Vitex (also called Chaste tree or Chaste berry) is a herbal 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.
Vitex is effective medicine for breast pain, irregular periods, premenstrual mood symptoms, and some types of acne.
How does Vitex work?
Vitex promotes ovulation by boosting dopamine and therefore lowering the hormone prolactin which has an ovulation-inhibiting effect. It also helps to relieve other symptoms of high prolactin such as breast pain and facial hair. The herbal medicine works best in the situation of high prolactin and is not usually a suitable treatment for polycystic ovary syndrome or PCOS.
Vitex also contains opiate-like constituents, which calm the nervous system and relieve premenstrual anxiety and sleep problems.
- Do use for PMS
It relieves premenstrual symptoms such as irritability, fluid retention, and breast pain. Vitex has performed well in several clinical trials for PMS and PMDD.
- 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 together with iodine for breast pain.
- Do take in the morning
The usual dose is first thing in the morning before breakfast because that is when your pituitary is most responsive to the Vitex’s prolactin-lowering effect.
- 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 can make periods less regular by raising luteinizing hormone (LH), a hormone that is already too high in most types of PCOS. It only works for the androgen excess that is caused by high prolactin. Read 4 causes of androgen excess in women.
- Do take in your follicular phase
Because it works to promote ovulation, Vitex works best when taken before ovulation and then continued until the first day of the period. If you don’t have regular periods, then 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, take five days off from the first day of your period. If you don’t have regular periods, dose the medicine for 25 days, then five days off, then 25 days on again. This pulsed-dosing prevents attenuation of the herb’s effect on the pituitary.
- Don’t take too soon after stopping the birth control pill
When you first come off the pill, your pituitary and ovaries start to communicate with each other for the first time in years (maybe decades). You want a gentle, slow start to that ovulation-communication and not 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. 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 taking the pill, then Vitex can be a gentler option.
Ask me in the comments.