active ingredient: extract from chaste tree fruits indication: menstrual disorders
TRANSCRIPT
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Active ingredient: Extract from Chaste tree fruits
Indication:Menstrual disorders
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Botany
Family: Verbenaceae(vervain plants)
Synonyms: Monk‘s pepperMönchspfefferAbrahamsstrauchChaste tree
Origin: Mediterranean area, Central Asia, Isle Krim. Preferably also on brooksides and riversides.
Vitex agnus castus L.
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Botany
Medicinal drug: Chaste tree fruits (Agni casti fructus), consisting of the ripe, dried fruits.
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Brief profile
Chaste tree is a shrub up to 4 m high.
The leaves are crossed-opposite, long-stemmed.
Separated finger-shaped with up to 7 lanceolate
feathered small leaves.
The mauve, ear-like inflorescences build
reddish-black, peppercorn-sized drupes.
Time of prosperity: June to September.
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Ingredients
bicyclic diterpenes (aucubin, agnoside)
lipophile flavonoids (casticin)
essential oil
fatty oil
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Effects
inhibition of the prolactin secretion and thus, reduction of increased prolactin levels
point of action at the hypophyseal portal system
dopaminergic effect
inhibition of lactation (experiments in animals)
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Release and inhibition of hormones in hormonal circuit of regulation
Quelle: PZ Nr. 10, 144 Jahrg. 1999
feed-back stimulating influence inhibiting influence
Hypo-thalamus
prolactin-release-inhibiting-hormone = dopamine
gonadotropin-releasing-hormone (GnRH)
adenohypophysis prolactin
ovaryestradiol progesterone
luteinizing hormone (LH)follicle-stimulating hormone (FSH)
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Fields of application
Traditional
- in the antique for women‘s diseases, especially fertility disorders
Gynaecology
- for all symptoms of corpus luteum insufficiency and estrogen-progesterone-imbalance
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1. Premenstrual syndrome (PMS)
Fields of application
symptoms:
psychic: nervousness, irritability, mood swings, depressive states, lack of concentration, insomnia.
somatic: migraine-like headache, feeling of tension in the breasts, swellings, edema, lower abdominal cramps, nausea, feeling of fullness, bloating, constipation, tiredness.
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2. Menstrual irregularities
Fields of application
irregularities of the menstrual rhythm polymenorrhea/oligomenorrhea: too frequently / too rarely
irregularities of the menstrual intensityhypomenorrhea/hypermenorrhea: too weak / too strong
irregularities of the duration of the menstruationmenorrhagia/brachymenorrhea: too long / shortened
secondary amenorrhea (absence of menstruation over a period of 6 months, after prior normal course)
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3. Mastodynia
Fields of application
premenstrual, mostly painful breast tension, complaints are mostly limited to the second half of the cycle
4. Fertility disorders
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Clinical efficacy
Rational phytotherapy with Vitex agnus castus
Menstrual irregularities
Increased prolactin levels, existing before start of the therapy, could be reduced during the treatment with Vitex agnus castus.
Roeder D, (1994): Therapy of menstrual cycle disturbancesVitex agnus-castus. Zeitschrift für Phytotherapie 15, 155-159
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Clinical efficacy
Rational phytotherapy with Vitex agnus castus
Premenstrual syndrome
The most frequent and most important symptoms such as headache, breast tension, nervousness, lack of concentration, emotional changes and depressions showed a clear improvement.
Berger D, Schaffner W, Schrader E, Meier B, Brattstrom A, (2000): Efficacy of Vitex agnus castus L. extract Ze 440 in patients with premenstrual syndrome (PMS). Arch Gynecol Obstet. Nov; 264 (3): 150-153
Loch EG, Selle H, Boblitz N, (2000): Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med. 9 (3): 315-320
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Clinical efficacy
Rational phytotherapy with Vitex agnus castus
Premenstrual syndrome
Placebo-controlled, randomised double-blind study
The treatment of PMS with monk‘s pepper is effective:
Significant reduction of irritability, mood swings, aggressiveness, headache and breast tensions.
Schellenberg R, et al., (2001): Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomized, placebo controlled study. BMJ 322: 134-137
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Clinical efficacy
Rational phytotherapy with Vitex agnus castus
Mastodynia
Halaska M, Beles P, Gorkow C, Sieder C, (1999): Treatment of cyclical mastalgia with a solution containing a Vitex agnus castus extract: results of a placebo-controlled double-blind study. Breast. 8 (4): 175-181
Placebo-controlled, randomised double-blind study
Reduction of the inconvenient feeling of tension and swelling in the breast before menstruation
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Clinical efficacy
Rational phytotherapy with Vitex agnus castus
Fertility disorders
Milewicz A, Gejdel E, Sworen H, Sienkiewicz K, Jedrzejak J, Teucher T, Schmitz H, (1993): [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 43 (7): 752-756
Placebo-controlled, randomised double-blind study
Duration of the luteal phases increased clearly
Release of prolactin decreased significantly
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Cefanorm® - Advantages at a glance
normalises cycle disorders in a natural and gentle way
stimulates corpus luteum
reduces prolactin level
does not contain any hormones
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Basic information
Fields of applicationIrregularities of the menstrual cycle, sensations of tension and swelling in the breasts (mastodynia), monthly recurring complaints before the onset of the menstruation (premenstrual symptoms).
CompositionActive ingredient:1 capsule contains: Dry extract from Chaste tree fruits (7 - 13 : 1) 4 mg.Extraction solvent: Ethanol 60% (m/m).
Excipients:Glucose syrup, lactose monohydrate, talc, maize starch, magnesium stearate, colloidal anhydrous silica, gelatin, sodium laurilsulfate (dodecylsulfate), purified water, titanium dioxide E 171.
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Contra-indicationsCefanorm® must not be taken in when suffering from hypersensitivity to Chaste tree fruits (Monk’s pepper) or to one of the excipients of the medicament, hypophyseal tumours, mammary carcinoma. Use during pregnancy and lactation: Due to not sufficient investigations Cefanorm® must not be taken in during pregnancy and lactation.
Interactions with other substancesInteractions are not known. There are references - based on experiments in animals - to a dopaminergic effect of the drug; thus an alternating weakening of the effect could be possible in case of administration of dopamine-receptor-antagonists.
WarningNone known.
DosageIntake of 1 capsule daily (corresponding to 40 mg drug).
Basic information
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Kind and duration of applicationCefanorm® capsules should preferably always be taken in at the same time of day. The preparation should be taken in over 3 menstrual cycles.
Side effectsAfter intake of Cefanorm® there are rarely itching rashes (urticarial exanthema).In the leaflet, the patient is instructed to stop the intake and immediately consulta physician in case of signs of hypersensitivity reactions.
Commercial formCapsules: 30 pcs.
Basic information
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Monograph
Chaste Tree fruit, Agni casti fructus
Official Monograph of the Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) (German Federal Institute for Drugs and Medical Devices)Commission E (Phytotherapy), BAnz.-No. 226 dated December 02, 1992
Name of DrugAgni castus fructus; chaste tree fruit, vitex fruit.
Composition of DrugChaste tree fruit composed of the ripe, dried fruits of Vitex agnus castus L. [Fam.Verbenaceae], as well as their preparations in effective dosage.
Pharmacological Properties, Pharmacokinetics, ToxicologyThere is evidence that aqueous-alcoholic extracts of chaste tree fruit inhibit secretion of prolactin in vitro. In human pharmacology there are no data about the lowering of prolactin levels. There is no knowledge regarding pharmacokinetics. Systematic studies about toxicology are unknown.
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Monograph
Clinical data
1. UsesIrregularities of the menstrual cycle. Premenstrual complaints. Mastodynia.Note: In case of feeling of tension and swelling of the breasts and at disturbances of menstruation, a physician should be consulted for diagnosis.
2. ContraindicationsNone known.
3. Side EffectsOccasional occurrence of itching, urticarial exanthemas.
4. Special Cautions for UseNone known.
5. Use During Pregnancy and LactationNo application during pregnancy. In animal experiments an influence on the nursing performance was observed.
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Monograph6. Interactions with Other DrugsInteractions are unknown. In animal experiments there is evidence of a dopaminergic effect of the drug; therefore, a reciprocal weakening of the effect can occur in case of ingestion of dopamine-receptor antagonists.
7. DosageUnless otherwise prescribed: Daily dosage:aqueous-alcoholic extracts corresponding to 30 - 40 mg of the drug.
8. Mode of AdministrationAqueous-alcoholic extracts (50 – 70 percent v/v) from the crushed fruits taken as liquid or dry extract.
9. OverdosageNone known.
10. Special warningsNone known.
11. Effects on Operators of Vehicles and MachinesNone known.
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Differentiation in the area of dysmenorrhoea – PMS (Cefadian® / Cefanorm®)
Cefadian®
• girls / young women, 14- 25 (up to an age of 30)• no children• dysmenorrhoea• (increased prostaglandin)
• most intensive on 1st day of menstruation
• colic-like lower abdominal pain
Cefanorm®
• grown-up women over 25• does often have children• PMS• (imbalance estrogen/progesterone)
• complaints during the last 10 days of the cycle
• lower abdominal pain + mastodynia
general accompanying symptoms such as nausea, backache, headache, mental depressive moods