Jan. 19, 2001 -- It probably wouldn't taste good on breakfast cereal, but a dried extract of the fruit of the chaste tree could help women who suffer from premenstrual syndrome find relief from symptoms such as irritability, mood swings, anger, headache, and breast fullness, according to German researchers.
In a study of 170 women with PMS, more than half of those who took the fruit extract over three menstrual cycles experienced improvements of 50% or greater in symptoms, according Rudiger Schellenberg, MD, PhD, and colleagues from the Institute for Health and Science in Hüttenberg, Germany. Their findings appear in the Jan. 20 issue of The British Medical Journal.
The extract -- known variously as agnus castus, Vitex, or chaste berry -- comes from the peppercorn-sized fruit of the chaste tree, a small woody shrub that grows along riverbanks and hillsides primarily in Mediterranean regions and Central Asia. As a medicine, the dried extract of the fruit has ancient roots, dating back centuries to European and Chinese traditional medicine.
According to several sources, the plant is mentioned in The Iliad and in the writings of the ancient Greek physician Hippocrates, who recommended it for use "when blood flows from the womb." The "chaste" part of the name reportedly comes from the plant's traditional use as a dampener of libido, a property that may be due to its status as a phytoestrogen, one of a family of plant-based chemicals similar to the hormone estrogen.
Vitex can serve as an alternative to hormonal therapy for women with severe PMS, Schellenberg tells WebMD, as well as an alternative to the occasional side effects of such therapy.
But another researcher familiar with the herbal product is more cautious.
"In general, phytoestrogens should be avoided by people who have been counseled to avoid estrogens. We're talking about people with, say, blood-clotting disorders, or people who have estrogen receptor-positive breast cancer, and I would probably even worry about it in people who have a family history of [this type of] breast cancer," says Patricia K. Eagon, PhD, associate professor of medicine and molecular genetics and biochemistry at the University of Pittsburgh.
Herbalists traditionally have used Vitex, along with other herbs, for treatment of the symptoms of menopause, but it only recently has been studied in systematic clinical trials, including a large-scale German study in which more than 80% of both patients and physicians reported favorable impressions of Vitex.
In the current study, 170 women were randomly assigned to receive either Vitex or an identical-looking placebo. The pills were taken over three consecutive menstrual cycles. A little more than half of the women who received the real Vitex reported improvements in five of six symptoms, including irritability, mood alteration, anger, headache, and breast fullness. It didn't seem to work any better than the placebo at relieving bloating, however.
Side effects were few and minor, with only one woman stopping the drug (because of pregnancy). But although the herbal product appears to be generally safe, it is still a drug, albeit a "natural" one, Eagon cautions.
"One of the biggest things that people get into with herbals is that they think they're harmless. They're not harmless; these are very potent drugs," she tells WebMD.
"Vitex is quite potent," she says. "In fact, we've shown that Vitex probably enhances the action of one's own hormones. So if a woman has some estrogen on her own and she takes Vitex, it may actually enhance the [effects of natural estrogen], more than just herbs plus the extract."
Therefore, any woman tempted to try Vitex or other herbs should consult her physician, especially if she is taking hormones in birth control pills or is trying to become pregnant. And if she does opt to try Vitex, she should give it some time to work, Eagon says, just as with other drugs prescribed for PMS.
"Generally speaking, one needs to take them a month to see any kind 'oh yes, I feel better' effect," she says.