Hypericum and Vitex for PMS in Peri-menopausal Women

 

Van Die, M, Bone K, Burger H, et al. Effects of a combination of Hypericum perforatum and vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: Findings from a subpopulation analysis. J Alternative and Comp Med 2009;15(9):1045-1048.

By Tori Hudson, ND

This double-blind randomized, placebo-controlled parallel trial was conducted in 14 perimenopausal women over 16 weeks. The primary objective was to evaluate Hypericum perforatum (St. John’s wort) and Vitex agnus-castus (chaste tree berry) in perimenopausal women with PMS.

The daily dose of St. John’s wort was an extract equivalent to 5400 mg dry herb flowers given in three tablets, each standardized to 990 mcg hypericins, 9 mg hyperforin and 18 mg flavonoid glycosides. The daily dose of chaste tree berry was an extract equivalent to 1,000 mg dry fruit. The chaste tree tablet was not a standardized extract. The Abraham’s Menstrual Symptom Questionnaire was used to record PMS-like symptoms. This questionnaire consists of clustering PMS symptoms into PMS-A (nervous tension, irritability, mood swings and anxiety); PMS-H (weight gain, swelling of extremities, breast tenderness and abdominal bloating); PMS-C (headaches, cravings for sweets, increased appetite, pounding heart, fatigue and dizziness); and PMS-D (depression, forgetfulness, crying, confusion and insomnia).

The St. John’s wort/Chaste tree berry combination was superior to placebo for total PMS like symptoms and the clusters of PMS-D and PMS-C.

Commentary: I am not surprised to see these results in perimenopausal women with PMS. Both of these herbs have been individually researched and shown significant benefit in PMS. St. John’s wort has also shown benefit in women with menopausal symptoms, while Chaste tree berry has not. Women with both PMS and perimenopausal symptoms are very common in my practice, and I often use both of these herbs to address the woman with both PMS and perimenopausal symptoms. Adding black cohosh is often necessary to address the hot flashes, and at least one study has shown the combination of black cohosh and St. John’s wort to be superior to placebo in the general menopause rating scale and the depression scale.

Tori Hudson, ND, graduated from the National College of Naturopathic Medicine and has served the college in several capacities, including: Medical Director, Associate Academic Dean, and Academic Dean. She has been practicing for 25 years, is currently a clinical professor at The National College of Naturopathic Medicine and Bastyr University, is medical director of her clinic in Portland, Ore., and director of product research and education for VITANICA. She is the author of Women's Encyclopedia of Natural Medicine second edition. Dr. Hudson serves on several editorial boards, advisory panels, and as a consultant to the natural products industry.