Vitex Agnus-castus and Female Reproductive Health: A Narrative Review of Phytochemistry, Mechanisms, and Clinical Evidence
Uchegbu Ifeoma Nneka *
Department of Chemistry, Imo State University, Owerri, Imo State, Nigeria.
Ikezu Ujupaul Joy Magret
Department of Chemistry, Imo State University, Owerri, Imo State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Vitex agnus-castus L. (chasteberry) is widely used in women’s health, particularly for premenstrual syndrome (PMS), cyclic mastalgia and selected menstrual disturbances. Its reproductive pharmacology is chemically and mechanistically complex, involving flavonoids, iridoid glycosides, diterpenoids, phenolic compounds and volatile constituents.
Aims: This narrative review critically evaluates the evidence linking these constituents with female reproductive physiology, with particular attention to the hypothalamic-pituitary-ovarian axis, dopamine-prolactin signalling and the biological plausibility of luteinizing hormone (LH) modulation.
Study Design: Structured narrative literature review.
Place and Duration of Study: Literature published from January 1993 through June 2026 was searched across PubMed/MEDLINE, Cochrane Library, Web of Science, Scopus and Google Scholar.
Methodology: Priority was given to peer-reviewed primary studies, randomised clinical trials, systematic reviews, analytical studies and recent mechanistic research that directly investigated V. agnus-castus or its constituents in relation to phytochemistry, reproductive/endocrine outcomes, pharmacological mechanisms, analytical characterisation or safety. No new pooled effect estimate was calculated; numerical outcomes were reported from the underlying studies and published evidence syntheses.
Results: The strongest clinical evidence concerns PMS and selected prolactin-associated menstrual abnormalities rather than infertility. Standardised preparations produced clinically meaningful improvements in PMS symptoms, while limited endocrine studies suggest effects on stimulated prolactin and luteal function. However, the evidence does not establish V. agnus-castus as a direct LH stimulant or a proven luteinizing hormone/chorionadotropin receptor (LHCGR) agonist. The most defensible mechanistic model is indirect neuroendocrine modulation, particularly through dopaminergic D₂-receptor activity and downstream prolactin regulation, with antioxidant and anti-inflammatory actions providing complementary biological plausibility.
Conclusion: Substantial chemical variability among plant parts, preparations and geographic sources emphasises the need for authenticated material, validated marker-based standardisation and chemically characterised interventions. Computational approaches may generate target hypotheses but cannot substitute for receptor, cellular, animal or clinical validation. V. agnus-castus remains a promising source of reproductive-health bioactives, but claims regarding ovulation, infertility, LH or LHCGR activity should remain hypothesis-generating until supported by target-specific experimental and adequately powered clinical studies.
Keywords: Vitex agnus-castus, chasteberry, premenstrual syndrome, prolactin, dopamine D₂ receptor, luteinising hormone, female reproductive health, phytochemistry, clinical evidence, standardization