Research Article| Volume 55, SUPPLEMENT 1, S55-S63, November 01, 2006

Vitex agnus castus: Successful treatment of moderate to severe premenstrual syndrome



      To assess efficacy and tolerability of a special extract of Vitex agnus castus (VAC, BNO 1095) in the treatment of women suffering from premenstrual syndrome (PMS) with moderate to severe complaints.


      Prospective, open, non-comparative, monocentre study. After a run-in phase lasting three cycles, eligible patients were treated for up to three cycles with VAC extract. Efficacy was assessed using a PMS-Diary (primarily) and the PMTS score.


      One hundred and twenty-one patients were enrolled, 118 provided efficacy data (full analysis set), and 109 completed the treatment phase. The severity of the PMS symptoms consistently decreased during treatment, on average from 22.8 score points during the baseline cycle to 10.2 during the third cycle. The mean decrease was 12.6 score points (95% CI: 10.9–14.4, p < 0.0001, Student's t-test). Response to treatment was found in 67.8% of the women during the third treatment cycle (95% CI: 58.6–77.0). Results for the PMTS were similar with a decrease on average from 22.5 to 11.0 score points, i.e. mean change −11.4 (95% CI: 10.1–12.8, p < 0.0001).


      Vitex agnus castus extract BNO 1095 is effective and well tolerated in the treatment of moderate to severe PMS.


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        • Sternfeld B.
        • Swindle R.
        • Chawla A.
        • Long S.
        • Kennedy S.
        Severity of premenstrual symptoms in a health maintenance organization population.
        Obstet Gynecol. 2002; 99: 1014-1024
        • Singh B.B.
        • Berman B.M.
        • Simpson R.L.
        • Annchild A.
        Incidence of premenstrual symptome and remedy usage: a national probability sample study.
        Altern Ther Health Med. 1998; 4: 75-79
        • Steiner M.
        Premenstrual syndrome and premenstrual dysphoric disorder: guidelines of management.
        J Psychiatry Neurosci. 2000; 45: 459-468
        • Wittchen H.U.
        • Becker E.
        • Liebt R.
        • et al.
        Prevalence, incidence and stability of premenstrual dysphoric disorder.
        Psychol Med. 2002; 32: 119-132
      1. American Psychiatric Association. Diagnostic and statistical manual of mental disoders, 4th ed. Washington, DC: Am. Psychiatric Ass. Press; 1994.

        • Ho K.Y.
        • Thorner M.O.
        Therapeutic applications of bromcriptine in endocrine and neurological diseases.
        Drugs. 1988; 36: 67-82
      2. Pravidel®. Summary of product characteristics (Fachinformation), Novartis Pharma GmbH, Germany, status: February 2004.

      3. The Register of medicines of Russia (Encyclopaedia of medicines), issue 9, 2002;170–1.

        • KiIicdag E.B.
        • Tarim E.
        • Bagis T.
        • et al.
        Fructus agni casti and bromocriptine for treatment of hyperprolactinemia and mastalgia.
        Int J Gynaecol Obstet. 2004; 85: 292-293
        • Wuttke W.
        • Gorkow C.
        • Jarry H.
        Dopaminergic compounds in Vitex agnus castus.
        in: Loew R.N. Darmstadt D. Phytopharmaka in Foschung und klinischer Anwendung. Steinkopff Verlag, 1995: 81-91
        • Christoffel V.
        • Spengler B.
        • Abel G.
        • Jarry H.
        • Wuttke W.
        Diterpenes from BNO 1095 (Vittex agnus castus) inhibit prolactin secretion.
        in: Proceedings of the 6th annual symposium on complementary health care, Exeter, UK1999
      4. Jarry H, Christoffel V, Spengler B, Popp MA, Wuttke W. Diterpens isolated from Vitex agnus castus BNO 1095 inhibit prolactin secretion via specific interaction with dopamine D2 receptors in the pituitary, Jahrestagung der Ges. Für Phytotherapie, Münster; 1999.

        • Merz P.G.
        • Gorkow C.
        • Schrödter A.
        • et al.
        The effects of a special Agnus Castus-extract (BP1095E1) on prolactin secretion in healthy male subjects.
        Exp Clin Endocrinol Diabetes. 1996; 104: 447-453
        • Jarry H.
        • Leonhardt S.
        • Gorkow C.
        • Wuttke W.
        In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay.
        Exp Clin Endocrinol. 1994; 102: 448-454
        • Wuttke W.
        • Jarry H.
        • Christoffel V.
        • Spengler B.
        • Seidlova-Wuttke D.
        Chaste-tree (Vitex agnus castus)—pharmacology and clinical indications.
        Phytomedicine. 2003; 10: 348-357
        • Brugisser R.
        • Burkard W.
        • Simmen U.
        • Schaffner W.
        Untersuchungen an opioid-rezeptoren mit Vitex agnus castus L..
        Phytotherapie. 1999; 20: 154-158
        • Hoberg E.
        Phytochemical and analytical investigations of Vitex agnus castus L. (dissertation).
        Swiss Federal Institute of Technology Zürich, Zürich, Switzerland1999 (Available from: Diss: ETH 13285)
        • Lauritzen Ch
        • Reuter H.D.
        • Repges R.
        • Böhnert K.J.
        • Schmidt U.
        Treatment of premenstrual tension syndrome with Vitex agnus castus. Controlled, double-blind study vs. pyridoxine.
        Phytomedicine. 1997; 4: 183-189
        • Schellenberg R.
        Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study.
        BMJ. 2001; 322: 134-137
        • Halaska M.
        • Beles P.
        • Gorkow C.
        • Sieder C.
        Treatment of ciclical mastalgia with a solution containing a Vitex agnus castus extract: results of a placebo-controlled double-blind study.
        Breast. 1999; 8: 175-181
        • Atmaca M.
        • Kumru S.
        • Tezcan E.
        Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder.
        Hum Psychopharmacol Clin Exp. 2003; 18: 191-195
        • Steiner M.
        • Haskett R.F.
        • Carroll B.J.
        Premenstrual tension syndrome: the development or research diagnostic criteria and rating scale.
        Acta Psychiat Scand. 1980; 62: 177-190
      5. European Union, Eudralex, Vol. 9. Pharmacovigilance-Medicinal Products for Human use and Veterinary Medicinal Products, specifically therein Chapter 1.5; June/July 2004

      6. Agnucaston, Summary of product characteristics (Fachinformation), Bionorica AG, Germany, status of information; February 2004