Vitex is not traditionally recommended in pregnancy. In practice, some herbalists use it during the first 8 weeks of pregnancy in cases of difficult conception. Chaste tree 223
PRACTICE POINTS/PATIENT COUNSELLING
• Several clinical trials have shown that vitex is an effective treatment for common PMS symptoms, such as mood changes and irritability, breast tenderness, headaches and constipation. According to one study, it is more effective than pyridoxine treatment and has a similar response rate to fluoxetine.
• Clinical research has also shown it to be effective in menstrual irregularities and mastalgia.
• Vitex is also used to relieve menopausal symptoms, enhance fertility in women with progesterone deficiency or luteal phase defects, and aid the expulsion of the placenta after birth, reduce fibroids and normalise hormones following the use of oral contraceptives.
• Traditionally, it is described as a galactagogue (i.e. a medicine able to increase milk production in lactation) and is used in low doses for this indication.
• A mechanism of action has not been conclusively identified, but it appears to inhibit prolactin release by selective stimulation of pituitary dopamine D2 receptors, increase progesterone levels and works via the opiate system.
ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS
What will this herb do for me?
Chasteberry is used to relieve common symptoms of PMS, such as irritability, mood swings, breast tenderness, headache and constipation. It is also used in combination with other herbal medicines to enhance fertility, relieve menopausal symptoms, regulate irregular menstruation, improve acne and promote milk production in new mothers.
When does it start to work?
Most trials show that treatment for at least three menstrual cycles may be required before symptom relief is experienced in PMS. Are there any safety issues?
In cases of irregular menstruation, investigation for serious pathology should be undertaken before use of this herb.
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