Over 50 hormones have been identified in the human body. An imbalance in any of them can negatively impact metabolism, growth, sexual function, reproduction, sleep, and mood. 80% of women have been found to suffer from symptoms of hormonal imbalances. The herb Vitex agnus-castus has traditionally been used as a natural treatment for women's hormonal imbalances. In this article, we will discuss the scientific basis and clinical evidence supporting its use as an effective therapy in treating premenstrual syndrome, menstrual irregularity, and more.

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Understanding Hormonal Imbalance in Women

In the female endocrine system, three key axes – the hypothalamic-pituitary-adrenal (HPA), hypothalamic-pituitary-thyroid (HPT), and hypothalamic-pituitary-gonadal (HPG) axes – are vital regulators of hormonal balance. The HPA axis orchestrates stress response by releasing cortisol, the HPT axis regulates thyroid hormones, and the HPG axis governs the production of reproductive hormones like estrogen and progesterone. 

Hormonal imbalances occur when there is too much or too little of one or more hormones in the body. Instead of functioning independently from one another, there is substantial overlap between the various endocrine axes to create desired outcomes in the body. Certain hormones exhibit synergistic interactions, producing more robust effects when combined, while others counteract each other's actions. The HPT, HPA, and HPG axes engage in intricate interplay, and disturbances in one axis have the potential to cascade into imbalances in the others, weaving a complex network of interconnected health challenges. (1)

For this article, let's focus on estrogen and progesterone imbalances in women. Estrogen is one of the primary female sex hormones responsible for maintaining sexual and reproductive health. Estrogen levels begin to rise during puberty, giving rise to secondary sex characteristics like breast development. Estrogen is also responsible for orchestrating the menstrual cycle, promoting fertility, and supporting bone density, cardiovascular health, and brain function. When estrogen levels are too high, symptoms like headaches, mood swings, heavy and/or painful periods, and weight gain can manifest. Estrogen dominance is associated with fibroids, endometriosis, fibrocystic breasts, and premenstrual syndrome (PMS). Conversely, insufficient estrogen can lead to menopausal-like symptoms, which include hot flashes, night sweats, vaginal atrophy and dryness, fatigue, irregular/absent periods, insomnia, and infertility. (20)

Progesterone is the other critical female sex hormone responsible for supporting a healthy menstrual cycle, maintaining pregnancy, and improving mood. Imbalances in progesterone are often associated with irregular menstrual cycles and contribute to conditions like polycystic ovary syndrome (PCOS) and infertility. Symptoms of low progesterone include anxiety, depression, and insomnia. Symptoms of high progesterone include breast swelling and tenderness, bloating, fatigue, and weight gain.

What Is Chasteberry?

Vitex agnus-castus, commonly known as chasteberry, chaste tree, and vitex,  is a shrub native to the Mediterranean region and parts of Asia. This deciduous plant belongs to the Verbenaceae family and is characterized by violet flowers and berries. Flavonoids, terpenoids, and, most notably, iridoid glycosides contribute to the therapeutic anti-inflammatory, analgesic, antihistamine, antimicrobial, and antioxidative properties of chasteberry. (26)

The historical use of chasteberry has been dated back over 2,000 years to the ancient Greeks, Romans, and Egyptians. Its name reflects the traditional belief that the plant promoted chastity, used by monks to suppress sexual libido. Records note that chasteberry was used in many cultures to treat gynecological disorders, acne, digestive complaints, and inflammation. Vitex was also believed to be a remedy for promoting lactation in nursing mothers. (26)

Today, chasteberry continues to be embraced for its potential benefits in women's health. Modern applications involve using vitex as a natural remedy for menstrual disorders, including irregular cycles, infertility, and symptoms associated with PMS. (2) 

Chasteberry's Role in Hormonal Regulation

Chasteberry's ability to modulate and balance estrogen and progesterone levels is attributed to its effects on the pituitary gland. Research suggests that vitex's constituents exert agonistic effects on the anterior pituitary's dopamine-2 receptors. This leads to a reduction in the release of prolactin and follicle-stimulating hormone (FSH) and a rise in luteinizing hormone (LH). The result is an enhancement of corpus luteum development and a balancing shift in estrogen and progesterone levels (favoring the latter) to correct luteal phase defects and progesterone deficiency (31). (51) 

It's important to note that this effect is dose-dependent. Low-to-moderate doses of chasteberry extract result in decreased estrogen levels and increased progesterone levels; however, very high doses suppress all anterior pituitary hormonal secretion due to feedback inhibition.

Using Chasteberry for Specific Women's Health Issues

Given its hormone-modulating effects, vitex has been used for thousands of years to address women's health concerns, namely those related to imbalances in estrogen and progesterone levels. Research suggests that chasteberry may be beneficial for managing symptoms of PMS, infertility, irregular menstrual cycles, and menopause. 

PMS

Chasteberry extract is widely used to treat physical and emotional premenstrual symptoms, which can encompass mood swings, difficulty concentrating, insomnia, changes in appetite, fatigue, acne, breast tenderness, headaches, bloating, and body pains. Numerous studies support the use of vitex for managing these symptoms.

In one study, participants took 20 mg of vitex extract daily for three months. Vitex was associated with improvements in all PMS parameters: irritability, changes in mood, headache, bloating, and breast fullness. Another similar study assessed the efficacy of chasteberry extract over three menstrual cycles in women with moderate-to-severe PMS, using a daily rating scale and the premenstrual syndrome diary (PMSD). Symptom scores for negative affect, water retention, food cravings, and pain were significantly reduced in women taking chasteberry compared to those taking a placebo at the end of the third cycle.

Fertility

A shortened luteal phase, a condition called luteal phase defect/deficiency (LPD), potentially caused by elevated prolactin levels, is associated with infertility. Given chasteberry's ability to reduce prolactin levels and promote balance between progesterone and estrogen, it has been studied as a natural therapeutic option to enhance fertility in menstruating individuals.

In a randomized controlled trial of 96 women with fertility disorders (secondary amenorrhea, luteal phase defect, and idiopathic infertility), those who received an herbal formula containing chasteberry twice daily for three months were able to get pregnant more easily than those in the placebo group. In women with amenorrhea or LPD, pregnancy in the treatment group occurred more than twice as often as in the placebo group. 

Irregular Menstrual Cycles

Menstrual irregularity refers to any deviation from the typical duration and quality of the menstrual cycle and menstruation. This can include menorrhagia (frequent or heavy periods), oligomenorrhea (infrequent menstrual periods), amenorrhea (lack of menstruation), and dysmenorrhea (painful menstrual periods). Hormonal imbalances in estrogen, progesterone, and prolactin can be a cause of menstrual cycle irregularities.

In a randomized placebo-controlled double-blind study, women with luteal phase defects due to hyperprolactinemia (elevated prolactin levels) who were given 20 mg of vitex daily for three months had reductions in serum prolactin, prolonged luteal menstrual phases, and normalized serum luteal phase progesterone levels at the end of the trial. 

Menopause

During perimenopause, menopause, and post-menopause, ovarian function begins to decline naturally, resulting in estrogen and progesterone deficiency and the associated symptoms of this hormonal withdrawal. Perimenopausal and menopausal symptoms can significantly impact women's quality of life.

Clinical research shows that taking vitex for eight weeks improves anxiety and vasomotor dysfunction by 76% and 88%, respectively, in menopausal women. Many studies that have examined the benefits of chasteberry for menopausal symptom management often involve supplementing it in combination with other herbs. For example, a study including pre- and post-menopausal women administered an herbal formula containing black cohosh, dong quai, milk thistle, red clover, American ginseng, and chaste tree berry for three months. Participants who received the herbal formula reported a significant reduction in hot flashes, night sweats, and sleep disturbances. 

Dosage and Administration of Chasteberry

Chaste tree can be consumed as a dietary supplement, most commonly available in capsule, tea, or tincture form. Clinical trials use varying doses. Because vitex's effects are dose-dependent, it is important to consult a trained healthcare provider to determine a safe and effective dose to achieve its desired effects. Vitex standardized fruit extract (0.5% agnuside) is often dosed between 200-4,000 mg daily. (41) 

Potential Interactions and Side Effects

Chaste tree berry is generally well tolerated and has a low side effect profile. Mild side effects, including diarrhea, nausea, stomach discomfort, and rash, may occur with its use. (21)

Given its effects on prolactin, the use of vitex may interfere with lactation, especially at higher doses. Individuals who are breastfeeding should avoid taking vitex until speaking with a healthcare provider.

Chasteberry has the potential to interact with birth control pills, drugs to treat Parkinson's disease, and antipsychotic medications (2).  

Integrating Chasteberry with Other Natural Therapies

As discussed earlier in this article, hormonal imbalances are complex in origin and often require a multifaceted, comprehensive treatment approach that starts with making healthy changes to lifestyle habits and diet. Aside from chasteberry, other ways to balance hormones include:

• Eat a plant-based diet that incorporates phytochemical- and fiber-rich foods like greens, cruciferous vegetables, berries, herbs, and spices
• Incorporate seed cycling into your diet
• Support the liver and gut health to optimize hormone metabolism and elimination 
• Keep your blood sugar balanced and treat insulin resistance if present
• Exercise regularly
• Get adequate sleep
• Manage stress
• Avoid alcohol consumption
• Avoid exposure to xenoestrogens found in plastics, personal care products, and food

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Chasteberry (Vitex) for Hormonal Balance: Final Thoughts

The benefits of chasteberry for women's health lie in its potential to address specific issues related to hormonal imbalances. Chasteberry is believed to influence estrogen and progesterone balance by acting on the pituitary gland, offering a natural solution for conditions like luteal phase defects and elevated prolactin levels. Consult a functional medicine health professional to discuss whether incorporating chasteberry into your personalized health plan would benefit your hormonal health.