Stop Taking Vitex for Hormone Balance
The fad that has taken the internet by storm and I see frequently in my infertility practice is women taking Vitex to promote hormone balance for infertility. It can be a huge mistake but so many people are told to take it. Why? Vitex is also called chasteberry, chaste tree or Vitex agnus-castus and is of the same genus the Vitex called Mang Jing Zi we use in TCM has been used for thousands but almost never for fertility or hormone balance. The herb has become one of the most commonly recommended herbal supplements for women with irregular periods, PMS and infertility. We are here to give you facts and encourage you to seriously consider stopping Vitex. If an herbalist recommended it to you then you are probably safe to take it as they have assessed your individual pattern and medical history to make that assessment.
There is a serious problem with taking Vitex to simply “balance your hormones”.
Hormones do not all need to be pushed in the same direction for every patient nor to try and balance every pattern. Women’s bodies are unique and so should their fertility recommendations. We customize what we do for fertility in Boise, every day.
Vitex has a real physiological influence; particularly involving its impact on dopamine and prolactin. This means it may be helpful for a carefully selected subset of women, but it is not an appropriate universal hormone-balancing herbal supplement.
What does Vitex actually do to a woman’s body?
Vitex appears to have dopaminergic activity in the body. This action is particularly noted through dopamine D2 receptors. One important downstream effect of this action is that it can suppress prolactin secretion in women.
That may be beneficial when prolactin is elevated and interfering with normal ovulation or a luteal-phase defect.
But that is wildly different from claiming Vitex “balances female hormones.”
A 2023 published in Frontiers in Endocrinology review of the research on Vitex and hyperprolactinemia concluded that Vitex may have a role in selected patients with mild hyperprolactinemia. However, they also emphasized that large, high-quality randomized controlled trials are still lacking. This still doesn’t cover the claim that Vitex is good for all women trying to conceive. (https://pubmed.ncbi.nlm.nih.gov/38075075/)
When might Vitex make sense for women TTC and enhance their fertility?
One of the more compelling situations is a woman with latent or mild hyperprolactinemia associated with a shortened luteal phase or inadequate luteal progesterone production. But taking a single herb is the most problematic and least effective way to use herbal medicine. Herbs need balancing ingredients to work effectively. Single ingredients always lead to unwanted side-effects down the road.
Many women will experience hot flashes or a more irregular cycle after starting vitex. It is because its nature doesn’t match the woman’s pattern that contributes to her infertility.
In a randomized, double-blind, placebo-controlled trial, women with luteal-phase defects specifically associated with latent hyperprolactinemia received 20 mg/day of a Vitex for three months. Vitex reduced prolactin secretion and improved the luteal-phase abnormalities and progesterone production; but keep in mind this study was only performed on 52 women. https://pubmed.ncbi.nlm.nih.gov/8369008/
That is a very specific clinical picture that honestly most providers don’t test or track to prove the necessity of this treatment plan.
It does not mean every woman struggling with infertility should take Vitex. In fact, most shouldn’t.
A more recent 2023 review of Vitex and hyperprolactinemia reached essentially the same conclusion: Vitex may have a place in very carefully, few, selected cases of mild hyperprolactinemia. The evidence is not nearly strong enough to justify indiscriminate use as a blanket cure all for those TTC. https://pmc.ncbi.nlm.nih.gov/articles/PMC10702745/
Has Vitex been proven to increase pregnancy rates?
This is where supplement marketing often gets ahead of the research, big time.
A double-blind placebo-controlled infertility study involving only 93 women did find a higher pregnancy rate after three months resulting in 26% pregnancy rate in the supplement group versus 10% with placebo. Promising outcome but a tiny study.
However, this is really, really important: the women weren’t taking Vitex alone.
These women took a combination supplement containing Vitex, green tea, L-arginine, folate, vitamins and minerals. Therefore, we cannot scientifically attribute the improved pregnancy rate specifically to Vitex and should never recommend it alone.
This critical distinction matters.
The best evidence for Vitex is considerably stronger for PMS symptoms and also helpful for selected prolactin-related menstrual disturbances. This is not a recommendation for infertility in general. A systematic review of randomized controlled trials found evidence supporting Vitex primarily for PMS, PMDD and latent hyperprolactinemia—not as a universal fertility enhancer. https://pubmed.ncbi.nlm.nih.gov/23136064/
Why wouldn’t I give Vitex to every fertility patient that walks in my door from the surrounding Boise and Treasure Valley?
Because infertility isn’t one hormonal condition and any time one gives a single herb, without balance, imbalances will eventually be produced.
A woman struggling with infertility or miscarriage may have:
low progesterone
high prolactin
low estrogen
high estrogen
PCOS/ PMOS
DOR diminished ovarian reserve
thyroid disease or dysfunction
endometriosis or endometritis
hypothalamic amenorrhea
anovulation
poor follicular development
or completely normal reproductive hormones but still struggling to get or stay pregnant.
It may be her partner. It may be both of them.
Giving every one of these women the identical herb simply because it has been marketed as a “female hormone balancer” doesn’t make medical sense: it’s poor medicine and differentiation is what matters most.
Test first. Treat second. Or better yet, treat with well-rounded, time-tested, herbal medicine proven to work on billions of women, not 92.
Can Vitex actually make someone feel worse?
Most Definitely, Yes.
Reported adverse effects include:
headache or dizziness
nausea or abdominal discomfort
acne
itching, rashes or other allergic reactions
menstrual irregularities, hot flashes or night sweats
intermittent spotting or changes in menstrual bleeding
Clinical safety reviews have documented menstrual disturbances along with gastrointestinal, neurologic, dermatologic and occasionally significant allergic reactions written up in the European Medicines Agency (EMA) .
The U.S. National Center for Complementary and Integrative Health also cautions that although Vitex is generally well tolerated short-term, evidence regarding many proposed uses remains limited. Chasteberry: Usefulness and Safety | NCCIH
Therefore, if your menstrual cycle becomes more irregular or you notice new hot flashes, night sweats or spotting between cycles after starting Vitex, or maybe your acne suddenly worsens or you simply feel worse don’t automatically assume this is your hormones “detoxing” or “adjusting” stop immediately and seek out professional help from a doctor in TCM herbal medicine.
The single herb may simply be wrong for you and thus cause serious side-effects.
Isn’t Vitex a Traditional Chinese Medicine herb?
This is one of the most common misconceptions about Vitex.
The popular Western fertility and menopause herb Vitex is Vitex agnus-castus. It is not a traditional Chinese fertility herb, not in the least.
Traditional Chinese Medicine does contain an herb from the Vitex genus called Man Jing Zi (蔓荆子), generally derived from Vitex trifolia and related botanical material and same genus.
But Vitex as Man Jing Zi has completely different traditional indications and uses.
In Chinese herbal medicine, Man Jing Zi is traditionally used to disperse wind-heat (think virus) and benefit the head and eyes, particularly for symptoms such as headache, painful or irritated eyes, fever, dizziness and related upper-body wind-heat (virus) presentations. And it is never suggested to take alone for these indications.
That would be the equivalent of trying to make a cookie out of sugar alone would not be very palatable. No balanced ingredients, way too sweet, and just not a cookie. A synergy of ingredients is needed to make a dessert and so it is also needed to make complex, effective herbal medicine.
It is not traditionally prescribed as a universal female hormone regulator or fertility tonic.
That distinction beautifully illustrates an important principle of Chinese herbal medicine:
Chinese medicine doesn’t treat every woman with the same herb and always with a combination of many herbs, often changes as her cycle changes with different herbal combinations for the different phases of her menstrual cycle.
Traditional Chinese herbal medicine is based on pattern differentiation that is complex and often changes depending on her luteal phase or her follicular phase: women can feel the difference in their bodies, so it is imperative for different herbal combinations to address those changes.
Two women can both have irregular periods or excruciatingly painful periods and receive entirely different herbal formulas because the underlying patterns may be completely different.
One may need Kidney and Heart Yin nourishment for their hot flashes and anxiety.
Another may need Kidney Yang support and warmth for their cold back and anxiety.
Another may have Liver Qi stagnation with anger and headaches.
Another may have Blood deficiency with anger, headaches, fatigue and poor follicular development.
Another may have Blood stasis with endometriosis and clots.
Another may have Damp-Phlegm interfering with ovulation and weight gain.
That individualized approach is very different from:
“Your hormones are off? Take Vitex.”
So, is Vitex good or is it bad?
Neither.
Vitex is a pharmacologically active herb that may be useful for a small percentage of women and completely inappropriate for other women.
The research we have found provides a reasonable argument for considering vitex in selected cases particularly mild or latent hyperprolactinemia associated with luteal-phase dysfunction.
What the research does not support is treating Vitex like a universal fix-all for women’s hormones at any phase of their life.
Before taking an herb specifically intended to alter reproductive hormones, I prefer to investigate and even test:
What hormone are we trying to increase or decrease? Why are we trying to change this in particular? And do we have evidence that it actually needs changing, in this woman, at this time?
That is a much better approach to fertility and hormone balance than an unwarranted supplement to a rather complex problem.
The main takeaways:
Always have a TCM herbalist recommend a robust combination of herbs for your condition particularly when dealing with something as serious as infertility, PMS, PMDD, PMOS or menopause.
Do not use single herbs to treat complex problems.
Never use one herb to treat every person who has a hormonal imbalance.
Sources:
Milewicz A, Gejdel E, Sworen H, Sienkiewicz K, Jedrzejak J, Teucher T, Schmitz H. Vitex agnus castus-Extrakt zur Behandlung von Regeltempoanomalien infolge latenter Hyperprolaktinämie. Ergebnisse einer randomisierten Plazebo-kontrollierten Doppelblindstudie [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 Jul;43(7):752-6. German. PMID: 8369008.
Puglia LT, Lowry J, Tamagno G. Vitex agnus castus effects on hyperprolactinaemia. Front Endocrinol (Lausanne). 2023 Nov 21;14:1269781. doi: 10.3389/fendo.2023.1269781. PMID: 38075075; PMCID: PMC10702745.
Van Die MD, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med. 2013 May;79(7):562-75. doi: 10.1055/s-0032-1327831. Epub 2012 Nov 7. PMID: 23136064.