Chasteberry (Vitex): PMS Evidence & Safety

The EMA assessment covers chaste-tree fruit preparations, including powders, tinctures and dry extracts. Its stronger PMS conclusion applies to a particular dry extract; some other preparations have a traditional-use position. These are not interchangeable levels of evidence.^{See reference 2}

A milligram figure does not establish that two extracts are equivalent. Record the plant part, extraction information and complete ingredient list. The botanical artwork identifies the plant; it does not certify the composition of a product.^{See reference 2}

The 2001 BMJ trial evaluated 170 women assigned to a named fruit extract, Ze 440, or placebo for three menstrual cycles. The responder definition was at least a 50% reduction in the assessed symptoms. Response occurred in 52% of the extract group and 24% of the placebo group.^{See reference 3}

The manufacturer supplied the medication and sponsored the study. The result concerns the tested preparation and period; it does not demonstrate permanent symptom relief, fertility benefit or the effectiveness of every retail Vitex product.^{See reference 3}

Laboratory work has explored pituitary and dopamine-related effects, but the EMA states that the mechanism is not fully understood. Its monograph says a reduction in elevated prolactin in humans has not been conclusively demonstrated. A mechanism hypothesis should not be turned into a promise to correct a personal hormone result.^{See reference 2,See reference 4}

EMA warnings cover a history of estrogen-sensitive cancer, pituitary disorders, and use of dopamine agonists or antagonists, estrogens or antiestrogens. They advise medical discussion before use. Potential interactions cannot be excluded; that is different from saying a particular interaction is proven.^{See reference 4}

Reported effects include gastrointestinal symptoms, headache, skin reactions and menstrual changes. The EMA also lists severe allergic reactions, with frequency unknown. Short-term tolerability in a small trial cannot establish safety for every person or long-term use.^{See reference 1,See reference 4}

NCCIH cautions that chasteberry may be unsafe during pregnancy or breastfeeding. The EMA monograph does not recommend use in pregnancy or lactation and identifies gaps in the evidence. PMS research should not be applied to those situations.^{See reference 1,See reference 4}

NCCIH finds no reliable evidence that chasteberry helps infertility. Do not use a PMS claim as evidence that it improves conception or replaces fertility assessment. This guide recommends no dose or hormone treatment.^{See reference 1}