Supplement

Chaste tree

Chaste tree is a shrub whose dried berries are used as an herbal extract, thought to act on the brain's dopamine and prolactin signaling, which helps steer the menstrual cycle. People mostly look at it for premenstrual syndrome, and the evidence is strong overall: in a trial of 405 women, breast tenderness improved, and anxiety symptoms also eased in a smaller group. Those anxiety findings came from only 64 women, so the evidence there is limited, and the breast tenderness result rests on a single study.

Sources: PMID 26860808

Updated 30 September 2026
How we grade
9 studies cited

Best evidence: Grade A
Conditions studied: 5
Outcomes: 15
Graded outcomes: 1020

Evidence by condition

Strong
Moderate
Limited
Very limited

5 conditions

Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS): outcomes studied for Chaste tree
Grade	Outcome	Effect	Size	Studies	People
	Breast Tenderness Moderate Improvement	Improves (the measure goes down)	Moderate effect	1 study	405 people
Studies that measured breast tenderness Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trialComplement Ther Med · PMID 26860808
	Anxiety Symptoms Small Improvement	Improves (the measure goes down)	Small effect		64 people
	PMS Symptoms	Improves (the measure goes down)		9 studies	883 people
Studies that measured pms symptoms Treatment of premenstrual tension syndrome with Vitex agnus castus controlled, double-blind study versus pyridoxinePhytomedicine · PMID 23195474 Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS)Arch Gynecol Obstet · PMID 11129515 Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label studyAdv Ther · PMID 24604699 Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndromePhytomedicine · PMID 23022391 Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observationActa Neurol Belg · PMID 22791378 Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese womenAust N Z J Obstet Gynaecol · PMID 20522079 Therapeutic effect of Vitex agnus castus in patients with premenstrual syndromeActa Med Iran · PMID 22359078 Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorderHum Psychopharmacol · PMID 12672170 Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in ChinaMaturitas · PMID 19269753
	Cramps	Improves (the measure goes down)			64 people
	Depression Symptoms	Improves (the measure goes down)			192 people
	Fatigue Symptoms	Improves (the measure goes down)			67 people
	Insomnia Signs and Symptoms	Improves (the measure goes down)			64 people
	Irritability	Improves (the measure goes down)			195 people
	Migraine Severity	Improves (the measure goes down)			128 people
	Sleep Quality	Improves (the measure goes up)			67 people

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD): outcomes studied for Chaste tree
Grade	Outcome	Effect	Size	Studies	People
	Depression Symptoms Small Improvement	Improves (the measure goes down)	Small effect		41 people
	PMS Symptoms	Improves (the measure goes down)		9 studies	41 people
Studies that measured pms symptoms Treatment of premenstrual tension syndrome with Vitex agnus castus controlled, double-blind study versus pyridoxinePhytomedicine · PMID 23195474 Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS)Arch Gynecol Obstet · PMID 11129515 Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label studyAdv Ther · PMID 24604699 Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndromePhytomedicine · PMID 23022391 Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observationActa Neurol Belg · PMID 22791378 Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese womenAust N Z J Obstet Gynaecol · PMID 20522079 Therapeutic effect of Vitex agnus castus in patients with premenstrual syndromeActa Med Iran · PMID 22359078 Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorderHum Psychopharmacol · PMID 12672170 Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in ChinaMaturitas · PMID 19269753

Migraine Headache

PMS Symptoms: improves

Migraine Headache: outcomes studied for Chaste tree
Grade	Outcome	Effect	Size	Studies	People	Studies list
	PMS Symptoms	Improves (the measure goes down)		9 studies	100 people
Studies that measured pms symptoms Treatment of premenstrual tension syndrome with Vitex agnus castus controlled, double-blind study versus pyridoxinePhytomedicine · PMID 23195474 Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS)Arch Gynecol Obstet · PMID 11129515 Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label studyAdv Ther · PMID 24604699 Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndromePhytomedicine · PMID 23022391 Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observationActa Neurol Belg · PMID 22791378 Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese womenAust N Z J Obstet Gynaecol · PMID 20522079 Therapeutic effect of Vitex agnus castus in patients with premenstrual syndromeActa Med Iran · PMID 22359078 Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorderHum Psychopharmacol · PMID 12672170 Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in ChinaMaturitas · PMID 19269753

Primary Dysmenorrhea (Menstrual Cramps)

PMS Symptoms: improves

Primary Dysmenorrhea (Menstrual Cramps): outcomes studied for Chaste tree
Grade	Outcome	Effect	Size	Studies	People	Studies list
	PMS Symptoms	Improves (the measure goes down)		9 studies	217 people
Studies that measured pms symptoms Treatment of premenstrual tension syndrome with Vitex agnus castus controlled, double-blind study versus pyridoxinePhytomedicine · PMID 23195474 Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS)Arch Gynecol Obstet · PMID 11129515 Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label studyAdv Ther · PMID 24604699 Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndromePhytomedicine · PMID 23022391 Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observationActa Neurol Belg · PMID 22791378 Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese womenAust N Z J Obstet Gynaecol · PMID 20522079 Therapeutic effect of Vitex agnus castus in patients with premenstrual syndromeActa Med Iran · PMID 22359078 Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorderHum Psychopharmacol · PMID 12672170 Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in ChinaMaturitas · PMID 19269753

Breast Pain

Breast Tenderness: improves

Breast Pain: outcomes studied for Chaste tree
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Breast Tenderness	Improves (the measure goes down)		1 study	159 people
Studies that measured breast tenderness Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trialComplement Ther Med · PMID 26860808

Key findings

Breast TendernessPremenstrual Syndrome (PMS)Improves (the measure goes down)
Anxiety SymptomsPremenstrual Syndrome (PMS)Improves (the measure goes down)
Depression SymptomsPremenstrual Dysphoric Disorder (PMDD)Improves (the measure goes down)

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Grade A

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Studies cited

9 studies from PubMed

Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS)Arch Gynecol Obstet · PMID 11129515
Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label studyAdv Ther · PMID 24604699
Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndromePhytomedicine · PMID 23022391
Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observationActa Neurol Belg · PMID 22791378
Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese womenAust N Z J Obstet Gynaecol · PMID 20522079
Therapeutic effect of Vitex agnus castus in patients with premenstrual syndromeActa Med Iran · PMID 22359078
Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorderHum Psychopharmacol · PMID 12672170
Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in ChinaMaturitas · PMID 19269753
Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trialComplement Ther Med · PMID 26860808