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Vitex Improves Symptoms of PMS

A large new clinical study adds to the growing body of evidence supporting the use of the small fruits of vitex, also known as chastetree (Vitex agnus-castus L., Verbenaceae), in the treatment of premenstrual syndrome (PMS), a variable complex of symptoms affecting up to 40 percent of fertile women (Loch et al., 2000).

According to results of the open-label German trial, 93 percent of study participants reported that their PMS symptoms either decreased or disappeared altogether after treatment with vitex over the course of three menstrual cycles. According to the investigators, PMS has been associated with up to 150 different symptoms, most of which fall into four classic "symptom complexes" defined as depression, anxiety, craving, and hyperhydration (DACH). Their study was designed to assess the efficacy and tolerability of a new solid vitex preparation called FemicurŪ, manufactured by Schaper & Brummer GmbH & Co., Salzgitter, Germany. Each capsule contains 1.6-3.0 mg dried extract of vitex berry in a ratio of 6.7-12.5:1, equivalent to 20 mg of dried berry.

The 1634 study participants received treatment with one capsule twice daily of Femicur, and changes from baseline were recorded on questionnaires completed by physicians based on interviews conducted before treatment and again after three menstrual cycles. The questionnaires were specifically designed to determine the effect of vitex on psychological and physical symptoms, the four classic DACH complexes, and single groups of characteristic symptoms. Improvement was assessed according to the standard Clinical Global Impression Scale, which allows patients to rate symptomatic change on a scale of one to seven (very much improved to very much worse).

At the end of the trial, statistically significant decreases were observed in the frequency of all symptoms and DACH complexes. Forty-two percent of patients reported that they were no longer affected by PMS, 51 percent had a decrease in symptoms, six percent reported no change, and one percent reported an increase in the number of symptoms. Eighty-six percent of physicians noted that vitex treatment had "a pronounced efficacy," and 81 percent of participants rated their status after treatment as "very much or much better." With regard to tolerability, 94 percent of the women rated the vitex preparation as good or very good, and no serious side effects were reported. Minor side effects reported by the remaining women included mild skin reactions and gastrointestinal upset. In an interesting aside, the authors suggested that vitex may have had a positive effect on fertility for some women who had trouble becoming pregnant before the trial. They noted, "Data from this trial support the occasionally described restoration of fertility by Vitex treatment. No woman was pregnant at the start of Vitex therapy, and 19 of the 23 women who conceived while on Vitex treatment belonged to the group of 126 women (8%) who had been to date unsuccessful at becoming pregnant."

- Evelyn Leigh, Herb Research Foundation [Loch E-G, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. Journal of Women's Health & Gender-Based Medicine 2000; 9(3): 315-320.]

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