Herbs for Women: Vitex Agnus Castus


Vitex in full flower

Photography by Steven Foster

Content Tools

Vitex, or chaste tree (Vitex agnus-castus)—celebrated by women in ancient Greek festivals and on holy days as a symbol of marriage, chastity and fertility—gives contemporary women cause for celebration, too: it can safely and effectively relieve the monthly misery of difficult menstrual cycles. Research confirms the wisdom of the ancient medicinal uses of vitex, and in Europe it is the preferred treatment for premenstrual syndrome (PMS).

The Herb

Vitex is a shrub or small tree native to western Asia and southwestern Europe. Introduced to the United States as an ornamental in the early nineteenth century, it has become naturalized in the southeastern states and as far north as Maryland. Typically, plants grow 9 to 17 feet tall, but specimens in the Deep South may reach 25 feet. The 1/8-inch round fruits have a pungent scent and flavor and have been used as a substitute for black pepper (hence the common names Indian spice and wild pepper).

Other common names—chaste tree, Abraham’s balm, chaste lamb-tree, safe tree and monk’s-pepper tree—refer to the belief that eating the fruits reduced sexual desire, an assertion debated for centuries. Andrew Duncan concluded in the The Edinburgh New Dispensatory (1789):

"These seeds have been celebrated as antiaphrodisiacs, and were formerly much used by monks for allaying the venereal appetite; but experience does not warrant their having any such virtues."

Ancient Uses

Among the ancient Greek and Roman writers who extolled the use of vitex to treat gynecological conditions was the first-century Roman naturalist Pliny, who noted, “The trees furnish medicines that promote urine and menstruation. They encourage abundant rich milk. . . .”

In festivals honoring Demeter, the Greek goddess of agriculture, fertility, and marriage, temples were strewn with vitex boughs and leaves. Women adorned themselves with vitex blossoms and refrained from sexual relations during the holy days. The goddess Hera, protector of marriage, was born under a vitex, and the Roman goddess of the hearth, Vesta, was exalted by virgins carrying twigs of vitex as symbols of purity. To the present day in some parts of Italy, novitiates entering the monastery tread a path strewn with vitex blossoms.

The English herbalist John Gerard suggested several ways in which vitex could be used. In his 1633 Herball, he wrote, "The decoction of the herbe and seed is good against pain and inflammations about the matrix, if women be caused to sit and bathe their privy parts therein; the seed being drunke with Pennyroiall bringeth downe the menses, as it doth also both in a fume and in a pessary. . . ."

The Twentieth Century

Interest in vitex was renewed in 1938, when the German researcher and pharmaceutical manufacturer Gerhard Madaus investigated the biological activity of different parts of the plant. He found that whereas extracts of the leaves, fruits and bark all slowed the onset of estrus (heat) in female rats without adverse effects on reproduction, fruit extracts were the most effective.

During World War II, medical practitioners in Germany recognized that women experiencing stress from Allied bombings had difficulty supplying milk to their babies. They discovered that vitex fruit preparations were effective in solving the problem. In the 1950s, animal studies confirmed that vitex stimulates lactation. A 1954 clinical study of 1,000 maternity patients found that while vitex and vitamin B1 each increased the mothers’ milk supply better than a placebo, vitex was more effective.

The timing of the pituitary gland’s release of hormones regulates ovarian functions affecting menstruation, fertility and other processes. Vitex fruit preparations act on the pituitary to regulate the production of hormones, which in turn normalize the menstrual cycle. They also appear to stimulate milk-producing hormones while interfering with those that reduce milk production.

No single constituent has been identified as accounting for vitex’s biological activity. The fruits contain flavonoids ­including casticin, orientin and isovitexin. Many vitex ­products are standardized as to flavonoid content.

Vitex in Germany Today

Several large German studies and numerous smaller ones during the past twenty years have highlighted the herb’s usefulness in treating menstrual disorders. Most have used the commercial vitex extract Agnolyte, made by Madaus AG of Cologne.

A 1990 clinical study followed 1,571 women with menstrual disorders for an average of 148 days (and some up to six years). Ninety percent reported elimination or alleviation of PMS symptoms; 1.9 percent reported side effects such as nausea and diarrhea, and one woman reported an allergic reaction. A 1992 survey of 1,542 women diagnosed with PMS found that 90 percent reported relief of symptoms after treatment for an average of 25 days. Two percent reported side effects, mostly gastrointestinal.

European phytotherapists now employ vitex extracts as a conventional treatment, not an alternative, in managing menstrual disorders and PMS, treating infertility, and relieving hot flashes early in menopause. Patients benefit from the extracts’ relatively low price.

The German Commission E allows use of vitex for menstrual irregularity, breast pain, and PMS. Tinctures are formulated to an average daily dose equivalent to 30 to 40 mg of the fruits. Although the commission reports no drug inter­actions, animal experiments indicate possible interactions with drugs that block dopamine, a neurotransmitter in the brain. Side effects noted include premature menstruation following delivery (resulting from activation of the pituitary) and, rarely, itching and rashes. Vitex preparations should not be used by pregnant women.

Herbs for Healthy Skin

You can hardly pick up a skin-care product today that doesn’t tout herbal ingredients—rosemary, balsam, marigold—on the label along with the binders, surfactants, buffers, fragrances and colorants. The advertising is likely to imply that the botanicals lend the product a special quality that other products lack.

In fact, the potency of the herb or herbs in most of these products is insufficient to affect the health of the skin. According to the Cosmetic, Toiletry and Fragrance Association’s Cosmetic Ingredient Handbook, the herbs are considered biological additives that “are believed to enhance the performance or consumer appeal of the product.” In other words, such herbal additives help attract customers and sell products, but they need not be proven effective.

On the other hand, numerous herbs have been shown to improve skin health. A dermatologist friend tells me that any substance placed on the skin is absorbed, to one degree or another, into the body. When many herbs are prepared for use on the skin, they are traditionally soaked in olive oil, which carries the healing herbal components deep into the skin. The herbal oil may be further used to prepare ointments, salves, plasters or lotions. Here are some of them.

Healing Aloe

The fresh leaf gel of aloe (Aloe vera) has been used to soothe minor burns, cuts and scrapes for more than 2,500 years. Animal studies have shown that it prevents the progressive skin damage that ­usually follows minor burns, frostbite and electrical injuries. The gel penetrates injured tissue to relieve pain and inflammation, and by dilating capillaries it increases blood supply to the injury. Overall, for minor skin problems aloe increases the strength of injured tissue and encourages more rapid healing. Applied alone, aloe gel can dry the skin, but applying a moisturizer after the gel has dried will prevent discomfort. Commercial aloe gel products should contain aloe as one of their primary ingredients; otherwise, there’s probably not enough of it to be effective.

Protective Echinacea

Echinacea has become very popular in the last few years as an herbal immune stimulant. It’s promoted to protect against colds and flu—as well as any other germ lurking about—when taken in extract, tablet, or syrup form. But echinacea has other uses, too, when applied to the skin as a lotion or cream. Echinacoside, a component of echinacea, appears to protect the skin from sun damage when applied externally. Exposure to sunlight damages collagen in the skin, causing wrinkling and roughness; sun worshippers can thus expect to look old years before their shade-loving counterparts. Italian researchers recently discovered that echinacoside neutralizes the free ­radicals that ­degrade collagen in sun-damaged skin and suggested that applying echinacea extracts to the skin could both prevent and treat sun damage. Their finding supports the use in ­Germany of echinacea preparations to treat minor burns, including sunburn.

Echinacea also has been used externally to treat wounds, eczema and herpes sores. Echinacea protects against infection and fosters healing by increasing blood circulation and immune activity at the wound site. Salves and ointments containing echinacea are increasingly available.

Gentle Chamomile

Salves or creams containing the essential oils or the extracts of the flowers of German chamomile (Matricaria recutita)­ may be used to treat skin ir­ritation and roughness. The herb not only helps wounds heal while fighting inflammation, it also relieves spasms and pain. To prepare a soothing chamomile skin wash, soak 1/4 ounce of the dried flowers in a quart of hot water. Wash the irritated area with the cooled liquid or lay a moistened cloth on the skin for 20 minutes, several times a day.

Tea Tree for Stubborn Problems

The essential oil of tea tree (Melaleuca alternifolia), when compared with the widely used conventional acne medication benzoyl peroxide, healed lesions as well (although more slowly) while causing less dryness, flaking and itching. It was as effective as a 1-percent clotrimazole solution in treating nail fungus. Research into other uses for the oil are continuing.

Soothing St. John’s Wort

This herb has gained a reputation as an effective treatment for mild to moderate depression, but its infused oil has long been used to treat wounds and minor skin irritations. Although the oil is no longer recommended for use on burns, herbalists advise using it as a secondary treatment for deep cuts and to reduce scar tissue.

Magnolia for Convulsions?

The magnificent evergreen southern magnolia or bull bay (Magnolia grandiflora), which can grow 100 feet tall and bears 10-inch-wide flowers, has a history of medicinal use as well as the potential for therapeutic applications today. The Louisiana Choctaw used a decoction of the the bark as a wash to relieve the itching of prickly heat rash, and early Florida settlers used the root bark to treat malaria. Some writers suggested that chewing magnolia bark could break the tobacco habit.

Native to the southeastern United States, the tree is also widely grown as an ornamental in Mexico. Folk practitioners there use its seeds to treat muscle spasms, epilepsy, high blood pressure, heart disorders, abdominal discomfort and infertility. A preliminary study by Mexican researchers evaluated the efficacy of ethyl ether and hydroalcoholic extracts of the seeds in preventing convulsions in adult male rats. They found that both extracts blocked generalized seizures in 50 percent of the rats tested, supporting the traditional use of the seeds to relieve muscle spasms and convulsive disorders. Toxicological and pharmacological evaluations must be carried out before use in humans can be recommended.(1)

Saw Palmetto Symposium

Most of the research on saw palmetto (Serenoa repens) has been published in European scientific journals. To bring that information to American herb wholesalers, manufacturers, practitioners, researchers and eventually consumers, the American Herbal Products Association held the first International Saw Palmetto Symposium in August 1998 in Naples, Florida.

It addressed both scientific and practical aspects of the herb and its uses. The sym­posium included reviews of European pharmacological and clinical studies; analyses of the plant’s chemistry; an overview of what consumers, pharmacists and practitioners need to know about it; information on marketing saw palmetto; and a review of its use in clinical practice. A field trip to observe the harvest of saw palmetto berries topped off the conference.

A paper by Hermann Kurth of Germany highlighted new ­information on extraction methods used for saw palmetto. Hexane, ethanolic, and supercritical liquid carbon dioxide ­extracts have all been used in clinical trials. Kurth’s research demonstrated that different ­extraction methods result in varying levels of phytosterols, fatty acids, and fatty acid ethyl esters in saw palmetto products and presumably varying effectiveness. Kurth advocated the use of high-quality berries—­unripe berries, which are widely used in American products, yield a poor-quality product—as well as analytical methods that show all the berries’ constituents to guarantee consistency of final products.(2)

Alkaloids in Gurana

The seeds of guarana (Paullinia cupana), a woody vine commercially cultivated in Brazil’s Amazon Basin, are the plant kingdom’s richest source of caffeine; they also contain other stimulating alkaloids including theobromine and theophylline. Theobromine is the major alkaloid in cocoa.

Guarana is also the name of a best-selling Brazilian beverage that contains the seed extract. Sparked by the Brazilian government’s new requirement that all guarana products contain at least 300 mg of guarana per 100 ml of soda, researchers at the City University of New York and the Institute of Economic Botany at the New York Botanical Garden measured the alkaloid content of forty-two samples of guarana and products containing it. They acquired seeds from Brazilian Indian markets along with carbonated beverages, powders, and syrups and purchased tinctures, pills, and chewing gum from stores in the United States and Germany.

Upon analysis, the dry-weight caffeine content of whole guarana seeds ranged from 0.376 percent to more than 11 percent. Numerous sodas and syrups, primarily from South America, contained up to ten times as much theobromine as caffeine, suggesting that many may have been adulterated with cocoa.(3)


(1) Bastidas-Ramirez, B. E., et al. “Anticonvulsant Effects of Magnolia grandiflora L. in the Rat.” Journal of Ethnopharmacology 1998, 61:143–152.

(2) Kurth, H. “Saw Palmetto Extracts: Standardization, Characterization and Analytical Comparison of Finished Products.” In 1998 International Saw Palmetto Symposium Work Book. Silver Spring, Maryland: American Herbal Products Association, 1998.

(3) Meurer-Grimes, B., A. Berkov, and H. Back. “Theobromine, Theophylline, and Caffeine in 42 Samples and Products of Guarana (Paullinia cupana, Sapindaceae).” Economic Botany 1998, 52(3):293–301.

Further Reading

Blumenthal, M., et al., eds. S. Klein, trans. German Commission E Therapeutic Monographs on Medicinal Herbs for Human Use. Austin, Texas: American Botanical Council, 1998.

Brown, D. “Vitex agnus-castus Clinical Monograph.” Quarterly Review of Natural Medicine 1994 (Summer): 111–121.

Coeugniet, E., E. Elek, and R. Kühnast. “Premenstrual Syndrome (PMS) and its Treatment.” Ärztezeitschrift für Naturheilverf 1986, 27(9):619–622.

Büshnert, K.-J., and G. Hahn. “Phytotherapy in Gynecology and Obstetrics: Vitex agnus-castus (Chaste Tree).” Acta Medica Empirica 1990, 9:494–502.

Duncan, A. The Edinburgh New Dispensatory. 2nd ed. Edinburgh: C. Elliot and T. Kay, 1789.

Feldmann, H. U., et al. “The Treatment of Corpus Luteum Insufficiency and Premenstrual Syndrome: Experience in a Multicentre Study under Practice Conditions.” Hygne 1990, 11(12):421.

Foster, S. Herbs for Your Health. Loveland, Colorado: Interweave Press, 1996.

Gerard, J. The Herball or Generall Historie of Plantes (1633). Reprint, New York: Dover, 1975.

Jones, W.H.S. Pliny. Natural History with an English Translation in Ten Volumes. Vol. 7. Cambridge, Massachusetts: Harvard University Press, 1966.

Lauritzen, C. H., et al. “Treatment of Premenstrual Tension Syndrome with Vitex agnus-castus: Controlled, Double-Blind Study Versus Pyridoxine.” Phytomedicine 1997 4(3):183–189.

Schilcher, H. “Phytotherapy and Classical Medicine.” Journal of Herbs, Spices, and Medicinal Plants 1994, 2(3):71–80.

Thorton, R. J. A Family Herbal. London: B.& B. Crosby, 1814.

Tyler, V. E. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, New York: Pharmaceutical Products Press, 1994.

Bassett, I. B., et al. “A Comparative Study of Tea Tree Oil Versus Benzoyl Peroxide in the Treatment of Acne.” Medical Journal of Australia 1990, 153(8): 455–458.

Blumenthal, M., et al., eds. S. Klein, trans. German Commission E Therapeutic Monographs on Medicinal Herbs for Human Use. Austin, Texas: American Botanical Council, 1998.

Buck, D. S., et al. “Comparison of Two Topical Preparations for the Treatment of Onychomycosis: Melaleuca alternifolia (Tea Tree) Oil and Clotrimazole.” The Journal of Family Practice 1994, 38(6): 601–605.

Faciano, R. M., et al. “Echinacoside and Caffeoyl Conjugates Protect Collagen from Free Radical-Induced Degradation: A Potential Use of Echinacea Extracts in the Prevention of Skin Photodamage.” Planta Medica 1995, 61:510–514, 1995.

Schulz, V., R. Hensel, and V. E. Tyler. Rational Phytotherapy: A Physician’s Guide to Herbal Medicine. Berlin: Springer-Verlag, 1998.

Tyler, V. E. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, New York: Pharmaceutical Products Press, 1994.

West, D. P., and P. A. Nowakowski. “Dermatological Products.” In Handbook of Nonprescription Drugs. 11th ed. Washington, D.C.: American Pharmaceutical Association, 1996.