Vitex
Vitex agnus-castus, L. Verbenaceae
Vitex (Vitex agnus-castus) is a shrubby plant from the Verbenaceae family, originating from the regions of Greece and Italy, where it has been used as a medicinal plant since ancient times. The stems of vitex are four-angled, ringed, and light green, while the elongated leaves are borne on long petioles and are palmately divided into 5-7 leaflets. The small purple or pink flowers are arranged in long, interrupted inflorescences. The fruit of vitex is a small reddish-black berry, harvested in early autumn, which resembles pepper in both appearance and taste.
The medicinal part of the plant is the fruit, which is rich in numerous bioactive compounds, the most important of which include flavonoids (casticin, C-heterosides, penduletin), iridoids (aucubin and agnuside), diterpenes (rotundifuran, vitexilactone), alkaloids (viticin), essential oil (rich in eucalyptol, sabinene, and farnesene), steroids, and fixed oil.
A large number of studies have confirmed that vitex fruit has a beneficial effect on the regulation of the menstrual cycle and helps alleviate symptoms of premenstrual syndrome (PMS) and menopause. Vitex fruit is widely used for a range of female reproductive conditions in both Anglo-American and European medical practice.
Research has shown that vitex fruit produces significantly better effects in the treatment of premenstrual syndrome than a combination of magnesium and vitamin B6, due to its strong antispasmodic activity. In cases of premenstrual dysphoric disorder (PMDD), one study demonstrated that vitex was comparable to fluoxetine in reducing symptoms. In addition, vitex has been shown to have a beneficial effect on prolactin levels and may therefore be recommended in cases of latent hyperprolactinemia.
The mechanism of action of the active constituents is based on their inhibitory effects on dopamine and opioid receptors. Inhibition of dopamine receptors contributes to the regulation of prolactin secretion, particularly during the premenstrual period, since hyperprolactinemia is one of the key causes of PMS symptoms. Pathologically elevated prolactin levels are also observed in Parkinson’s disease; therefore, vitex may be used in this case as well to help alleviate symptoms.
With regard to menstrual complaints, nervousness, acne, and unpleasant symptoms associated with premenstrual syndrome – such as lower abdominal pain, irritability, insomnia, and breast pain – vitex is considered a reliable option for symptom relief. It is recommended during all stages of life in which the menstrual cycle is irregular.
The EMA (European Medicines Agency) recognizes vitex fruit as a traditional herbal medicinal product for the relief of mild symptoms of premenstrual syndrome. This conclusion is based on the long-standing traditional use of the plant.
The only contraindication to the use of vitex fruit is hypersensitivity. Patients who have or have had estrogen-sensitive cancers should consult their physician before using vitex fruit. Patients taking dopamine agonists, dopamine antagonists, or estrogens should consult their physician prior to using vitex fruit. Use in children and adolescents under 18 years of age has not been established due to a lack of adequate data. Vitex fruit is believed to act on the pituitary gland and hypothalamus; therefore, patients with a history of pituitary disorders should consult a physician before use. Use during pregnancy and breastfeeding is not recommended due to insufficient evidence.