Vitex or Cyclic Progesterone?

[lcw13]

Hi Dr. Briden,

This question comes after reading your articles The Dos and Don’ts of Vitex for Period Problems, as as well as Cyclic Progesterone Therapy for PCOS and the Period Repair Manual.

I've been on Vitex (NFH Chastetree+ SAP) for about two months now. Originally taking 600mg and now my ND has had me on 1,200mg for a month. I've had some bad side effects from it (headaches, anxiety, pelvic pain, lengthened cycle, spotting). My period finally came and I didn't have my usual breast tenderness and extreme cramps, but the other side effects are impacting my life.

I don't think any of your resources recommend a particular dosage of vitex, but do you think my current dosage may be too high? Is there a chance this is temporary and my body will adjust over the next few months or is this a sign it's not right for me? I'm wondering if I should stop vitex and try cyclic progesterone.

Quick health history: 33 years old. I still am not sure whether I have PCOS. My only abnormal hormone is consistently high prolactin (last reading 60), and I have always had irregular anovulatroy cycles, hirsuitism, acne, insomnia, breast tenderness and extreme period pain. From your resources I thought that it may not be PCOS, and all my issues may be from high prolactin, but my body does not seem to be reacting well to vitex (unless it just needs time to adjust). I'm also taking inositol, spironolactone, 100 mg B6 and iodized salt (which may be what helped my breast tenderness, not the vitex?)

Any thoughts on whether I should stop/continue/lower the vitex or try progesterone would be amazing.

Thank you for everything that you do!

Leslie

[Lara]

Of course, I cannot say specifically what you should do. But I'll make a few general points:
- When prolactin is high, Vitex is usually a good choice
- I usually recommend quite a low dose of Vitex because a lower dose can sometimes be more effective
- be careful with the dose of vitamin B6... (see my updated B6 post)
- spironolactone can disrupt cycles.

As for whether it's PCOS or not, do you happen to have day 2 LH and FSH readings?

[lcw13]

I just feel so "off" on Vitex. When I started taking inositol with spironolactone my cycle actually regulated. It's the recent addition of Vitex that threw it off again.

The possibility of progesterone improving my sleep and mood (which Vitex hasn't) is very attractive, as I'm fairly desperate to improve those. But I'll lower my Vitex dose and B6 dose (one at a time, to determine effect) and see how that goes for now.

I have day 3 readings - LH 7.8 IU/L and FSH 5 IU/L. Do those suggest PCOS? They seem fairly close to 1:1. My doctor usually tests on day 3, but please let me know if day 2 is actually better.

Thanks again.
Leslie

[Lara]

Those LH and FSH readings do not strongly suggest PCOS but it still could still be PCOS. Especially since inositol worked for you. I would be tempted to stick with inositol rather than vitex.