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Dong Quai

Dong quai is the root of Angelica sinensis, an herb long used in traditional Chinese medicine, with plant compounds that appear to relax uterine muscle. Most people look at it for menopausal symptoms, and trials found no clear difference from placebo in hot flashes, vaginal changes or overall symptoms. Studies were small, so the evidence is only moderate, and its other suggested uses rest mostly on animal or lab work.

Sources: PMID 9418683; PMID 16278617

Best evidence
Grade B
Conditions studied
2
Outcomes
8
Graded outcomes
0125

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

2 conditions, plus general outcomes

General

General: outcomes studied for Dong Quai
GradeOutcomeEffectSizeStudiesPeopleStudies list
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.

Improves (the measure goes down)Small effect7 studies200 people

Studies that measured menopausal symptoms (monotherapy)

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.

Worsens (the measure goes up)Moderate effect7 studies

Studies that measured bleeding risk (anticoagulant interaction)

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.

Improves (the measure goes up)Small effect6 studies100 people

Studies that measured estrogenic activity

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.

Improves (the measure goes down)Small effect6 studies

Studies that measured dysmenorrhea symptoms

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.

Improves (the measure goes up)Small effect5 studies

Studies that measured iron deficiency anemia

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.

Improves (the measure goes up)Small effect5 studies

Bone Health

Bone Health: outcomes studied for Dong Quai
GradeOutcomeEffectSizeStudiesPeopleStudies list
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.

Improves (the measure goes up)Small effect5 studies

Studies that measured bone density

Age-Associated Memory Impairment and Cognitive Decline (AAMCD)

Age-Associated Memory Impairment and Cognitive Decline (AAMCD): outcomes studied for Dong Quai
GradeOutcomeEffectSizeStudiesPeopleStudies list
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.

Improves (the measure goes up)Small effect4 studies

Studies that measured cognitive function

Key findings

  • Menopausal Symptoms (Monotherapy)Improves (the measure goes down)
  • Bleeding Risk (Anticoagulant Interaction)Worsens (the measure goes up)
  • Estrogenic ActivityImproves (the measure goes up)

Safety notes in the studies

  • Dong quai contains coumarins and compounds with known antiplatelet activity, posing clinically significant bleeding risk especially when combined with anticoagulant medications.

Shop the evidence-backed picks

Third-party tested Dong Quai products, in the forms the graded studies used where we can match them.

  • Grade B

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Studies cited

21 studies from PubMed

  1. A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicinesPLoS One, 2017 · PMID 23844228
  2. The role of traditional Chinese medicines in osteogenesis and angiogenesis.Phytotherapy Research, 2014 · PMID 23494901
  3. Phytochemical and pharmacological studies on Radix Angelica sinensis.Chinese Journal of Natural Medicines, 2013 · PMID 24345498
  4. Dong Quai (Angelica sinensis) in the treatment of hot flashes for men on androgen deprivation therapy: results of a randomized double-blind placebo controlled trialCan Urol Assoc J, 2010 · PMID 20165579
  5. Dong Quai (Angelica sinensis).Journal of the Society for Integrative Oncology, 2009 · PMID 19706236
  6. 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.Climacteric, 2008 · PMID 18568789
  7. Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins.Neurocritical Care, 2007 · PMID 17634840
  8. Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study.Gynecological Endocrinology, 2007 · PMID 17454163
  9. Effect of Angelica sinensis polysaccharide-iron complex on iron deficiency anemia in rats.Chinese Journal of Integrative Medicine, 2007 · PMID 18180896
  10. A Chinese herbal decoction, Danggui Buxue Tang, prepared from Radix Astragali and Radix Angelicae Sinensis stimulates the immune responses.Planta Medica, 2006 · PMID 16902872
  11. Use of dong quai (Angelica sinensis) to treat peri- or postmenopausal symptoms in women with breast cancer: is it appropriate?Menopause, 2005 · PMID 16278617
  12. Effect of dang-gui-ji-hwang-yeum on osteoporosis in ovariectomized rats.The American Journal of Chinese Medicine, 2004 · PMID 15344418
  13. Effect of Chinese drugs on proliferation and differentiation of hemopoietic stem/progenitor cells.Zhongguo Zhong Xi Yi Jie He Za Zhi, 2004 · PMID 15307717
  14. Effect of supplemented danggui shaoyao powder and its disassembled prescriptions on lymphocytes proliferation in aged rats.Zhongguo Zhong Xi Yi Jie He Za Zhi, 2003 · PMID 14666767
  15. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms.Menopause, 2002 · PMID 11875334
  16. Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine.Biomedicine & Pharmacotherapy, 2002 · PMID 12224599
  17. Danggui shaoyao san improve colchicine-induced learning acquisition impairment in rats.Acta Pharmacologica Sinica, 2001 · PMID 11749816
  18. Gynaecomastia and the herbal tonic 'Dong Quai'.Singapore Medical Journal, 2001 · PMID 11405562
  19. Myocardial protection against ischaemia-reperfusion injury by a Polygonum multiflorum extract supplemented 'Dang-Gui decoction for enriching blood', a compound formulation, ex vivo.Phytotherapy Research, 2000 · PMID 10815014
  20. Potentiation of warfarin by dong quaiPharmacotherapy, 1999 · PMID 10417036
  21. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trialFertil Steril, 1997 · PMID 9418683