Zeitschrift für Phytotherapie 2015; 36(01): 4-9
DOI: 10.1055/s-0034-1395839
Forschung
© Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Vitex agnus-castus: Evidenzbasierte Therapie bei zyklusabhängigen Beschwerden

André-Michael Beer
Further Information

Publication History

Publication Date:
16 March 2015 (online)

Zusammenfassung

Vitex agnus-castus L. ist eine bewährte Arzneipflanze zur Behandlung zyklusabhängiger Beschwerden. Umfangreiche pharmakologische und klinische Daten untermauern den Stellenwert des Mönchspfeffers als evidenzbasierte Therapieoption. Extrakte aus den getrockneten Früchten zeigen dopaminerge Wirkungen und können damit eine Hyperprolaktinämie günstig beeinflussen, welche Zyklusbeschwerden in vielen Fällen zugrunde liegt. Mastodynien, prämenstruelle Beschwerden sowie Regeltempoanomalien können effektiv behandelt werden. Auch bei Corpus-luteum-Insuffizienz-bedingter Infertilität und Dysmenorrhö ist der Einsatz von Vitex agnus-castus sinnvoll.

Summary

Vitex agnus-castus: evidence-based treatment of menstrual cycle complaints

Vitex agnus-castus L. is a proven medicinal herb for treating menstrual cycle-related complaints. Extensive pharmacological and clinical data support the significance of Vitex agnus-castus as evidence-based treatment option. Extracts from the dried fruits show dopaminergic effects and can therefore have a positive effect on hyperprolactinemia, in many cases the cause of menstrual cycle complaints. Breast tenderness, premenstrual symptoms and cycle irregularities can be effectively treated. In addition, the use of Vitex agnus-castus is reasonable for the treatment of corpus luteum insufficiency-related infertility and dysmenorrhea.

 
  • Literatur

  • 1 Kommission E. Monographie „Agni casti ­fructus (Keuschlammfrüchte)“. BAnz Nr. 226 vom 2.12.1992
  • 2 Beer AM, Schilcher H, Loew D. Phytopharmaka als Alternative zu Synthetika. MMW-Fortschr Med Originalien 2013; 155: 97-99
  • 3 European Medicines Agency. Community ­herbal monograph on Vitex agnus-castus L., fructus. 25 November 2010. http://www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_Community_herbal_monograph/2011/08/WC500110099.pdf
  • 4 Wuttke W, Seidlová-Wuttke D, Jarry H, Artymuk N. Der Stellenwert des Mönchspfeffers (Vitex agnus-castus) in der gynäkologischen Endokrinologie. Z Phytother 2010; 31: 294-298
  • 5 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: 448-454
  • 6 Wuttke W, Jarry H, Christoffel V et al. Chaste tree (Vitex agnus-castus) − pharmacology and clinical indications. Phytomedicine 2003; 10: 348-357
  • 7 Röhrl J, Mähler N, Künstle G, Haunschild J. Receptor targeting activities for Vitex agnus- castus dry extract (BNO 1095) as active component of Agnucaston®. Poster, 17th Inter­national Congress Phytopharm, Vienna 2013
  • 8 Kilicdag EB, Tarim E, Bagis T et al. Fructus agni casti and bromocriptine for treatment of hyper­prolactinemia and mastalgia. Int J ­Gynaecol Obstet 2004; 85: 292-293
  • 9 Webster DE, He Y, Chen SN et al. Opioidergic mechanisms underlying the actions of Vitex agnus-castus L. Biochem Pharmacol 2011; 81: 170-177
  • 10 Röhrl J, Künstle G, Haunschild J. The Vitex agnus-­castus dry extract BNO 1095 contained in Agnucaston® is effective to prevent uterus contractions in vitro. Poster, 16th World ­Congress of the International Society of ­Gynecological Endocrinology (ISGE), Firenze 2014
  • 11 van Die MD, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus extracts for female repro­duc­tive disorders: a systematic review of ­clinical trials. Planta Med 2013; 79: 562-575
  • 12 He Z, Chen R, Zhou Y et al. Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-­center ­placebo controlled study in China. Maturitas 2009; 63: 99-103
  • 13 Ma L, Lin S, Chen R, Wang X. Treatment of ­moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Gynecol Endocrinol 2010; 26: 612-616
  • 14 Prilepskaya VN, Ledina AV, Tagiyeva AV, Revazova FS. Vitex agnus castus: Successful ­treatment of moderate to severe premenstrual syndrome. Maturitas 2006; 55 (Suppl. 1): S55-S63
  • 15 Berger D, Schaffner W, Schrader E et al. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS). Arch Gynecol Obstet 2000; 264: 150-153
  • 16 Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001; 322: 134-137
  • 17 Schellenberg R, Zimmermann C, Drewe J et al. Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome. Phytomedicine 2012; 19: 1325-1331
  • 18 Loch EG, Selle H, Boblitz N. Treatment of ­premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus . J Womens Health Gend Based Med 2000; 9: 315-320
  • 19 Onaran Y, Kurtay G, Binici S. Premenstrual Mood. A comparison of the activity of Vitex agnus castus extract and oral contraceptives on mood in premenstrual syndrome. Kadin Dogum Dergisi 2003; 2: 73-77
  • 20 Atmaca M, Kumru S, Tezcan E. Fluoxetine ­versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003; 18: 191-195
  • 21 Lauritzen C, Reuter HD, Repges R et al. Treatment of premenstrual tension syndrome with Vitex agnus castus. Controlled, double-­blind study versus pyridoxine. Phytomedicine 1997; 4: 183-189
  • 22 Aydin I, Baltaci D, Türkyilmaz S, Öncü M. ­Comparison of Vitex agnus castus with melo­xicam and placebo in treatment of patients with cyclical mastalgia. Düzce Tip Dergisi 2012; 14: 1-5
  • 23 Dinc T, Coskun F. Comparison of fructus agni casti and flurbiprofen in the treatment of ­cyclic mastalgia in premenopausal women. Ulusal Cer Derg 2014; 30: 34-38
  • 24 Milewicz A, Gejdel E, Sworen H et al. Vitex ­agnus castus-Extrakt zur Behandlung von ­Regeltempoanomalien infolge latenter Hyperprolaktinämie. Ergebnisse einer randomisierten Plazebo-kontrollierten Doppelblindstudie. Arzneimittelforschung 1993; 43: 752-756
  • 25 Eltbogen R, Litschgi M, Gasser UE et al. Vitex agnus-castus extract (Ze 440) improves symptoms in women with menstrual cycle irregularities. Planta Med 2014; 80 SL19
  • 26 Aksoy AN, Gözükara I, Kabil Kucur S. Evaluation of the efficacy of fructus agni casti in women with severe primary dysmenorrhea: a prospective comparative Doppler study. J Obstet Gynaecol Res 2014; 40: 779-784
  • 27 Berger D. Vitex agnus-castus: Unbedenklichkeit und Wirksamkeit beim prämenstruellen Syndrom. Wirkprinzipien und Wirkmechanismen eines neu entwickelten Extraktes [Dissertation]. Basel: Universität; 1998
  • 28 Liu J, Burdette JE, Xu H et al. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem 2001; 49: 2472-2479
  • 29 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: 448-454
  • 30 Sliutz G, Speiser P, Schultz AM et al. Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Horm Metab Res 1993; 25: 253-255
  • 31 Christoffel V, Spengler B, Jarry H et al. Selective estrogenic activity of Vitex agnus-castus . Revista de Fitoterapia 2002; 2 (Suppl. 1, SL10): 63-
  • 32 Jarry H, Spengler B, Porzel A et al. Evidence for estrogen receptor β-selective activity of Vitex agnus-castus and isolated flavones. Planta Med 2003; 69: 945-947
  • 33 Jarry H, Spengler B, Wuttke W, Christoffel V. In vitro assays for bioactivity-guided isolation of endocrine active compounds in Vitex agnus-castus . Maturitas 2006; 55 (Suppl. 1): S26-S36
  • 34 Ye Q, Zhang QY, Zheng CJ et al. Casticin, a flavonoid isolated from Vitex rotundifolia, inhibits prolactin release in vivo and in vitro. Acta Pharmacol Sin 2010; 31: 1564-1568
  • 35 Ohyama K Akaike T, Hirobe C, Yamakawa T. Cytotoxicity and apoptotic inducibility of Vitex agnus-castus fruit extract in cultured human normal and cancer cells and effect on growth. Biol Pharm Bull 2003; 26: 10-18
  • 36 Obi N, Chang-Claude J, Berger J et al. The use of herbal preparations to alleviate climacteric disorders and risk of postmenopausal breast cancer in a German case-control study. Cancer Epidemiol Biomarkers Prev 2009; 18: 2207-2213
  • 37 Deutsche Pharmazeutische Gesellschaft e.V. Gute Substitutionspraxis [Leitlinie]. Stand: 24.2.2014 http://www.dphg.de/fileadmin/content/pdfs/dphg_leitlinie_gute_substitutionspraxis.pdf