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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2026№6

Vitex agnus-castus in the treatment of premenstrual syndrome: a 30-year data analysis

DOI
https://dx.doi.org/10.18565/aig.2026.149

Artymuk N.V., Tachkova О.А.

Kemerovo State Medical University, Ministry of Health of Russia, Kemerovo, Russia

Background. Premenstrual syndrome (PMS) significantly reduces the quality of life for women of reproductive age. Preparations containing chaste tree fruit extract (Vitex agnus-castus, VAC) are widely used to alleviate PMS symptoms; however, the evidence regarding their efficacy requires systematic review.
Objective. To summarize and analyze data from meta-analyses, systematic reviews, and randomized clinical trials (RCTs) on the efficacy and safety of VAC in the treatment of PMS.
Materials and methods. A search was conducted in the Cochrane, MEDLINE, and PubMed databases. The keywords ‘premenstrual syndrome’ and ‘Vitex agnus-castus’ were used. The search covered a 30-year period (1997–2026). The analysis included 10 systematic reviews/meta-analyses and 11 RCTs.
Results. Data from large-scale meta-analyses demonstrate a significant advantage of VAC over placebo: the probability of remission increases by 2.57 times with a Hedges’g effect size of -1.21. RCTs confirm a statistically significant decrease in both physical (mastalgia, swelling) and psychoemotional symptoms. In a comparative study with fluoxetine, VAC demonstrated matching efficacy in premenstrual dysphoric disorder, while showing greater improvement in physical symptoms. A nonlinear dose-response relationship was observed, with a 20 mg dose yielding the optimal result. The safety profile of VAC-based medications is considered favorable: side effects (mild dyspeptic disorders, headache) were rare, reversible, and did not require discontinuation of therapy. Several authors point to the high heterogeneity of studies (I2 up to 91%) and the risk of systematic errors.
Conclusion. Vitex agnus-castus can be considered as an option for symptomatic treatment in patients with mild to moderate PMS, particularly when somatic symptoms predominate, provided that standardized medications are used and the limitations of the evidence base are taken into account. The strongest body of evidence has been accumulated from treatment courses lasting at least three menstrual cycles. However, the high heterogeneity of the studies requires additional multicenter RCTs to confirm these findings.

Authors’ contributions. Artymuk N.V., Tachkova О.А. – developing the concept and design of the study, editing the article; Artymuk N.V. – search and analysis of the material, writing the text.
Conflicts of interest. Authors declare lack of the possible conflicts of interests.
Funding. The study was conducted without sponsorship.
Generative Artificial Intelligence. The authors claim that they did not use artificial intelligence technologies when writing the article and conducting research.
For citation: Artymuk N.V., Tachkova О.А. Vitex agnus-castus in the treatment of premenstrual syndrome: a 30-year data analysis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (6): 49-58 (in Russian)
https://dx.doi.org/10.18565/aig.2026.149

Keywords

Vitex agnus-castus
premenstrual syndrome
chaste tree
phytotherapy
efficacy
Cyclodynon
premenstrual dysphoric disorder
Full text (in Russian)

References

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Received 30.04.2026

Accepted 02.06.2026

About the Authors

Natalya V. Artymuk, Dr. Med. Sci., Professor, Head of the G.A. Ushakova Department of Obstetrics and Gynecology, Kemerovo State Medical University, Ministry of Health of Russia, 22a, Voroshilov str., Kemerovo, 650056, Russia, +7(3842)73-48-56, +7(960)923-33-55, artymuk@gmail.com, https://orcid.org/0000-0001-7014-6492
Olga A. Tachkova, PhD, Associate Professor, Department of Hospital Therapy and Clinical Pharmacology, Kemerovo State Medical University, Ministry of Health of Russia,
22a Voroshilov str., Kemerovo, 650056, Russia, ol.an.t@yandex.ru, https://orcid.org/0000-0002-6537-3460
Corresponding author: Natalya V. Artymuk, artymuk@gmail.com

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