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Dong Quai

Dong quai is a traditional Chinese medicine herb called 'female ginseng' due to its historical use for menstrual and menopausal symptoms. Contains ferulic acid, ligustilide, coumarins, and polysaccharides with antispasmodic and antiplatelet effects. Despite widespread traditional use, clinical trials show dong quai ALONE does NOT relieve hot flashes or menopausal symptoms better than placebo. May have weak estrogenic activity. CRITICAL: Major interaction with warfarin and anticoagulants - increases bleeding risk significantly.

Quick Answer

What it is

Dong quai is a traditional Chinese medicine herb called 'female ginseng' due to its historical use for menstrual and menopausal symptoms. Contains ferulic acid, ligustilide, coumarins, and polysaccharides with antispasmodic and antiplatelet effects.

Key findings

  • Grade B: Menopausal Symptoms (Monotherapy)
  • Grade C: Estrogenic Activity
  • Grade C: Bleeding Risk (Anticoagulant Interaction)

Safety

  • CRITICAL: Major interaction with warfarin and anticoagulants - increases bleeding risk significantly.
  • Dong quai contains coumarins and compounds with known antiplatelet activity, posing clinically significant bleeding risk especially when combined with anticoagulant medications.
ℹ️ Quick Facts: Dong Quai

Quick Facts: Dong Quai

  • Best Evidence:Grade D
  • Conditions Studied:2
  • Research Outcomes:8
  • Grade B Findings:1
  • Key Effect:Age-Associated Memory Impairment and Cognitive Decline (AAMCD)
Outcomes by grade:
A0
B1
C2
D5
2 conditions · 8 outcomes

Detailed Outcomes

|
B
Menopausal Symptoms (Monotherapy)
In a well-designed double-blind, placebo-controlled RCT of 71 postmenopausal women over 24 weeks (Hirata 1997), dong quai monotherapy showed NO significant difference vs placebo in hot flash frequency, vaginal maturation index, or composite menopausal symptoms. A separate RCT of Dang Gui Buxue Tang in Hong Kong Chinese women also found no benefit. NEGATIVE FINDING: evidence consistently shows dong quai alone does not relieve menopausal symptoms.
small↓Improves
C
Estrogenic Activity
The primary 24-week double-blind RCT (Hirata 1997) found no effect of dong quai on endometrial thickness, estradiol, or estrone levels in postmenopausal women. In vitro screening of menopausal botanicals found dong quai had minimal estrogenic activity compared to other herbs. A case report documented gynecomastia in a man using dong quai, suggesting some hormonal activity, but clinical trial evidence does not support meaningful estrogenic effects at standard doses. NEGATIVE FINDING at clinical doses.
small↑Improves
C
Bleeding Risk (Anticoagulant Interaction)
A published case report documented significant potentiation of warfarin anticoagulation with dong quai use, with INR elevated to dangerous levels. A separate case described multifocal and recurrent subarachnoid hemorrhage attributed to dong quai's natural coumarin content. Dong quai contains coumarins and compounds with known antiplatelet activity, posing clinically significant bleeding risk especially when combined with anticoagulant medications.
moderate↑Worsens
D
Immune Function
Danggui Buxue Tang (astragalus + dong quai) stimulated immune responses including cytokine production in preclinical studies. Supplemented danggui shaoyao powder enhanced lymphocyte proliferation in aged rats. A fish model study also showed enhanced non-specific immunity. All evidence is preclinical and from combination formulas, making dong quai's individual contribution uncertain.
small↑Improves
D
Dysmenorrhea Symptoms
Dong quai has centuries of traditional use for menstrual cramps in Chinese medicine. Pharmacological reviews describe antispasmodic activity and effects on uterine smooth muscle rhythm via ferulic acid and ligustilide content. However, no rigorous placebo-controlled clinical trial has specifically evaluated dong quai monotherapy for dysmenorrhea. Evidence is limited to traditional use and mechanistic plausibility.
small↓Improves
D
Iron Deficiency Anemia
In a rat model of iron deficiency anemia, Angelica sinensis polysaccharide-iron complex improved hematological parameters including hemoglobin and red blood cell counts. Separate preclinical research showed effects on hematopoietic stem/progenitor cell proliferation and differentiation in vitro. No controlled human clinical trial data exists for anemia treatment with dong quai.
small↓Improves
D
Bone Density
In ovariectomized rats (a model of postmenopausal osteoporosis), a dong quai-containing formula (dang-gui-ji-hwang-yeum) improved bone density markers. A review of traditional Chinese medicines also identified dong quai components as having roles in osteogenesis and angiogenesis in preclinical models. No human clinical trial data exists for bone outcomes.
small↑Improves
D
Cognitive Function
In a rat model, Danggui Shaoyao San (a traditional combination formula containing dong quai) improved colchicine-induced learning acquisition impairment. This represents a single preclinical study using a multi-herb combination formula, not dong quai alone, limiting attribution of effects.
small↑Improves

Research Citations (21)

A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines
(2017)
PMID: 23844228
The role of traditional Chinese medicines in osteogenesis and angiogenesis.
(2014)
PMID: 23494901
Phytochemical and pharmacological studies on Radix Angelica sinensis.
(2013)
PMID: 24345498
Dong Quai (Angelica sinensis) in the treatment of hot flashes for men on androgen deprivation therapy: results of a randomized double-blind placebo controlled trial
(2010)
PMID: 20165579
Dong Quai (Angelica sinensis).
(2009)
PMID: 19706236
A randomized, double-blind, placebo-controlled study of the effect of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) on menopausal symptoms in Hong Kong Chinese women.
(2008)
PMID: 18568789
Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins.
(2007)
PMID: 17634840
Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study.
(2007)
PMID: 17454163
Effect of Angelica sinensis polysaccharide-iron complex on iron deficiency anemia in rats.
(2007)
PMID: 18180896
A Chinese herbal decoction, Danggui Buxue Tang, prepared from Radix Astragali and Radix Angelicae Sinensis stimulates the immune responses.
(2006)
PMID: 16902872

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