Vitex (also called Chaste tree or Chaste berry) is a popular and effective herbal medicine. I prescribe it all the time. I also frequently de-prescribe Vitex when I can see it is doing more harm than good.
Vitex is strong medicine. Please don’t use it casually.
What is Vitex?
Vitex is a medicine prepared from the berries of a large Mediterranean tree (Vitex agnus-castus). In ancient times, it was used to suppress the libido of monks—hence the name. Fortunately, it does not have that effect on women.
How does Vitex work?
Essentially, Vitex promotes progesterone by promoting ovulation. It does this by preventing your pituitary gland from making too much prolactin. Prolactin has an ovulation-inhibiting effect, so less prolactin=better ovulation. Vitex also contains opiate-like constituents, which calm your nervous system. That’s why it’s helpful for premenstrual anxiety and sleep problems.
- Do use for PMS
It relieves premenstrual symptoms such as irritability, fluid retention, and breast pain. Vitex has performed extremely well in clinical trials in Germany, where it’s routinely prescribed for PMS.
- Do use for breast pain
It’s particularly helpful for premenstrual breast pain, and reduces lumpiness and pain within just two cycles. I recommend it be used alongside the other major natural treatment for breast pain: Iodine.
- Do take in the morning
The usual dose is first thing in the morning before breakfast because that is when your pituitary is most receptive.
- Do consider for irregular periods, but use caution with PCOS
Vitex promotes ovulation and can bring on a period within two to three months. That said, it does not work for everyone, and if you have PCOS, it may actually worsen things. That’s because it may raise LH (luteinizing hormone), a hormone that is already too high in some types of PCOS. That said, Vitex can improve the androgen excess associated with prolactin. See 7 Best Anti-Androgen Treatments for Hirsutism.
- Do take in your follicular phase
Because it works to promote ovulation, you should take Vitex in the first part of your cycle before ovulation (and continue until the first day of your period). If you don’t have regular periods, then just pulse the dose as described below.
- Do take a break every month
Take a five-day break from the herb every month. If you have regular periods, then take five days off from the first day of your period. If you don’t have regular periods, then dose 25 days on/5 days off, then take another five days off from the first day of your period. This pulsed-dosing prevents attenuation of the herb’s effect on the pituitary.
- Don’t take too soon after stopping the birth control pill
I know it’s scary to stop hormonal birth control. And you may want you to want to transition straight on to a natural alternative. But Vitex is too strong for that. When you first come off the Pill, your pituitary and your ovaries must communicate with each other for the first time in years (maybe decades). You want a gentle, slow start to that ovulation-communication. You don’t want to confuse things with a strong pituitary herb before you can even see what your ovaries can do. For more detailed advice about coming off the Pill, see Period Repair Manual.
- Don’t combine with fertility drugs or IVF
Combining Vitex with ovulation-stimulating drugs can result in a serious condition called ovarian hyperstimulation syndrome.
- Don’t take for too long
Vitex is most effective during the first three to six months of use. After that, its effect on the pituitary starts to diminish. It is probably safe to take Vitex for longer than six months, but you should not need to take it that long. If Vitex is the right treatment for you, it will work within the first three or four months. You can then stop it, and still maintain ovulation and healthy periods with diet and other supplements. See my Ovulation post. After a month or two break, you can return to the herb, if you felt better on it.
- Don’t give it to teenagers
I rarely prescribe Vitex for girls younger than 18. That’s because their pituitary-ovarian communication is still developing, and I don’t want to disturb it. That said, if their pituitary-ovarian communication is already disturbed, say by Pill-use at a young age, then I might consider the herb to treat stubborn post-Pill amenorrhea.
What is your experience?