Key finding
In 170 women with premenstrual syndrome (PMS), a daily Vitex agnus-castus fruit extract (Ze 440, 20 mg) taken for three cycles improved irritability, mood changes, anger, headache and breast fullness more than placebo. Over half of the women taking Vitex (52%) had at least a 50% fall in symptoms, compared with 24% on placebo. Side effects were mild and similar in both groups, and bloating did not improve more than with placebo.
Vitex is a reasonable option for women whose PMS is mainly mood and breast symptoms. Advise use over at least three cycles before judging the effect, avoid it in pregnancy and breastfeeding, and take care alongside dopamine-acting medicines or hormonal treatments. The trial was funded by the extract's manufacturer.
Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001;322(7279):134-137.
Read the original paperSummarised by the Draxer Clinical Advisory Department for health professionals. It supports, and does not replace, clinical judgement.