Vitex (Chasteberry): Benefits, Dosage & Side Effects

The chaste tree, Vitex agnus-castus, is a shrub native to the Mediterranean and Central Asia that sends up long spikes of small violet flowers.6 Its dried berries are the herb called vitex, or chasteberry, and for more than 2,500 years they've been used mostly for women's cycles.7

I consider vitex the best-studied herb for PMS. It works through the pituitary gland, the hormone control center in the brain, gently lowering prolactin and supporting the second half of the cycle, when progesterone should rise.4 European regulators recognize a 20 mg vitex extract as a well-established medicine for PMS.8

Did you know?

• The EU recognizes vitex two ways: a 20 mg extract as a well-established medicine for PMS, and the powdered berry and tinctures as traditional herbal medicines for minor premenstrual symptoms.8

• In lab tests, compounds from the berry called clerodadienols suppressed prolactin almost as strongly as dopamine itself.9

• Vitex's placebo-controlled trials have run in Germany, China, the Czech Republic and Iran, and a trial without a placebo group ran in Japan.110111213

Advertisement

What is vitex (chaste tree berry)?

The part used is the fruit, the small berry left behind after the flowers fade, and it's the part the main PMS trials used and the EU monograph covers.18 When people talk about vitex seeds, these dried berries are what they mean.

The berries carry several families of active compounds: iridoids such as agnuside and aucubin, flavonoids such as casticin and apigenin, aromatic oils, and diterpenes.14 The diterpenes matter most for hormones. Some of them, the clerodadienols, act on the same receptor dopamine uses to keep prolactin in check, which is the main way researchers think vitex works.9

A short history of vitex

The name chasteberry may reflect an old belief that the plant promoted chastity, and in the Middle Ages, monks reportedly used it to dampen sexual desire, which is why it's also called monk's pepper.6 Through most of its long history, the dried fruits were used for gynecological conditions,7 and vitex was also traditionally used for mood complaints and for skin conditions tied to hormones.6 In modern times, Germany's Commission E, the country's expert panel on herbal medicines, approved vitex for irregular cycles, premenstrual complaints and breast pain.15

In the language of traditional herbal energetics, vitex comes from the Mediterranean tradition, and here's its profile:45

What is vitex good for?

How does vitex work?

Researchers propose that vitex works mainly through the pituitary gland and one hormone in particular, prolactin. Here's the research, step by step:

Europe's herbal committee notes that the exact mode of action isn't known,8 and in healthy men the lowest dose raised prolactin while higher doses lowered it, so the effect depends on the dose.23 Lab studies also show vitex extracts activate the body's opioid receptors, a proposed route for its calming effect on PMS irritability.24254

Vitex benefits, ranked by evidence

Ranked by evidence, vitex does the most for PMS and cyclic breast tenderness, with encouraging trials for high prolactin, PMDD, fertility and menopause symptoms.

Does vitex help PMS?

PMS, premenstrual syndrome, is the mix of emotional and physical symptoms that builds in the days before a period: irritability, tension, low mood, fluid retention, breast tenderness, headache and bloating.1

A trial published in the BMJ in 2001 ran in six German community clinics. Of 178 women randomized, 170 were evaluated, 86 on vitex and 84 on placebo, with an average age of 36. They took one 20 mg tablet of vitex fruit extract or a matching placebo every day for three cycles, and neither the women nor the researchers knew who got what. Their combined symptom score fell by about half on vitex, against about 30% on placebo, and irritability, mood swings, anger, headache and breast fullness all improved more on vitex; bloating and other menstrual symptoms didn't differ between the groups. Mild side effects were reported by 4 women on vitex and 3 on placebo, and none stopped. The extract's maker sponsored the trial.1

A later placebo-controlled trial tested the dose. In 162 women aged 18 to 45, the same extract at 20 mg a day eased PMS more than placebo and more than 8 mg, while 30 mg did no better than 20 mg, which supports 20 mg as the daily dose.26

A placebo-controlled trial in China enrolled more women still. Of 217 women with moderate to severe PMS who were randomized, 208 were analyzed after up to three cycles on an extract equal to 40 mg of the fruit a day or placebo. Their symptom-diary scores fell from 29.23 to 6.41 on vitex, against 28.14 to 12.64 on placebo, a clear edge for vitex even with a placebo effect the researchers put at 50%.10 In a second Chinese placebo-controlled trial of 67 women, 64 of whom finished, every one of the 17 symptoms tracked improved more on vitex than on placebo except lower-abdominal cramping.2728

The pooled analyses point the same way. When Hungarian researchers combined the three placebo-controlled trials that described their products well enough to judge, 520 women in all, women on vitex were 2.57 times more likely to have their symptoms remit.16 In the 2017 review, 13 of the 14 trials it pooled reported a benefit on total PMS symptoms.19

Vitex also held its own against a partner in my own hormone protocol, vitamin B6.5 In a randomized trial of 175 women over three cycles, in which neither the women nor the researchers knew who got what, both brought PMS tension scores down to the same 5.1 points, from 15.2 on vitex and 11.9 on B6, and vitex eased breast tenderness, swelling, inner tension and headache more; 36.1% of the women on vitex and 21.3% on B6 rated themselves free of complaints.29

Studies without a comparison group add real-world numbers. In 1,634 women who took vitex for three cycles, 93% reported fewer PMS symptoms or none at all,30 and in 69 women in Japan, symptoms began easing in the first cycle and kept falling through the third.13 Of 107 women who had both PMS and migraines, 100 finished 3 months on 40 mg a day, and 42% of them had their monthly migraine attacks cut by more than half, again with no comparison group.31

Vitex is first on my list of remedies for PMS, alongside dong quai, cramp bark, and magnesium with vitamin B6.32 For period cramps, researchers judged vitex about as effective as a birth control pill in a comparison study of 60 women with severe period pain over three cycles,33 and cramp bark, also on my list, relieves cramps and PMS symptoms.32

PMDD

PMDD, premenstrual dysphoric disorder, is the severe, mood-heavy form of PMS. In a randomized trial of 41 women with PMDD, in which the raters who scored symptoms didn't know who got what, after 2 months a similar share responded to vitex and to fluoxetine, an antidepressant: 57.9% on vitex against 68.4% on fluoxetine, a difference that wasn't statistically significant. Fluoxetine did more for the emotional symptoms, and vitex did more for the physical ones.17 A 2013 review of the randomized trials concluded that they suggest benefits for vitex in PMDD as well as PMS; of its two PMDD trials, one found vitex equal to fluoxetine and the other favored the drug.34 If PMDD persists after two full cycles, the safety section lists the next step.5

Does vitex help cyclic breast pain?

Yes. Across 6 placebo-controlled trials with 718 women aged 18 to 45, vitex eased cyclic breast pain, the tender, swollen breasts that come in the days before a period, with a moderate effect, typically at 20 to 40 mg a day for 3 months. The same 2020 review gathered 25 studies in all and found vitex lowered raised prolactin in these women, with only mild side effects that went away, and in seven trials vitex held its own against prescription treatments for breast pain, including dopamine drugs, anti-inflammatory painkillers, antidepressants and hormonal birth control.2 Researchers think much premenstrual breast pain traces to latent high prolactin, the stress- and sleep-linked pattern described in how vitex works above.9

The clearest single trial ran in Prague, and neither the women nor the researchers knew who got what. In 97 women with cyclic breast pain, 48 on vitex and 49 on placebo, a vitex liquid that also carried five other herbs in homeopathic dilutions, taken as 30 drops twice a day, lowered pain on a 100 mm scale by 21.4 mm after one cycle, against 10.6 mm on placebo, and by 33.7 mm against 20.3 mm after two cycles, both statistically significant differences. After the third cycle the gap narrowed, 34.3 mm against 25.7 mm, just short of statistical significance. Side effects were similar, 5 against 4.11

Flaxseed works as a partner here. In a 2-month placebo-controlled trial of 159 women in Iran, split into three groups of 53, a daily vitex tablet and 25 grams of ground flaxseed a day both eased breast pain more than a double placebo, by similar amounts.35

Vitex has also been compared with a prescription drug. In a randomized trial of 40 women with cyclic breast pain, 40 mg of vitex a day for 3 months lowered pain scores from 6.8 to 1.9, and bromocriptine, a dopamine drug, 2.5 mg twice a day, lowered them from 6.3 to 0.89, with no significant difference between the two.207 No side effects were reported on vitex, while 12.5% of the women on bromocriptine had nausea or vomiting.36

Does vitex lower prolactin and raise progesterone?

Your cycle has two halves. The first builds toward ovulation, and the second, the luteal phase, is when progesterone should rise. When prolactin from the pituitary runs a little high, that second half can come up short, with too little progesterone, and the medical name for it is a luteal phase defect.3 I list vitex for irregular periods and luteal phase defects.37

That's exactly the group one placebo-controlled trial tested. Researchers enrolled 52 women with luteal phase defects from latent high prolactin, and 37 completed the 3 months, 17 on a daily vitex capsule equal to 20 mg of the dried fruit38 and 20 on placebo, in a trial where neither the women nor the researchers knew who got what. On vitex, prolactin release after a stimulation test fell, short luteal phases normalized, lengthening by about 5 days, and low progesterone in the second half of the cycle was corrected. None of these changes happened on placebo, no side effects were seen, and two women on vitex became pregnant.37

The bromocriptine trial above had a second group, 40 women with mildly high prolactin, and it points the same way: 40 mg of vitex a day for 3 months lowered prolactin by about 44%, while bromocriptine lowered it by about 47%, with no significant difference between the two.2036 A 2023 review of the prolactin research concluded that vitex may have a role in managing mild high prolactin.7

My hormone protocol uses vitex the same way, in a set order: clearing estrogen before rebuilding progesterone is the whole strategy, so its first two phases clear estrogen your body can't get rid of and steady blood sugar and the stress hormone cortisol. Then its rebuild phase starts vitex in the morning, because it works on the pituitary to raise progesterone output, and pairs it with vitamin B6 and zinc, the two nutrients the body uses to make progesterone after ovulation.5 The same phase builds meals around foods such as pasture-raised eggs, wild salmon, sardines, pumpkin seeds, sweet potato, lentils and berries, which supply nutrients your body uses to make its own hormones.5 Avocado, sesame seeds and chickpeas round out the progesterone side: eggs supply cholesterol, salmon and avocado healthy fats, salmon and chickpeas vitamin B6, and sesame zinc, all of which your body uses to make progesterone. Our guide to female hormones explains how they work together.

Can vitex help you get pregnant?

On my show, I've explained that in Chinese medicine, conception rests on the health of the adrenals, the kidneys and the reproductive organs, and that trouble conceiving most often traces to an adrenal reserve run low by stress or missing nutrients, so that's where I start. Hormone balance comes next, then a diet with a good amount of protein, plenty of vegetables, berries and rice, foods that in Chinese medicine feed the water element tied to conception, and a life with stress kept low and time scheduled for the things that bring you joy.39 Vitex fits into that plan at the hormone-balance step, alongside the other ways to balance hormones naturally.

The fertility trial followed 96 women in Germany: 38 whose periods had stopped, 31 with a short or weak second half of the cycle, and 27 with unexplained infertility. They took 30 drops twice a day of a vitex liquid that also carried five other herbs in homeopathic dilutions, or a placebo, for 3 months, and neither they nor the researchers knew who got what. The goal was pregnancy, or a period returning for the women without periods, or better hormone levels in the second half of the cycle for the others. Of the 66 women who could be evaluated, 31 reached it: 57.6% on vitex against 36.0% on placebo, a difference just short of statistical significance. Fifteen women conceived during the study, and among the women without periods or with a weak second half, pregnancy came more than twice as often on vitex as on placebo. Side effects were very few.18 A second placebo-controlled trial of the same liquid, in 84 women, found 9 pregnancies in each group.40

A blend gave the clearest pregnancy numbers. At Stanford, 93 women aged 24 to 42 who had tried to conceive for 6 to 36 months took a supplement of chasteberry, green tea, L-arginine, vitamins including folate, and minerals, or a placebo, and neither they nor the researchers knew who got what. After 3 months, 14 of the 53 women on the blend were pregnant, 26%, against 4 of the 40 on placebo, 10%, a significant difference, and 3 more conceived by 6 months. Progesterone in the second half of the cycle rose significantly in women who started below 9 ng/mL, the number of days with temperatures over 98°F after ovulation went up, and cycles that had run short or long normalized, with no significant side effects.21 Because the blend carried several ingredients, those results belong to the blend.

For women trying to conceive, my hormone protocol is often the first step. It starts vitex in the morning in the rebuild phase and tracks ovulation with basal body temperature or LH strips, which pick up the hormone surge that comes just before ovulation.5 That phase runs across two cycles because ovulation responds slowly: the follicle that ovulates this month started developing three months ago.5 Once you're pregnant, keep the food, magnesium, B6 and folate, and see the safety section on vitex in pregnancy; if you're in fertility treatment or IVF, read its interaction check before you start.5

Does vitex help perimenopause and menopause symptoms?

It may. In an 8-week placebo-controlled trial in Iran, 61 women who were 1 to 3 years past their last period and had at least two hot flashes a day took a 30 mg vitex extract capsule morning and evening or a placebo, and neither they nor the researchers knew who got what. Among the 52 who finished, aged 48 to 58, total scores on the Greene menopause scale fell from 29.54 to 12.15 on vitex, against 26.88 to 20.12 on placebo, the score for hot flashes and night sweats fell from 3.73 to 0.46 against 3.76 to 2.72, and anxiety eased more too. Depression, physical and sexual symptom scores didn't differ between the groups.12 In a 16-week placebo-controlled trial of 100 women, a blend of St. John's wort and vitex brought about the same improvement as placebo, with both groups getting better.41

For menopause itself, black cohosh sits at the top of my list, and for women in their 30s and 40s with hormone imbalance, vitex is the herb I name.42 That makes vitex a natural fit for the years leading up to your last period, and our guide to perimenopause symptoms covers what to watch for. My free Perimenopause & Menopause protocol lays out the full plan, and our guides to menopause supplements, red clover and shatavari cover the other herbs worth knowing for this stage.

How to take vitex: dosage, timing and forms

Vitex is sold in several forms, and the milligrams on the label mean different things for each one. A 20 mg tablet of concentrated extract and a 400 mg capsule of powdered berry are different products, so check which one you have before you compare doses.

When to take vitex, and for how long

Take it once a day in the morning, on an empty stomach.4 In the trials, women took it every day through the whole cycle, not just in the days before a period.1

Vitex is slow and steady, so give it three full cycles before you judge it.4 Europe's herbal committee also recommends continued use over three months for the best effect.8

Some women notice a change early. In the 69 women in Japan, symptoms began easing in the first cycle,13 and my hormone protocol expects the first shift in cycle two: lighter mood, less bloating and an easier period.5 If two full cycles pass with no shift, the protocol tests for thyroid, insulin or PCOS before extending.5 When women stopped vitex after three cycles in a study of 43 women with no comparison group, their symptoms crept back gradually but were still 20% below where they started three cycles later.43

How do you know vitex is working?

The protocol uses these signs, cycle by cycle:5

• Cycle two: a shorter, lighter period with fewer clots, and PMS that shrinks from a week to a day or two.5

• Cycle three: breast tenderness gone for most women, and mood steady through the whole month.5

• Your temperature: a basal body temperature that rises after ovulation and holds for 10 to 14 days, the sign that progesterone is back.5

They line up with what the trials measured: symptoms easing over three cycles and breast pain falling within one to two.111

Vitex tea and the dried berries

Some people brew the crushed dried berries as a tea, though no trial has tested a tea dose. If you want to match the amounts on this page, use the powdered berry or a standardized extract. Grinding the dried berries and filling capsules gets you closest to the 400 to 800 mg morning amount in my hormone protocol.5 Our guide to herbal tea benefits covers other teas worth brewing.

How to choose a vitex supplement

Vitex products vary a lot, so check the label for these:

• The form and its milligrams: milligrams of standardized extract or of powdered berry, so you can match the table above; an extract labeled as equal to 40 mg of berry isn't 40 mg of extract.

• The berry: look for the dried fruit on the label, the same part the trials used.18

• Vitex alone or a blend: the PMS results came from vitex on its own, while many fertility and menopause products are blends.11621

• Third-party testing for purity, with results the maker will share.

Vitex side effects, interactions and who should skip it

NCCIH notes it has been used safely in studies for up to 3 months.6

Pregnancy: stop vitex once you're pregnant.5 Europe's herbal committee doesn't recommend it in pregnancy,8 and a review of the pregnancy evidence found only theoretical and lab signs that it may have hormonal and uterine-stimulating effects.45 Progesterone support in early pregnancy belongs with your OB.5

Breastfeeding: skip vitex while you're nursing. The U.S. lactation database notes that low doses may raise prolactin and higher doses may lower it and reduce milk, that no valid trials support it for milk supply, and that it should be avoided during lactation.14 The EU monograph doesn't recommend it while breastfeeding either.8 Our guide to breast milk covers what does support supply.

Under 18: the EU monograph doesn't recommend vitex for anyone under 18, because there isn't enough data in that age group.8

Hormone-sensitive cancers: NCCIH notes that vitex may not be safe for women with hormone-sensitive conditions such as breast, uterine or ovarian cancer, and the EU monograph asks women who have or have had an estrogen-sensitive cancer to check with their doctor first.68

Pituitary conditions: vitex works on the pituitary, so the EU monograph asks anyone with a history of a pituitary disorder to check first.8 In one documented case, an 18-year-old with missed periods and nipple discharge had high prolactin; while she waited for her specialist appointment, vitex brought back a regular cycle, and a scan later found a small prolactin-secreting tumor.467

The bottom line

Vitex: frequently asked questions

References

1. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ. 2001;322(7279):134-7. doi:10.1136/bmj.322.7279.134
2. Ooi SL, Watts S, McClean R, et al. Vitex Agnus-Castus for the Treatment of Cyclic Mastalgia: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt). 2020;29(2):262-278. doi:10.1089/jwh.2019.7770
3. Milewicz A, Gejdel E, Sworen H, et al. [Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study]. Arzneimittelforschung. 1993;43(7):752-6.
4. Axe J. Top 50 Healing Herbs & Essential Oils: A Field Guide to God's Pharmacy. DrAxe.com protocol; 2026 (Women's Hormones: Vitex entry, with its top uses ranked by research, how to take it, how it works, traditional energetics and cautions).
5. Axe J. Hormone Balance for Women: The 90-Day Healing Protocol. DrAxe.com protocol; 2026 ("How to use this guide," p. 2; the four phases, p. 15; Phase 3, "Rebuild," p. 18; "Top 8 hormone balancers," p. 20; "For stubborn cases," p. 25; FAQ and the progesterone question).
6. National Center for Complementary and Integrative Health. Chasteberry: Usefulness and Safety. NCCIH; updated 2024. Accessed October 18, 2026.
7. Puglia LT, Lowry J, Tamagno G. Vitex agnus castus effects on hyperprolactinaemia. Front Endocrinol (Lausanne). 2023;14:1269781. doi:10.3389/fendo.2023.1269781
8. European Medicines Agency, Committee on Herbal Medicinal Products. European Union herbal monograph on Vitex agnus-castus L., fructus. EMA/HMPC/606742/2017. London: EMA; 27 March 2018.
9. Wuttke W, Jarry H, Christoffel V, et al. Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications. Phytomedicine. 2003;10(4):348-57. doi:10.1078/094471103322004866
10. He Z, Chen R, Zhou Y, et al. Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in China. Maturitas. 2009;63(1):99-103. doi:10.1016/j.maturitas.2009.01.006
11. Halaska M, Beles P, Gorkow C, et al. Treatment of cyclical mastalgia with a solution containing a Vitex agnus castus extract: results of a placebo-controlled double-blind study. Breast. 1999;8(4):175-81. doi:10.1054/brst.1999.0039
12. Naseri R, Farnia V, Yazdchi K, et al. Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study. Korean J Fam Med. 2019;40(6):362-367. doi:10.4082/kjfm.18.0067
13. Momoeda M, Sasaki H, Tagashira E, et al. Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label study. Adv Ther. 2014;31(3):362-73. doi:10.1007/s12325-014-0106-z
14. Drugs and Lactation Database (LactMed). Chasteberry. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Updated November 15, 2024. NBK501807.
15. Daniele C, Thompson Coon J, Pittler MH, et al. Vitex agnus castus: a systematic review of adverse events. Drug Saf. 2005;28(4):319-32. doi:10.2165/00002018-200528040-00004
16. Csupor D, Lantos T, Hegyi P, et al. Vitex agnus-castus in premenstrual syndrome: A meta-analysis of double-blind randomised controlled trials. Complement Ther Med. 2019;47:102190. doi:10.1016/j.ctim.2019.08.024
17. Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol. 2003;18(3):191-5. doi:10.1002/hup.470
18. Gerhard I, Patek A, Monga B, et al. Mastodynon(R) bei weiblicher Sterilität [Mastodynon for female infertility: randomized, placebo-controlled, clinical double-blind study]. Forsch Komplementarmed. 1998;5(6):272-278. doi:10.1159/000021154
19. Verkaik S, Kamperman AM, van Westrhenen R, et al. The treatment of premenstrual syndrome with preparations of Vitex agnus castus: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;217(2):150-166. doi:10.1016/j.ajog.2017.02.028
20. Kilicdag EB, Tarim E, Bagis T, et al. Fructus agni casti and bromocriptine for treatment of hyperprolactinemia and mastalgia. Int J Gynaecol Obstet. 2004;85(3):292-3. doi:10.1016/j.ijgo.2004.01.001
21. Westphal LM, Polan ML, Trant AS. Double-blind, placebo-controlled study of Fertilityblend: a nutritional supplement for improving fertility in women. Clin Exp Obstet Gynecol. 2006;33(4):205-8.
22. Jarry H, Leonhardt S, Gorkow C, et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol. 1994;102(6):448-54. doi:10.1055/s-0029-1211317
23. Merz PG, Gorkow C, Schrödter A, et al. The effects of a special Agnus castus extract (BP1095E1) on prolactin secretion in healthy male subjects. Exp Clin Endocrinol Diabetes. 1996;104(6):447-53. doi:10.1055/s-0029-1211483
24. Webster DE, Lu J, Chen SN, et al. Activation of the mu-opiate receptor by Vitex agnus-castus methanol extracts: implication for its use in PMS. J Ethnopharmacol. 2006;106(2):216-21. doi:10.1016/j.jep.2005.12.025
25. Webster DE, He Y, Chen SN, et al. Opioidergic mechanisms underlying the actions of Vitex agnus-castus L. Biochem Pharmacol. 2011;81(1):170-7. doi:10.1016/j.bcp.2010.09.013
26. Schellenberg R, Zimmermann C, Drewe J, et al. Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome. Phytomedicine. 2012;19(14):1325-31. doi:10.1016/j.phymed.2012.08.006
27. Ma L, Lin S, Chen R, et al. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Gynecol Endocrinol. 2010;26(8):612-6. doi:10.3109/09513591003632126
28. Ma L, Lin S, Chen R, et al. Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Aust N Z J Obstet Gynaecol. 2010;50(2):189-93. doi:10.1111/j.1479-828X.2010.01137.x
29. Lauritzen C, Reuter HD, Repges R, et al. Treatment of premenstrual tension syndrome with Vitex agnus castus controlled, double-blind study versus pyridoxine. Phytomedicine. 1997;4(3):183-9. doi:10.1016/S0944-7113(97)80066-9
30. Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med. 2000;9(3):315-20. doi:10.1089/152460900318515
31. Ambrosini A, Di Lorenzo C, Coppola G, et al. Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observation. Acta Neurol Belg. 2013;113(1):25-9. doi:10.1007/s13760-012-0111-4
32. Axe J. Ancient Remedies: Secrets to Healing with Herbs, Essential Oils, CBD, and the Most Powerful Natural Medicine in History. Little, Brown Spark; 2021 ("Prescriptions for 70+ Conditions": top 5 ancient prescriptions for PCOS, p. 271, and for PMS, p. 273).
33. Aksoy AN, Gözükara I, Kabil Kucur S. Evaluation of the efficacy of Fructus agni casti in women with severe primary dysmenorrhea: a prospective comparative Doppler study. J Obstet Gynaecol Res. 2014;40(3):779-84. doi:10.1111/jog.12221
34. van Die MD, Burger HG, Teede HJ, et al. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med. 2013;79(7):562-75. doi:10.1055/s-0032-1327831
35. Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Ahmadpour P, et al. Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trial. Complement Ther Med. 2016;24:90-5. doi:10.1016/j.ctim.2015.12.009
36. Arentz S, Abbott JA, Smith CA, et al. Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings. BMC Complement Altern Med. 2014;14:511. doi:10.1186/1472-6882-14-511
37. Axe J, Cole W. Heal Your Cells. Avery; 2026. ISBN 9798217181353 ("Reversing Hormone Age," women's supplement list, p. 337).
38. European Medicines Agency, Committee on Herbal Medicinal Products. Assessment report on Vitex agnus-castus L., fructus. EMA/HMPC/606741/2017. London: EMA; 27 March 2018.
39. Axe J. Natural Fixes for Frequent Headaches, Hormone Imbalance, and Infertility. The Dr. Josh Axe Show. November 28, 2023 (Chinese medicine, conception and the adrenals at 14:00 to 14:43; vitex for an estrogen-progesterone imbalance at 15:35; diet, the water element and stress at 15:35 to 16:27).
40. Yogasundram HM, Hui AJO, Sia CYS, et al. Reproductive outcomes in women and men using complementary and alternative medicine treatment and not receiving artificial reproductive technology: a systematic review. Arch Gynecol Obstet. 2021;303(3):821-835. doi:10.1007/s00404-020-05836-4
41. van Die MD, Burger HG, Bone KM, et al. Hypericum perforatum with Vitex agnus-castus in menopausal symptoms: a randomized, controlled trial. Menopause. 2009;16(1):156-63. doi:10.1097/gme.0b013e31817fa9e0
42. Axe J. 11 Supplements Every 40+ Adult Should Consider. The Dr. Josh Axe Show. 2026 (black cohosh for menopause and vitex for women in their 30s and 40s, at 26:41).
43. Berger D, Schaffner W, Schrader E, et al. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS). Arch Gynecol Obstet. 2000;264(3):150-3. doi:10.1007/s004040000123
44. Cahill DJ, Fox R, Wardle PG, et al. Multiple follicular development associated with herbal medicine. Hum Reprod. 1994;9(8):1469-70. doi:10.1093/oxfordjournals.humrep.a138731
45. Dugoua JJ, Seely D, Perri D, et al. Safety and efficacy of chastetree (Vitex agnus-castus) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15(1):e74-9.
46. Gallagher J, Lynch FW, Barragry J. A prolactinoma masked by a herbal remedy. Eur J Obstet Gynecol Reprod Biol. 2008;137(2):257-8. doi:10.1016/j.ejogrb.2006.12.020
47. Axe J. The PCOS Protocol. DrAxe.com protocol; 2026 ("The PCOS stack").

Dr. Josh Axe, DC, DNM, CNS

Doctor of Natural Medicine · Founder, DrAxe.com

Dr. Axe is a certified doctor of natural medicine, clinical nutritionist, and multiple New York Times bestselling author. He has spent 20+ years in clinical practice helping people heal at the root cause and founded one of the most-visited natural-health platforms in the world.

Read the full bio →

This article is for educational purposes. See our medical disclaimer.