Vitex ** A Practical Guide

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A PRACTICAL GUIDE TO ESSENTIAL OIL Vitex Agnus Castus

ã 2002 Barbara Chopin Lucks, RA

 

This work is dedicated to my daughter, Marjorie, and the women of her

generation. May they meet the challenges and changes of life with

confidence, courage and a sustainable partnership with the natural

world.

 

On July 9, 2002, the National Institutes of Health abruptly halted a

long-term study of 16,000+ women using a combination of conjugated

equine estrogen and medroxyprogesterone acetate (brand name PremPro) for

menopausal balance. Participants were advised to stop this form of

hormone replacement therapy (HRT) due to increased risk of breast

cancer, heart attack and stroke. This announcement left staggering

numbers of American women and their physicians asking " What now? " to the

question of managing the physical, mental and emotional discomforts of

menopause.

 

American society is rapidly approaching a time when over half the women

in the nation will be post-menopausal. Unfortunately, many women fear

this transition. Perhaps the fear is well grounded. So many women have

watched their friends or family members struggle through a difficult

menopause with disruptive symptoms. They have seen marriages, careers

and friendships rocked by " the change " .

 

It is all too easy to tell a woman to just " guts it out " . It is easy

until sleepless nights, cognitive dysfunction and emotional roller

coasters become a personal issue. Women have turned to their physicians

for help and a " game plan " , but all too often have come away with

nothing more than a prescription slip for a menopausal magic bullet. In

all fairness to the physicians, many women have demanded an easy fix.

Doctors and pharmaceutical companies have simply responded to the

market.

 

Now our standard, one-size-fits-all therapy has shed its golden aura to

reveal a heart of lead. Our days of evading personal responsibility, as

well as stubbornly denying that our bodies and spirits are undergoing a

natural transition, are gone.

 

Does menopause have to be a rocky road? I believe the answer is a firm

NO with one important caveat. The menopausal woman MUST take

responsibility for her own unique experience. She must educate herself.

She must retain personal responsibility for her health, even if she

seeks the counsel of a health professional. She must acknowledge her

entry into a transition that has been rightly compared to adolescence in

both duration and transfiguration. Not changing is NOT an option.

 

For a minority of American women, it is all smooth sailing. The

majority will experience some waves, and approximately 15% will be

tossed on some pretty rough seas. However, there are some very valuable

tools for navigating the waters. This paper will focus on a tool that

is showing increasing promise in both research and daily use, the

essential oil of Vitex agnus castus, commonly known as chaste berry.

 

Essential oil Vitex agnus castus is quickly proving itself to be a very

useful tool for hormonal balancing in many stages of a woman's life.

While there are hosts of studies and centuries of empirical data

confirming the efficacy of the herb, study of the therapeutic effect of

the volatile components of the plant is relatively new.

 

Essential oil Vitex is exhibiting a remarkable ability to reduce or

eliminate hot flashes and night sweats. Many women also report that

vaginal tone and lubrication is markedly improved with use of the oil.

A majority of test subjects who reported irregular periods before using

the oil reported regulation of periods after a few months of use.

However, the effect that elicits the most grateful comments is the

apparent ability of Vitex to calm emotional swings and help with some of

the cognitive changes during menopause.

 

This assessment is based on four years of personal use, plus

communication from approximately 100 correspondents over the same period

of time. Some information came from two survey-based studies I

conducted, while other came from personal communications. I prefer to

think of my work as an anthology, or collection of experience, rather

than a formal study. I am sure that most professionals who conduct

formal studies would agree with me. However, the collaboration of pure

researchers with those of us who are out in the field collecting

anecdotal data is evolving into a unique brand of aromatherapy research

that is beginning to receive serious attention.

 

I conducted a small, survey-based study two years ago (2000) using the

oil as a tool for menopausal balance. 80% of the 23 subjects reported

moderate to significant improvement in menopausal symptoms after using

the oil for 2-3 months. 10% noted no difference, while the other 10%

found that their symptoms worsened. An interesting side note of the

2000 study was a comparison of an oil distilled from the leaves (area of

origin, Turkey) with another oil distilled from the berries (area of

origin, Crete). The leaf oil generally appeared to be both gentler and

broader in its scope of efficacy, with more benefits and fewer unwanted

side effects than the berry oil. The evidence is anecdotal, and formal

trials would be helpful in confirming or negating this apparent

difference.

 

Comparison of the Principal Constituents of Vitex agnus-castus essential

oil

Constituent Leaf Berry

sabinene 20.71% 24.16%

a-pinene 16.60% 6.61%

p-cymene 0.99% 0.92%

1,8-cineole 25.16% 19.61%

(e)-beta-farnesene 11.25% 6.18%

(e)-beta-caryophyllene 7.78% 3.81%

a-terpinyl acetate 6.03% 4.16%

trans-sabinene hydrate 0.29% 0.31%

cis-sabinene hydrate 0.23% 0.27%

terpinen-4-ol 1.06% 2.37%

a-terpineol 1.55% 0.82%

 

Janina Maria Sorensen, a scientist and the distiller of the berry oil

used in the trial, continues to do formal research in this area. She

has recently published an article on the topic in the IFPA journal, " In

Essence. " As a writer who is NOT a scientist, it has been my pleasure

to collaborate with Janina. A collaborative presentation of the

original Vitex Anthology is scheduled for late summer publication in

" Complementary Therapies in Nursing and Midwifery " , a British nursing

publication. One of the most challenging aspects of getting this work

published in a journal that usually covers standard research protocols

was the difficulty of conveying why there cannot be an aromatherapy

" placebo " .

 

The original Vitex Anthology was published in " Aromatherapy Today " out

of Australia. John Kerr, the publisher of the journal, wanted the story

as much as the data, for which I am grateful. I am, and will remain,

foremost a writer.

 

When I wanted to conduct a second round of trials, I knew I needed a

collaborator. I knew that the format needed to be tighter, and yet I

wanted it close enough to the original format that the prior data could

be integrated into the new data. Dr. Janet Scavarda, chiropractor and

aromatherapist, friend and associate, was of immeasurable assistance in

refining the original format. She was also a participating

practitioner, as well as a subject.

 

The second round of survey-based trials is currently in progress, using

a Turkish oil distilled from both leaf and berry. Over a dozen

practitioners in the U.S. and Canada have monitored 3-7 subjects apiece,

using a standard dermal cream application of essential oil Vitex agnus

castus over a three-month period. At the date of this writing (August

2002), results from the practitioners are just beginning to come in.

Full results will be reported at the 5th Scientific Holistic

Aromatherapy Conference hosted by PIA in San Francisco and scheduled for

October 18-20, 2002

 

What is this essential oil, and how do you know if it is right for you

or your clients? First of all, do not make the mistake of assuming that

there is a magic green bullet that will replace the pharmaceutical fix.

Menopause is not dysfunction that needs fixing; it is transition that

requires education and management. Effective management demands

assessment of many life choices from diet to exercise to the quality of

personal relationships. Stress management, spiritual nurturing and

realistic attitude are key.

 

Vitex agnus castus has been used in herbal form for many hundreds of

years for female complaints. Native to Mediterranean climates, the

plant is a member of the verbenaceae family. The berries are the part

traditionally used, most often powdered in capsules or in a tincture.

The volatile oil is a very recent addition to the market, and has an

extremely low yield, with one metric tonne of plant material needed to

produce one kilogram of essential oil. As the botanical name implies,

the plant was used to promote chastity, and was so successful in

quashing desire in medieval monasteries that it was added to the food as

a seasoning, thus earning one of its common names, " monks pepper " . Most

people know the plant as chaste tree. It has been used in Europe, and

much more recently in the United States, for a wide variety of female

hormonal imbalances. Many modern works on menopause, including Dr.

Christiane Northrup's " The Wisdom of Menopause " , reference the herb as a

valuable tool.

 

Vitex agnus castus acts directly on the pituitary, helping to normalize

progesterone levels. The exact mode of action, or so-called active

ingredient, has not been identified. Much current thinking on

menopausal imbalance echoes the work of Dr. John Lee, who proposes that

a lack of estrogen is not the culprit behind our menopausal woes.

Rather, it may well be a dominance of estrogen and an imbalance of

progesterone. The effectiveness of Vitex may add further support to

this line of thought.

 

So why use the essential oil if the capsules and tinctures derived from

the berries work? One reason is that the herb and the essential oil are

two different things. Some women who cannot tolerate the herbal

preparations do very well with the essential oil. A second reason is the

convenience of using the essential oil in pocket inhalers and dermal

creams. A third is the long shelf life of the essential oil. However,

one of the most intriguing reasons is the ability to access the power of

the leaf, which may add a breadth and gentleness to the impact of the

berry. Standard herbal preparations use only the berry. It appears

that to obtain a therapeutic dosage of the volatile components of the

leaf, the isolation and concentration of distillation may be required.

 

Essential oil Vitex agnus castus is not for every woman at every stage

of transition. Experience suggests that it tends to work better as a

woman progresses past monthly periods, with more unwanted side effects

reported while women are still menstruating. However, a marked number

of women troubled by irregular periods and heavy bleeding find that use

of vitex moderates and regulates perimenopausal menstruation.

 

The first good news is that you will not need to guess if the oil is

right for you. The oil will tell you, and it probably will not be

subtle! Intolerance of the oil may be marked by nausea, headache,

nightmares, skin rash or a worsening of menopausal symptoms. Literature

indicates that use of the herb may result in formication (note the " m "

rather than the " n " !), the sensation of ants crawling on the skin, not

unlike a mild nettle rash. A few respondents have reported this

phenomenon with use of the essential oil. Both the literature and

experience warn that use of either the herb or oil may exacerbate

depression, potentially to the point of suicidal visualization. A few

respondents chose to discontinue the oil following emotional crises.

Many people, especially men, find the smell downright revolting and

experience a strong visceral response.

 

The other good news is that, to date, all reported undesirable side

effects have disappeared promptly with discontinuation of the oil,

lowering of dosages, or changes in method of application. Most problems

manifest themselves within two weeks of use, and many manifest within a

few days. A trial period is suggested to evaluate personal response to

the oil.

 

An abrupt change from pharmaceutical HRT to an herbal alternative is not

recommended; women who wish to discontinue synthetic HRT are advised to

work with a naturopathic physician or a medical herbalist.

 

Specific contraindications are noted later in this paper. After four

years of happy personal experience with the essential oil, as well as

reports from well over 100 women and/or their medical consultants, I am

firmly convinced that this is not an " over the counter " essential oil.

Caring and informed evaluation and monitoring are essential to this

essential oil. Vitex agnus castus is by far the trickiest and most

subtle essential oil this aromatherapist has ever used. A little goes a

long, long way. I currently use just four drops per week to keep in

balance. The spiritual impact is as profound as the physical impact.

 

Even after four years of use, I find I must constantly listen to my body

and spirit and adjust use accordingly. Every new harvest of essential

oil is by definition a unique product, and has required recalibration on

my part.

 

However, if the oil is right for a particular woman at a particular

time, she is likely to find the smell acceptable. Very, very few people

say they actually like it, though some women report that when they

really need the oil, they crave it and it does indeed smell attractive.

 

Response to the oil can take 4-6 weeks of regular use, or response can

be almost instant. I have witnessed very rapid release from hormonal

headaches and hot flashes by women who use the oil by inhalation.

Symptoms such as irregular periods and flooding generally start showing

improvement after 6-12 weeks of regular use. People who expect an

essential oil to work with the speed of a synthetic drug may give up too

soon on Vitex. Even if a woman has had an adverse response to vitex in

the past, experience shows that it may be a good tool if the woman has

progressed in her menopausal transition to the point where vitex works

well. It is worth another try.

 

What is the best way to use the essential oil? I suggest starting with

simple inhalation or application (to feet or abdomen) of a cream/lotion

containing 1%-2% oil Vitex. Suggested amount is ¼ to ½ teaspoon of

cream per application. Suggested frequency is once daily, 5-7 times per

week. Ingestion of the essential oil is not suggested unless monitored

by a medical professional. A suggested starting dosage for monitored

ingestion is one drop per day, 4-6 times per week. Stomach upset

frequently occurs with ingestion.

 

There are several important contraindications to the use of Vitex agnus

castus, in both herbal and oil form. It should not be mixed with any

form of hormone replacement without professional monitoring. This

includes progesterone cream and bioidentical, plant-derived hormones.

 

If a woman wishes to use it with hormone replacement, it is likely that

the progesterone-balancing aspect of the program can be reduced or

eliminated. " Double dipping " on the progesterone side can lead to

unwanted bleeding. Expert monitoring should look out for possible

ovarian hyperstimulation syndrome, as well as potentially life

threatening depression if estrogen levels drop too low. A medical

herbalist or naturopath is probably best prepared to suggest effective

herbal alternatives if estrogen balancing is indicated.

 

Vitex can reduce the effectiveness of oral contraceptives; it has

actually shown significant efficacy in infertility treatment. It should

not be used when pregnant or nursing. Finally, it should not be used

with drugs that are dopamine antagonists, such as haloperidol or

thioridazine. Vitex agnus castus is a proven dopamine agonist. An

agonist is a substance that binds to a receptor and triggers a response

in the cell. Agonists can be weak or strong depending on the strength

of response they elicit. An antagonist occupies the receptor without

triggering a response while preventing other substances from binding

with the receptor.

 

Early reports on the second round of survey-based trials have prompted

me to use caution with any woman who is using Prozac or similar drugs,

or who is dealing with difficult emotional issues by the use of drugs,

prescription or otherwise. At menopause, the body and psyche finally

refuse to keep tolerating habits and relationships that do not serve

us. Christiane Northrup, MD discusses this with tough insight in her

book, " The Wisdom of Menopause " . Based on reports I have received and

my own experience, vitex seems to force women to face their own issues,

and it may just be too much for some. Early reports also suggest that

women with autoimmune disorders may be more susceptible to paradoxical

responses to vitex, another reason for monitoring. It is quite possible

that there are other contraindications that will reveal themselves as

the herb and oil are used more widely.

 

It is also quite possible that other benefits of the plant, and

specifically the essential oil, will be revealed.

 

A small informal study conducted by the Pacific Institute of

Aromatherapy showed a remarkable improvement of PMS symptoms in women

using the essential oil. The women reported that it worked better than

any other herbal or over-the-counter treatments they had used for PMS.

 

Several texts suggest a possible anti-inflammatory property of the

sesquiterpenoids in the essential oil. A few trial subjects have

reported relief of arthritis symptoms when using the essential oil, even

though the questionnaire did not specifically ask about arthritis. Is

there a therapeutic potential here? It seems the more we experiment and

share information, the more potential therapeutic applications emerge.

 

Research in Europe has clearly demonstrated that the herb and oil act as

dopamine agonists; this stimulates interesting questions about its

potential use for Parkinson's disease and other central nervous system

disorders. Janina Maria Sorensen has brought up these questions in her

work. The following anecdotal case reports add to the argument that

this aspect may be worthy of formal study.

 

One participant in the 2000 trials made a blend of essential oils vitex

agnus castus, myristica fragrans and citrus limon for her mother, who

suffered from involuntary muscle movement as the result of a head injury

from a fall many years ago. As the lady aged, the tremors and

involuntary movement had progressed to the point that she was reluctant

to leave her home for fear of embarrassment. The essential oil blend

provided by her daughter, a trained aromatherapist, has restored her to

day-to-day life and society. She simply puts a few drops of the blend

on her collar, and this has reduced the tremors to the point that she is

comfortable going out in public.

 

I have personally seen a significant reduction in my own struggle with

Restless Leg Syndrome when I apply the oil in a 1.5% solution to my feet

at bedtime. Still, it is evident to me that the ultimate solution to my

own issue is stress management, and vitex simply does not have the same

quieting effect when my stress is high.

 

Can a woman with breast cancer issues use Vitex? According to Northrup

and other sources, yes. It is not a phytoestrogen, nor does is

stimulate estrogen production. It may even be protective by preventing

estrogen dominance. Of course, any woman dealing with breast cancer

issues should seek the counsel of a medical professional before using

Vitex or any hormone-balancing program.

 

What about estrogen?

 

Well, I, for one, need the stuff. I feel pretty miserable without it,

but I take it in bioidentical, plant-derived form. My M.D. prescribes

it and I get it mail order from a compounding pharmacy. Since

prescribing " unopposed estrogen " is generally a medical " no-no " , I have

a deal with my M.D. I believe that the vitex is effectively balancing

the estrogen, and she is willing to trust my judgment as long as I agree

to come in for an ultrasound and evaluation with the slightest

breakthrough bleeding. This seems reasonable to me, and I respect her

integrity in showing caution. Still, so far, I have experienced no

breakthrough bleeding. Plus, the persistent little fibroid that I have

had for about 5 years just went away.

 

However, I have a more compelling reason for making the personal choice

to use supplemental estrogen. I want to protect my body from endocrine

disruptors, the dread xeno-estrogens. These estrogen-like molecules are

in our food, water and air. Commercially produced meat, dairy and eggs,

and water bottled in plastic are common sources. Agricultural chemicals,

which are carried by the wind and water, are ubiquitous endocrine

disruptors. Strong estrogen receptor agonists, they latch on and cause

the cell to respond in a much stronger way than is natural or healthy.

It is believed that the American diet and environment, so full of these

Frankenstein hormone-mimickers, may be to blame for much of the

disproportional menopausal discomfort American women suffer. This is a

special problem if you live in an agricultural area, as I do. A really

good ceramic water filter is a health investment. Cheaper filters are

not fine enough to trap the endocrine disruptors. But we're still

breathing the stuff, carried on the wind. There's really no getting away

from it. If avoidance is impossible, protection becomes essential.

 

Phytochemicals with estrogen-like effects, such as those in soy, red

clover and other herbs, are weak agonists. That is, they occupy the

receptor sites without over firing the cell. This affords some

protection from endocrine disruptors, which are opportunistic

" squatters " . I think I'd like to choose who is residing in my

receptors, thank you. There are many, many time-proven, safe herbal

alternatives. Consult a good herbalist or naturopath; you are not going

to find the guidance you need in most health food stores.

 

Use of essential oil Vitex must still be regarded as experimental, and I

suggest that any woman using the oil must be fully informed of the

relative newness of the oil. Practitioners may wish to consider signed

consent forms. Any data on response to the oil, including intolerance,

is very valuable and is welcomed by the author.

 

Given the strength and subtlety of the essential oil, I feel that

exploration of varied extracts of vitex is warranted. Maybe there is

something between the essential oil and the crude herb that would

benefit many women and have the virtue of being accessible from the

small scale American producer. I am personally a big believer in

botanicals of the region. Given the volatility of world politics, I

would prefer not to rely entirely on overseas sources of botanicals when

we can grow so many right here at home.

 

Rhavda Cooper Emison of Texas has been hand-crafting intensely infused

oils for many years. She wrote me reporting that the vitex essential

oil studies prompted her to make an intensely infused oil of Vitex agnus

castus from plants growing in her garden, which she blended with several

other infused oils, including rose. She reports excellent results from

the blend.

 

Given the low yield of essential oil and the efficacy of very small

doses, the question of the possible use of the hydrosol has come up in

informal discussions. This is being further explored by a grower and

hydrosol distiller in Missouri who started as a subject in the first

round of vitex trials and continues to use the essential oil.

 

Vitex agnus castus is no magic bullet. It does not work for everyone,

but it does work remarkably well for a lot of women. It works best in

the context of a holistic health maintenance program. Factors, which

should be addressed, include diet, exercise, attitude, stress management

and spiritual balance. Its use should be monitored by a health

professional who is aware of the contraindications and possible side

effects. I have found essential oil Vitex agnus castus to be a steady

friend in my own navigation of menopause. With further use and

research, it is quite possible that this ancient remedy will take its

place at the cutting edge of women's medicine.

 

MANY THANKS to the subjects who participated in the second round of

trials, and especially to the practitioners who supported and monitored

the process. The practitioners are:

 

Barbara Lucks, Snowmass Village, CO

Dr. Janet Scavarda, Grand Junction, CO

Laurel Dewey, Glenwood Springs, CO

Peggy Jo Meehan, Norwood, CO

Jodi Baglien, Maple Grove, MN

Deb Galerneau/Renee Votta, Converse, TX

Linda Weihbrecht, Etters, PA

Janice Gagnon-Warr, New Bedford, MA

Tammy Wytrychowski, Yellow Knife, Northwest Territory, Canada

Dr. Chuck Woodfield, Wilmington, NC

Paula Warren, Webberville, MI

Marcia Elston, Seattle, WA

Linda Spicer, Ft. Smith, AR

 

REFERENCES

 

Emison, Rhavda Cooper, Herbalist. Personal e-mail communication re: use

of infused oil Vitex agnus castus

 

Kamen, Betty. Hormone Replacement Therapy: Yes or No? 1996 Nutrition

Encounter, Novato, CA.

 

Lucks, Barbara; Sorensen, J.; Veal, L. Vitex agnus-castus Essential

Oil and Menopausal Balance: A Self-Care Survey, " Complementary Therapies

in Nursing and Midwifery " . Elsvier Science, London. Scheduled

publication: August, 2002

 

Northrup, Christiane, M.D., The Wisdom of Menopause, 2001, Bantam

Books, New York, NY

 

Ody, Penelope, The Complete Medicinal Herbal, 1993, Dorling Kindersley,

London

 

Ojeda, Linda, Menopause without Medicine, 1995, Hunter House, Inc.,

Alameda, CA

 

Owen, Butch. Distiller/Broker. Personal e-mail communication re: yield

essential oil Vitex agnus castus

 

Proefrock, Kenneth, N.D., Botanicals as Selective Hormone Receptor

Modulators, Proceedings of the Southwest Conference on Botanical

Medicine, April, 2002, Tempe, AZ

 

Skidmore-Roth, Linda, Mosby's Handbook of Herbs and Natural Supplements,

2001, Mosby, Inc., St. Louis, MO

 

Winston, David, AHG, Herb-Drug Interactions and Herb Toxicity: Myth,

Facts and Theory. Proceedings of the Southwest Conference on Botanical

Medicine, April 2002, Tempe, AZ