Vitex For Female Health and Hormonal Balance

Vitex agnus-castus, also called ChasteTree is a shrub in the Verbena family and is native to the Mediterranean area of the world. It loves growing in wet places, along river beds, and other wet areas, but has been cultivated throughout Europe and used medicinally worldwide. I can attest to its desire for water as I have been growing one in a pot for a couple of years. The Northeastern climate in the United States is not conducive to garden cultivation of Mediterranean plants so I move it back and forth from my porch to my living room seasonally. It definitely requires daily watering or the leaves will wilt. The dried fruits are the part that is used medicinally and they look like dark purple pepper seeds when dried. The seeds can also be used a spice and have a slight peppery, warming flavor.  Another common name for Vitex is ‘hemp tree’,  I’m assuming this is because its leaves resemble cannabis leaves being palmate with five separate leaves connected at the center.                  

The word Agnus is derived from the Greek word Agnos, Ἄγνος for chaste or pure and may also come from a-gonos meaning seedless or childless. Castus from Latin, also meaning chaste. The Greeks also called it Lygos a word also used to describe Willows that looked similar to Vitex and had similar uses with their bendable twigs. The first word Vitex is derived from the Latin vitilis meaning plaited or interwoven indicating the use of its branches to make plaited fences and also a description that was used for Willow. When reading through the ancient history of Vitex it is sometimes referred to as “willow’ because they grew in similar conditions and had similar utilitarian uses.

Vitex is acrid, spicy or pungent ,warm, a bit bitter, aromatic  and astringent with the power of motion and movement or what might be called diffusive.  It has a warming and stimulating action but is said to decrease excess heat and libido probably because of its normalizing function.  It has also been called “monks pepper” and was famed throughout history to decrease the libido of monks who had taken vows of chastity. It is also quite possible that its association with monks stems from its ancient use as a sacred plant. Many of the indigenous ritual and practices of Europe were re-threaded into Christian traditions so it is no wonder that Vitex was sanctified by priests and monks. It was recorded as a ritual plant in ancient Greece, Rome and Egypt. Vitex was said to be the plant under which Hera, the Greek sky goddess and Queen of Heaven was born on the island of Sami. “The Samians themselves hold that the goddess [Hera] was born in the island by the side of the river Imbrasos under the willow that even in my time grew in the Heraion (temple of Hera)."  Pausanias, Description of Greece 7. 4. 4 (trans. Jones) (Greek travelogue C2nd A.D.) Here it is referenced as “willow” and also in this quote from Pliny the Elder the Roman philosopher and naturalist:

“Not much unlike the willow, for the use that is made of it in wicker-work, is the vitex, which also resembles it in the leaves and general appearance, though the smell of it is more agreeable. The Greeks call it "lygos," or "agnos," from the fact that the matrons of Athens, during the Thesmophoria, a period when the strictest chastity is observed, are in the habit of strewing their beds with the leaves of this tree.” Pliny the Elder, The Natural History ,John Bostock, M.D., F.R.S., H.T. Riley, Esq., B.A., Ed.

Pliny also mentions that it was used to adorn priestesses during the yearly festival celebrating Demeter the goddess of fertility and agriculture. Dioscorides, the Turkish born physician and botanist who worked with the army of Roman Empire recorded the use of Vitex during ceremonial sacrifices to Ceres the Roman goddess of agriculture. He also indicated its use as birth control, to increase milk supply or “bring down milk”, and for menstrual cramps he describes as “inflammation around the womb”. These were times when the sacred and profane were not compartmentalized as separate facets of life but were united, and humans were still connected to the spiritual qualities of the Earth, land, flora and fauna. Their gods were alive and dwelled among them and within them being still perceived and interpreted by senses and intuition. These skills had not yet been dulled and deteriorated from lack of use and over-focus on the linear and mundane.  In this medium it is clear that Vitex was resonant with reproduction, fertility, and the vital force of procreation and these attributes have carried on into its modern day uses.

 Vitex has also been touted as an aphrodisiac although this use is not commonly known and I’ve been a bit confused about it in the past. I had been taught over the years that it decreases libido in men, or at least in monks, and increases libido in women and as Susun Weed says in her book “Menopausal Years”, “Whether it makes him droop or you horny, vitex does have a powerful effect on the endocrine glands.”
According to Peter Holmes’ monograph of Vitex:

“Chastetree was seen as a regulator of sexuality, depending on the condition and constitution of the person taking it. In Chines medical terms, we would say that the remedy harmonizes the chong and ren extra meridians in their capacity of regulating menstrual and reproductive events. Hence its use for bothe uterus blodd and Qi deficiency (or arguably uterus cold) presenting either amenorrhea, sexual disinterest or overstimulations.  “

Vitex was once thought to merely increase progesterone in the second half of the cycle during the luteal phase and somewhere along the line I had learned that it contained progesterone. Currently we have a lot more information, and although its exact mechanism of action is not known, it is now shown to balance and regulate hormones throughout the entire cycle.  Vitex is used in Western Herbalism to alleviate PMS symptoms, infertility, menorrhagia, amenorrhea, fibrosa, polycystic ovarian syndrome, menopausal complaints and any irregularity of the menstrual cycle. It has become a somewhat of a catch-all/go to herb for women’s health.  

Wise Women and Men and folk herbalists world over have been using Vitex for centuries with great success for women’s issues but without a scientific understanding of its physiological mechanism of action. Even now with a wider breadth of methodological research it is still not completely understood; not that I ever have the expectation of science being able to fully understand the complex synergistic effect of any plant on the human body.  Directly observable, anecdotal, intuitive, decades upon decades of experience with this plant has found it a powerful ally for women’s issues. My own clinical experience with my clients and myself has shown me that it is immensely helpful for PMS, irregular periods, to regulate periods during withdrawal from birth control pills, peri-menopausal symptoms, infertility, low progesterone, hot flashes and any hormonally related reproductive condition. Vitex can be used alone for simple menstrual irregularities and in a formula for more complex situations and sometimes, even then, I’ll make a separate formulation and have the client take the Vitex alone to assure proper dosage. It is indicated when there appears to be low progesterone, estrogen dominance, a shortened second half of the cycle, or a short cycle all together.

 My favorite way to use it is alone as a single tincture at a dose of ½ teaspoon two times a day or an infusion of 1tsp. of berries in one cup of water also two times a day.  I usually don’t expect to see much change for at least a month and it can take up to three months. If you are going to make your own tincture the ratio is 1:5 with 60% alcohol and you have to grind the berries in the blender after you have mixed them in the alcohol solution as they are very hard, dry seeds that need to be broke open the release the medicine.

So why did Vitex become so famous for women’s health and why was it believed to increase progesterone? We are learning more and more about its true nature, and what science has provided is evidence that Vitex acts not on the ovaries to increase progesterone, but on the Hypothalamic-Pituitary-Gonadal feedback loop by affecting the anterior pituitary gland to reduce excessive secretion of prolactin. Prolactin is the hormone responsible for milk production after childbirth and, in this instance, Vitex has been used to increase milk production. It does this again using its normalizing function, but there is a caution here; if you’re breastfeeding you can still get pregnant and Vitex will increase your chances. I usually use other herbs for increasing breast milk.  Excessive prolactin secretion, or hyperprolactemia, is thought to interfere with the complete development of the corpus luteum by suppression of luteinizing hormone released by the pituitary during the second half of the cycle. The corpus luteum is responsible for progesterone secretion and so Vitex does indirectly increase progesterone. It does this in a couple of ways one of which is by creating a dopaminergic effect because it binds dopamine-2 receptors.

Dopamine is the neurotransmitter we all know a love because it is known as the “pleasure molecule” and contributes to our ability to feel happy, motivated, focused and helps with the relief of pain. A deficit of dopamine is thought to be one cause of depression and an integral component of addiction physiology.  Nicotine, cocaine, marijuana, alcohol and let’s not forget chocolate, are among the addictive substances thought to interfere with the natural stimulation and release of dopamine acting as dopamine agonists. This means that these substances compete with endogenous dopamine to bind dopamine receptors leaving more free circulating dopamine in the neural synapse and therefore creating a rush of good feelings and euphoria.  Dopamine also inhibits prolactin secretion in the pituitary and so its deficit may result in excess prolactin which, again, inhibits progesterone.

The other activity of Vitex is that it reduces thyrotropin releasing hormone(TRH), a hormone responsible for the release of prolactin thereby, again, inhibiting prolactin. TRH is released in the hypothalamus and regulates the release of TSH and prolactin when it travels to the pituitary. TSH also signals the thyroid and stimulates T4 production. An excess can cause hyperthyroidism making Vitex a possible ally for this also.

Both the dopaminergic action and the TRH inhibition beg even deeper questions. We can give someone Vitex to mitigate these problems but the underlying causes may go unattended.  If we decide to use Vitex as a first line treatment for menstrual disorders we must continue to identify and resolve what may be primary causes that can lead to further longterm conditions. There can be nutritional deficiencies, immune system problems and emotional issues that shouldn’t be ignored.  According to Paul Bergner, “Magnesium, B-6, Zinc, essential fatty acids, vitamin C, and iron” are all necessary for proper hormone regulation not to mention the function of all other bodily systems.  I think it’s also important to mention here that there is now research that is making us aware that dopamine deficiency is sometimes developed by a genetic predisposition. Some of these studies have been pioneered in research to uncover the cause of schizophrenia where an excess of dopamine is the problem. This, of course, doesn’t mean all is lost and you can’t change it because it’s genetic. We have also learned from the study of epigenetics that we can and do change our genetic expression through a variety of avenues particularly nutrition and lifestyle.

I would also like to share my personal opinion and philosophy about the emotional and spiritual implications of living with less than optimal dopamine.  It has been, not just my belief, but my direct experience in my own life and the lives of many I have known that the medicine lies within the wound or, at very least, the wound is an opening that allows in the necessary, albeit often uncomfortable at first, light that guides us to our greatest gifts. In this case, when we have low dopamine we don’t feel good. Dopamine makes us happy and motivated and focused. Without it we are without those qualities and so we are driven to find them elsewhere and this, obviously, lends itself to addiction, but also can initiate an individual to seek the source of happiness and peace either deeper in themselves or from a higher power. This can be a path to self-discovery and greater connection with what we may discover to be our strengths as no one is without their own special medicine that will not only enlighten also those with which they share and offer their gifts.  If we were contented and perfectly awash in good, yummy dopamine some of us may be inclined to just sit there. This is not to say that this type of work is easy or without complications. It’s also important to recognize how a plant like Vitex can support the growth and exploration of the soul on a physical level. If we are a mess with hormonal symptoms, health issues and the related emotional effects it may be difficult to stabilize enough to see our circumstances, gifts and all, through a clear lens.  Although Vitex may not address the underlying causes it can stabilize the person enough to begin that deeper journey.

Vitex has been also long thought to increase Luteinizing hormone(LH) and inhibit Follicle-stimulating hormone(FSH) but I haven’t found any research to support this. If this is true it would make sense because LH is another necessary hormone in the development of the corpus luteum.  The increase in LH would also balance the progesterone/estrogen ratio. Vitex contains volatile oils, iridoid glycosides, rotundifuran and vitexilatone, both deterpenes, terpenes and flavonoids all working synergistically with our body chemistry so it would seem, as with all whole plant medicines, that the scientific method would be hard pressed to conclusively determine the exact ratio of integration and outcome of such from so many chemical relationships. This circles back around to the importance of cultivating our capacity to observe, witness and discern the effects of this plant or any other.

Based on all of the research and all of the historical and present day use of Vitex it is an excellent choice for PMS especially with anxiety, food cravings and irritability as these indicate luteal phase defects, infertility, excessive bleeding,  lack of menstruation and even ovarian cysts and fibroids. Vitex tones the reproductive system by regulating hormones and the hormonal feedback loop.  It regulates libido with its normalizing ability creating healthy flux and flow of hormones. It is very supportive in depression, fibromayalgia, rhematism and addictions when there seems to be a hormonal component indicating a dopamine deficiency.  It is contraindicated in pregnancy and schizophrenia. Also it may potentiate dopamine agonist medications so should be avoided.

Sources

Lecture notes from class on the endocrine system with Dr. Jody Noe

Botanical Medicine for Women’s Health by Aviva Romm

Vitex: the Chaste Tree by Christopher Hobbs, Ph.D., L.Ac., A.H.G

http://www.ncbi.nlm.nih.gov/pubmed/23136064 Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. van Die MD1, Burger HG, Teede HJ, Bone KM.

Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications.http://www.ncbi.nlm.nih.gov/pubmed?filters=&orig_db=PubMed&cmd=Search&term=10%2A%5Bvolume%5D%20AND%20348%5Bpage%5D%20AND%202003%5Bpdat%5D%20AND%20Wuttke%20W%5Bauth%5D . Wuttke W1, Jarry H, Christoffel V, Spengler B, Seidlová-Wuttke D.

Pliny the Elder, The Natural History  John Bostock, M.D., F.R.S., H.T. Riley, Esq., B.A., Ed.

Vitex not for PMS-Henriette’s blog: http://www.henriettes-herb.com/blog/vitex-not-pms.html

Chaste Tree-Orto Botanico Universita di Padova- http://www.ortobotanicopd.it/en/agnocasto-vitex-agnus-castus-l

The Greek Herbal of Dioscorides, A New Indexed Version In Modern English By TA Osbaldeston AND RPA Wood

Back to Basics 4: Dopamine! Neurotic Physiology: http://scicurious.scientopia.org/2010/08/26/back-to-basics-4-dopamine/

First photo: By Sten Porse (Own photo, taken near Pont-du-Gard, Provence.) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC BY-SA 2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/2.5-2.0-1.0)], via Wikimedia Commons