worse in some women. 

Breast Milk Production

At lower doses, chaste tree berry may support healthy breast milk production. Research has found that women taking Vitex experience an increase in breast milk production, but more evidence is needed to understand the use of the herb. Definitely ask your doctor before taking any herb while breastfeeding. 

Because chaste tree at higher doses can be used to lower prolactin, the hormone responsible for lactation, it is recommended that women currently breastfeeding avoid high dose supplements. In my practice, I advise my patients to avoid dosing above 200 mg.

Bromocriptine vs. Vitex

In cases of hyperprolactinemia, vitex may have a prolactin-reducing effect comparable to a prescription drug called bromocriptine (Parlodel). A study of 100 participants found that vitex and bromocriptine had similar effects on prolactin, but bromocriptine had more side effects. 

Vitex Side Effects and Precautions 

Vitex is generally considered safe with very few women experiencing side effects when taking reasonable doses. It is important to note that while Vitex is a wonderful herb, more of a good thing isn’t necessarily better. In fact, I’ve found the majority of my patients who have ever reported issues have been taking doses that far exceeded the recommended dose. 

Be cautious when selecting supplements because some forms are extremely high dose or are poorly sourced. Herbs are effective when grown in the correct conditions, harvested at the right time, and processed in a way that maintains their active ingredients. 

Some reports have shown that supplements sold at grocery and department stores did not contain any of the herbs listed. In fact, some supplements that listed herbs didn’t actually have any of that herb and instead contained house plant material!

If you’re taking a supplement and feel it is ineffective or you’re not feeling well on it then you’d be wise to check the source. Unfortunately, where you buy your supplements matters, and a little bit of research can steer you toward the right brands with the quality of ingredients you’re after. 

Look for supplements with GMP (Good Manufacturing Practice) on the label and non-GMO ingredients.

Vitex Side Effects and Precautions

Vitex is typically well-tolerated and most studies show no side effects with appropriate doses.

Uncommon side effects include headache, upset stomach, rashes, acne, weight gain, and difficulty sleeping.

If you’re pregnant or breastfeeding, please check with your doctor before starting any new supplements. If you currently have or have a personal or family history of hormone-sensitive cancers such as breast or ovarian cancer then it is important to consult your doctor first. Women with a family history of Parkinson’s disease or a personal history of mental illness should discuss Vitex with their doctor.

Warnings

Vitex may interfere with certain antipsychotic drugs. In general, if you are taking a medication then it is not advised that you begin any supplement without first consulting your doctor. Also be sure to mention any supplements you are taking to your doctor before starting a new prescription.

Little is known about the effect of Vitex in women taking hormonal birth control. It is true that Vitex modulates your natural hormones and as such, it may theoretically interfere with synthetic hormones found in birth control. 


Vitex Dosage

Most women benefit from a daily dose of 100-200 mg by mouth. 

Balance—Women’s Hormone Support contains a 200 mg per serving. Typical dose is two caps twice daiy with meals.

Ways to Take Vitex

Vitex is an herb taken by mouth. Dried chasteberry is used to create tincture (liquid extract), solid extracts, and capsules. 

You can also use Vitex dried herb in teas. Some companies will make an herbal blend that contains Vitex, but it may not be in a high enough dose to get the desired effects. Vitex can be purchased dried if you’d prefer to make your own tea at home. 

Where to Find Vitex

Balance—Women’s Hormone Support is comprehensive women's formula designed to harmonize sex hormones and improve common hormone related issues. Formulated with B Vitamins, antioxidants and hormone supporting herbs, this blend helps support the body in eliminating excess estrogens and environmental toxins.  

Balance contains 200 mg of Vitex per serving, along with Black Cohosh, Resveratrol, Green Tea Extract (no caffiene), and other hormone supporting nutrients.

How does vitex affect fertility in women? 

Vitex has traditionally been used to support fertility and is a favorite herb among women trying to conceive. 

It is beneficial in reducing prolactin levels. When prolactin is elevated, things can get dicey: missing periods, irregular periods…basically, the opposite of what you need if you’re trying for a baby. When you’re trying to get pregnant, prolactin will work against you. We want prolactin to be normal, not high prior to conception. Prolactin should be elevated in women who are breastfeeding.

Vitex also aids in normalizing the length of your menstrual cycle and creating a healthy luteal phase. The luteal phase is approximately the two weeks following ovulation when progesterone should be at its highest. If the luteal phase is too short, progesterone levels may be too low. Progesterone is important for preparing the uterine lining for possible fertilization.  

I talk more about natural ways to increase progesterone levels and improve fertility in this article

Summary

Vitex (also called chaste tree berry and monk’s pepper) is an herb used for thousands of years in Greece and Italy to promote fertility and balance hormones. It has been shown to be effective in reducing PMS, PMDD symptoms, regulating periods, and normalize cycle length, as well as improving fertility. Vitex can be used to balance hormones such as estrogen, progesterone and prolactin. 

References

  1. Ahangarpour A, Najimi SA, Farbood Y. Effects of Vitex agnus-castus fruit on sex hormones and antioxidant indices in a d-galactose-induced aging female mouse model. Journal of the Chinese Medical Association. 2016;79(11):589-596. doi:10.1016/j.jcma.2016.05.006 https://www.ncbi.nlm.nih.gov/pubmed/27595438
  2. Nasri S, Oryan S, Rohani AH, Amin GR. The Effects of Vitex agnus castus Extract and its Interaction with Dopaminergic System on LH and Testosterone in Male Mice. Pakistan Journal of Biological Sciences. 2007;10(14):2300-2307. doi:10.3923/pjbs.2007.2300.2307 https://pubmed.ncbi.nlm.nih.gov/19070148/ 
  3. Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlová-Wuttke D. Chaste tree (Vitex agnus-castus) – Pharmacology and clinical indications. Phytomedicine. 2003;10(4):348-357. doi:10.1078/094471103322004866 https://www.ncbi.nlm.nih.gov/pubmed/12809367
  4. MediLexicon International. (n.d.). Prolactin levels: Test, ranges, results, and treatment. Medical News Today. Retrieved January 2, 2023, from https://www.medicalnewstoday.com/articles/322279.php
  5. Loch E-G, Selle H, Boblitz N. Treatment of Premenstrual Syndrome with a Phytopharmaceutical Formulation Containing Vitex agnus castus. Journal of Womens Health & Gender-Based Medicine. 2000;9(3):315-320. doi:10.1089/152460900318515 https://pubmed.ncbi.nlm.nih.gov/10787228/ 
  6. Chopin Lucks B. Vitex agnus castus essential oil and menopausal balance: a research update [Complementary Therapies in Nursing and Midwifery 8 (2003) 148-154]. Complement Ther Nurs Midwifery. 2003;9(3):157-160. doi:10.1016/S1353-6117(03)00020-9 https://www.ncbi.nlm.nih.gov/pubmed/12852933
  7. Ambrosini A, Lorenzo CD, Coppola G, Pierelli F. Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observation. Acta Neurologica Belgica. 2012;113(1):25-29. doi:10.1007/s13760-012-0111-4 https://www.ncbi.nlm.nih.gov/pubmed/22791378 
  8. Cerqueira RO, Frey BN, Leclerc E, Brietzke E. Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Archives of Womens Mental Health. 2017;20(6):713-719. doi:10.1007/s00737-017-0791-0 https://pubmed.ncbi.nlm.nih.gov/29063202/ 
  9. Die MV, Burger H, Teede H, Bone K. Vitex agnus-castus Extracts for Female Reproductive Disorders: A Systematic Review of Clinical Trials. Planta Medica. 2012;79(07):562-575. doi:10.1055/s-0032-1327831 https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0032-1327831
  10. Atmaca M, Kumru S, Tezcan E. Fluoxetine versusVitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Human Psychopharmacology: Clinical and Experimental. 2003;18(3):191-195. doi:10.1002/hup.470 https://www.ncbi.nlm.nih.gov/pubmed/12672170
  11. MediLexicon International. (n.d.). Why Is a Prolactin Level Test Done? – Medical News Today. Retrieved December 28, 2022 from https://www.medicalnewstoday.com/articles/322279 
  12. 3 Excellent Natural Therapies for Perimenopause Treatment – University Health News Daily. Retrieved December 28, 2022 from https://universityhealthnews.com/daily/aging-independence/3-excellent-natural-therapies-for-perimenopause-treatment/ 
  13. Vitex. Health Library – Michigan Medicine. Retrieved December 28, 2022 from https://www.uofmhealth.org/health-library/hn-2181002 
  14. van Die M, Burger H, Teede H, Bone K. Vitex Agnus-Castus extracts for female reproductive disorders: A systematic review of Clinical Trials. Planta Medica. 2012;79(07):562-575. doi:10.1055/s-0032-1327831 https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0032-1327831
About The Author

Dr. Jolene Brighten

Facebook Twitter

Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.