Vitex (also called chaste tree or chasteberry) is a herbal medicine prepared from the berries of the Mediterranean tree Vitex agnus-castus. In ancient times, it was used to suppress the libido of monks, hence the name. Fortunately, it does not have that effect on women.
Vitex is effective medicine for breast pain, irregular periods, premenstrual mood symptoms, and some types of acne.
How does vitex work?
Vitex promotes ovulation by boosting dopamine and lowering prolactin. It can also relieve symptoms of high prolactin, such as premenstrual mood symptoms, breast pain, acne, and facial hair.
Dos
- Do use for PMS
Thanks to its prolactin-lowering and calming effects on the nervous system, vitex can relieve premenstrual symptoms such as irritability, fluid retention, and breast pain. It has performed well in several clinical trials for PMS and PMDD. It can also help with perimenopausal mood symptoms. - Do use for breast pain
Together with iodine, vitex can improve premenstrual breast pain and reduce lumpiness and pain. - Do take in the morning
It works best in the morning because that’s when the pituitary is most responsive to vitex’s prolactin-lowering effect. - Do consider for irregular periods, but use caution with PCOS
Vitex can promote ovulation and menstruation but does not work for everyone and can, in some cases, worsen PCOS. At the same time, vitex can relieve the androgen excess caused by high prolactin. Read 4 causes of androgen excess in women. Before trying vitex for hypothalamic amenorrhea, be sure to first increase food intake to at least 2500 calories per day. Read Are you eating enough to get a period? - Do take in the follicular phase
Because it works by promoting ovulation, vitex should be started early in the follicular phase and then continued until day 1 of the period. - Do take a break every month
Taking regular breaks from vitex can prevent its effects from attenuating. If you have regular periods, take five days off from the first day of your period (day 1 to 5). If you don’t have regular periods, take it for 25 days, stop for five days, and repeat until a regular cycle is established.
Don’ts
- Don’t start too soon after stopping the oral contraceptive pill
Upon stopping the pill, the pituitary and ovaries start to communicate with each other for the first time in years (maybe decades). It’s best to allow that communication to proceed for a few months before confusing things with vitex’s effects on the pituitary gland. For more about coming off the pill, see Period Repair Manual. - Don’t combine vitex with fertility medication
Combining vitex with IVF medication can result in side effects such as ovarian hyperstimulation syndrome. - Don’t take for too long
For regulating cycles, vitex is most effective during the first three to six months of use. After that, its effects can attenuate. That’s why I usually recommend a six-month course, followed by a break to see if cycles are maintained. For premenstrual mood symptoms, it’s fine to take vitex long-term. - Don’t give it to teenagers
I rarely prescribe vitex for girls younger than 18 because their hypothalamic-pituitary-ovarian (HPO) axis is still maturing, and I don’t want to disturb it. That said, vitex is a gentler option than the pill.
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