The effects of Vitex agnus-castus on menstrual bleeding: A systematic review and meta-analysis
-
Sanaz Mollazadeh
und
Nafiseh Ghassab Abdollahi
Abstract
Introduction
Vitex agnus-castus, also called Vitex, is a plant with many medicinal properties. This systematic study examined the evidence of the effectiveness and safety of Vitex on menstrual bleeding (primary outcome) and its side effects (secondary outcomes).
Materials and methods
This systematic review study examined all papers that were a randomized controlled trial, quasi-experimental, and cross-over conducted on the effect of Vitex on menstrual bleeding, following the PICO (population, intervention, control, and outcomes) criteria without any time limits in December 2017. The participants were women of reproductive age with no gynecologic disorders. The intervention included the use of Vitex in form of tablets, capsule, or oral drops with different doses. The control group included the placebo or mefenamic acid group. The search strategy in this study was in accordance with MeSH terms. The keywords used separately or in combination with other words were Menstrual bleeding OR Menstruation OR Menorrhagia AND Vitexcastus OR Vitex OR Chasteberry AND randomized controlled trial OR randomized trial OR randomized clinical trial OR randomized controlled. All papers, including Persian or English, were searched for in the databases; Medline (through PubMed), Scopus, Embase (through Ovid), Cochrane Library, Web of Sciences, Google Scholar, SID, Magiran, Irandoc, and Iranmedex, without any time limits. Two authors independently reviewed the quality of the papers and assessed the risk of bias based on Cochrane handbook, and the disputes were resolved through discussion and consensus with a third person. The meta-analysis was done on continuous data (mean of menstrual bleeding). In meta-analysis, subgroup analysis was performed based on the type of comparison group.
Results
Out of the 8,905 searched papers in the databases, 8,905 titles, 720 abstracts, 85 full texts, and 20 references of the papers were reviewed, of which 5 papers entered this study. Based on the subgroup analysis, the consumption of Vitex did not have a significant effect on the amount of menstrual bleeding compared to the placebo group in the first (mean difference [MD]: 3.08; 95% CI: −3.11–9.26; p=0.33; I2=0%) and second menstrual cycles (MD: 0.00; 95% CI: −5.75–5.75; p=1.00; I2=0%). Also, the Higham mean score was statistically more in the Vitex group compared to the mefenamic acid group in the first menstrual cycle (MD: 7.17; 95% CI: 0.33–14.01; p=0.04; I2=0%) but there was no statistical significant difference between Vitex and mefenamic acid groups in the second menstrual cycle (MD: 12.18; 95% CI: −5.57–29.94; p=0.18; I2=75%). Only nausea and abdominal pain were reported as side effects of Vitex in the included studies.
Conclusions
The results of this study showed that the consumption of Vitex in the intervention group did not have a significant effect on menstrual bleeding in comparison with the placebo group. However, due to the relatively low quality of the papers, it is essential to perform clinical trials with an appropriate design to determine the effect of Vitex on menstrual bleeding.
Funding statement: There was no financial support source for this study.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Ethical statement: Primary data for human nor for animals were not collected for this research work.
Abbreviation form of the names of authors
Sanaz Mollazadeh: Mollazadeh S
Mojgan Mirghafourvand: Mirghafourvand M
Nafiseh Ghassab Abdollahi: Ghassab Abdollahi N
References
[1] Peyvandi F, Garagiola I, Menegatti M. Gynecological and obstetrical manifestations of inherited bleeding disorders in women. J Thromb Haemost 2011;9:236–45.10.1111/j.1538-7836.2011.04372.xSuche in Google Scholar PubMed
[2] Finch CA, Cook J, Labbe R, Culala M. Effect of blood donation on iron stores as evaluated by serum ferritin. Blood 1977;50:441–7.10.1182/blood.V50.3.441.441Suche in Google Scholar
[3] Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health 2007;10:183–94.10.1111/j.1524-4733.2007.00168.xSuche in Google Scholar PubMed
[4] Willman EA, Collins W, Clayton S. Studies in the involvement of prostaglandins in uterine symptomatology and pathology. BJOG 1976;83:337–41.10.1111/j.1471-0528.1976.tb00839.xSuche in Google Scholar PubMed
[5] Madhra M, Fraser IS, Munro MG, Critchley HO. Abnormal uterine bleeding: advantages of formal classification to patients, clinicians and researchers. Acta Obstet Gynecol Scand 2014;93:619–25.10.1111/aogs.12390Suche in Google Scholar PubMed
[6] Lethaby A, Augood C, Duckitt K, Farquhar C. Nonsteroidal anti-inflammatory drugs for heavy menstrual bleeding. Cochrane Database Syst Rev 2007;4:CD000400.10.1002/14651858.CD000400.pub2Suche in Google Scholar PubMed
[7] Romm A. Botanical medicine for women’s health. St Louis, Mo: Churchill Livingstone/Elsevier, 2010.Suche in Google Scholar
[8] Miraj S, Rafieian-Kopaei, Kiani S. Melissa officinalis L: a review study with an antioxidant prospective. J Evid Based Complementary Altern Med 2017;22:385–94.10.1177/2156587216663433Suche in Google Scholar PubMed PubMed Central
[9] Dennehy CE. The use of herbs and dietary supplements in gynecology: an evidence-based review. JMWH 2006;51:402–9.10.1016/j.jmwh.2006.01.004Suche in Google Scholar PubMed
[10] Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlova-Wuttke D. Chaste tree (Vitex agnus-castus)–pharmacology and clinical indications. Phytomedicine 2003;10:348–57.10.1078/094471103322004866Suche in Google Scholar PubMed
[11] Donald J, Brown N. Vitexclinical monograph. Med Ser 1994;45:132–7.Suche in Google Scholar
[12] Yavarikia P, Shahnazi M, Mirzaie SH, Javadzadeh Y, Lutfi R. Comparing the effect of mefenamic acid and Vitexon intrauterine device induced bleeding. J Caring Sci 2013;2:245.Suche in Google Scholar
[13] Zamani M, Mansour GM, Farimani M, Nasr ES. Efficacy of mefenamic acid and Vitex in reduction of menstrual blood loss and HB changes in patients with a complaint of menorrhagia. Iran J Obstet Gynecol Infertil 2007;10:79–86.Suche in Google Scholar
[14] Daniele C, Coon JT, Pittler MH, Ernst E. Vitexcastus. Drug Saf 2005;28:319–32.10.2165/00002018-200528040-00004Suche in Google Scholar PubMed
[15] Shahhosseini Z, Amin G, Danesh M, Abedian K. Double blind study of anti primary dysmenorrhea effects of vitagnus. J Mazandaran Univ Med Sci 2005;15:15–21.Suche in Google Scholar
[16] Shobeiri F, Zeraati F, Mansouri Z, Araghchian M, Nazari M. The comparative effect of herbal extract of vitagnus and mefenamic acid on primary dysmenorrhea. Zahedan J Res Med Sci 2012;14:30–3.Suche in Google Scholar
[17] Schulz V, Hänsel R, Tyler VE. The 100 most commonly prescribed herbal medications in Germany. In: Rational phytotherapy. Springer, Berlin, Heidelberg: Springer, 1998:287–92.10.1007/978-3-642-97704-6_10Suche in Google Scholar
[18] Milewicz A, Gejdel E, Sworen H, Sienkiewicz K, Jedrzejak J, Teucher T, et al. Vitexcastus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 1993;43:752–6.Suche in Google Scholar
[19] Ryu A, Kim TH. Premenstrual syndrome: a mini review. Maturitas 2015;82:436–40.10.1016/j.maturitas.2015.08.010Suche in Google Scholar PubMed
[20] Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitexcastus extract in the treatment of remenstrual dysphoric disorderp. Hum Psychopharmacol 2003;18:191–5.10.1002/hup.470Suche in Google Scholar PubMed
[21] Shobeiri F, Zeraati F, Araghchian M, Nazari M. The effect of fennelin, vitagnus and mefenamic acid in the treatment of menstrual bleeding. Sci J Hamadan Univ Med Sci 2014;21:171–6.Suche in Google Scholar
[22] Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Ahmadpour P, Javadzadeh Y. Effects of Vitexand Flaxseed on cyclic mastalgia: a randomized controlled trial. Complement Ther Med 2016;24:90–5.10.1016/j.ctim.2015.12.009Suche in Google Scholar PubMed
[23] van Die MD, Burger HG, Bone KM, Cohen MM, Teede HJ. Hypericum perforatum with Vitex agnus-castus in menopausal symptoms: a randomized, controlled trial. Menopause 2009;16:156–63.10.1097/gme.0b013e31817fa9e0Suche in Google Scholar PubMed
[24] Daniele C, Thompson Coon J, Pittler MH, Ernst E. Vitexcastus: a systematic review of adverse events. Drug Saf 2005;28:319–32.10.2165/00002018-200528040-00004Suche in Google Scholar PubMed
[25] Dugoua JJ, Seely D, Perri D, Koren G, Mills E. Safety and efficacy of chastetree (Vitex agnus-castus) during pregnancy and lactation. Can J Clin Pharmacol 2008;15:e74–9.Suche in Google Scholar
[26] Cerqueira RO, Frey BN, Leclerc E, Brietzke E. Vitexcastus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Arch Women’s Mental Health 2017;20:713–19.10.1007/s00737-017-0791-0Suche in Google Scholar PubMed
[27] Maleki-Saghooni N, Karimi FZ, Moghadam ZB, Najmabadi KM. The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review. Avicenna J Phytomedicine 2018;8:96.Suche in Google Scholar
[28] Verkaik S, Kamperman AM, van Westrhenen R, Schulte PFJ. The treatment of premenstrual syndrome with preparations of Vitexcastus: a systematic review and meta-analysis. Am J Obstet Gynecol 2017;217:150–66.10.1016/j.ajog.2017.02.028Suche in Google Scholar PubMed
[29] Rafieian-Kopaei M, Movahedi M. Systematic review of premenstrual, postmenstrual and infertility disorders of VitexCastus. Electron Physician 2017;9:3685.10.19082/3685Suche in Google Scholar PubMed PubMed Central
[30] van Die MD, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med 2013;79:562–75.10.1055/s-0032-1327831Suche in Google Scholar PubMed
[31] Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. United Kingdom, England: John Wiley & Sons, 2011.Suche in Google Scholar
[32] Mirghafourvand M, Mohammad Alizadeh charandabi S, Javadzadeh Y, Ahmadpour P. The effect of Vitexand flaxseed on the menstrual bleeding: a randomized controlled trial. ZUMS J 2015;23:1–12.Suche in Google Scholar
© 2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Review
- Phytochemistry and neuroprotective effects of Eclipta alba (L.) Hassk
- The effects of Vitex agnus-castus on menstrual bleeding: A systematic review and meta-analysis
- RA-Experimental
- Evaluation of the hypoglycemic effect of seven wild folkloric edible plants from Palestine
- Antioxidant activity, carotenoids, chlorophylls and mineral composition from leaves of Pallenis spinosa: an Algerian medicinal plant
- Terminalia ferdinandiana, a traditional medicinal plant of Australia, alleviates hydrogen peroxide induced oxidative stress and inflammation, in vitro
- In vivo neuroprotective, antinociceptive, anti-inflammatory potential in Swiss albino mice and in vitro antioxidant and clot lysis activities of fractionated Holigarna longifolia Roxb. bark extract
- Virgin coconut oil supplementation in diet modulates immunity mediated through survival signaling pathways in rats
- Amelioration of Aflatoxin B1-induced gastrointestinal injuries by Eucalyptus oil in rats
- Effect of crude Moringa oleifera Lam. seed extract on the blood markers of metabolic syndrome in high-fructose diet-fed growing Sprague-Dawley rats
- Warionia saharae induces antihypertensive and vasorelaxant activities through nitric oxide and KATP channels pathways in rats
- Celecoxib, ibuprofen, and indomethacin alleviate depression-like behavior induced by interferon-alfa in mice
- RA-Clinical
- Effect of hot arm and foot bath on heart rate variability and blood pressure in healthy volunteers
- Effectiveness of training program combining chakrayoga and meditation
- Effects of treadmill training on the balance, functional capacity and quality of life in Parkinson’s disease: A randomized clinical trial
- Effects of zinc supplementation on oxidant/antioxidant and lipids status of pesticides sprayers
- The effect of successful low-dose immunotherapy ascertained by provocation neutralization on lymphocytic calcium ion influx following electric field exposure
- Effect of emotional regulation training on depression, anxiety and stress among the patients with alcohol dependence admitted in selected de-addiction centers at south India
- Aromatherapy reduces fatigue among women with hypothyroidism: A randomized placebo-controlled clinical trial
- Efficacy of osteopathic treatment in patients with stable moderate-to-severe chronic obstructive pulmonary disease: a randomized controlled pilot study
- Workshop and package education intervention to knowledge, attitude and practice of ICU nurses on the use of physical restraints
Artikel in diesem Heft
- Review
- Phytochemistry and neuroprotective effects of Eclipta alba (L.) Hassk
- The effects of Vitex agnus-castus on menstrual bleeding: A systematic review and meta-analysis
- RA-Experimental
- Evaluation of the hypoglycemic effect of seven wild folkloric edible plants from Palestine
- Antioxidant activity, carotenoids, chlorophylls and mineral composition from leaves of Pallenis spinosa: an Algerian medicinal plant
- Terminalia ferdinandiana, a traditional medicinal plant of Australia, alleviates hydrogen peroxide induced oxidative stress and inflammation, in vitro
- In vivo neuroprotective, antinociceptive, anti-inflammatory potential in Swiss albino mice and in vitro antioxidant and clot lysis activities of fractionated Holigarna longifolia Roxb. bark extract
- Virgin coconut oil supplementation in diet modulates immunity mediated through survival signaling pathways in rats
- Amelioration of Aflatoxin B1-induced gastrointestinal injuries by Eucalyptus oil in rats
- Effect of crude Moringa oleifera Lam. seed extract on the blood markers of metabolic syndrome in high-fructose diet-fed growing Sprague-Dawley rats
- Warionia saharae induces antihypertensive and vasorelaxant activities through nitric oxide and KATP channels pathways in rats
- Celecoxib, ibuprofen, and indomethacin alleviate depression-like behavior induced by interferon-alfa in mice
- RA-Clinical
- Effect of hot arm and foot bath on heart rate variability and blood pressure in healthy volunteers
- Effectiveness of training program combining chakrayoga and meditation
- Effects of treadmill training on the balance, functional capacity and quality of life in Parkinson’s disease: A randomized clinical trial
- Effects of zinc supplementation on oxidant/antioxidant and lipids status of pesticides sprayers
- The effect of successful low-dose immunotherapy ascertained by provocation neutralization on lymphocytic calcium ion influx following electric field exposure
- Effect of emotional regulation training on depression, anxiety and stress among the patients with alcohol dependence admitted in selected de-addiction centers at south India
- Aromatherapy reduces fatigue among women with hypothyroidism: A randomized placebo-controlled clinical trial
- Efficacy of osteopathic treatment in patients with stable moderate-to-severe chronic obstructive pulmonary disease: a randomized controlled pilot study
- Workshop and package education intervention to knowledge, attitude and practice of ICU nurses on the use of physical restraints
