Following on from my previous posts on premenstrual syndrome (PMS) I wanted to discuss the herb vitex agnus castus and how this supplement may also be useful to women suffering from PMS.  Previously I have mentioned this herb in relation to breast pain in women

The herb, vitex Agnus Castus, also known as chasteberry, grows in subtropical climates throughout the world.  Traditionally it has been used in the treatment of many ‘female ills’.  The herb itself does not contain any hormones, or hormone-like substances but it does appear to have an effect on part of the brain known as the pituitary gland which controls the production of the hormone progesterone from the ovaries.  It also appears to stop the excessive production of a hormone called prolactin which usually regulates breast-milk production but also has other, lesser-known, actions.  Prolactin is thought by some scientists to be responsible for certain PMS symptoms.  Vitex also contains the flavonoids casticin and isovitexin and it is thought that these flavonoids may help reduce the symptoms of fluid retention in PMS since flavonoids appear to facilitate repair of damage responsible for small blood vessel permeability which lead to fluid retention.

Many practitioners find that vitex agnus castus is incredibly useful in the treatment of PMS and there are many published research papers which back up their practical experiences.  Early studies (1,2,3) indicate that vitex is useful in the treatment of PMS symptoms.  One of these studies (3) published in the British Journal of Medicine concluded that “Dry extract of agnus castus fruit is an effective and well tolerated treatment for the relief of symptoms of the premenstrual syndrome”.  Symptoms that were aided with vitex agnus castus included: irritability, mood alteration, anger, headache, breast fullness and bloating.  Studies tended to run for at least 3 menstrual cycles.

A paper published this year (4) looked at the efficacy of vitex agnus castus compared to placebo treatment for PMS in over 200 women for three menstrual cycles.  The results show that the herb was safe, well tolerated and effective in the treatment of moderate to severe PMS.  Another interesting study published this year (5) found that agnus castus in combination with St.John’s Wort was effective in treating PMS-like symptoms among women starting to go through the menopause (perimenopausal women).

If you suffer from PMS on a regular monthly basis it may well be worth trying a vitex agnus castus supplement to see if it is useful for you.  The herb is commonly available as drops, tablets and capsules and most practitioners recommend that it is taken first thing in the morning upon waking up.  It may take a while before a significant benefit is seen and often it is recommended that supplements be taken for at least four menstrual cycles to determine whether or not they are proving useful to the individual woman.  The strength of supplement varies from manufacturer to manufacturer so always check the dosage instructions and adhere to those.

1.Berger D et al.  2000.  Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS). Arch Gynecol Obstet. 264(3):150-3.
2.Loch EG et al.  2000.  Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med. 9(3):315-20.
3.Schellenberg R.  2001.  Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomized, placebo controlled study.  BMJ.  322:134-137. 
4. He Z et al.  2009.  Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in China. Maturitas. 63(1):99-103
5. van Die MD et al.  2009.  Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis. J Altern Complement Med. 15(9):1045-8.
Written by Ani Kowal

Most women develop breast pain, known as mastalgia, at some stage in life (1). In most cases the pain develops in the days just before a period, sometimes accompanied by lumpiness and an increase in breast size, and is probably hormone related. In a few cases the pain is not related to periods. Usually the pain is mild, causing a nuisance, but in some women it is more severe and can affect quality of life.  Activities such as jogging or gym work can be painful as can simple things such as hugging children and sexual activity.  Some women find that they are psychologically affected and may suffer depression, a feeling of helplessness and loss of self-esteem.  Conventional treatment options include painkillers and topical (rub-on) anti-inflammatory drugs which may have side-effects.

Often the problem may only last 3-6 menstrual cycles before disappearing for a couple of years but may reappear over time.  The role of diet in preventing or minimising breast pain is unclear and further investigative studies are necessary.

Caffeine
Cutting out caffeine may help prevent breast pain.  Although there are no scientific studies to support the idea, many women have found that caffeine makes their pain worse.  In the week or so before a period it may be worth trying to cut out caffeine containing drinks such as coffee, tea and cola which contain caffeine to see if this helps the symptoms(1).

Fatty acids
Women who suffer with mastalgia have alsobeen found to have abnormal plasma fatty acid profiles (1), but the role of dietary fats in the cause of breast pain has not yet been rigorously tested.  Omega 3 fatty acids can help to reduce inflammation in the body which can often lead to pain, so it may well be worth taking an omega 3 fatty acid supplement (providing around 250mg EPA and 250mg DHA per day) daily for a couple of months to see if it provides any benefit.

Herbal help – Vitex Agnus Castus, a treatment worth trying!
The herb, vitex Agnus Castus, also known as chasteberry, grows in subtropical climates throughout the world.  Hippocrates and other physicians of ancient Greece used the herb for the treatment of many ‘female ills’.  The herb itself does not contain any hormones, or hormone-like substances but it does appear to have an effect on part of the brain known as the pituitary gland which controls the production of the hormone progesterone from the ovaries.  It also appears to stop the excessive production of a hormone called prolactin which usually regulates breast-milk production but also has other, lesser-known, actions.  Prolactin is thought by some scientists to be responsible for period-associated breast-pain.

Agnus Castus certainly seems to be helpful in the treatment of breast pain
A recent review study published earlier this year(2) concluded that there was convincing evidence, both laboratory based and clinical, that Agnus Castus is a safe, efficient and effective treatment for cyclical mastalgia, breast pain associated with the monthly menstrual cycle.  Available medical studies are small but do show that the herb can elicit a 45%-85% reduction in breast pain. 

Agnus castus is readily available from high-street chemists and health-food stores as well as on the internet.  It may be worth trying an agnus castus supplement for a few months if your breasts often get tender just before your period.

Please see your doctor if you have any concerns about breast pain or any other breast symptoms. In particular, see a doctor immediately if you feel any lump in a breast.

(1) Mansel RE.  1994.   ABC of breast diseases. Breast pain. BMJ.  309(6958):866-8.
(2) Carmichael AR.  2008.  Can Vitex Agnus Castus be Used for the Treatment of Mastalgia? What is the Current Evidence? Evid Based Complement Alternat Med.  5(3):247-50.

Written by Ani Kowal