Herbs for Women: Vitex Agnus Castus

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Vitex in full flower
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Frost-nipped vitex shrub, Brixey, Missouri
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Aloe
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Vitex in full flower
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German chamomile
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Magnolia
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Saw palmetto
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Echinacea

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)

References

(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.

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