Top 3 Herbs in Women’s Health for Codependency

By Karta Purkh Khalsa.

Natural health programs aim to nourish, restore and balance the body functions that have been taxed by the wear and tear of daily life. Signs of aging are all marks of lack of “juice”, from arthritis with lack of joint fluids, to fatigue with lack of endocrine hormones, to menopause difficulties with vaginal dryness. You can compare aging to old leaves that dry out and blow away: bodies become shorter, smaller, and stringier as they age. Health practices are directed toward strengthening, purifying and nourishing body tissues to hold onto that glow of youth, that “juiciness”.  

Generally, compared to men, women tend to be colder (think those cold feet under the covers), drier (remember all those bottles of moisturizers?), and lighter. Over a lifetime, the goal for a woman is to stay warm, juicy and grounded.

Natural rejuvenation comes in two forms—lifestyle and remedies. While a routine of diet, sleep and stress management goes without saying, herbal remedies can tip the balance. Three outstanding herbs top the list of healing for women.

Dong quai (Angelica sinensis)

Dong quai, the Chinese “queen of herbs,” is a fragrant herbal vegetable of the parsley family. The carrot-like roots are harvested in the fall, after about 3 years in the field. Also bearing the moniker “female ginseng,” this herb is one of the major herbs in the repertoire of Chinese herbalists, it is often used to treat female hormone imbalances and is the preferred herb for general menstrual health.1 Although Modern Western practitioners often recommended dong quai as a treatment for PMS, as well as for menstrual cramps and menopause, it is not commonly used this way in Chinese medicine, instead using it along with other herbs to create a highly individualized treatment, often in combination with peony root or bupleurum root. These herbal combinations see use for PMS, menstrual pain, fibrocystic breast disease and pelvic inflammatory disease. A 2014 study showed promising results for dong quai extract in osteoporosis.2 Use 2 grams of dong quai per day in capsules.

Chasteberry fruit (Vitex agnus-castus)

For millions of American women, the words “premenstrual syndrome” describe a monthly torture that makes them dread each new turn of the calendar. Premenstrual syndrome can involve any of a diverse range of possible symptoms. Bottom line, it is a condition of hormone imbalance that produces discomfort during the time immediately preceding the woman’s menstrual period. 

The herb chasteberry is a widely used European treatment for PMS symptoms, and is especially effective for breast tenderness. Chasteberry, a shrub in the verbena family, is found growing on riverbanks and nearby foothills around the Mediterranean. Chasteberry has a dark brown, peppercorn-size fruit, with a pleasant peppermint-like odor. 

Chasteberry’s use in modern herbal medicine began in the 1950s, when a German pharmaceutical firm produced a standardized extract. This extract has become a mainline European treatment for PMS, along with cyclical breast tenderness, and menstrual irregularities. 

The basic working indication for this herb is a relative progesterone deficiency, or said another way, relative estrogen excess. Chasteberry is believed to work by suppressing the release of the hormone prolactin from the pituitary gland.3 This hormone rises naturally during pregnancy to stimulate milk production and other body changes. Past studies have found chasteberry to be of benefit for all types of PMS except those women with a definitive picture including headache, craving for sweets, palpitations and dizziness. In another study comparing the efficacy of Vitex with placebo, women suffering from PMS symptoms such as breast tenderness, abdominal bloating, migraine and acne experienced a 40% reduction of symptoms compared to a 10% reduction of symptoms in the women on placebo.4

A double-blind placebo-controlled study of 178 women found that treatment with chasteberry over three menstrual cycles significantly reduced PMS symptoms. Women in the treatment group experienced significant improvements in symptoms, including irritability, depression, headache and breast tenderness. The women in the chasteberry group had more than double the response of those in the placebo group.5 A 2014 Japanese journal article reported that Vitex improved PMS symptoms with no substantial adverse effects.6

Chasteberry also appears to be sedative and antispasmodic, something many PMS and menstrual discomfort sufferers can use a little of. Studies have shown that chasteberry can stimulate increased lactation as well.

Prolactin may also play a role in cyclic breast pain (cyclic mastalgia). In Germany, chasteberry is widely used to treat cyclic mastalgia because of its effect on the pituitary gland to suppress the release of prolactin. The evidence is pretty good that chasteberry can help the cyclic breast tenderness that is often, but not necessarily, connected with PMS.7

No single constituent has been identified as being the active one, as Vitex contains mainly constituents also found in other plants. The total sum of constituents appears to generate a synergistic effect. Because it lowers prolactin levels, chasteberry is not suitable for pregnant or nursing mothers. Use 2 grams per day in capsules.

Bupleurum root (Bupleurum chinense) (“Chai Hu” “hare’s ear root”)

Chinese herbal formulas designed to regulate the menstrual cycle or treat PMS almost always center on bupleurum, a “minor tonic”. The main action of this herb is to relieve blood stagnation in the liver.8 In women, liver stagnation can cause menstrual cramps, breast swelling, irregular menstrual flow, irritability and food cravings, according to Traditional Chinese Medicine. Numerous recent studies have found beneficial affects for the liver and supported immunomodulatory, anti-inflammatory and antiviral properties.9 Because bupleurum is relaxing, it can be very helpful in PMS with anxiety and irritability. Its liver supportive qualities help to reduce sugar cravings, a common PMS symptom. The energy of bupleurum is bitter and cool, so it is particularly good in women who are always hot or who are developing a fever.

The classic bupleurum patient is a woman who is hot or feverish (maybe with chills), irritable, nauseated, and dizzy, with menstrual pain, high cholesterol and a tight, sore chest. You may find bupleurum combined with dong quai. Use 2 grams per day in capsules.

Considering that medical treatment of women’s hormonal issues often involves potent antidepressants, alternatives sure seem like a good idea. Many women have discovered that herbal remedies can bring hope to a life that used to mean two weeks of monthly misery. To guard your lifelong health as a woman, these safe and effective supplements are certainly worth a look.

Karta Purkh Singh Khalsa, Yogaraj (Ayurveda), A.D., D.N.-C, R.H., has over 50 years of experience in holistic medicine, and is one of the foremost natural healing experts in North America. Khalsa is President Emeritus of the American Herbalists Guild, director emeritus of the National Ayurvedic Medical Association, and is a respected teacher, writer and lecturer. Use gift coupon “Gift” towards a retail value of $45 here: https://internationalintegrative.com/

  1. Chin J Nat Med. 2013 Nov;11(6):577-87. doi: 10.1016/S1875-5364(13)60067-9.
    Phytochemical and pharmacological studies on Radix Angelica sinensis.
    Chen XP1, Li W2, Xiao XF3, Zhang LL2, Liu CX4.
    Abstract
    The roots of Angelica sinensis (RAS), are a Chinese herbal medicine traditionally used in prescriptions for replenishing blood, treating abnormal menstruation, and other women’s diseases. It has also been widely marketed as health food for women’s care in Asia, and as a dietary supplement in Europe and America. RAS is well-known for its hematopoietic, antioxidant, and immunoregulatory activities. RAS also possesses anti-cancer, memory, radioprotective, and neuroprotective effects. Phytochemical investigations on this plant led to organic acids, phthalides, polysaccharides, and other metabolites. Based on recent animal studies and clinical trials, RAS has been used in the treatment of gynecologic diseases, cardio-cerebrovascular disease, nervous system diseases, and nephrotic syndrome. In this review, the recent phytochemical and pharmacological studies, drug-drug interactions, clinical applications, and toxicity of RAS are summarized. ↩︎
  2.  Nutrients. 2014 Oct 16;6(10):4362-72. doi: 10.3390/nu6104362.
    Anti-osteoporotic effects of Angelica sinensis (Oliv.) Diels extract on ovariectomized rats and its oral toxicity in rats.
    Lim DW1, Kim YT2.
    Abstract
    Angelica sinensis root is one of the herbs most commonly used in China; it is also often included in dietary supplements for menopause in Europe and North America. In the present study, we examined the anti-osteoporotic effects of A. sinensis extract in an ovariectomized (OVX) rat model of osteoporosis as well as toxicity of the extract after repeated oral administration. The OVX rats were treated with 17β-estradiol (10 μg/kg i.p. once daily) or A. sinensis extract (30, 100, and 300 mg/kg, p.o. once daily) for four weeks. The bone (femur) mineral density (BMD) of rats treated with the extract (300 mg/kg) was significantly higher than that of the OVX-control, reaching BMD of the estradiol group. Markers of bone turnover in osteoporosis, serum alkaline phosphatase, collagen type I C-telopeptide and osteocalcin, were significantly decreased in the extract group. The body and uterus weight and serum estradiol concentration were not affected, and no treatment-related toxicity was observed during extract administration in rats. The results obtained indicate that A. sinensis extract can prevent the OVX-induced bone loss in rats via estrogen-independent mechanism. ↩︎
  3.  Milewicz A, Gejdel E, Sworen H, Sienkiewicz K, Jedrzejak J, Teucher T, Schmitz H [Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study]. Arzneimittelforschung 1993 Jul;43(7):752-6
    Abteilung fur Endokrinologie, Medizinische Hochschule, Hamburg.
    The efficacy of a Vitex agnus castus preparation (Strotan capsules) was investigated in a randomized double blind study vs. placebo. This clinical study involved 52 women with luteal phase defects due to latent hyperprolactinaemia. The daily dose was one capsule (20 mg) Vitex agnus castus preparation and placebo, respectively. Aim of the study was to prove whether the elevated pituitary prolactin reserve can be reduced and deficits in luteal phase length and luteal phase progesterone synthesis be normalized. Blood for hormonal analysis was taken at days 5-8 and day 20 of the menstrual cycle before and after three month of therapy. Latent hyperprolactinaemia was analysed by monitoring the prolactin release 15 and 30 min after i.v. injection of 200 micrograms TRH. 37 complete case reports (placebo: n = 20, verum: n = 17) after 3 month of therapy were statistically evaluated. The prolactin release was reduced after 3 months, shortened luteal phases were normalised and deficits in the luteal progesterone synthesis were eliminated. These changes were significant and occurred only in the verum group. All other hormonal parameters did not change with the exception of 17 beta-estradiol which rouse up in the luteal phase in patients receiving verum. Side effects were not seen, two women treated with the Vitex agnus castus preparation got pregnant. The tested preparation is thought to be an efficient medication in the treatment of luteal phase defects due to latent hyperprolactinaemia.
     Jarry H, Leonhardt S, Gorkow C, Wuttke W In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 1994;102(6):448-54
    Dept. Clinical and Experimental Endocrinology, University of Gottingen, Germany.
    Women suffering from premenstrual mastodynia often respond to stimuli of prolactin (Prl) release with a hypersecretion of this hormone. Pharmacological reduction of Prl release by dopamine agonists or treatment with extracts of Agnus castus (AC) improve the clinical situation of patients with such premenstrual symptoms. Extracts of AC contain compounds which inhibit in vivo Prl release in women as well as in vitro from dispersed rat pituitary cells. It is yet unknown whether this inhibitory action of AC is only exerted on Prl release or whether release of other pituitary hormones like LH and FSH is also affected. The effects of AC on LH and FSH release were examined in vitro using rat pituitary cell cultures. To rule out that the Prl-inhibiting properties of AC are at least in part due to a cytotoxic component, pituitary cell cultures were subjected to the MTT test. To assess whether the Prl inhibitory effect of AC preparations is due to compounds acting as dopamine (DA) agonists, we used the corpus striatum membrane DA receptor binding assay. Our results demonstrate for the first time that AC extract contains an active principle that binds to the D2 receptor. Thus, it is very likely that it is this dopaminergic principle which inhibits Prl release in vitro from rat pituitary cells. Furthermore we give evidence for the specificity of action of AC on hormone release, since gonadotropin secretion remained unaffected. The findings of the present study support the therapeutical usefulness of AC extracts for treatment of premenstrual mastodynia which is associated with hypersecretion of Prl. Furthermore, the beneficial effects of AC appear to be due to the inhibition of pituitary Prl release. ↩︎
  4. Alschuler, Lise, N.D., Vitex monograph, Department of Botanical Medicine, Bastyr University, Bothell, Washington. ↩︎
  5. Schellenberg R Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001 Jan 20;322(7279):134-7
    Institute for Health Care and Science, 35625 Huttenberg, Germany. med@t-online.de
    OBJECTIVES: To compare the efficacy and tolerability of agnus castus fruit (Vitex agnus castus L extract Ze 440) with placebo for women with the premenstrual syndrome. DESIGN: Randomised, double blind, placebo controlled, parallel group comparison over three menstrual cycles. SETTING: General medicine community clinics. Participants: 178 women were screened and 170 were evaluated (active 86; placebo 84). Mean age was 36 years, mean cycle length was 28 days, mean duration of menses was 4.5 days. INTERVENTIONS: Agnus castus (dry extract tablets) one tablet daily or matching placebo, given for three consecutive cycles. MAIN OUTCOME MEASURES: Main efficacy variable: change from baseline to end point (end of third cycle) in women’s self assessment of irritability, mood alteration, anger, headache, breast fullness, and other menstrual symptoms including bloating. Secondary efficacy variables: changes in clinical global impression (severity of condition, global improvement, and risk or benefit) and responder rate (50% reduction in symptoms). RESULTS: Improvement in the main variable was greater in the active group compared with placebo group (P<0.001). Analysis of the secondary variables showed significant (P<0.001) superiority of active treatment in each of the three global impression items. Responder rates were 52% and 24% for active and placebo, respectively. Seven women reported mild adverse events (four active; three placebo), none of which caused discontinuation of treatment. CONCLUSIONS: Dry extract of agnus castus fruit is an effective and well tolerated treatment for the relief of symptoms of the premenstrual syndrome. ↩︎
  6. Adv Ther. 2014 Mar;31(3):362-73. doi: 10.1007/s12325-014-0106-z. Epub 2014 Mar 7.
    Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label study.
    Momoeda M1, Sasaki H, Tagashira E, Ogishima M, Takano Y, Ochiai K.

    Abstract
    INTRODUCTION: 
    Herbal medicine containing Vitex agnus-castus (VAC) extract is widely used by women with premenstrual syndrome (PMS) in Europe, however, in Japan, clinical evidence remains to be determined. This study attempted to investigate the efficacy and safety profiles of VAC extract in Japanese patients with PMS.
    METHODS: 
    A multi-center, prospective, open-label, single-arm, phase 3 study was performed in Japanese women with PMS and aged 18-44 years. The patients received Prefemin® (Max Zeller Söhne AG, Romanshorn, Switzerland), containing 20 mg of VAC extract, once daily for three menstrual cycles. The efficacy profile was examined based on the intensity of ten PMS symptoms-irritability, depressed mood, anger, headache, bloating, breast fullness, skin disorder, fatigue, drowsiness, and sleeplessness-recorded by patients via a visual analog scale (VAS). In addition, the responder rate was calculated based on the total VAS score defined by the sum of the VAS scores of the first six symptoms mentioned above. Furthermore, physician’s global assessment (PGA) scores were recorded. Adverse events including vital signs and laboratory test values were monitored as safety evaluation.
    RESULTS: 
    Sixty-nine patients received Prefemin®. After the first menstrual cycle, a statistically significant decrease in total VAS score was observed (P<0.001), and the score continued to diminish for the following two cycles. Each of the ten symptom scores decreased significantly in this manner. In addition, the responder rate increased in a time-dependent manner; the rate at the third menstrual cycle was 91.0%, and almost all of the patients were without symptoms or exhibited only mild symptoms based on PGA. Eight patients exhibited non-serious adverse events, one of which was allergic dermatitis whose causal relationship with VAC was not ruled out.
    CONCLUSION: 
    VAC extract improved PMS symptoms in Japanese patients, with no substantial adverse events. This is the first study to report the effect of VAC extract in Japanese patients. ↩︎
  7.  Halaska M, Raus K, Beles P, Martan A, Paithner KG[Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo]. Ceska Gynekol 1998 Oct;63(5):388-92
    The aim of study presented here was to gather the data about the tolerability and efficacy of Vitex agnus castus (VACS) extract. The study was designed as double-blind, placebo controlled in two parallel groups (each 50 patients). Treatment phase lasted 3 consequent menstrual cycles (2 x 30 drops/day = 1.8 ml of VASC) or placebo. Mastalgia during at least 5 days of the cycle before the treatment was the strict inclusion condition. For assessment of the efficacy visual analogue scale was used. Altogether 97 patients  were included into the statistical analysis (VACS: n = 48, placebo: n = 49). Intensity of breast pain diminished quicker with VACS group. The tolerability was satisfactory. We found VACS to be useful in the treatment of cyclical breast pain in women. ↩︎
  8. Bensky, Dan and Gamble, Andrew, Chinese Herbal Medicine Materia Medica, Eastland Press, Seattle. ↩︎
  9. J Pharm Pharmacol. 2011 Mar;63(3):305-21. doi: 10.1111/j.2042-7158.2010.01170.x. Epub 2010 Nov 16.
    Genus Bupleurum: a review of its phytochemistry, pharmacology and modes of action.
    Ashour ML1, Wink M.
    Abstract
    OBJECTIVES: 
    Radix Bupleuri represents one of the most successful and widely used herbal drugs in Asia for treatment of many diseases over the past 2000 years. Thorough studies have been carried out on many species of this genus and have generated immense data about the chemical composition and corresponding biological activity of extracts and isolated secondary metabolites. In this work, we review the chemistry and pharmacology of the genus Bupleurum and explore the relationships between the pharmacological effects and the chemical composition of these drugs.
    KEY FINDINGS: 
    Early studies on the genus Bupleurum had focused only on the traditional uses of the plants in the treatment of inflammatory disorders and infectious diseases. After chemical profiling, several groups of secondary metabolites were characterized with relevant biological activity: triterpene saponins (saikosaponins), lignans, essential oils and polysaccharides. As a result, present interest is now focused on the bioactivity of the isolated triterpene saponins acting as immunomodulatory, anti-inflammatory and antiviral agents, as well as on the observed ant-iulcer activity of the polysaccharides and anti-proliferative activity of different lignans. Many saikosaponins exhibited very potent anti-inflammatory, hepatoprotective and immunomodulatory activities both in vivo and in vitro.
    CONCLUSIONS: 
    Further investigations and screenings are required to explore other Bupleurum species, to evaluate the clinical safety and possible interactions with other drugs or herbs. Standardization of Bupleuri extracts is crucial for them being integrated into conventional medicine due to large chemical and biological variations between different species and varieties. ↩︎

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