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Expert Q&A

	By Traci Kurtzer Obstetrician and Gynecologist

I have really irregular periods from time to time and now I am trying to conceive. I have heard a lot about Chaste Berry (Vitex) helping with menstruation and fertility -- that it is real similar to Clomid. Is it safe and effective?

Chasteberry, or vitex, is one of those herbs that has been around for centuries with reported help for all kinds of female ailments from heavy periods and premenstrual syndrome to menopausal symptoms. It always amazes me when one herb can supposedly correct so many problems.

As with many traditional herbal remedies, the only problem with recommending them is that we really do not have a lot of evidence, besides observational studies and anecdotal use, that they really help the problem. Experts in herbal medicine think vitex works indirectly by increasing secretion of one of the pituitary hormones (luetinizing hormone, LH) to stimulate secretion of progesterone from the ovary and by inhibiting another pituitary hormone (prolactin) which if elevated can cause irregular cycles and infertility.

The only clinical study evaluating the effects of vitex on infertile women was not controlled and not blinded. This means there was no comparison to an untreated group to determine a true medication effect and both the researchers and patients knew they were getting treatment which can lead to biased results. This study showed that only seven of 45 women became pregnant. This kind of study is not felt to be very scientific, however, and so it leaves a lot of unanswered questions as to true effects of vitex in infertility.

We certainly don't know if vitex could have any ill effects in pregnancy and since women can be pregnant for a few weeks before they know it, I would be concerned about using any medication (herbal or other) that had no data on pregnancy effects. Herbs that can actually interfere with fertility or can be harmful to developing fetuses include: Asian ginseng, mistletoe, ephedra, blue and black cohosh, St. John's wort, castor oil, valerian, honeysuckle, echinacea, pennyroyal, goldenseal, camphor, tansey, gingko, comfrey, yarrow, yucca, and ginger in large quantities. In general, you should be just as cautious about taking herbal remedies during pregnancy as you are about taking pharmaceuticals.

To answer your question: I would encourage you to be evaluated for your irregular periods and make sure you are participating in a low stress lifestyle. If you have already been evaluated and advised to take clomid by your doctor, then you can be assured of it's efficacy and safety from many good scientific studies. It is not clear from the studies available if vitex is either effective or safe."

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