A.Vogel PMS Vitex SPM Helps to relieve premenstrual symptoms. Made from Agnus-castus fruit Sugar-, gluten- and lactose-free Composition EACH mL CONTAINS TINCTURE OF: Medicinal ingredient: Chasteberry (Vitex agnus-castus) fruit (1:10) ........542 mg, equivalent to 54.2 mg of dried fruit. Non-medicinal ingredient: 1 mL of tincture contains 0.69 mL alcohol (ethanol). 1 mL = 33 drops. Dropper included. Dosage Adults: Take 20 drops, 2 times daily with water, 15 minutes before meals. Salivate before swallowing. Duration of use: Use for a minimum of 3 months to see beneficial effects. Historical overview Chaste tree (Vitex agnus castus) is a shrub from the Mediterranean region that adapts to all warm climates. The taste and the look of its fruits resemble peppercorns. Chaste tree has the reputation of being an anaphrodisiac. It is nicknamed "Monks pepper" because the monks used its berries to chase away "demons and evil thoughts" and to keep chaste. Chaste tree is mentioned in the texts of ancient authors such as Hippocrates and Galen. It was used for menstrual troubles, to improve milk production, for all sorts of sexual dysfunction problem in both men and women and to reduce mens libido. Today, researchers focus on Chaste trees effect on premenstrual syndrome. Actions and pharmacology Vitex active components are mainly flavonoids (casticine, luteolin, artemetin, isorhamnetin), essential oils (terpenes: 1,8-cineol, alpha-pinenes and beta-pinenes), iridoid glycosides (aucubine, agnoside or agnuside, eurostoside) and alkaloids (viticine). Chaste trees action mechanism is not yet fully understood. We know that it inhibits prolactin secretion (milk production hormone) probably via an action on dopamine receptors in the pituitary gland.(1,2) Some authors speculate that chaste tree contains progesterone but most researchers have not found any. If progesterone is present at all, it is in quantities too small to explain the effect of the extract. It is more probable that chaste trees action on the pituitary gland results in a stimulation of the corpus luteum increasing its progesterone secretion. This increased secretion normalizes the oestrogen/progesterone ratio in the 2nd half of the menstrual cycle. These two effects (prolactin inhibition and increased progesterone secretion) combine to make vitex a most effective tool to relieve PMS symptoms. Note however that it may take up to 3 months for relief to appear. The German Commission E acknowledges its benefits in cases of: menstrual irregularities, PMS, and mastodynia (painful breasts). Scientific studies Many studies confirm the efficacy of Chaste tree extracts to relieve premenstrual syndrome. The first studies date from the 1930s in Germany.(2) A recent clinical study on 178 women showed the efficacy of Chaste tree in relieving PMS symptoms: irritability, mood alteration, anger, headache, breast fullness, and other menstrual symptoms including bloating.(3) The same authors conducted another study on 43 patients for a duration of 8 cycles. In both studies, they concluded that Chaste tree was innocuous and efficacious.(4) In 2000, 1634 women participated in an uncontrolled open study to determine the efficacy and safety of Chaste tree. Four major PMS symptoms were evaluated: depression, anxiety, cravings, and hyperhydration (DACH). 93% of women reported an important reduction of symptoms or a cessation of PMS altogether. Mastodynia (breast tenderness) was the symptom that had the smallest response to treatment since it was still present, though less severe, after 3 months. Only 1.2% of women reported mild side effects (see below).(5) In another placebo-controlled study (49 women received a placebo and 48 received Chaste tree). Researchers evaluated the effect of Chaste tree on breast tenderness in the last 5 days of the cycle. Pain diminished markedly in the group receiving Chaste tree.(6) Precautions, contraindications and interactions Consult a healthcare practitioner prior to use if you are taking hormone-containing medications such as progesterone preparations, oral contraceptives or hormone replacement therapy. Avoid taking in case of known allergy to any of the ingredients in the product. Consult a healthcare practitioner if symptoms persist or worsen. Do not use if safety seal is broken. Keep out of reach of children. Some rare cases (less than 2% of users) of nausea, gastric irritation and skin troubles (acne and rash) have been reported. Because of the possible effect on dopamine receptors (in vitro), it is suggested to avoid taking Chaste tree when using medication for Parkinsons disease or medications like metoclopramide (Maxeran® or Reglan®). References 1-Meier B, Berger D, Hoberg E et al. Pharmacological activities of Vitex agnus-castus extracts in vitro. Phytomedicine 2000 Oct;7(5):373-81. 2- Principles And Practice of Phytotherapy, modern herbal medicine. Mills S, Bone K. Churchill Livingstone 2000. London UK. 3- Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001 Jan 20;322(7279):134-7. 4- Berger D, Schaffner W, Schrader E et al. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS). Arch Gynecol Obstet 2000 Nov;264(3):150-3. 5- Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med 2000 Apr;9(3):315-20. 6- Halaska M, Raus K, Beles P et al. Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo. Ceska Gynekol 1998 Oct;63(5):388-92.