Pre-menstrual syndrome (PMS) is thought to affect about 90 p.c. of women at some point in their lives, with a significant proportion of these suffering regularly from severe and debilitating symptoms. While conventional treatment for PMS is based on the Pill and antidepressants, there is evidence that increasing numbers of women are seeking a more natural approach to this problem. One of the most established natural treatments for PMS is an extract of an exotic fruit known as Agnus castus. Just this month, the British Medical Journal (BMJ) published a study which proved the effectiveness of this natural remedy in the treatment of PMS. Over half the women in this study had significant improvement in their symptoms, and the treatment was found to be safe and generally free of side-effects. A favourite folk remedy for hundreds of years, Agnus castus appears to be making it’s way into mainstream medicine. Now would seem to be an ideal time to examine the effects of this herb on the body, and explore its potential in the treatment of PMS and other hormone-related problems.

Pre-menstrual syndrome (PMS) is a term used to describe a combination of various physical and mental symptoms that usually occur in the week or two prior to menstruation. Typical features of PMS include irritability, depression, tearfulness, fatigue, food cravings, abdominal bloating, breast fullness and tenderness, fluid retention and weight gain. The condition is highly individual, with the exact blend of symptoms and their duration varying considerably between women.

PMS is related to hormonal fluctuations in the second half of the menstrual cycle. One common feature of women with PMS is higher-than-normal levels of a hormone known as prolactin which is secreted by the pituitary gland at the base of the brain. Excess prolactin in the system can itself upset the balance of other hormones, and in particular is thought to result in a deficit of the hormone progesterone. Progesterone balances the effects of another hormone - oestrogen - in the body. A lack of progesterone can therefore give rise to a condition known as oestrogen dominance, which itself often seems to be an underlying factor in PMS.

Research from Germany shows that Agnus castus (also known as Chasteberry, Monk’s pepper and Vitex) can reduce prolactin levels and increase the production of progesterone. These effects help to correct the hormonal imbalances common in PMS, thereby helping to ease its symptoms. The recent BMJ study is not the only evidence which supports the use of Agnus castus in PMS. Last year, the Journal of Women’s Health and Gender Based Medicine published a study which examined the effect of Agnus castus in more than 1600 women. The study lasted three months, after which time 93 p.c. of the women reported an improvement in or elimination of their PMS symptoms. Four out of five women rated themselves as ‘much better’ or ‘very much better’. In keeping with these very positive findings, 85 p.c. of the doctors assessing the women rated the effectiveness of Agnus castus as ‘good’ or ‘very good’. The results of this study are even more encouraging than those of this month’s BMJ article. Interestingly, the original research used twice the dose of Agnus castus employed in the more recent study (20 mg of herb twice a day compared to only once a day).

While PMS is common, it is not the only consequence of hormonal imbalance in the female body. Many women find that the condition of their skin noticeably worsens before a period. One study dating from 1967 showed that Agnus castus may be effective in the treatment of the ‘acne flare’ common in the pre-menstrual phase. Agnus castus may also help in some cases of infertility. While female infertility may have many different causes, hormone imbalance, including high levels of prolactin and low levels of progesterone, can be a factor. Women with such imbalances may benefit from treatment with Agnus castus, though it may take a year or more for benefit to become apparent. Once pregnancy is confirmed, Agnus castus should be stopped as it may interfere with important hormone changes at this time.

Agnus castus appears to be an extremely safe and well-tolerated herb. In studies, side effect rates are low (typically between 1 – 5 p.c.), and tend to be mild in nature. The normal recommended dose of Agnus castus is 40 mg of dried herb or 40 drops of concentrated liquid extract once a day, or 20 mg of dried herb, twice a day. Agnus castus preparations are readily available in health food stores.

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